title: Pathogen profile and drug resistance analysis of spontaneous peritonitis in cirrhotic patients.
abstract: OBJECTIVE
  To investigate the microbiological characteristics and drug resistance in liver cirrhosis patients with spontaneous peritonitis.
  
  
  METHODS
  We analyzed the data of patients with liver cirrhosis and abdominal infection at the First Affiliated Hospital of Zhejiang University between January 2011 and December 2013. Pathogens present in the ascites were identified, and their sensitivity to various antibiotics was determined.
  
  
  RESULTS
  We isolated 306 pathogenic bacteria from 288 cases: In 178 cases, the infection was caused by gram-negative strains (58.2%); in 85 cases, gram-positive strains (27.8%); in 9 cases, fungi (2.9%); and in 16 cases, more than one pathogen. The main pathogens were Escherichia coli (E. coli) (24.2%), Klebsiella pneumoniae (18.9%), Enterococcus spp. (11.1%), and Staphylococcus aureus (7.5%). Of the 306 isolated pathogens, 99 caused nosocomial infections and 207 caused community-acquired and other infections. The E. coli and K. pneumoniae strains produced more extended-spectrum β-lactamases in cases of nosocomial infections than non-nosocomial infections (62.5% vs 38%, P < 0.013; 36.8% vs 12.8%, P < 0.034, respectively). The sensitivity to individual antibiotics differed between nosocomial and non-nosocomial infections: Piperacillin/tazobactam was significantly more effective against non-nosocomial E. coli infections (4% vs 20.8%, P < 0.021). Nitrofurantoin had stronger antibacterial activity against Enterococcus species causing non-nosocomial infections (36.4% vs 86.3%, P < 0.009).
  
  
  CONCLUSIONS
  The majority of pathogens that cause abdominal infection in patients with liver cirrhosis are gram-negative, and drug resistance is significantly higher in nosocomial infections than in non-nosocomial infections.
authors.affiliation: Yong-Tao Li, Cheng-Bo Yu, Jian-Rong Huang, Lan-Juan Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Yong-Tao
authors.initials: YT
authors.lastname: Li
authors.affiliation: Yong-Tao Li, Cheng-Bo Yu, Jian-Rong Huang, Lan-Juan Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Cheng-Bo
authors.initials: CB
authors.lastname: Yu
authors.affiliation: Yong-Tao Li, Cheng-Bo Yu, Jian-Rong Huang, Lan-Juan Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Huang
authors.affiliation: Yong-Tao Li, Cheng-Bo Yu, Jian-Rong Huang, Lan-Juan Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Zheng-Ji
authors.initials: ZJ
authors.lastname: Qin
authors.affiliation: Yong-Tao Li, Cheng-Bo Yu, Jian-Rong Huang, Lan-Juan Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Lan-Juan
authors.initials: LJ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D002681:China; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010538:Peritonitis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Drug resistance; Drug sensitive test; Liver cirrhosis; Spontaneous peritonitis