title: Recent increase in antibiotic-resistant microorganisms in patients with spontaneous bacterial peritonitis adversely affects the clinical outcome in Korea.
abstract: OBJECTIVE
  Recently, antibiotic-resistant microorganisms have been increasingly noted in Korean patients with spontaneous bacterial peritonitis (SBP). The present study investigated the changing pattern of antibiotic resistance and its effects on the clinical outcome in treating SBP.
  
  
  METHODS
  The present study retrospectively analyzed 87 episodes of SBP in 1995, 222 in 1998, and 271 in 1999. The isolated microorganisms and their antibiotic susceptibility were compared, and prognostic factors for survival were analyzed.
  
  
  RESULTS
  Microorganisms were isolated in 41% of total episodes. The three most frequently isolated organisms were Escherichia coli (48%), Klebsiella pneumoniae (15%), and Aeromonas (8%). Strains that were resistant to cefotaxime in Gram-negative bacilli significantly increased from 7% in 1995 to 28% in 1999, and those to ciprofloxacin increased from 10% to 32%. Treatment failure also increased from 6% to 23%. Combined hepatocellular carcinoma and SBP caused by extended-spectrum beta-lactamase-producing strains were two independent prognostic factors for survival.
  
  
  CONCLUSIONS
  Considering the increase in antibiotic-resistant microorganisms related to SBP, measures to prevent the in-hospital spread of resistant strains and the indiscriminate use of antibiotics should be instituted more stringently.
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Park
authors.forename: Han Chu
authors.initials: HC
authors.lastname: Lee
authors.forename: Hee Gon
authors.initials: HG
authors.lastname: Song
authors.forename: Saera
authors.initials: S
authors.lastname: Jung
authors.forename: Soo Hyung
authors.initials: SH
authors.lastname: Ryu
authors.forename: Jung Woo
authors.initials: JW
authors.lastname: Shin
authors.forename: Young-Hwa
authors.initials: YH
authors.lastname: Chung
authors.forename: Yung Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Suh
mesh_terms: D042462:4-Quinolones / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology* / Q000401:mortality; D018550:Cephalosporin Resistance; D016009:Chi-Square Distribution; D024881:Drug Resistance, Bacterial; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007723:Korea; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy* / Q000382:microbiology* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D042462:4-Quinolones; D000900:Anti-Bacterial Agents