Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy
Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patte...
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Gespeichert in:
| Autor*in: |
Bhat, Ganesh [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2013 |
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| Schlagwörter: |
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| Anmerkung: |
© Indian Society of Gastroenterology 2013 |
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| Übergeordnetes Werk: |
Enthalten in: Indian Journal of Gastroenterology - Springer-Verlag, 2009, 32(2013), 5 vom: 21. März, Seite 297-301 |
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| Übergeordnetes Werk: |
volume:32 ; year:2013 ; number:5 ; day:21 ; month:03 ; pages:297-301 |
| Links: |
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| DOI / URN: |
10.1007/s12664-013-0329-y |
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SPR026656108 |
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| 520 | |a Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. | ||
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10.1007/s12664-013-0329-y doi (DE-627)SPR026656108 (SPR)s12664-013-0329-y-e DE-627 ger DE-627 rakwb eng Bhat, Ganesh verfasserin aut Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2013 Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. Antibiotic sensitivity (dpeaa)DE-He213 Ascitic fluid culture (dpeaa)DE-He213 Peritoneal infections (dpeaa)DE-He213 Vandana, K. E. aut Bhatia, Sumit aut Suvarna, Deepak aut Pai, Cannanore Ganesh aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 32(2013), 5 vom: 21. März, Seite 297-301 (DE-627)SPR02665167X nnns volume:32 year:2013 number:5 day:21 month:03 pages:297-301 https://dx.doi.org/10.1007/s12664-013-0329-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 32 2013 5 21 03 297-301 |
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10.1007/s12664-013-0329-y doi (DE-627)SPR026656108 (SPR)s12664-013-0329-y-e DE-627 ger DE-627 rakwb eng Bhat, Ganesh verfasserin aut Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2013 Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. Antibiotic sensitivity (dpeaa)DE-He213 Ascitic fluid culture (dpeaa)DE-He213 Peritoneal infections (dpeaa)DE-He213 Vandana, K. E. aut Bhatia, Sumit aut Suvarna, Deepak aut Pai, Cannanore Ganesh aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 32(2013), 5 vom: 21. März, Seite 297-301 (DE-627)SPR02665167X nnns volume:32 year:2013 number:5 day:21 month:03 pages:297-301 https://dx.doi.org/10.1007/s12664-013-0329-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 32 2013 5 21 03 297-301 |
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10.1007/s12664-013-0329-y doi (DE-627)SPR026656108 (SPR)s12664-013-0329-y-e DE-627 ger DE-627 rakwb eng Bhat, Ganesh verfasserin aut Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2013 Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. Antibiotic sensitivity (dpeaa)DE-He213 Ascitic fluid culture (dpeaa)DE-He213 Peritoneal infections (dpeaa)DE-He213 Vandana, K. E. aut Bhatia, Sumit aut Suvarna, Deepak aut Pai, Cannanore Ganesh aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 32(2013), 5 vom: 21. März, Seite 297-301 (DE-627)SPR02665167X nnns volume:32 year:2013 number:5 day:21 month:03 pages:297-301 https://dx.doi.org/10.1007/s12664-013-0329-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 32 2013 5 21 03 297-301 |
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10.1007/s12664-013-0329-y doi (DE-627)SPR026656108 (SPR)s12664-013-0329-y-e DE-627 ger DE-627 rakwb eng Bhat, Ganesh verfasserin aut Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2013 Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. Antibiotic sensitivity (dpeaa)DE-He213 Ascitic fluid culture (dpeaa)DE-He213 Peritoneal infections (dpeaa)DE-He213 Vandana, K. E. aut Bhatia, Sumit aut Suvarna, Deepak aut Pai, Cannanore Ganesh aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 32(2013), 5 vom: 21. März, Seite 297-301 (DE-627)SPR02665167X nnns volume:32 year:2013 number:5 day:21 month:03 pages:297-301 https://dx.doi.org/10.1007/s12664-013-0329-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 32 2013 5 21 03 297-301 |
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10.1007/s12664-013-0329-y doi (DE-627)SPR026656108 (SPR)s12664-013-0329-y-e DE-627 ger DE-627 rakwb eng Bhat, Ganesh verfasserin aut Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2013 Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. Antibiotic sensitivity (dpeaa)DE-He213 Ascitic fluid culture (dpeaa)DE-He213 Peritoneal infections (dpeaa)DE-He213 Vandana, K. E. aut Bhatia, Sumit aut Suvarna, Deepak aut Pai, Cannanore Ganesh aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 32(2013), 5 vom: 21. März, Seite 297-301 (DE-627)SPR02665167X nnns volume:32 year:2013 number:5 day:21 month:03 pages:297-301 https://dx.doi.org/10.1007/s12664-013-0329-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 32 2013 5 21 03 297-301 |
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Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy |
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Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy |
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Bhat, Ganesh |
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2013 |
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Bhat, Ganesh Vandana, K. E. Bhatia, Sumit Suvarna, Deepak Pai, Cannanore Ganesh |
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10.1007/s12664-013-0329-y |
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spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy |
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Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy |
| abstract |
Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. © Indian Society of Gastroenterology 2013 |
| abstractGer |
Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. © Indian Society of Gastroenterology 2013 |
| abstract_unstemmed |
Background Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients leading to significant morbidity and mortality. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a prospective study to determine bacterial etiology, susceptibility patterns, and clinical epidemiology including 1-month mortality of SAIs among patients with cirrhosis. Methods Records of 600 patients with suspected SAI over a 4-year period were analyzed. Empirical cefotaxime/ceftriaxone was initiated in patients who had a neutrophil count >250/$ mm^{3} $. Treatment failure was defined by absence of clinical improvement and/or significant decrease in neutrophil count of ascites (<25 % of base line value) by 72 h of therapy. Results Seventy patients (11.6 %) had SAI, including 40 (57.1 %) culture-negative neutrocytic ascites (CNNA), 25 (35.8 %) spontaneous bacterial peritonitis (SBP), and five (7 %) monomicrobial non-neutrocytic bacterascites (MNB). Gram-negative bacilli (Klebsiella and E. coli) were the commonest organisms. The overall response rate to ceftriaxone was 62.8 % (44/70). Among culture-positive patients (SBP and MNB), sensitivity rates to ceftriaxone was 50 %, while it was 53.3 % for quinolones, 70 % for piperacillin–tazobactam, and 93.3 % for cefoperazone–sulbactam combination. Thirty-day mortality was lower for CNNA compared to SBP (20 % vs. 40 %, p < 0.001) and for patients with response compared to no response to first antibiotic (11.3 % vs. 53.8 %, p < 0.001). Conclusion The response of SAI to third-generation cephalosporins was low at our center. Cefoperazone–sulbactam could be a better alternative choice. © Indian Society of Gastroenterology 2013 |
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Spontaneous ascitic fluid infection in liver cirrhosis: bacteriological profile and response to antibiotic therapy |
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Vandana, K. E. Bhatia, Sumit Suvarna, Deepak Pai, Cannanore Ganesh |
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