Spontaneous Bacterial Peritonitis in Patients with Hepatitis B Virus-Related Liver Cirrhosis: Community-Acquired versus Nosocomial.
10.3349/ymj.2012.53.2.328
- Author:
Seung Up KIM
1
;
Young Eun CHON
;
Chun Kyon LEE
;
Jun Yong PARK
;
Do Young KIM
;
Kwang Hyub HAN
;
Chae Yoon CHON
;
Sinyoung KIM
;
Kyu Sik JUNG
;
Sang Hoon AHN
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ahnsh@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Ascites;
cirrhosis;
community-acquired;
nosocomial;
spontaneous bacterial peritonitis
- MeSH:
Community-Acquired Infections/etiology/*microbiology/mortality/virology;
Female;
Hepatitis B virus/*pathogenicity;
Humans;
Liver Cirrhosis/complications/mortality/*virology;
Male;
Middle Aged;
Peritonitis/etiology/*microbiology/mortality/*virology;
Retrospective Studies
- From:Yonsei Medical Journal
2012;53(2):328-336
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Spontaneous bacterial peritonitis (SBP) frequently develops in patients with liver cirrhosis; however, there is little data to suggest whether the acquisition site of infection influences the prognosis. This study compared the bacteriology, clinical characteristics and treatment outcomes of community-acquired SBP (CA-SBP) and nosocomial SBP (N-SBP). MATERIALS AND METHODS: The medical records of 130 patients with hepatitis B virus (HBV)-related liver cirrhosis, who had experienced a first episode of SBP between January 1999 and December 2008, were reviewed. RESULTS: The study population included 111 (85.4%) patients with CA-SBP and 19 (14.6%) patients with N-SBP. Baseline and microbiological characteristics as well as clinical course, including in-hospital mortality, did not differ between patients with CA-SBP and those with N-SBP (all p>0.05). The median survival time was 6.5 months, and 117 (90.0%) patients died during the follow-up period. Patients with CA-SBP and N-SBP survived for median periods of 6.6 and 6.2 months, respectively, without significant difference (p=0.569). Time to recurrence did not differ between patients with CA-SBP and N-SBP (4.7 vs. 3.6 months, p=0.925). CONCLUSION: The acquisition site of infection did not affect clinical outcomes for patients with HBV-related liver cirrhosis who had experienced their first episode of SBP. Third-generation cephalosporins may be effective in empirically treating these patients, regardless of the acquisition site of the infection.