Bacteriological profile of patients with periampullary cancer and effect of preoperative biliary drainage on bacterial flora

Aim: This study aims to identify the frequency of bacteriobilia, commonly isolated bacteria and their antibiotic susceptibility pattern from cancer patients with periampullary carcinoma attending a regional cancer center in the North-East India. Materials and Methods: This was a retrospective 1-year study of patients with obstructive jaundice due to periampullary carcinoma treated between January 2018 and December 2018. Intraoperative bile samples were obtained for microbiological analysis after transection of the common bile duct. Bile specimens were transported to the microbiology laboratory, and processing was done according to the standard protocol used in our clinical microbiology laboratory. Results: Intraoperative bile samples were obtained from 27 patients, and in 21 (77.77%) patients, it was culture positive. Stenting was done in 10 (37.07%) patients, and in those who underwent stenting, microbial contamination of bile was increased significantly (80%) compared to 61.90% in those without stenting. Organisms isolated were Escherichia coli 9 (42.85%), Klebsiella pneumonia 7 (33.33%), Pseudomonas 3 (14.28%), and Enterococcus cloacae 2 (9.52%). Carbapenamase producing E. coli(n = 1) and K. pneumonia (n = 1) was isolated from the two stented patient and one was vancomycin-resistant enterococcus (n = 1). Conclusion: Patients who underwent stenting for periampullary carcinoma had a significant risk for acquiring infection with multidrug-resistant bacteria.