Browse

Enterococcus: not an innocent bystander in cirrhotic patients with spontaneous bacterial peritonitis

Cited 15 time in Web of Science Cited 16 time in Scopus
Authors
Lee, J. -H.; Yoon, J. -H.; Kim, B. H.; Chung, G. E.; Kim, W.; Kim, E. -C.; Lee, H. -S.; Kim, Y. J.; Myung, S. J.
Issue Date
2009-01
Publisher
SPRINGER
Citation
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES; Vol.28 1; 21-26
Abstract
Clinicians sometimes experience treatment failure in the initial empirical antibiotics treatment using cephalosporins in cirrhotic patients with spontaneous bacterial peritonitis (SBP). Enterococcus, which is intrinsically resistant to cephalosporins, may be one of the causes of treatment failure. The aim of this study was to evaluate the clinical importance and the clinical characteristics of spontaneous enterococcal peritonitis (SEP). This was a retrospective cohort study of 359 patients with SBP treated in a single tertiary care center in South Korea from January 2000 through December 2004. We evaluated the clinical manifestation and the treatment results of SBP patients with enterococci identified from ascites culture. During the observation period, 13 of 359 patients (3.6%) diagnosed with culture-positive SBP had enterococcal peritonitis. For the initial empirical treatment, third-generation cephalosporins were administered to the 13 patients, ten of whom (76.9%) did not improve in the first 48 h. An in vitro antibiotic sensitivity test showed that the identified enterococci were susceptible to ampicillin plus gentamycin in eight patients (61.5%) and there was no vancomycin-resistant enterococcus. Although antibiotics were changed to antienterococcal antibiotics in 11 patients, only five patients improved. As a result, eight of the 13 patients (61.5%) with enterococcal SBP died during the observation period, and the one-month mortality was significantly higher from enterococcal SBP than from nonenterococcal SBP (P = 0.038). We conclude that enterococcal SBP has poor prognosis and it is reasonable to use antienterococcal antibiotics when enterococcus is identified from ascites culture of patients with liver cirrhosis.
ISSN
0934-9723
Language
English
URI
https://hdl.handle.net/10371/77369
DOI
https://doi.org/10.1007/s10096-008-0578-3
Files in This Item:
There are no files associated with this item.
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Laboratory Medicine (검사의학전공)Journal Papers (저널논문_검사의학전공)
  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse