Role of host and bacterial virulence factors in Escherichia coli spontaneous bacterial peritonitis

Cereto, Ferran; Herranz, Xavier; Moreno, Eva; Andreu, Antònia; Vergara, Mercedes; Fontanals, Dionísia; Roget, Mercè; Simó, María; González, Antonio; Prats, Guillem; Genescà, Joan

doi:10.1097/meg.0b013e3282fc7390

Cited by 21 publications

(14 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…E coli is one of the most frequently isolated bacteria causing SBP, particularly when community-acquired 10 58. The use of β blockers in advanced liver cirrhosis has recently been reported to lower the probability of community-acquired SBP,59 and a recent meta-analysis concluded that this protective effect is even independent of the haemodynamic response achieved 60.…”

Section: Discussionmentioning

confidence: 99%

Splanchnic sympathectomy prevents translocation and spreading of E coli but not S aureus in liver cirrhosis

Worlicek

Knebel

Linde

et al. 2010

Gut

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Splanchnic sympathectomy prevents translocation and spreading of E coli but not S aureus in liver cirrhosis

Worlicek

Knebel

Linde

et al. 2010

Gut

View full text Add to dashboard Cite

show abstract

“…In patients who develop resistance to quinolones, trimethoprim/sulfamethoxazole has been suggested as an alternative to norfloxacin [78] . However, there is a high rate of SBP caused by trimethoprimsulfamethoxazole resistant Gram-negative bacteria (44%-72%), suggesting that this antibiotic is not a suitable alternative to norfloxacin [79,80] . Data supporting the use of trimethoprim/sulfamethoxazole are weak, while its side effects are potentially dangerous and probably under-reported [81] .…”

Section: Secondary Prophylaxis In Patients With Prior Sbpmentioning

confidence: 99%

Diagnosis and management of bacterial infections in decompensated cirrhosis

Pleguezuelo

Benítez²,

Jurado³

et al. 2013

WJH

View full text Add to dashboard Cite

Bacterial infections are one of the most frequent complications in cirrhosis and result in high mortality rates. Patients with cirrhosis have altered and impaired immunity, which favours bacterial translocation. Episodes of infections are more frequent in patients with decompensated cirrhosis than those with compensated liver disease. The most common and life-threatening infection in cirrhosis is spontaneous bacterial peritonitis followed by urinary tract infections, pneumonia, endocarditis and skin and soft-tissue infections. Patients with decompensated cirrhosis have increased risk of developing sepsis, multiple organ failure and death. Risk factors associated with the development of infections are severe liver failure, variceal bleeding, low ascitic protein level and prior episodes of spontaneous bacterial peritonitis (SBP). The prognosis of these patients is closely related to a prompt and accurate diagnosis. An appropriate treatment decreases the mortality rates. Preventive strategies are the mainstay of the management of these patients. Empirical antibiotics should be started immediately following the diagnosis of SBP and the first-line antibiotic treatment is third-generation cephalosporins. However, the efficacy of currently recommended empirical antibiotic therapy is very low in nosocomial infections including SBP, compared to community-acquired episodes. This may be associated with the emergence of infections caused by Enterococcus faecium and extended-spectrum β-lactamaseproducing Enterobacteriaceae, which are resistant to the first line antimicrobial agents used for treatment. The emergence of resistant bacteria, underlines the need to restrict the use of prophylactic antibiotics to patients with the greatest risk of infections. Nosocomial infections should be treated with wide spectrum antibiotics. Further studies of early diagnosis, prevention and treatment are needed to improve the outcomes in patients with decompensated cirrhosis.

show abstract

“…A majority of the studies (15 of 18) were retrospective and 78% (14 of 18) stated relevant baseline data. The accepted definition of SBP was applied in 11 of 18 (61%) of the studies, whereas the rest required culture positivity in addition to an increased neutrophil count, 11,14,15,18–20 or based the diagnosis of SBP on hospital diagnostic codes. 10 Three studies evaluated only Escherichia coli -positive SBP.…”

Section: Description Of Prognostic Studiesmentioning

confidence: 99%

“…10 Three studies evaluated only Escherichia coli -positive SBP. 11,18,19 All studies reported the number of deaths but only 50% (9 of 18) stated the causes of death and only 3 studies did not overfit variables. 10,15,20 Ten studies fulfilled our predefined quality criteria.…”

Section: Description Of Prognostic Studiesmentioning

confidence: 99%

Renal Dysfunction Is the Most Important Independent Predictor of Mortality in Cirrhotic Patients With Spontaneous Bacterial Peritonitis

Tandon

García–Tsao

2011

Clinical Gastroenterology and Hepatology

160

View full text Add to dashboard Cite

BACKGROUND & AIMS Spontaneous bacterial peritonitis (SBP) is the most common infection among patients with cirrhosis. To improve stratification of patient care, we performed a systematic review to identify the most robust predictors of mortality in cirrhotic patients with SBP. METHODS We reviewed prognostic studies (English language only) of adult patients with SBP, defined as a polymorphonuclear ascitic fluid cell count of 250 cells/mm3 or more, with or without positive results from culture of ascitic fluid. We reviewed only studies that performed survival and multivariate analyses and reported in-hospital or mortalities within 30 days. RESULTS Of 2008 available references, 18 were included in the study (median, 115 patients per trial). The median age of patients was 56 years (68% male). The most common predictors of death were renal dysfunction, lack of SBP resolution, immunosuppressive factors, and hospital-acquired SBP. Sensitivity analysis using the 12 best-quality studies identified renal dysfunction and levels of blood urea nitrogen and creatinine as the most important variables. The mortality rate among patients with renal dysfunction was 67%, compared with only 11% of patients who maintained normal renal function. CONCLUSIONS Renal dysfunction is the main prognostic factor for cirrhotic patients with SBP, followed by the MELD score. Further studies are needed to determine whether these factors identified retain prognostic value in high-risk patients who receive albumin. Risk stratification might be used to select additional treatments, such as early vasoconstrictor therapy, for the highest-risk group.

show abstract

Role of host and bacterial virulence factors in Escherichia coli spontaneous bacterial peritonitis

Cited by 21 publications

References 33 publications

Splanchnic sympathectomy prevents translocation and spreading of E coli but not S aureus in liver cirrhosis

Splanchnic sympathectomy prevents translocation and spreading of E coli but not S aureus in liver cirrhosis

Diagnosis and management of bacterial infections in decompensated cirrhosis

Renal Dysfunction Is the Most Important Independent Predictor of Mortality in Cirrhotic Patients With Spontaneous Bacterial Peritonitis

Contact Info

Product

Resources

About