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Background: Gallstone disease (GSD) is a significant global health burden with variable prevalence influenced by metabolic, genetic, and infectious factors. Increasing evidence suggests that Gram-positive bacteria, particularly Staphylococcus aureus and Enterococcus species, contribute to gallstone pathogenesis through enzymatic activity and biofilm formation.
Objectives: To characterize Gram-positive bacteria within gallstones from Iraqi patients, evaluate their biofilm-forming capacity, and analyze the relationship between bacterial colonization, gallstone type, and cholesterol levels.
Methods: A total of 100 gallstones were obtained from patients undergoing elective cholecystectomy between October 2024 and March 2025. Stones were
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