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.