Pathogens of spontaneous bacterial peritonitis in patients with liver cirrhosis
10.3760/cma.j.issn.1674-2397.2011.03.010
- VernacularTitle:肝硬化合并自发性细菌性腹膜炎的病原学研究
- Author:
Chuantong LU
;
Dezhou LI
;
Guosheng GAO
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Spontaneous bacterial peritonitis;
Drug resistance
- From:
Chinese Journal of Clinical Infectious Diseases
2011;4(3):168-171
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the pathogens and their antibiotic resistance profile of hospital and community-acquired spontaneous bacterial peritonitis ( SBP) in patients with liver cirrhosis. Methods Eighty-four cirrhotic patients with SBP were recruited, in which 61 (72. 6% ) were diagnosed as communityacquired SBP and 23 (27.4% ) were diagnosed as hospital-acquired SBP. Bacterial identification and drug susceptibility tests were performed. SPSS 16. 0 was used for statistical analysis. Results There were 68 (81.0%) Gram-negative strains and 16 (19.0%) Gram-positive strains. Escherichia coli and Klebsiella pneumoniae were the top two prevalent strains. In community-acquired group, there were 21 (21/61, 34. 4% ) strains of Escherichia coli and 15 ( 15/61 , 24. 6% ) strains of Klebsiella pneumoniae; while in hospital-acquired group, it was 12 (12/23, 52.2%) strains and 6 (6/23, 26. 1%) strains, respectively. There were no statistical differences in the infection rates of Escherichia coli and Klebsiella pneumoniae between community and hospital-acquired SBP patients (x2 = 2. 21 and 0. 02, P > 0. 05). Drug susceptibility tests showed that Escherichia coli and Klebsiella pneumoniae were 100% sensitive to impenem, and the sensitivity to Piperacillin/Tazobactam was also high. But these strains were highly resistant to Ampicillin and Ampicillin/Sulbactam. All extended spectrum β-lactamases ( ESBLs) positive strains were resistant to cephalosporins, while ESBLs-negative strains were all sensitive to cephalosporins. Conclusions SBP in patients with liver cirrhosis are mainly caused by Gram-negative strains, especially Escherichia coli and Klebsiella pneumoniae. ESBLs-positive strains are highly resistant to cephalosporins, so proper use of right antibacterial agents is important.
