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Verfasst von:Friedrich, Kilian [VerfasserIn]   i
 Nüßle, Simone [VerfasserIn]   i
 Rehlen, Tobias [VerfasserIn]   i
 Stremmel, Wolfgang [VerfasserIn]   i
 Mischnik, Alexander [VerfasserIn]   i
 Eisenbach, Christoph [VerfasserIn]   i
Titel:Microbiology and resistance in first episodes of spontaneous bacterial peritonitis
Titelzusatz:implications for management and prognosis
Verf.angabe:Kilian Friedrich, Simone Nüssle, Tobias Rehlen, Wolfgang Stremmel, Alexander Mischnik, and Christoph Eisenbach
Jahr:2016
Jahr des Originals:2015
Umfang:5 S.
Fussnoten:First published: 17 December 2015 ; Gesehen am 15.08.2019
Titel Quelle:Enthalten in: Journal of gastroenterology and hepatology
Ort Quelle:Oxford [u.a.] : Wiley-Blackwell, 1986
Jahr Quelle:2016
Band/Heft Quelle:31(2016), 6, Seite 1191-1195
ISSN Quelle:1440-1746
Abstract:Purpose International guidelines for antibiotic treatment of spontaneous bacterial peritonitis (SBP) are based on studies conducted decades ago and do not reflect regional differences of bacterial epidemiology. Methods We retrospectively analyzed epidemiology of agents, antibiotic resistance patterns, and survival in liver cirrhosis patients with their first episode of SBP during the years 2007-2013. Results Of the 311 patients included, 114 patients had a positive ascites culture, and 197 had an ascitic neutrophil count >250 μL. Gram-positive bacteria (47.8%) were more frequently found than Gram-negatives (44.9%), fungi in 7.2%. Enterobacter spp. (40.6%), Enterococcus spp. (26.1%), and Staphylcoccus spp. (13.8%) were the most frequently isolated agents. Third-generation cephalosporins covered 70.2% of non-nosocomial and 56.3% of nosocomial-acquired SBP cases.When SBP was diagnosed by a positive ascitic culture, survival was highly significantly reduced (mean: 13.9 ± 2.9 months; 95% confidence interval [CI]: 8.1-19.8) compared with culture-negative SBP patients (mean: 44.1 ± 5.4 months; 95% CI: 33.4-54.9; P = 0.000). Along with model of end-stage liver disease score and intensive care unit contact, a positive ascites culture remained an independent risk factor associated with poor survival (odds ratio: 1.49; 95% CI: 1.09-2.03) in multivariate analysis; piperacillin/tazobactam proved to be an adequate antibiotic for nosocomial and non-nosocomial SBP in 85.1% and 92.5%, respectively. SBP infection with Enterococcus spp. was associated with poor patient survival (P = 0.048). Conclusions Third-generation cephalosporins have poor microbial coverage for treatment of SBP. Current guidelines need to adapt for the emerging number of Gram-positive infectious agents in SBP patients.
DOI:doi:10.1111/jgh.13266
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: https://doi.org/10.1111/jgh.13266
 Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/jgh.13266
 DOI: https://doi.org/10.1111/jgh.13266
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:antibiotic resistance
 culture-positive SBP
 Gram-positive SBP
 spontaneous bacterial peritonitis
 third-generation cephalosporins
K10plus-PPN:1671443098
Verknüpfungen:→ Zeitschrift

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