Comparison of conventional culture and multiplex PCR results in bile sample taken during endoscopic retrograde cholangiopancreatography in acute cholangitis and evaluation of its effect on acute cholangitis treatment

Since bacterial translocation is rapid in acute cholangitis and the risk of sepsis development is high, empirical antibiotic therapy should be started within four hours at latest and within one hour at latest if the patient is in septic shock. It is vital to detect pathogens as soon as possible and reduce morbidity and mortality. In our study, it was aimed to compare the results of the multiplex PCR- based syndromic panel tests, which give results in less than three hours, with the results of automated culture and to contribute to the literatüre on this subject, where data is limited. In our study, although there was growth in culture in %25,8 patients, the agent could nat be detected by PCR. There was no growth with panel in %4,8 of the cases that did not grow in culture. Monomicrobial, %40,9 of growths and in polimicrobials %21,5 of growths were determined jointly in multiplex PCR and culture. Microorganisms different from those isolated in culture were observed %29 of the agents detected in PCR. The most common reproducing agents are enterococcal spp., respectively E. coli and candida spp. As a result of PCR, teicoplanin and flucanazole containing treatments were used alone or combination in 13 patients, and teicoplanin and anidulafungin in one patient. It was observed that teicoplanin was non needed because gram positive growth was not detected in culture in only one patient and the other treatments were appropriate and necessary according to the culture results Key Words: Acute cholangitis, Automated culture Multiplex PCR, Syndromic panel