Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites

2015 ◽  
Vol 35 (9) ◽  
pp. 2121-2128 ◽  
Author(s):  
Philipp Schwabl ◽  
Theresa Bucsics ◽  
Kathrin Soucek ◽  
Mattias Mandorfer ◽  
Simona Bota ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

Risk factors for spontaneous bacterial peritonitis in cirrhotic patients with ascites

1993 ◽  
Vol 104 (4) ◽  
pp. 1133-1138 ◽  
Author(s):  
Montserrat Andreu ◽  
Ricard Sola ◽  
Antonio Sitges-Serra ◽  
Concepcion Alia ◽  
Manuel Gallen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

scholarly journals Prognostic Factors Associated with Mortality in Cirrhotic Patients with Bleeding Varices

2019 ◽  
Vol 5 (02) ◽  
pp. 46-52
Author(s):  
Alshaimaa Fathy Eldesouky ◽  
Mohamed Abd Elraoof Tawfik ◽  
Maha Mahmoud Hagras ◽  
Taher Eldemerdash Attia ◽  
Mohammed Elsayed Elhendawy
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Hepatic Encephalopathy ◽  
Serum Creatinine ◽  
Variceal Bleeding ◽  
Death Rate ◽  
Spontaneous Bacterial Peritonitis ◽  
Apache Ii ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

Abstract Objective Bleeding gastroesophageal varices are a cause of high mortality among cirrhotic patients. Aim The aim of this study was to study prognostic factors for mortality in cirrhosis associated with variceal bleeding. Patients and Methods This prospective study was conducted on 100 cirrhotic patients admitted to the Tanta University Hospital with an acute first variceal bleeding episode. Baseline clinical, laboratory, and endoscopic findings were recorded at presentation. Results During the first 6 weeks 15 patients died, 3 following the initial bleed and 12 after an early rebleed. At 6 months, a further 21 patients had died. Statistical analysis utilizing the baseline data revealed that high early death rate was associated with number of blood units transfused, lower systolic blood pressure, thrombocytopenia, increased serum creatinine and international normalized ratio (INR). High MELD, AIMS56, acute physiology and chronic health evaluation II (APACHE II) and ROCKall scores were risk factors for mortality. Risk factors for early rebleeding included presence of diabetes mellitus, leucocytosis, high Child score, model for end-stage liver disease (MELD), AIMS56, and sepsis-associated organ failure assessment (SOFA) scores. A high Child score, presence of ascites, and associations such as hepatic encephalopathy and spontaneous bacterial peritonitis, leucocytosis, elevated alanine transaminase, aspartate transaminase, bilirubin, INR, and creatinine as well as low albumin were associated with decreased survival. Conclusion High MELD, AIMS56, APACHE II, and ROCKall scores were risk factors for mortality after acute variceal bleeding. High death rate during the first 6 weeks is associated with anemia, hypotension, thrombocytopenia, increased serum creatinine, and INR. Decreased survival at 6 months is associated with increased Child score, presence of ascites and associations such as hepatic encephalopathy and spontaneous bacterial peritonitis.

scholarly journals Spontaneous Bacterial Peritonitis among Cirrhotic Patients: Prevalence, Clinical Characteristics, and Outcomes

2021 ◽  
Vol 11 (1) ◽  
pp. 227
Author(s):  
Naim Abu-Freha ◽  
Tal Michael ◽  
Liat Poupko ◽  
Asia Estis-Deaton ◽  
Muhammad Aasla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Cox Regression ◽  
Positive Culture ◽  
Multidrug Resistant ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
Escherichia Coli Bacteria

(1) Background: Spontaneous bacterial peritonitis (SBP) is a feared complication of liver cirrhosis. We investigated the prevalence of SBP, positive ascitic fluid cultures, and risk factors for mortality. (2) Methods: A retrospective analysis of all patients with cirrhosis hospitalized or in follow-up in a single center between 1996 and 2020. The clinical data, long-term complications, and mortality of SBP patients were compared with those of non-SBP patients. Ascitic fluid positive culture was compared with those without growth. (3) Results: We included 1035 cirrhotic patients, of which 173 (16.7%) developed SBP. Ascitic fluid culture growth was found in 47.4% of the SBP cases, with Escherichia coli bacteria detected in 38%, 24.4% grew ESBL-producing bacteria, and 14.5% displayed multidrug resistance. In a Cox regression model, SBP, male sex, prolonged INR at diagnosis, and hepatocellular carcinoma were found to be risk factors for mortality in cirrhotic patients. The long-term all-cause mortality was 60% in non-SBP and 90% in SBP patients. (4) Conclusions: Only a minority of cirrhotic patients developed SBP, 47.4% of which had positive ascitic fluid cultures with high antibiotic resistance. Growth of ESBL and multidrug resistant organisms is becoming more frequent in the clinical setting, reaching SBP mortality of 90%.

scholarly journals The Risk of Clostridioides difficile Infection in Cirrhotic Patients Receiving Norfloxacin for Secondary Prophylaxis of Spontaneous Bacterial Peritonitis—A Real Life Cohort

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 964
Author(s):  
Irina Girleanu ◽  
Anca Trifan ◽  
Laura Huiban ◽  
Cristina Muzica ◽  
Roxana Nemteanu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Spontaneous Bacterial Peritonitis ◽  
Real Life ◽  
Secondary Prophylaxis ◽  
Cox Regression Analysis ◽  
Bacterial Peritonitis ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Cirrhotic Patients

Background and Objectives: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication of liver cirrhosis. Antibiotic prophylaxis is effective but can lead to an increased incidence of Clostridioides difficile infection (CDI). The aim of this study was to evaluate the incidence of CDI and the risk factors in cirrhotic patients with a previous episode of SBP receiving norfloxacin as secondary prophylaxis. Materials and Methods: We performed a prospective, cohort study including patients with liver cirrhosis and SBP, successfully treated over a 2-year period in a tertiary university hospital. All the patients received secondary prophylaxis for SBP with norfloxacin 400 mg/day. Results: There were 122 patients with liver cirrhosis and SBP included (mean age 57.5 ± 10.8 years, 65.5% males). Alcoholic cirrhosis was the major etiology accounting for 63.1% of cases. The mean MELD score was 19.7 ± 6.1. Twenty-three (18.8%) of all patients developed CDI during follow-up, corresponding to an incidence of 24.8 cases per 10,000 person-years. The multivariate Cox regression analysis demonstrated that alcoholic LC etiology (HR 1.40, 95% CI 1.104–2.441, p = 0.029) and Child-Pugh C class (HR 2.50, 95% CI 1.257–3.850, p = 0.034) were independent risk factors for CDI development during norfloxacin secondary prophylaxis. The development of CDI did not influence the mortality rates in cirrhotic patients with SBP receiving norfloxacin. Conclusions: Cirrhotic patients with SBP and Child-Pugh C class and alcoholic liver cirrhosis had a higher risk of developing Clostridioides difficile infection during norfloxacin secondary prophylaxis. In patients with alcoholic Child-Pugh C class liver cirrhosis, alternative prophylaxis should be evaluated as SBP secondary prophylaxis.

Microbial epidemiology in cirrhotic patients with spontaneous bacterial peritonitis in Vienna

2013 ◽  
Vol 51 (05) ◽  
Author(s):  
P Schwabl ◽  
K Soucek ◽  
T Bucsics ◽  
M Mandorfer ◽  
A Blacky ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients
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