Prognostic significance of infection acquisition sites in spontaneous bacterial peritonitis: nosocomial versus community acquired.
Spontaneous bacterial peritonitis (SBP) is an ascitic fluid infection as a complication of end stage liver disease. The outcome is related to the severity of hepatorenal function, gastrointestinal bleeding, and many others; however it is not well known whether the infection acquisition sites have an effect on the prognosis of SBP. In order to identify the prognostic significance of the acquisition sites, we studied 106 patients who were diagnosed as culture positive SBP between October 1998 and August 2003. Thirty-two episodes were nosocomial and 74 were community acquired. Gram-negative bacilli such as Escherichia coli were dominant in both of the nosocomial and community-acquired SBPs. Despite significantly higher resistance to cefotaxime in nosocomial isolates compared to community-acquired isolates (77.8% vs. 13.6%, p=0.001), no difference was found regarding short or long term prognosis. Infection acquisition sites were not related to short or long term prognosis either. Shock, gastrointestinal bleeding and renal dysfunction were related to short term prognosis. Only Child-Pugh class C was identified as an independent prognostic factor of long-term survival.
Song
Joon Young
JY
Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Guro-gu, Seoul, Korea.
Jung
Seong Ju
SJ
Park
Cheong Won
CW
Sohn
Jang Wook
JW
Kim
Woo Joo
WJ
Kim
Min Ja
MJ
Cheong
Hee Jin
HJ
D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001424:Bacterial Infections / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D002439:Cefotaxime / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D017714:Community-Acquired Infections / Q000150:complications / Q000382:microbiology / Q000473:pathology; D003428:Cross Infection / Q000150:complications / Q000382:microbiology / Q000473:pathology; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects / Q000254:growth & development; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology / Q000401:mortality; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000254:growth & development; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010538:Peritonitis / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D011379:Prognosis; D012769:Shock / Q000209:etiology / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002439:Cefotaxime