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Increasing frequency of Gram‐positive bacteria in spontaneous bacterial peritonitis
Author(s) -
Cholongitas Evangelos,
Papatheodoridis George V.,
Lahanas Alexandros,
Xanthaki Anna,
KontouKastellanou Chrysoula,
Archimandritis Athanasios J.
Publication year - 2005
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2004.0985.x
Subject(s) - spontaneous bacterial peritonitis , gram negative bacteria , bacteria , medicine , gastroenterology , peritonitis , gram positive bacteria , ascitic fluid , microbiological culture , antibiotics , albumin , gram , microbiology and biotechnology , ascites , biology , escherichia coli , biochemistry , genetics , gene
Aim: To evaluate the characteristics and possible recent changes of the microbial causes of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. Methods: We retrospectively evaluated 42 cirrhotic patients with positive ascitic fluid culture and without evidence of secondary peritonitis who were admitted consecutively to our Department between 1998 and 2002. Results: Twenty (48%) of 42 patients with positive ascitic fluid culture were diagnosed during 1998–1999 (period A) and the remaining 22 (52%) patients during 2000–2002 (period B). Gram‐negative bacteria were the cause of SBP in 15 (75%) of the 20 patients during period A and in only nine (41%) of the 22 patients during period B ( P =0.026). SBP patients with Gram‐positive bacteria compared with those with Gram‐negative bacteria were less frequently in Child class C ( P =0.058) and had significantly higher ascitic fluid protein ( P =0.014) and albumin concentrations ( P =0.009) and lower ascitic fluid neutrophil count ( P =0.008). Resistance to quinolones was detected significantly more frequently in the isolated Gram‐positive than Gram‐negative bacteria ( P <0.001). Conclusion: Culture‐positive SBP in cirrhotic patients are caused more frequently by Gram‐positive bacteria during the recent years, which are, in their vast majority, resistant to quinolones.