Abstract
Backgrounds/Aims: The causative agents for spontaneous bacterial peritonitis (SBP) and antibiotic resistance rate vary according to the regions and time. This study evaluated the recent changes in the profiles of microorganisms and antibiotic resistance rate for the choice of effective antibiotics in treating SBP. Methods: The clinical records of 1,018 episodes of SBP from November, 1994 to December, 2005, were analyzed retrospectively. The profiles of the causative agents for SBP and the rate of antibiotic resistance were compared in every 4-year-term. Results: The microorganisms were isolated in 394 out of 1018 episodes (38.7%). Gram negative and positive organisms constituted 71.6% and 21.3%, respectively. The five most commonly isolated organisms were E. coli (35.8%), K. pneumoniae (15.5%), viridans Streptococci (10.4%), S. pneumoniae (4.8%) and Aeromonas group (4.6%). The rate of E. coli resistant to cefotaxime (0%, 5.4%, 7.4%) and ciprofloxacin (4.3%, 21.6%, 28.4%) were increased in recent years. In the gram positive organisms, all isolates of viridans Streptococci and Pneumococci were sensitive to cefotaxime and ciprofloxacin. Recently, methicillin-resistant Staphylococcus aureus (MRSA) (28%) and vancomycin-resistant Enterococci (VRE) (31%) have been isolated. In each period, the overall antibiotic resistance rates to cefotaxime were 12.5%, 14.0%, 14.8%, to ciprofloxacin were 3.1%, 16.7%, 18.0%, and to imipenem were 4.7%, 7.0%, 4.2%. Conclusions: Cefotaxime may still be the choice of primary empirical antibiotics for the treatment of SBP in Korea because the rate of resistance is acceptable. However, it is important to be aware of the recent increase in ciprofloxacin-resistant E. coli, extended spectrum beta-lactamase (ESBL)-producing gram negative bacilli, MRSA and VRE. (Korean J Hepatol 2007;13:370-377)
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Citations to this article as recorded by
- Effect of acute kidney injury on long‐term outcomes of spontaneous bacterial peritonitis in cirrhotic patients using the International Club of Ascites‐acute kidney injury criteria
Won Sohn, Jung Hee Kim, Ju‐Yeon Cho
Journal of Gastroenterology and Hepatology.2020; 35(5): 870. CrossRef - KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications
Clinical and Molecular Hepatology.2018; 24(3): 230. CrossRef - Spontaneous Bacterial Peritonitis
Do Seon Song
The Korean Journal of Gastroenterology.2018; 72(2): 56. CrossRef - Prognosis of Spontaneous Bacterial Peritonitis in Hepatocellular Carcinoma Patients
Jeong Han Kim, Won Hyeok Choe, So Young Kwon, Byung-chul Yoo
Journal of Korean Medical Science.2018;[Epub] CrossRef - Comparison of clinical characteristics and outcomes of spontaneous bacterial peritonitis and culture negative neutrocytic ascites
Sun Hee Na, Eun Jung Kim, Eun Young Nam, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Ji Hwan Bang, Eu Suk Kim, Sang Won Park, Hong Bin Kim, Myoung-don Oh, Nam Joong Kim
Scandinavian Journal of Gastroenterology.2017; 52(2): 199. CrossRef - Do We Need to Change the Treatment Strategy for Spontaneous Bacterial Peritonitis in Patients with Advanced Cirrhosis?
Chang Wook Kim
The Korean Journal of Gastroenterology.2017; 69(2): 93. CrossRef - Clinical Features of Spontaneous Bacterial Peritonitis: A 10-year Experience from a Single Center
Ha Young Na, Jeong Han Kim, Won Hyeok Choe, So Young Kwon, Byung-chul Yoo
The Korean Journal of Gastroenterology.2017; 69(2): 129. CrossRef - Appropriateness of antibiotic usage for gastrointestinal disorders in a tertiary care hospital
Gayathri Madhu S, Emmanuel James, Rama P Venu
European Journal of Hospital Pharmacy.2016; 23(5): 283. CrossRef - Pathogen profile and drug resistance analysis of spontaneous peritonitis in cirrhotic patients
Yong-Tao Li
World Journal of Gastroenterology.2015; 21(36): 10409. CrossRef - A Case of Spontaneous Bacterial Peritonitis Following Argon Plasma Coagulation for Angiodysplasias in the Colon
Hye Jin Jung, Soo Hyung Ryu, Kyoung Sik Park, Won Jae Yoon, Jin Nam Kim, You Sun Kim, Jeong Seop Moon
