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 High Prevalence of Multidrug Resistant Bacteria in Cirrhotic Patients with Spontaneous Bacterial Peritonitis: Is It Time to Change the Standard Antimicrobial Approach?

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Jerônimo De Conto Oliveira ◽  
Enrique Carrera ◽  
Roberta C. Petry ◽  
Caroline Deutschendorf ◽  
Augusto Mantovani ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Bacterial Peritonitis ◽  
High Prevalence ◽  
Cirrhotic Patients ◽  
End Stage

Introduction. Spontaneous bacterial peritonitis (SBP) has a deleterious clinical impact in end-stage liver disease, and multidrug resistance has increased, raising concern about effectiveness of traditional antibiotic regimens. Patients and Methods. Single-center retrospective study of ascitic fluid infections in cirrhotic patients. Results. We analyzed medical records related to 2129 culture-positive ascitic fluid and found 183 samples from cirrhotic patients. There were 113 monobacterial SBP cases from 97 cirrhotic patients; 57% of patients were male; hepatitis C and alcohol were the main etiologies for cirrhosis. Multidrug resistant bacteria were isolated in 46.9% of SBP samples, and third-generation cephalosporin and quinolone resistant reached 38.9% and 25.7% of SBP cases. Conclusion. SBP due to multidrug resistant bacteria is a growing problem, and one should consider reported resistance profiles for the decision-making process of empirical first-line treatment prescription.

SAT-009-Pharmacokinetics of ertapenem in plasma and ascitic fluid in cirrhotic patients with spontaneous bacterial peritonitis

2019 ◽  
Vol 70 (1) ◽  
pp. e628-e629
Author(s):  
Alberto Amador ◽  
Sara Cobo ◽  
Ariadna Padulles ◽  
Raul Rigo ◽  
Inmaculada Grau ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

scholarly journals Human Amnion-Derived Mesenchymal Stromal Cells in Cirrhotic Patients with Refractory Ascites: A Possible Anti-Inflammatory Therapy for Preventing Spontaneous Bacterial Peritonitis

2021 ◽  
Author(s):  
Mariangela Pampalone ◽  
Simona Corrao ◽  
Giandomenico Amico ◽  
Giampiero Vitale ◽  
Rossella Alduino ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Spontaneous Bacterial Peritonitis ◽  
Refractory Ascites ◽  
M2 Macrophage ◽  
Human Amnion ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
Anti Inflammatory

AbstractCirrhosis is associated with dysregulated immune cell activation and immune dysfunction. These conditions modify gut flora, facilitate bacterial translocation, and increase susceptibility to bacterial peritonitis and consequent systemic infections by dramatically affecting long-term patient survival. Human amnion-derived mesenchymal stromal cells (hA-MSCs) exert immunomodulatory potential benefit, and have the ability to modulate their actions, especially in situations requiring immune activation through mechanisms not fully understood. In this study, we aimed to investigate, in vitro, the immunostimulant or immunosuppressive effects of hA-MSCs on cellular components of ascitic fluid obtained from cirrhotic patients with refractory ascites. We found that hA-MSCs viability is not affected by ascitic fluid and, interestingly, hA-MSCs diminished the pro-inflammatory cytokine production, and promoted anti-inflammatory M2 macrophage polarization. Moreover, we found that there was no simultaneous significant decrease in the M1-like component, allowing a continual phagocytosis activity of macrophages and NK cells to restore a physiological condition. These data highlight the plasticity of hA-MSCs’ immunomodulatory capacity, and pave the way to further understanding their role in conditions such as spontaneous bacterial peritonitis. Graphical abstract

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 Prospective study of bedside inoculation of blood culture bottles with ascitic fluid versus delayed inoculation for the detection of spontaneous bacterial peritonitis

2017 ◽  
Vol 6 (1) ◽  
pp. 139
Author(s):  
Girish Iyyanna ◽  
Manjunath F. V. ◽  
Taruni Ng
Keyword(s):  
Blood Culture ◽  
Ascitic Fluid ◽  
Bacterial Infections ◽  
Spontaneous Bacterial Peritonitis ◽  
Culture Media ◽  
Positive Culture ◽  
Culture Methods ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Bacterial Yield

Background: Spontaneous bacterial peritonitis (SBP) is the most common bacterial infection in cirrhosis, accounting for 10%-30% of all reported bacterial infections in the patients admitted to hospital. Spontaneous bacterial peritonitis (SBP) is the most frequent and life-threatening infection in patients with liver cirrhosis. All forms of cirrhosis have been reported to be complicated by SBP. A delay in the time period between the collection of the ascitic fluid sample, and its inoculation into the blood culture media, has been one of the reasons implicated to account for low-test positivity. There was lack of studies for comparing the bacterial yield between bedside inoculated blood culture bottles with ascitic fluid over delayed inoculation in the detection of SBP. Hence this study is done to compare the bacterial yield between bedside inoculated blood culture bottles with ascitic fluid over delayed inoculation for the detection of SBP.Methods: Cross sectional study.Results: Maximum number of cases of cirrhosis with ascites with SBP was seen in the age group of 31-40years (54.4%) with mean age of study population being 39.66years, more common in males, bed side inoculation yielded more positive culture reports compared to delayed inoculation and E. coli and klebsilla being the common organisms.Conclusions: Difference between 2 culture methods in isolating organism in SBP cases was not statically significant. But, among culture positive cases, this study demonstrates that bedside inoculation of blood culture bottles is superior to delayed laboratory inoculation.

scholarly journals The pattern of microbial flora in Spontaneous bacterial peritonitis in Cirrhotic patients

2020 ◽  
pp. 62-67
Author(s):  
Sehrish Jahan Asif ◽  
Murataza Gondal ◽  
Shahida Parveen ◽  
Sumera Mushtaq ◽  
Shumaila Awan ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
E Coli ◽  
Bacterial Peritonitis ◽  
Serious Infection ◽  
Culture Sensitivity ◽  
Cirrhotic Patients ◽  
Biochemical Examination

Background: Spontaneous bacterial peritonitis (SBP) is the bacterial infection of ascitic fluid in the absence of other apparent causes. It is the most prevalent and serious infection in cirrhosis and leads to significant morbidity and mortality. The frequency of SBP in hospitalized patients with cirrhosis varies from 7 to 23% in the west and it is around 33% in Pakistan. Our study aim was to determine the frequency of microbial organisms isolated from spontaneous bacterial peritonitis in cirrhotic patients. Material and Methods: We did a cross-sectional study at the Department of Medicine, Fauji Foundation Hospital Rawalpindi for 6 months. Cirrhosis was diagnosed on the bases of clinical, biochemical and ultrasonography findings. Peripheral blood samples were obtained for the evaluation of complete blood cell count, polymorphonuclear leukocyte count, albumin and coagulation parameters. At the same time, the patients underwent paracentesis and a 20ml ascitic fluid sample was taken for culture sensitivity along with routine biochemical examination from the pathology department lab at our hospital. Results: A total of 150 patients were enrolled according to the inclusion criteria of the study. The mean age (yrs) of patients was 32.3+9.31. The frequency and percentages of male and female patients were 70 (46.7) and 80 (53.3) respectively. Frequency and percentages of E Coli and streptococcal pneumonia were 94 (62.7) and 34 (22.7) respectively, whereas frequency and percentages of staph aureus and Klebsiella were 22 (14.7). Conclusion: SBP is quite common in patients with cirrhosis. It should be suspected in all such cases presenting with typical or atypical features. E Coli was the most common causative organisms in our study but gram-positive organisms were quite frequent as well. Keywords: SBP, Cirrhosis, Peritonitis.

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