title: [Changes in the profiles of causative agents and antibiotic resistance rate for spontaneous bacterial peritonitis: an analysis of cultured microorganisms in recent 12 years].
abstract: OBJECTIVE
  The causative agents for spontaneous bacterial peritonitis (SBP) and antibiotic resistance rate vary according to the regions and time. This study evaluated the recent changes in the profiles of microorganisms and antibiotic resistance rate for the choice of effective antibiotics in treating SBP.
  
  
  METHODS
  The clinical records of 1,018 episodes of SBP from November, 1994 to December, 2005, were analyzed retrospectively. The profiles of the causative agents for SBP and the rate of antibiotic resistance were compared in every 4-year-term.
  
  
  RESULTS
  The microorganisms were isolated in 394 out of 1018 episodes (38.7%). Gram negative and positive organisms constituted 71.6% and 21.3%, respectively. The five most commonly isolated organisms were E. coli (35.8%), K. pneumoniae (15.5%), viridans Streptococci (10.4%), S. pneumoniae (4.8%) and Aeromonas group (4.6%). The rate of E. coli resistant to cefotaxime (0%, 5.4%, 7.4%) and ciprofloxacin (4.3%, 21.6%, 28.4%) were increased in recent years. In the gram positive organisms, all isolates of viridans Streptococci and Pneumococci were sensitive to cefotaxime and ciprofloxacin. Recently, methicillin-resistant Staphylococcus aureus (MRSA) (28%) and vancomycin-resistant Enterococci (VRE) (31%) have been isolated. In each period, the overall antibiotic resistance rates to cefotaxime were 12.5%, 14.0%, 14.8%, to ciprofloxacin were 3.1%, 16.7%, 18.0%, and to imipenem were 4.7%, 7.0%, 4.2%.
  
  
  CONCLUSIONS
  Cefotaxime may still be the choice of primary empirical antibiotics for the treatment of SBP in Korea because the rate of resistance is acceptable. However, it is important to be aware of the recent increase in ciprofloxacin-resistant E. coli, extended spectrum beta-lactamase (ESBL)-producing gram negative bacilli, MRSA and VRE.
authors: Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
authors: Moon Kyung
authors: MK
authors: Park
authors: Joon Hyoek
authors: JH
authors: Lee
authors: Young Hye
authors: YH
authors: Byun
authors: Hyang Ie
authors: HIe
authors: Lee
authors: Geum Youn
authors: GY
authors: Gwak
authors: Moon Seok
authors: MS
authors: Choi
authors: Kwang Cheol
authors: KC
authors: Koh
authors: Seung Woon
authors: SW
authors: Paik
authors: Byung Chol
authors: BC
authors: Yoo
authors: Jong Chul
authors: JC
authors: Rhee
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D002439:Cefotaxime / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents; D002439:Cefotaxime