Spontaneous bacterial peritonitis in patients with hepatitis B virus-related liver cirrhosis: community-acquired versus nosocomial.

Abstract

PURPOSE:

Spontaneous bacterial peritonitis (SBP) frequently develops in patients with liver cirrhosis; however, there is little data to suggest whether the acquisition site of infection influences the prognosis. This study compared the bacteriology, clinical characteristics and treatment outcomes of community-acquired SBP (CA-SBP) and nosocomial SBP (N-SBP).

MATERIALS AND METHODS:

The medical records of 130 patients with hepatitis B virus (HBV)-related liver cirrhosis, who had experienced a first episode of SBP between January 1999 and December 2008, were reviewed.

RESULTS:

The study population included 111 (85.4%) patients with CA-SBP and 19 (14.6%) patients with N-SBP. Baseline and microbiological characteristics as well as clinical course, including in-hospital mortality, did not differ between patients with CA-SBP and those with N-SBP (all p>0.05). The median survival time was 6.5 months, and 117 (90.0%) patients died during the follow-up period. Patients with CA-SBP and N-SBP survived for median periods of 6.6 and 6.2 months, respectively, without significant difference (p=0.569). Time to recurrence did not differ between patients with CA-SBP and N-SBP (4.7 vs. 3.6 months, p=0.925).

CONCLUSION:

The acquisition site of infection did not affect clinical outcomes for patients with HBV-related liver cirrhosis who had experienced their first episode of SBP. Third-generation cephalosporins may be effective in empirically treating these patients, regardless of the acquisition site of the infection.

• Authors: Seung Up Kim, Young Eun Chon, Chun Kyon Lee, Jun Yong Park, Do Young Kim, Kwang-Hyub Han, Chae Yoon Chon, Sinyoung Kim, Kyu Sik Jung, Sang Hoon Ahn
• Journal: Yonsei medical journal (Yonsei Med J) Vol. 53 Issue 2 Pg. 328-36 (Mar 2012) ISSN: 1976-2437 [Electronic] Korea (South)
• PMID: 22318820 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Community-Acquired Infections (etiology, microbiology, mortality, virology)
• Female
• Hepatitis B virus (pathogenicity)
• Humans
• Liver Cirrhosis (complications, mortality, virology)
• Male
• Middle Aged
• Peritonitis (etiology, microbiology, mortality, virology)
• Retrospective Studies