Clinical Features and Prognosis of Spontaneous Bacterial Peritonitis in Korean Patients with Liver Cirrhosis: A Multicenter Retrospective Study.
- Author:
Jeong HEO
1
;
Yeon Seok SEO
;
Hyung Joon YIM
;
Taeho HAHN
;
Sang Hoon PARK
;
Sang Hoon AHN
;
Jun Yong PARK
;
Ji Young PARK
;
Moon Young KIM
;
Sung Keun PARK
;
Mong CHO
;
Soon Ho UM
;
Kwang Hyub HAN
;
Hong Soo KIM
;
Soon Koo BAIK
;
Byung Ik KIM
;
Se Hyun CHO
Author Information
1. Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Liver cirrhosis;
Peritonitis;
Prognosis;
Resistance
- MeSH:
Anti-Bacterial Agents;
Ascitic Fluid;
Candida;
Carcinoma, Hepatocellular;
Cell Count;
Ciprofloxacin;
Cohort Studies;
Fibrosis;
Gram-Negative Bacteria;
Hospital Mortality;
Humans;
Liver;
Liver Cirrhosis;
Liver Diseases;
Male;
Penicillins;
Peritonitis;
Prognosis;
Retrospective Studies;
Treatment Failure
- From:Gut and Liver
2009;3(3):197-204
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea. METHODS: This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of >250 cells/mm3 in the absence of data compatible with secondary peritonitis. RESULTS: The mean age of the cohort was 56 years, and 121 (77%) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42%): Gram-negative bacteria in 54 (81.8%), Gram-positive in 11 (16.7%), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17%), to ciprofloxacin in 11 (20.8%), and to penicillin in 33 (62.3%). The treatment failure and in-hospital mortality rates were 12.1% and 21%, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum beta-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality. CONCLUSIONS: SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.
