PATHOGENS

• Usually, inflammatory and noninfectious
• If infectious, frequently polymicrobial. Leading pathogens:
  • Gram Negatives:
    • Enterobacterales: E. coli, Klebsiella species, Enterobacter species
    • Pseudomonas species are more common in hospital-acquired infections but also associated with community-acquired cholecystitis
  • Gram Positives:
    
    • Enterococcus
  • Anaerobes:
    • Clostridium and Bacteroides species
• The pathogenic role of enterococci and anaerobes is not well defined, and empirical coverage is not usually required.
• Organisms cultured from bile/gallbladder: unclear pathogenicity unless also recovered in blood