N Singh1, M M Wagener, T Gayowski. 1. Veterans Affairs Medical Center, Pittsburgh, PA 15240, USA. nis5+@pitt.edu
Abstract
OBJECTIVES: To determine whether antimicrobial resistance in pathogens and outcome in patients with spontaneous bacterial peritonitis (SBP) has evolved over time. METHODS: Sixty-one consecutive episodes of SBP were studied in patients with end-stage liver disease undergoing evaluation for liver transplantation between 1991 and 2001. Patients were dichotomized into a cohort between 1991 and 1995 (the earlier cohort) and 1996-2001 (the later cohort). RESULTS: Overall, 19% of all bacteria were multiply-antibiotic resistant. The frequency of multiple-antibiotic resistance in bacteria increased from 8.3% to 38.5% in the earlier as compared to the later cohort (P = 0.07). Overall, mortality at 30 days in the study patients was 26% and had remained unchanged between the two cohorts. The mortality rate was significantly higher in patients with multiply-antibiotic-resistant bacteria than in those with other bacteria (P = 0.045). However, the Child-Pugh score (P = 0.003), and renal failure (P = 0.04) were the only independently significant predictors of mortality in patients with SBP. CONCLUSIONS: Mortality in patients with end-stage liver disease who developed SBP has remained unchanged over the last decade. Although multiple-antibiotic resistance in bacteria causing SBP has increased over time, the severity of hepatic and renal dysfunction were the predominant determinants of outcome in these patients.
OBJECTIVES: To determine whether antimicrobial resistance in pathogens and outcome in patients with spontaneous bacterial peritonitis (SBP) has evolved over time. METHODS: Sixty-one consecutive episodes of SBP were studied in patients with end-stage liver disease undergoing evaluation for liver transplantation between 1991 and 2001. Patients were dichotomized into a cohort between 1991 and 1995 (the earlier cohort) and 1996-2001 (the later cohort). RESULTS: Overall, 19% of all bacteria were multiply-antibiotic resistant. The frequency of multiple-antibiotic resistance in bacteria increased from 8.3% to 38.5% in the earlier as compared to the later cohort (P = 0.07). Overall, mortality at 30 days in the study patients was 26% and had remained unchanged between the two cohorts. The mortality rate was significantly higher in patients with multiply-antibiotic-resistant bacteria than in those with other bacteria (P = 0.045). However, the Child-Pugh score (P = 0.003), and renal failure (P = 0.04) were the only independently significant predictors of mortality in patients with SBP. CONCLUSIONS: Mortality in patients with end-stage liver disease who developed SBP has remained unchanged over the last decade. Although multiple-antibiotic resistance in bacteria causing SBP has increased over time, the severity of hepatic and renal dysfunction were the predominant determinants of outcome in these patients.
Authors: E Shaw; J Castellote; M Santín; X Xiol; G Euba; C Gudiol; C Lopez; X Ariza; F Gudiol Journal: Eur J Clin Microbiol Infect Dis Date: 2006-05 Impact factor: 3.267
Authors: Min Jae Kim; Kyoung-Ho Song; Nak-Hyun Kim; Pyoeng Gyun Choe; Wan Beom Park; Ji Hwan Bang; Eu Suk Kim; Sang Won Park; Hong Bin Kim; Hyo-Suk Lee; Myoung-Don Oh; Nam Joong Kim Journal: Hepatol Int Date: 2014-06-08 Impact factor: 6.047