title: Nosocomial and Community-Acquired Spontaneous Bacterial Peritonitis in patients with liver cirrhosis in China: Comparative Microbiology and Therapeutic Implications.
abstract: Spontaneous bacterial peritonitis (SBP) is a common complication of liver cirrhosis. This study was performed to compare the microbiological characteristics of nosocomial and community-acquired episodes of bacterial peritonitis in China. Five hundred and seventy-five strains were isolated from the ascitic fluid of cirrhotic patients from the Beijing 302 Hospital from January 2014 to December 2014. The patients in the community-acquired SBP (n = 264) and the nosocomial SBP (n = 311) groups exhibited significant differences in clinical symptoms (P < 0.01) [corrected]. In both groups, most of the bacteria were Escherichia coli, Klebsiella pneumoniae, coagulase-negative staphylococcus and Enterococcus. There were more frequent gram-positive cocci (G+C) in the nosocomial group (n = 170). Compared with the community-acquired group, the proportion of Enterococcus was significantly increased in the nosocomial group (9.0% vs. 16.6%, P < 0.05). The resistance rate of the main pathogenic bacteria to the recommended first-line drug in the guideline was very high. Community-acquired and nosocomial SBP groups exhibited differences in clinical symptoms and antibiotic susceptibility tests. Optimal treatments should be provided for these patients. We recommend that cefoperazone/sulbactam or piperacillin/tazobactam should be used for the empirical treatment of SBP.
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Shi
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wu
authors.affiliation: Medical Administration Division, Beijing 302 Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wei
authors.affiliation: Blood Purification Center, Beijing 302 Hospital, Beijing, China.
authors.forename: Suxia
authors.initials: S
authors.lastname: Liu
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Tu
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Yangxin
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Laboratory, Beijing 302 Hospital, Beijing, China.
authors.forename: Yanan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Wang
authors.affiliation: Tumor Radiotherapy Center, Beijing 302 Hospital, Beijing, China.
authors.forename: Liying
authors.initials: L
authors.lastname: Liu
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Fusheng
authors.initials: F
authors.lastname: Wang
authors.affiliation: Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China.
authors.forename: Enqiang
authors.initials: E
authors.lastname: Qin
mesh_terms: D001202:Ascitic Fluid / Q000382:microbiology; D001419:Bacteria / Q000378:metabolism; D001424:Bacterial Infections / Q000382:microbiology* / Q000628:therapy*; D002681:China; D017714:Community-Acquired Infections / Q000382:microbiology* / Q000628:therapy*; D003428:Cross Infection / Q000382:microbiology* / Q000628:therapy*; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010538:Peritonitis / Q000382:microbiology*