SynthesisAnnals of Saudi medicine
Microbiology and antimicrobial resistance in biliary tract infections including acute and post-ERCP cholangitis: a systematic review and meta-analysis.
Synthesis in Annals of Saudi medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
backgroundOrganisms cultured from bile in biliary tract infection, and their resistance, vary widely between settings, and pooled estimates to guide empirical therapy are lacking.
objectiveEstimate bile-culture yield, organism distribution, and resistance.
designSystematic review and random-effects meta-analysis of PubMed and reference lists.
settingReports spanned nine countries across Asia, Europe, Africa, and North America.
methodsWe extracted ductal-bile culture data from observational studies published from 2015 to 2025 of biliary infection/cholangitis; noninfectious, gall bladder-only, microbiome-only, and nonextractable reports were excluded. DerSimonian-Laird models, subgroup analysis, and JBI appraisal were used.
main outcome measureCulture yield; secondary organism proportions and resistance. SAMPLE SIZE: 5147 patients (97% retrospective; 3% prospective); organisms: 35 267 observations.
resultsYield was 77.3% (95% CI, 67.8-84.6); Gram-negative organisms 69.8% (65.6-73.7), HETEROGENEITY: I RISK OF BIAS: Fourteen reports were low risk, two moderate; exclusions minimally changed estimates.
conclusionBile-culture yield was high and Gram-negative organisms, particularly LIMITATIONS: PubMed-only/open-access search, retrospective designs, inconsistent definitions, one dominant dataset. REGISTRATION: Retrospectively registered on OSF (89wqs; DOI: 10.17605/OSF.IO/89WQS).
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