Nosocomial and Community-Acquired Spontaneous Bacterial Peritonitis in patients with liver cirrhosis in China: Comparative Microbiology and Therapeutic Implications

Sci Rep. 2017 Apr 6:7:46025. doi: 10.1038/srep46025.

Abstract

Spontaneous bacterial peritonitis (SBP) is a common complication of liver cirrhosis. This study was performed to compare the microbiological characteristics of nosocomial and community-acquired episodes of bacterial peritonitis in China. Five hundred and seventy-five strains were isolated from the ascitic fluid of cirrhotic patients from the Beijing 302 Hospital from January 2014 to December 2014. The patients in the community-acquired SBP (n = 264) and the nosocomial SBP (n = 311) groups exhibited significant differences in clinical symptoms (P < 0.01) [corrected]. In both groups, most of the bacteria were Escherichia coli, Klebsiella pneumoniae, coagulase-negative staphylococcus and Enterococcus. There were more frequent gram-positive cocci (G+ C) in the nosocomial group (n = 170). Compared with the community-acquired group, the proportion of Enterococcus was significantly increased in the nosocomial group (9.0% vs. 16.6%, P < 0.05). The resistance rate of the main pathogenic bacteria to the recommended first-line drug in the guideline was very high. Community-acquired and nosocomial SBP groups exhibited differences in clinical symptoms and antibiotic susceptibility tests. Optimal treatments should be provided for these patients. We recommend that cefoperazone/sulbactam or piperacillin/tazobactam should be used for the empirical treatment of SBP.

Publication types

  • Comparative Study

MeSH terms

  • Ascitic Fluid / microbiology
  • Bacteria / metabolism
  • Bacterial Infections / microbiology*
  • Bacterial Infections / therapy*
  • China
  • Community-Acquired Infections / microbiology*
  • Community-Acquired Infections / therapy*
  • Cross Infection / microbiology*
  • Cross Infection / therapy*
  • Drug Resistance, Microbial
  • Female
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / microbiology
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Peritonitis / microbiology*