title: Clinical features and prognosis of spontaneous bacterial peritonitis in korean patients with liver cirrhosis: a multicenter retrospective study.
abstract: OBJECTIVE
  Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea.
  
  
  METHODS
  This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of >250 cells/mm(3) in the absence of data compatible with secondary peritonitis.
  
  
  RESULTS
  The mean age of the cohort was 56 years, and 121 (77%) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42%): Gram-negative bacteria in 54 (81.8%), Gram-positive in 11 (16.7%), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17%), to ciprofloxacin in 11 (20.8%), and to penicillin in 33 (62.3%). The treatment failure and in-hospital mortality rates were 12.1% and 21%, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum beta-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality.
  
  
  CONCLUSIONS
  SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.
authors.affiliation: Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.
authors.forename: Jeong
authors.initials: J
authors.lastname: Heo
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Taeho
authors.initials: T
authors.lastname: Hahn
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
authors.forename: Moon Young
authors.initials: MY
authors.lastname: Kim
authors.forename: Sung Keun
authors.initials: SK
authors.lastname: Park
authors.forename: Mong
authors.initials: M
authors.lastname: Cho
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Kwang Hyub
authors.initials: KH
authors.lastname: Han
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Kim
authors.forename: Se Hyun
authors.initials: SH
authors.lastname: Cho