The Korean Journal of Gastroenterology.2014; 64(2): 115. CrossRef - Patterns of Antimicrobial Resistance in the Causative Organisms of Spontaneous Bacterial Peritonitis: A Single Centre, Six-Year Experience of 1981 Samples
Sara Sheikhbahaei, Alireza Abdollahi, Nima Hafezi-Nejad, Elham Zare
International Journal of Hepatology.2014; 2014: 1. CrossRef - Clinical outcomes of spontaneous bacterial peritonitis due to extended-spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumoniae: a retrospective cohort study
Min Jae Kim, Kyoung-Ho Song, Nak-Hyun Kim, Pyoeng Gyun Choe, Wan Beom Park, Ji Hwan Bang, Eu Suk Kim, Sang Won Park, Hong Bin Kim, Hyo-Suk Lee, Myoung-don Oh, Nam Joong Kim
Hepatology International.2014; 8(4): 582. CrossRef - Etiology and Antimicrobial Susceptibility Profile of Isolates from Ascitic Fluid of Patients with Spontaneous Bacterial Peritonitis
Veenu Gupta, Rajoo Singh Chhina, Jyoti Chaudhary, Manisha Aggarwal, Priyam Chawla, Deepinder Kaur
Journal of Gastrointestinal Infections.2014; 4(1): 47. CrossRef - Identification of Bacterial Pathogens and their Antibiogram from Ascitic Fluid in a Rural Tertiary Care Hospital of North India
Anuradha Sood, Kamlesh Thakur, Subhash Chand Jaryal, Puneet Kumar Gupta, Smriti Chauhan
Journal of Gastrointestinal Infections.2014; 4(1): 19. CrossRef - Etiology and Antimicrobial Susceptibility Profile of Isolates from Ascitic Fluid of Patients with Spontaneous Bacterial Peritonitis
Veenu Gupta, Rajoo Singh Chhina, Jyoti Chaudhary, Manisha Aggarwal, Priyam Chawla, Deepinder Kaur
Journal of Gastrointestinal Infections.2014; 4(1): 47. CrossRef - Identification of Bacterial Pathogens and their Antibiogram from Ascitic Fluid in a Rural Tertiary Care Hospital of North India
Anuradha Sood, Kamlesh Thakur, Subhash Chand Jaryal, Puneet Kumar Gupta, Smriti Chauhan
Journal of Gastrointestinal Infections.2014; 4(1): 19. CrossRef - Predictive factors that influence the survival rates in liver cirrhosis patients with spontaneous bacterial peritonitis
Pei Chuan Tsung, Soo Hyung Ryu, In Hye Cha, Hee Won Cho, Jin Nam Kim, You Sun Kim, Jeong Seop Moon
Clinical and Molecular Hepatology.2013; 19(2): 131. CrossRef - Role of ascitic fluid C3 in spontaneous bacterial peritonitis
Amany Talaat Kamal, Eman Nagib Osman, Rasha Youssef Shahin
Egyptian Journal of Medical Human Genetics.2012; 13(1): 81. CrossRef - First-line treatment with cephalosporins in spontaneous bacterial peritonitis provides poor antibiotic coverage
Srdan Novovic, Synne Semb, Henrik Olsen, Claus Moser, Jenny Dahl Knudsen, Christian Homann
Scandinavian Journal of Gastroenterology.2012; 47(2): 212. CrossRef - Prevalence of spontaneous bacterial peritonitis in asymptomatic inpatients with decompensated liver cirrhosis – a pilot study
B Kasztelan – Szczerbinska, M Słomka, K Celinski, M Serwacki, M Szczerbinski, H Cichoz- Lach
Advances in Medical Sciences.2011; 56(1): 13. CrossRef - Routine analysis of cirrhotic ascites for evidence of infection – not worth the effort?
Varghese Thomas
Indian Journal of Gastroenterology.2011; 30(5): 201. CrossRef - Immune Dysfunction and Infections in Patients With Cirrhosis
Alexander R. Bonnel, Chalermrat Bunchorntavakul, K. Rajender Reddy
Clinical Gastroenterology and Hepatology.2011; 9(9): 727. CrossRef - Current status of liver diseases in Korea: Liver cirrhosis
Jeong Won Jang
The Korean Journal of Hepatology.2009; 15(Suppl 6): S40. CrossRef - Bacterial epidemiology and antimicrobial resistance in ascitic fluid: A 2-year retrospective study
Lionel Piroth, André Pechinot, Anne Minello, Benoit Jaulhac, Isabelle Patry, Tahar Hadou, Yves Hansmann, Christian Rabaud, Pascal Chavanet, Catherine Neuwirth
Scandinavian Journal of Infectious Diseases.2009; 41(11-12): 847. CrossRef - Identification of bacterial DNA in neutrocytic and non-neutrocytic cirrhotic ascites by means of a multiplex polymerase chain reaction
Tony Bruns, Svea Sachse, Eberhard Straube, Sentayehu Assefa, Andreas Herrmann, Stefan Hagel, Marc Lehmann, Andreas Stallmach
Liver International.2009; 29(8): 1206. CrossRef - Microbiological Characteristics of Spontaneous Bacterial Peritonitis in Korea
Jeong Heo, Soon Ho Um
The Korean Journal of Hepatology.2007; 13(3): 304. CrossRef
