Abstract
AIM: To assess all clinically and bacteriologically documented episodes of spontaneous bacterial peritonitis diagnosed in a single unit over a 20 year period, to identify changes in the nature and antibiotic resistance of the causative bacteria. SETTING: A specialist liver disease unit in a tertiary care centre. MATERIAL: Cultured ascitic fluid obtained in the course of 240 consecutive episodes of clinically and bacteriologically proven spontaneous bacterial peritonitis. Patient recruitment remained stable during the 20 year period in terms of the number of cirrhotic patients admitted and the severity of their condition. RESULTS: 78.7% of isolates were Enterobacteriaceae (Escherichia coli in 51%) and 19% were Gram positive cocci. Until 1979 all the Enterobacteriaceae had the wild phenotype, compared with only 50% at the end of the study period. Since 1993, 22% of Enterobacteriaceae have been resistant to third generation cephalosporins. Methicillin resistant staphylococci were only isolated after 1989. CONCLUSIONS: Changes in the epidemiology and antibiotic resistance of bacteria causing spontaneous bacterial peritonitis must be monitored for optimal treatment.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bobadilla M., Sifuentes J., Garcia-Tsao G. Improved method for bacteriological diagnosis of spontaneous bacterial peritonitis. J Clin Microbiol. 1989 Oct;27(10):2145–2147. doi: 10.1128/jcm.27.10.2145-2147.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dupeyron C., Mangeney N., Sedrati L., Campillo B., Fouet P., Leluan G. Rapid emergence of quinolone resistance in cirrhotic patients treated with norfloxacin to prevent spontaneous bacterial peritonitis. Antimicrob Agents Chemother. 1994 Feb;38(2):340–344. doi: 10.1128/aac.38.2.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ginés P., Rimola A., Planas R., Vargas V., Marco F., Almela M., Forné M., Miranda M. L., Llach J., Salmerón J. M. Norfloxacin prevents spontaneous bacterial peritonitis recurrence in cirrhosis: results of a double-blind, placebo-controlled trial. Hepatology. 1990 Oct;12(4 Pt 1):716–724. doi: 10.1002/hep.1840120416. [DOI] [PubMed] [Google Scholar]
- Hoefs J. C. Spontaneous bacterial peritonitis: prevention and therapy. Hepatology. 1990 Oct;12(4 Pt 1):776–781. doi: 10.1002/hep.1840120424. [DOI] [PubMed] [Google Scholar]
- Kammerer J., Dupeyron C., Vuillemin N., Leluan G., Fouet P. Apport des examens cytologiques et bactériologiques du liquide d'ascite cirrhotique au diagnostic de péritonite bactérienne. A propos de 610 prélevements chez 156 malades. Med Chir Dig. 1982;11(4):243–251. [PubMed] [Google Scholar]
- Kammerer J., Taleb M., Dupeyron C., Vuillemin N., Leluan G., Fouet P. Péritonites bactériennes spontanées du cirrhotique. A propos de 26 épisodes. Gastroenterol Clin Biol. 1979 Oct;3(10):709–718. [PubMed] [Google Scholar]
- Llovet J. M., Rodríguez-Iglesias P., Moitinho E., Planas R., Bataller R., Navasa M., Menacho M., Pardo A., Castells A., Cabré E. Spontaneous bacterial peritonitis in patients with cirrhosis undergoing selective intestinal decontamination. A retrospective study of 229 spontaneous bacterial peritonitis episodes. J Hepatol. 1997 Jan;26(1):88–95. doi: 10.1016/s0168-8278(97)80014-1. [DOI] [PubMed] [Google Scholar]
- Novella M., Solà R., Soriano G., Andreu M., Gana J., Ortiz J., Coll S., Sàbat M., Vila M. C., Guarner C. Continuous versus inpatient prophylaxis of the first episode of spontaneous bacterial peritonitis with norfloxacin. Hepatology. 1997 Mar;25(3):532–536. doi: 10.1002/hep.510250306. [DOI] [PubMed] [Google Scholar]
- Runyon B. A. Spontaneous bacterial peritonitis: an explosion of information. Hepatology. 1988 Jan-Feb;8(1):171–175. doi: 10.1002/hep.1840080131. [DOI] [PubMed] [Google Scholar]
- Soriano G., Guarner C., Teixidó M., Such J., Barrios J., Enríquez J., Vilardell F. Selective intestinal decontamination prevents spontaneous bacterial peritonitis. Gastroenterology. 1991 Feb;100(2):477–481. doi: 10.1016/0016-5085(91)90219-b. [DOI] [PubMed] [Google Scholar]