Spontaneous bacterial peritonitis in patients with hepatitis B virus-related liver cirrhosis: community-acquired versus nosocomial.
OBJECTIVE
Spontaneous bacterial peritonitis (SBP) frequently develops in patients with liver cirrhosis; however, there is little data to suggest whether the acquisition site of infection influences the prognosis. This study compared the bacteriology, clinical characteristics and treatment outcomes of community-acquired SBP (CA-SBP) and nosocomial SBP (N-SBP).


METHODS
The medical records of 130 patients with hepatitis B virus (HBV)-related liver cirrhosis, who had experienced a first episode of SBP between January 1999 and December 2008, were reviewed.


RESULTS
The study population included 111 (85.4%) patients with CA-SBP and 19 (14.6%) patients with N-SBP. Baseline and microbiological characteristics as well as clinical course, including in-hospital mortality, did not differ between patients with CA-SBP and those with N-SBP (all p>0.05). The median survival time was 6.5 months, and 117 (90.0%) patients died during the follow-up period. Patients with CA-SBP and N-SBP survived for median periods of 6.6 and 6.2 months, respectively, without significant difference (p=0.569). Time to recurrence did not differ between patients with CA-SBP and N-SBP (4.7 vs. 3.6 months, p=0.925).


CONCLUSIONS
The acquisition site of infection did not affect clinical outcomes for patients with HBV-related liver cirrhosis who had experienced their first episode of SBP. Third-generation cephalosporins may be effective in empirically treating these patients, regardless of the acquisition site of the infection.
Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
Seung Up
SU
Kim
Young Eun
YE
Chon
Chun Kyon
CK
Lee
Jun Yong
JY
Park
Do Young
DY
Kim
Kwang-Hyub
KH
Han
Chae Yoon
CY
Chon
Sinyoung
S
Kim
Kyu Sik
KS
Jung
Sang Hoon
SH
Ahn
D017714:Community-Acquired Infections / Q000209:etiology / Q000382:microbiology* / Q000401:mortality / Q000821:virology; D005260:Female; D006515:Hepatitis B virus / Q000472:pathogenicity*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology / Q000382:microbiology* / Q000401:mortality / Q000821:virology*; D012189:Retrospective Studies