Clinical features and prognosis of spontaneous bacterial peritonitis in Korean patients with liver cirrhosis: A multicenter retrospective study

Jeong Heo, Seok Seo Yeon, Joon Yim Hyung, Taeho Hahn, Hoon Park Sang, Hoon Ahn Sang, Yong Park Jun, Young Park Ji, Young Kim Moon, Keun Park Sung, Mong Cho, Ho Um Soon, Hyub Han Kwang, Soo Kim Hong, Koo Baik Soon, Ik Kim Byung, Hyun Cho Se

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background/Aims: Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea. Methods: This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of > 250 cells/mm 3 in the absence of data compatible with secondary peritonitis. Results: The mean age of the cohort was 56 years, and 121 (77%) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42%): Gram-negative bacteria in 54 (81.8%), Gram-positive in 11 (16.7%), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17%), to ciprofloxacin in 11 (20.8%), and to penicillin in 33 (62.3%). The treatment failure and in-hospital mortality rates were 12.1% and 21%, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum β-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality. Conclusions: SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.

Original languageEnglish
Pages (from-to)197-204
Number of pages8
JournalGut and liver
Volume3
Issue number3
DOIs
Publication statusPublished - 2009 Sep 1

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Peritonitis
Liver Cirrhosis
Multicenter Studies
Retrospective Studies
Hospital Mortality
End Stage Liver Disease
Ascitic Fluid
Cephalosporins
Korea
Ciprofloxacin
Gram-Negative Bacteria
Treatment Failure
Candida
Penicillins
Hepatocellular Carcinoma
Fibrosis
Cell Count
Anti-Bacterial Agents
Mortality

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Heo, Jeong ; Yeon, Seok Seo ; Hyung, Joon Yim ; Hahn, Taeho ; Sang, Hoon Park ; Sang, Hoon Ahn ; Jun, Yong Park ; Ji, Young Park ; Moon, Young Kim ; Sung, Keun Park ; Cho, Mong ; Soon, Ho Um ; Kwang, Hyub Han ; Hong, Soo Kim ; Soon, Koo Baik ; Byung, Ik Kim ; Se, Hyun Cho. / Clinical features and prognosis of spontaneous bacterial peritonitis in Korean patients with liver cirrhosis : A multicenter retrospective study. In: Gut and liver. 2009 ; Vol. 3, No. 3. pp. 197-204.
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title = "Clinical features and prognosis of spontaneous bacterial peritonitis in Korean patients with liver cirrhosis: A multicenter retrospective study",
abstract = "Background/Aims: Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea. Methods: This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of > 250 cells/mm 3 in the absence of data compatible with secondary peritonitis. Results: The mean age of the cohort was 56 years, and 121 (77{\%}) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42{\%}): Gram-negative bacteria in 54 (81.8{\%}), Gram-positive in 11 (16.7{\%}), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17{\%}), to ciprofloxacin in 11 (20.8{\%}), and to penicillin in 33 (62.3{\%}). The treatment failure and in-hospital mortality rates were 12.1{\%} and 21{\%}, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum β-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality. Conclusions: SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.",
author = "Jeong Heo and Yeon, {Seok Seo} and Hyung, {Joon Yim} and Taeho Hahn and Sang, {Hoon Park} and Sang, {Hoon Ahn} and Jun, {Yong Park} and Ji, {Young Park} and Moon, {Young Kim} and Sung, {Keun Park} and Mong Cho and Soon, {Ho Um} and Kwang, {Hyub Han} and Hong, {Soo Kim} and Soon, {Koo Baik} and Byung, {Ik Kim} and Se, {Hyun Cho}",
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Clinical features and prognosis of spontaneous bacterial peritonitis in Korean patients with liver cirrhosis : A multicenter retrospective study. / Heo, Jeong; Yeon, Seok Seo; Hyung, Joon Yim; Hahn, Taeho; Sang, Hoon Park; Sang, Hoon Ahn; Jun, Yong Park; Ji, Young Park; Moon, Young Kim; Sung, Keun Park; Cho, Mong; Soon, Ho Um; Kwang, Hyub Han; Hong, Soo Kim; Soon, Koo Baik; Byung, Ik Kim; Se, Hyun Cho.

In: Gut and liver, Vol. 3, No. 3, 01.09.2009, p. 197-204.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical features and prognosis of spontaneous bacterial peritonitis in Korean patients with liver cirrhosis

T2 - A multicenter retrospective study

AU - Heo, Jeong

AU - Yeon, Seok Seo

AU - Hyung, Joon Yim

AU - Hahn, Taeho

AU - Sang, Hoon Park

AU - Sang, Hoon Ahn

AU - Jun, Yong Park

AU - Ji, Young Park

AU - Moon, Young Kim

AU - Sung, Keun Park

AU - Cho, Mong

AU - Soon, Ho Um

AU - Kwang, Hyub Han

AU - Hong, Soo Kim

AU - Soon, Koo Baik

AU - Byung, Ik Kim

AU - Se, Hyun Cho

PY - 2009/9/1

Y1 - 2009/9/1

N2 - Background/Aims: Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea. Methods: This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of > 250 cells/mm 3 in the absence of data compatible with secondary peritonitis. Results: The mean age of the cohort was 56 years, and 121 (77%) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42%): Gram-negative bacteria in 54 (81.8%), Gram-positive in 11 (16.7%), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17%), to ciprofloxacin in 11 (20.8%), and to penicillin in 33 (62.3%). The treatment failure and in-hospital mortality rates were 12.1% and 21%, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum β-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality. Conclusions: SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.

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