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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2016 ; 95
(17
): e3489
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Predictive Factors of Spontaneous Bacterial Peritonitis Caused by Gram-Positive
Bacteria in Patients With Cirrhosis
#MMPMID27124049
Kim JH
; Jeon YD
; Jung IY
; Ahn MY
; Ahn HW
; Ahn JY
; Ku NS
; Han SH
; Choi JY
; Ahn SH
; Song YG
; Han KH
; Kim JM
Medicine (Baltimore)
2016[Apr]; 95
(17
): e3489
PMID27124049
show ga
Spontaneous bacterial peritonitis (SBP) in patients with cirrhosis is typically
caused by gram-negative bacteria. However, the number of SBP cases due to
gram-positive bacteria is steadily increasing. To date, little is known about the
predictive factors involved in SBP infections.We performed a retrospective cohort
study of patients (>18 years) with SBP due to gram-positive and -negative
bacteria who were enrolled from January 2006 to December 2013 at Severance
Hospital in Seoul, Korea where the incidences of hepatitis B virus associated
chronic liver disease, cirrhosis, and hepatocellular carcinoma are high. Only the
1st SBP episode for each patient within the study period was included in our
analysis.We identified 77 patients with cirrhosis and SBP. Of these, 27 patients
(35%) had gram-positive bacterial infections and 50 patients (65%) had
gram-negative bacterial infections. Our univariate analysis revealed that an
early stage of cirrhosis (P?=?0.004), lower creatinine level (P?=?0.011), lower
Sequential Organ Failure Assessment (SOFA) score (P?=?0.001), lower Model for
End-Stage Liver Disease score (P?=?0.005), and use of systemic antibiotics within
30 days before SBP diagnosis (P?=?0.03) were significantly associated with
gram-positive bacterial infections. Our multivariate analysis indicated that the
use of systemic antibiotics within 30 days before SBP diagnosis (odds ratio,
3.94; 95% CI, 1.11-13.96; P?=?0.033) and a lower SOFA score (odds ratio, 0.56;
95% CI, 0.37-0.86; P?=?0.007) were independent predictive factors of SBP caused
by gram-positive bacterial infections in patients with cirrhosis. However, we did
not observe a statistically significant difference in the 28-day mortality
between the gram-positive and -negative bacterial infection groups (40.7% vs
46.0%, respectively; P?=?0.407).In this study, the incidence rate of SBP caused
by gram-positive bacteria in patients with cirrhosis was similar to the rates
reported in recently published studies. Furthermore, the use of systemic
antibiotics within 30 days before SBP diagnosis and a lower SOFA score were
significantly associated with SBP caused by gram-positive bacteria in patients
with cirrhosis.