Background: Acute inflammation of the gallbladder wall usually follows obstruction of the cystic duct by a stone. Bacterial inflammation which may play a role in 50% to 85% of patients of acute cholecystitis. The common organisms isolated from bile culture in this patients are Esch. Coli, Klebsiella spp, Streptococcus spp, B.fragilis and clostridium species. Aim: The purpose of this study is to isolate and identify the bacterial infections of the bile in gallbladder diseases at RIMS Hospital, Imphal and to know the drug sensitivity pattern of the isolated bacteria. Material and Method: This study was done in the Department of Microbiology in collaboration with the Department of Surgery RIMS, Imphal on patients undergoing elective cholecystectomy for gall bladder diseases during the period from October 2020 to October 2022. Results and Discussion: Out of the 131 samples collected, culture was positive in 22 while the total number of isolates were 25 as three cases had coinfection with 2 isolates each. Gram negative bacteria with 17 isolates (68%) were much more common than the Gram positive bacteria with 8 isolates (32%). The commonest organism was Escherichia coli 9/25 (36%), followed by Klebsiella pneumoniae 5/25 (20%), Staphylococcus aureus 4/25 (16%), Enterococcus faecalis 4/25 (16%) and Enterobacter spp 3/25 (12%). The Gram negative bacteria was 100% sensitive to Colistin and imipenem, 88% sensitive to gentamicin, 35.2% sensitive to ceftazidime and 58.8% to a combination of ceftazidime and clavulanic acid. Extended spectrum β-lactamase production was seen in 44.4% of Escherichia coli, 20% in Klebsiella pneumoniae and 33.3% of Enterobacter spp. Among the Staphylococcus aureus, 100% sensitivity was seen to linezolid, vancomycin and gentamicin, 75% sensitivity to erythromycin and ciprofloxacin, 50% sensitive to clindamycin, 100% resistance to ampicillin and 75% resistance to amoxicillin was seen. One methicillin resistant Staphylococcus aureus was isolated. The Enterococcus faecalis were 100% sensitive to vancomycin and linezolid. Conclusion: routine bile culture and sensitivity should be done in patients undergoing cholecystectomy as it will guide the surgeons for empirical antibiotic therapy, antibiotic prophylaxis and pathogens directed therapy to reduce the clinical outcome indicators such as morbidity and mortalility and to prevent emergence of drug resistance.
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