Beta-Glucuronidase-Producing Bacteria in Bile from the Common Bile Duct in Patients Treated with Endoscopic Papillotomy for Gallstone Disease

Abstract

This paper reports the occurrence of β-glucuronidase-producing bacteria in the bile in gallstone patients treated with endoscopic papillotomy (EPT). The study included 36 patients—18 women and 18 men, aged 43–87 years, with a median of 72.5 years. Bile sampling was done with an endoscopic technique. All bacterial strains were tested for β-glucuronidase activity with a rapid chromogenic tablet test, using 4-nitrophenyl-β-D-glucuronic acid as substrate. Bacterial growth was found in the bile in 35 patients. Of 103 strains isolated, 30 produced β-glucuronidase. Twenty-five of the patients had at least one β-glucuronidase-producing strain in the bile. All 26 strains of Escherichia coli were producing the enzyme. Both strains in the Bacteroides fragilis group and one out of two strains of Clostridium perfringens were producing β-glucuronidase. The activity of the bacterial β-glucuronidase was found within the pH range of the bile in these patients. A relationship between the presence of β-glucuronidase-producing bacteria in the bile and pigment gallstone is suggested.

Key Words:

• Bile
• Escherichia coli
• endoscopic papillotomy
• gallstones
• β-glucuronidase