Which organisms are most commonly associated with cholangitis?

Cholangitis is an infection of the bile duct system, commonly arising due to obstruction, often caused by gallstones or other forms of bile duct blockage. The most prevalent organisms associated with this condition are Gram-negative bacteria, particularly Escherichia coli and Klebsiella species. These organisms are part of the normal flora of the gastrointestinal tract and can enter the biliary system when there is a disruption, such as obstruction or stasis.

The presence of E. coli and Klebsiella in cholangitis is significant because they can lead to severe complications if not treated promptly, including sepsis and septic shock. The typical clinical presentation includes symptoms like fever, jaundice, and right upper quadrant abdominal pain, which are often referred to as the classic triad of cholangitis.

While other microorganisms may be associated with infections in different contexts, they are not the primary culprits in cholangitis. For instance, Staphylococcus and Streptococcus are more commonly related to skin and soft tissue infections rather than biliary infections. Fungal organisms and mycobacteria are generally less frequent causes, often associated with special circumstances like immunocompromised states or chronic infections. Anaerobic bacteria can be present in some contexts but are