Association Between Bacterial Colonization and Stent Occlusion in Plastic Biliary Stents

Abstract

Background: Biliary stent occlusion is a significant clinical concern with potentially severe consequences for patients. This study aimed to evaluate common microorganisms detected by culture from plastic biliary stents, assess their association with stent occlusion, and evaluate their antimicrobial sensitivity. Methods: Forty patients with plastic biliary stents were included in this study. They were divided into two groups: Group (I) 20 patients with clinical signs of stent occlusion and Group (II) 20 patients scheduled for stent extraction within three months after placement. Various clinical, laboratory, and imaging assessments were conducted. The plastic stents were extracted and subjected to microbiological culture to identify aerobic and anaerobic organisms, followed by antimicrobial sensitivity testing. Results: Patients in Group (I) exhibited a higher prevalence of clinical symptoms indicative of stent occlusion, abnormal vital signs, and elevated laboratory parameters (TLC, ESR, CRP, Total Bilirubin., Direct Bilirubin, ALP, ALT, AST, PT, INR and creatinine) compared to Group (II). Microbiological analysis revealed the presence of various organisms, with Klebsiella sp, Proteus, Pseudomonas, and E. coli being the most common. Sensitivity and resistance to antibiotics varied among these microorganisms. Conclusion: Klebsiella was prevalent in stent occlusion (65%), while Proteus dominated non-occlusion (60%). No anaerobic organisms were found. Amikacin, Meropenem, and Imipenem showed the highest sensitivity of microbes in patient with stent occlusion, and Meropenem, Colistin, and Imipenem the highest sensitivity of microbes in patient with non- stent occlusion. Both groups exhibited 100% resistance to various antibiotics.