J Korean Med Sci.  2006 Aug;21(4):666-671. 10.3346/jkms.2006.21.4.666.

Prognostic Significance of Infection Acquisition Sites in Spontaneous Bacterial Peritonitis: Nosocomial versus Community Acquired

• Song JY
• Jung SJ
• Park CW
• Sohn JW
• Kim WJ
• Kim MJ
• Cheong HJ

• KMID: 2157818
• DOI: http://doi.org/10.3346/jkms.2006.21.4.666

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. Gramnegative 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.

Keyword

Liver Cirrhosis; Peritonitis; Cross Infection; Community-Acquired Infections

MeSH Terms

Time Factors
Survival Rate
Shock/etiology/mortality
Prognosis
Peritonitis/complications/microbiology/*pathology
Multivariate Analysis
Middle Aged
Male
Klebsiella pneumoniae/drug effects/growth & development
Kidney Diseases/etiology/mortality
Humans
Gastrointestinal Hemorrhage/etiology/mortality
Female
Escherichia coli/drug effects/growth & development
Drug Resistance, Bacterial
Cross Infection/complications/microbiology/pathology
Community-Acquired Infections/complications/microbiology/pathology
Ciprofloxacin/pharmacology
Cefotaxime/pharmacology
Bacterial Infections/complications/microbiology/*pathology
Anti-Bacterial Agents/pharmacology
Aged

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