Prognostic significance of infection acquisition sites in spontaneous bacterial peritonitis: Nosocomial versus community acquired

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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. Gram-negative 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.

Original languageEnglish
Pages (from-to)666-671
Number of pages6
JournalJournal of Korean Medical Science
Volume21
Issue number4
Publication statusPublished - 2006 Aug 15

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Peritonitis
Infection
Hemorrhage
End Stage Liver Disease
Cefotaxime
Ascitic Fluid
Only Child
Bacillus
Shock
Escherichia coli
Kidney
Survival

Keywords

  • Community-Acquired Infections
  • Cross infection
  • Liver cirrhosis
  • Peritonitis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Prognostic significance of infection acquisition sites in spontaneous bacterial peritonitis: Nosocomial versus community acquired",
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. Gram-negative 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.",
keywords = "Community-Acquired Infections, Cross infection, Liver cirrhosis, Peritonitis",
author = "Joon-Young Song and Seong, {Ju Jung} and Cheong, {Won Park} and Sohn, {Jang Wook} and Kim, {Woo Joo} and Min, {Ja Kim} and Hee-Jin Cheong",
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journal = "Journal of Korean Medical Science",
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T1 - Prognostic significance of infection acquisition sites in spontaneous bacterial peritonitis

T2 - Nosocomial versus community acquired

AU - Song, Joon-Young

AU - Seong, Ju Jung

AU - Cheong, Won Park

AU - Sohn, Jang Wook

AU - Kim, Woo Joo

AU - Min, Ja Kim

AU - Cheong, Hee-Jin

PY - 2006/8/15

Y1 - 2006/8/15

N2 - 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. Gram-negative 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.

AB - 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. Gram-negative 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.

KW - Community-Acquired Infections

KW - Cross infection

KW - Liver cirrhosis

KW - Peritonitis

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