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Clinical Features and Prognosis of Spontaneous Bacterial Peritonitis in Korean Patients with Liver Cirrhosis: A Multicenter Retrospective Study
Gut and Liver ; : 197-204, 2009.
Article in English | WPRIM | ID: wpr-76192
ABSTRACT
BACKGROUND/

AIMS:

Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea.

METHODS:

This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of >250 cells/mm3 in the absence of data compatible with secondary peritonitis.

RESULTS:

The mean age of the cohort was 56 years, and 121 (77%) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42%) Gram-negative bacteria in 54 (81.8%), Gram-positive in 11 (16.7%), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17%), to ciprofloxacin in 11 (20.8%), and to penicillin in 33 (62.3%). The treatment failure and in-hospital mortality rates were 12.1% and 21%, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum beta-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality.

CONCLUSIONS:

SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Penicillins / Peritonitis / Prognosis / Fibrosis / Candida / Ascitic Fluid / Ciprofloxacin / Cell Count / Retrospective Studies / Cohort Studies Type of study: Etiology study / Incidence study / Observational study / Prognostic study Limits: Humans / Male Language: English Journal: Gut and Liver Year: 2009 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Penicillins / Peritonitis / Prognosis / Fibrosis / Candida / Ascitic Fluid / Ciprofloxacin / Cell Count / Retrospective Studies / Cohort Studies Type of study: Etiology study / Incidence study / Observational study / Prognostic study Limits: Humans / Male Language: English Journal: Gut and Liver Year: 2009 Type: Article