Prognostic Significance of Infection Acquisition Sites in Spontaneous Bacterial Peritonitis: Nosocomial versus Community Acquired.
10.3346/jkms.2006.21.4.666
- Author:
Joon Young SONG
1
;
Seong Ju JUNG
;
Cheong Won PARK
;
Jang Wook SOHN
;
Woo Joo KIM
;
Min Ja KIM
;
Hee Jin CHEONG
Author Information
1. Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea. heejinmd@medimail.co.kr
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords:
Liver Cirrhosis;
Peritonitis;
Cross Infection;
Community-Acquired Infections
- MeSH:
Time Factors;
Survival Rate;
Shock/etiology/mortality;
Prognosis;
Peritonitis/complications/microbiology/*pathology;
Multivariate Analysis;
Middle Aged;
Male;
Klebsiella pneumoniae/drug effects/growth & development;
Kidney Diseases/etiology/mortality;
Humans;
Gastrointestinal Hemorrhage/etiology/mortality;
Female;
Escherichia coli/drug effects/growth & development;
Drug Resistance, Bacterial;
Cross Infection/complications/microbiology/pathology;
Community-Acquired Infections/complications/microbiology/pathology;
Ciprofloxacin/pharmacology;
Cefotaxime/pharmacology;
Bacterial Infections/complications/microbiology/*pathology;
Anti-Bacterial Agents/pharmacology;
Aged
- From:Journal of Korean Medical Science
2006;21(4):666-671
- CountryRepublic of Korea
- Language:English
-
Abstract:
Spontaneous bacterial peritonitis (SBP) is an ascitic fluid infection as a complication of end stage liver disease. The outcome is related to the severity of hepatorenal function, gastrointestinal bleeding, and many others; however it is not well known whether the infection acquisition sites have an effect on the prognosis of SBP. In order to identify the prognostic significance of the acquisition sites, we studied 106 patients who were diagnosed as culture positive SBP between October 1998 and August 2003. Thirty-two episodes were nosocomial and 74 were community acquired. Gramnegative bacilli such as Escherichia coli were dominant in both of the nosocomial and community-acquired SBPs. Despite significantly higher resistance to cefotaxime in nosocomial isolates compared to community-acquired isolates (77.8% vs. 13.6%, p=0.001), no difference was found regarding short or long term prognosis. Infection acquisition sites were not related to short or long term prognosis either. Shock, gastrointestinal bleeding and renal dysfunction were related to short term prognosis. Only Child-Pugh class C was identified as an independent prognostic factor of long-term survival.
