Prevalence and Predictors of Third-Generation Cephalosporin Resistance in the Empirical Treatment of Spontaneous Bacterial Peritonitis

Sunjaya, Dharma; Lennon, Ryan J.; Shah, Vijay H.; Kamath, Patrick S.; Simonetto, Douglas A.

doi:10.1016/j.mayocp.2018.12.036

Cited by 18 publications

(19 citation statements)

References 23 publications

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“…Only 27.27% of the patients in our series had a positive culture. These results were comparable to those of Xiao et al (South Korea) [24] and Sanjaya et al (United States) [25] with a respective rate of 21.49% and 20%. Among the positive cultures, the majority of the bacteria found were Gram negative bacteria (66.67%).…”

Section: Discussionsupporting

confidence: 90%

Clinical and Bacteriological features of spontaneous bacterial peritonitis in Malagasy patients with Cirrhosis

Rakotozafindrabe¹,

Razafindrazoto²,

Rasolonjatovo³

et al. 2021

Preprint

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Background: Spontaneous bacterial peritonitis (SBP) represent frequent and serious complications in cirrhosis patients with ascites. Our aim was to describe the clinical and bacteriological characteristics of SBP in Madagascar.Methods: This is a 21-month prospective study between January 2018 and October 2019, including hospitalized patients with cirrhosis, with clinical and biological symptoms of SBP.Results: Thirty-three patients were included. The mean age was 48.09 ± 13.55 years (extremes: 19 – 78 years), the sex ratio was 3.12. Abdominal pain (55%), fever (36%), diarrhea (6%), hepatic encephalopathy (18%) are the most common symptoms. Gastrointestinal bleeding (18.18%) was the main risk factor to SBP. SBP was community-acquired in 87.88% of cases. A culture of ascites fluid was positive for 9 patients (27.27%). The infectious agents found were Escherichia coli (12.10%), Klebsiella pneumoniae (3%), Pseudomonas (3%), Streptococcus mitis (9.1%). Escherichia coli were wild with one case resistant to Ceftriaxone. The Klebsiella were multidrug resistant. The other two pathogens did not show resistance. After antibiotic therapy adapted to the antibiogram, healing was observed in 26 patients (78.78%). Seven patients (21.22%) died from various complications. All deceased patients had bacteria identified in ascites fluid.Conclusion: SBP defined according to clinical and biological criteria is apparently sterile in the majority of cases. Gram-negative bacteria were the major pathogens involved in SBP in cirrhotic patients. Escherichia coli and streptococcus were the most common pathogen isolated. Bacteriological study is essential to adapt antimicrobial to multidrug-resistant bacteria.

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Section: Discussionsupporting

confidence: 90%

Clinical and Bacteriological features of spontaneous bacterial peritonitis in Malagasy patients with Cirrhosis

Rakotozafindrabe¹,

Razafindrazoto²,

Rasolonjatovo³

et al. 2021

Preprint

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“…Sixty-one patients met the above criteria of 404 consecutive patients admitted with SBP (International Classification of Diseases, version 9 [ICD 9] code 567.23 and ICD 10 K65.2) between January 1, 2010, and December 31, 2018. Three of these cases were nosocomial-acquired, 39 were health careeassociated, and 19 were community-acquired in our study, according to the modified criteria also applied by Sunjaya et al 1 Although the overall baseline patient characteristics and low culturepositive SBP rate (15.1%) were However, 28% of the authors' study population was comprised of these patients. Bacterascites have been associated with better outcomes than SBP.…”

Section: Increasing Resistance To Third-generation Cephalosporins In Spontaneous Bacterial Peritonitismentioning

confidence: 54%

“…To the Editor: We read with immense interest the article entitled "Prevalence and Predictors of Third-Generation Cephalosporin Resistance in the Empirical Treatment of Spontaneous Bacterial Peritonitis" by Sunjaya et al 1 Notably, the rate of third-generation cephalosporin resistance in the authors' study cohort was only 10% despite reported higher resistance rates in the recent literature from the United States, Europe, and China. [2][3][4][5] A recent study we conducted at our university hospital revealed similarly higher thirdgeneration cephalosporin resistance rate (36.1%).…”

Section: Increasing Resistance To Third-generation Cephalosporins In Spontaneous Bacterial Peritonitismentioning

confidence: 96%

Increasing Resistance to Third-Generation Cephalosporins in Spontaneous Bacterial Peritonitis

Tripathi

Koirala

Kato

2020

Mayo Clinic Proceedings

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“…[4][5][6][7] Poor antimicrobial coverage with cephalosporins has also been reported earlier, but in the range of 10%-45%. [8][9][10][11] As ours is a tertiary care referral centre, it is possible that patients may have been partially treated elsewhere previously. Nonetheless, vancomycin resistant Enterococci were fewer than in a German study, 12 and we did not see Vancomycin resistance in Staphylococci as in a Chinese study.…”

Section: Mittal Et Almentioning

confidence: 99%

Microbiological profile of pathogens in spontaneous bacterial peritonitis secondary to liver cirrhosis: a retrospective study

2020

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Spontaneous bacterial peritonitis (SBP) is an acute bacterial infection of ascitic fluid without an obvious source. The prevalence of SBP in patients with cirrhosis is in the range of 10%–30%. With increasing use of antibiotics, there is a gradual shift in the causative flora of SBP from Gram-negative bacteria to Gram-positive and, more importantly, to drug-resistant bacteria. The aim of this retrospective study on 721 cases was to identify the prevalence of various organisms causing SBP along with their drug sensitivity and resistance patterns. A prevalence of 38.2% culture positivity was observed in our South Indian population. Escherichia coli was the most common pathogen isolated. Third-generation cephalosporins showed high rates of resistance, but a susceptibility of 74.5% to amikacin was found. Nonetheless, 42% of culture-positive isolates exhibited multidrug resistance, the highest rates being seen with Enterococcus faecium (64.2%) and Acinetobacter baumannii (71.4%).

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Prevalence and Predictors of Third-Generation Cephalosporin Resistance in the Empirical Treatment of Spontaneous Bacterial Peritonitis

Cited by 18 publications

References 23 publications

Clinical and Bacteriological features of spontaneous bacterial peritonitis in Malagasy patients with Cirrhosis

Clinical and Bacteriological features of spontaneous bacterial peritonitis in Malagasy patients with Cirrhosis

Increasing Resistance to Third-Generation Cephalosporins in Spontaneous Bacterial Peritonitis

Microbiological profile of pathogens in spontaneous bacterial peritonitis secondary to liver cirrhosis: a retrospective study

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