1.Spontaneous Bacterial Peritonitis in Patients with Hepatitis B Virus-Related Liver Cirrhosis: Community-Acquired versus Nosocomial.
Seung Up KIM ; 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
Yonsei Medical Journal 2012;53(2):328-336
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.
Community-Acquired Infections/etiology/*microbiology/mortality/virology
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Female
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Hepatitis B virus/*pathogenicity
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Humans
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Liver Cirrhosis/complications/mortality/*virology
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Male
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Middle Aged
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Peritonitis/etiology/*microbiology/mortality/*virology
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Retrospective Studies