Phenotypic and genotypic analysis of microorganisms identified in bile and gallstones sonication fluid

Abstract

Cholelithiasis is a disease of the digestive system with high prevalence in the world. In Brazil, it is a routine condition, whose studies suggest a prevalence of around 10% of adults. Bacterial colonization of bile and gallstones can occur in cholelithiasis and occurs when there is cholestasis and bacterial proliferation. This proliferation is facilitated by the ability of some bacteria to adhere (in the form of biofilm). There are also lithogenic processes that involve bacterial participation. Recent studies have shown changes in the gallbladder microbiota of patients undergoing cholecystectomy due to complicated and uncomplicated cholelithiasis, which can impact empirical treatment with antibiotics. Objective: This study aims to compare the microorganisms found in bile and gallstone sonication fluid using the phenotypic and genotypic microbiological research and identification methods; Characterize by complete genomic sequencing the virulence genes, the biofilm-forming genes and the bacterial resistance genes of the microorganisms found in bile and gallstone sonication fluid; Determine by the phenotypic method and compare with the genotypic method the sensitivity profile of microorganisms found in bile and gallstone sonication fluid; Stratify according to the severity of the disease caused (uncomplicated cholelithiasis and the different classifications of acute cholecystitis according to Tokyo guidelines) the phenotypic and genotypic microbiological findings of bile and gallstone sonication fluids. Methods: From February 2021 to December 2021, the gallstones and bile samples of all patients over 14 years of age who have cholelithiasis will be analyzed in the microbiology laboratory of the FCM Santa Casa de São Paulo School of Medicine. Undergo cholecystectomy due to uncomplicated cholelithiasis or acute cholecystitis at Hospital São Luiz Gonzaga. The fluid resulting from the sonication of gallstones and bile will be shown in culture media and the germs found will be analyzed from a phenotypic and genotypic point of view so that, in addition to identification, their virulence and bacterial resistance profiles are determined. (AU)