Open Access

Emerging Gram‑positive bacteria and drug resistance in cirrhosis patients with spontaneous bacterial peritonitis: A retrospective study

  • Authors:
    • Jingjing Guo
    • Jingren Shi
    • Huizhu Wang
    • Hui Chen
    • Shunai Liu
    • Junnan Li
    • Yajie Wang
  • View Affiliations

  • Published online on: April 18, 2019     https://doi.org/10.3892/etm.2019.7502
  • Pages: 4568-4576
  • Copyright: © Guo et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Spontaneous bacterial peritonitis (SBP) is one of the most severe complications in liver cirrhosis (LC) patients with ascites. The aim of the present study was to retrospectively analyze the bacterial spectrum and drug resistance in ascites culture of patients with SBP. A total of 3, 189 patients with ascites were enrolled in the present study, including 912 LC patients, of which 247 had SBP. It was revealed that in the 3, 189 patients, the ratio of SBP exhibited annual increases, especially in 2015, and this trend remained when cases were divided into two groups: Group A (admission, 2011‑2013) and Group B (admission, 2014‑2016). The 247 SBP patients were then stratified into two groups: Group 1 (admission, 2011‑2013) and Group 2 (admission, 2014‑2016). The rate of infection with gram‑positive bacteria (GPB) was markedly higher in Group 2 compared with Group 1. Over time, GPB and gram‑negative bacteria (GNB) were increased, while the increase of GPB was greater than that of GNB. Direct bilirubin and C‑reactive protein levels, and the positive rate of ascites culture in Group 2 were greater than in Group 1. Furthermore, marked differences in serological and ascitic indexes or pathogeny, as well as complications between the patients with GPB and GNB infection were observed. The results regarding drug sensitivity revealed that the resistance rate of GPB and GNB to penicillin (ampicillin) was 100%, while the resistance rate to amikacin, imipenem, meropenem and piperacillin/tazobactam was 0% for GNB, and similarly, the resistance rate to vancomycin, teicoplanin, amikacin and linezolid was 0% for GPB. The results suggested that combined use of ampicillin/sulbactam or piperacillin/tazobactam should be selected forempirical therapy. In cases of nosocomial infection, these drugs should be combined with vancomycin, linezolid or teicoplanin when required.

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June 2019
Volume 17 Issue 6

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Copy and paste a formatted citation
APA
Guo, J., Shi, J., Wang, H., Chen, H., Liu, S., Li, J., & Wang, Y. (2019). Emerging Gram‑positive bacteria and drug resistance in cirrhosis patients with spontaneous bacterial peritonitis: A retrospective study. Experimental and Therapeutic Medicine, 17, 4568-4576. https://doi.org/10.3892/etm.2019.7502
MLA
Guo, J., Shi, J., Wang, H., Chen, H., Liu, S., Li, J., Wang, Y."Emerging Gram‑positive bacteria and drug resistance in cirrhosis patients with spontaneous bacterial peritonitis: A retrospective study". Experimental and Therapeutic Medicine 17.6 (2019): 4568-4576.
Chicago
Guo, J., Shi, J., Wang, H., Chen, H., Liu, S., Li, J., Wang, Y."Emerging Gram‑positive bacteria and drug resistance in cirrhosis patients with spontaneous bacterial peritonitis: A retrospective study". Experimental and Therapeutic Medicine 17, no. 6 (2019): 4568-4576. https://doi.org/10.3892/etm.2019.7502