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Recent increase in antibiotic‐resistant microorganisms in patients with spontaneous bacterial peritonitis adversely affects the clinical outcome in Korea
Author(s) -
PARK YOUNG HWAN,
LEE HAN CHU,
SONG HEE GON,
JUNG SAERA,
RYU SOO HYUNG,
SHIN JUNG WOO,
CHUNG YOUNGHWA,
LEE YUNG SANG,
SUH DONG JIN
Publication year - 2003
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2003.03086.x
Subject(s) - spontaneous bacterial peritonitis , medicine , cefotaxime , antibiotics , ciprofloxacin , microbiology and biotechnology , antibiotic resistance , peritonitis , klebsiella pneumoniae , acinetobacter , klebsiella , escherichia coli , ascites , biology , biochemistry , gene
Background and Aim: Recently, antibiotic‐resistant microorganisms have been increasingly noted in Korean patients with spontaneous bacterial peritonitis (SBP). The present study investigated the changing pattern of antibiotic resistance and its effects on the clinical outcome in treating SBP. Methods: The present study retrospectively analyzed 87 episodes of SBP in 1995, 222 in 1998, and 271 in 1999. The isolated microorganisms and their antibiotic susceptibility were compared, and prognostic factors for survival were analyzed. Results: Microorganisms were isolated in 41% of total episodes. The three most frequently isolated organisms were Escherichia coli (48%), Klebsiella pneumoniae (15%), and Aeromonas (8%). Strains that were resistant to cefotaxime in Gram‐negative bacilli significantly increased from 7% in 1995 to 28% in 1999, and those to ciprofloxacin increased from 10% to 32%. Treatment failure also increased from 6% to 23%. Combined hepatocellular carcinoma and SBP caused by extended‐spectrum β‐lactamase‐producing strains were two independent prognostic factors for survival. Conclusion: Considering the increase in antibiotic‐resistant microorganisms related to SBP, measures to prevent the in‐hospital spread of resistant strains and the indiscriminate use of antibiotics should be instituted more stringently.