Community-Acquired vs. Nosocomial Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis

Young Eun Chon, Seung Up Kim, Chun Kyon Lee, Jun Yong Park, Do Young Kim, Kwang Hyub Han, Chae Yoon Chon, Sinyoung Kim, Kyu Sik Jung, Sang Hoon Ahn

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background/Aims: Spontaneous bacterial peritonitis (SBP) is a common complication in patients with end-stage liver disease, but reports comparing community-acquired SBP (CA-SBP) with nosocomial SBP (N-SBP) are rare. This study compared the clinical characteristics, microbiological characteristics, and treatment outcomes of patients with CA-SBP and N-SBP. Methodology: Records for 248 patients (173 men, 75 women) with cirrhosis who experienced SBP were retrospectively reviewed. Results: The study population included 202 (81.5%) patients with CA-SBP and 46 (18.5%) patients with N-SBP. Patients with CA-SBP or N-SBP showed no significant differences in baseline or microbiological characteristics, except for a high frequency of previous SBP history in the N-SBP population (P=0.020). During hospitalization, antibiotic switching and in-hospital mortality were significantly higher for patients with N-SBP than CA-SBP (35.6% vs. 8.9%; P=0.001 and 30.4% vs. 12.9%; P=0.028). There were 202 (81.5%) deaths during the follow-up period, with longer overall survival time in patients with CA-SBP (7.9 vs. 3.9 months; P=0.041). However, time to recurrence was not significantly different between the two groups (4.7 vs. 3.6 months; P=0.910). Conclusions: N-SBP was significantly associated with increased antibiotic switching, higher inhospital mortality and shorter overall survival. Third-generation cephalosporin may be inappropriate as first-line empirical antibiotics for patients with N-SBP.

Original languageEnglish
Pages (from-to)2283-2290
Number of pages8
JournalHepato-gastroenterology
Volume61
Issue number136
DOIs
Publication statusPublished - 2014 Nov 1

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Peritonitis
Liver Cirrhosis
Anti-Bacterial Agents
Hospital Mortality
End Stage Liver Disease
Survival
Cephalosporins
Population
Hospitalization
Fibrosis
History
Recurrence

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

@article{a3baf0b5681648108cdb0273357ab91d,
title = "Community-Acquired vs. Nosocomial Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis",
abstract = "Background/Aims: Spontaneous bacterial peritonitis (SBP) is a common complication in patients with end-stage liver disease, but reports comparing community-acquired SBP (CA-SBP) with nosocomial SBP (N-SBP) are rare. This study compared the clinical characteristics, microbiological characteristics, and treatment outcomes of patients with CA-SBP and N-SBP. Methodology: Records for 248 patients (173 men, 75 women) with cirrhosis who experienced SBP were retrospectively reviewed. Results: The study population included 202 (81.5{\%}) patients with CA-SBP and 46 (18.5{\%}) patients with N-SBP. Patients with CA-SBP or N-SBP showed no significant differences in baseline or microbiological characteristics, except for a high frequency of previous SBP history in the N-SBP population (P=0.020). During hospitalization, antibiotic switching and in-hospital mortality were significantly higher for patients with N-SBP than CA-SBP (35.6{\%} vs. 8.9{\%}; P=0.001 and 30.4{\%} vs. 12.9{\%}; P=0.028). There were 202 (81.5{\%}) deaths during the follow-up period, with longer overall survival time in patients with CA-SBP (7.9 vs. 3.9 months; P=0.041). However, time to recurrence was not significantly different between the two groups (4.7 vs. 3.6 months; P=0.910). Conclusions: N-SBP was significantly associated with increased antibiotic switching, higher inhospital mortality and shorter overall survival. Third-generation cephalosporin may be inappropriate as first-line empirical antibiotics for patients with N-SBP.",
author = "Chon, {Young Eun} and Kim, {Seung Up} and Lee, {Chun Kyon} and Park, {Jun Yong} and Kim, {Do Young} and Han, {Kwang Hyub} and Chon, {Chae Yoon} and Sinyoung Kim and Jung, {Kyu Sik} and Ahn, {Sang Hoon}",
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Community-Acquired vs. Nosocomial Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis. / Chon, Young Eun; Kim, Seung Up; Lee, Chun Kyon; Park, Jun Yong; Kim, Do Young; Han, Kwang Hyub; Chon, Chae Yoon; Kim, Sinyoung; Jung, Kyu Sik; Ahn, Sang Hoon.

In: Hepato-gastroenterology, Vol. 61, No. 136, 01.11.2014, p. 2283-2290.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Community-Acquired vs. Nosocomial Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis

AU - Chon, Young Eun

AU - Kim, Seung Up

AU - Lee, Chun Kyon

AU - Park, Jun Yong

AU - Kim, Do Young

AU - Han, Kwang Hyub

AU - Chon, Chae Yoon

AU - Kim, Sinyoung

AU - Jung, Kyu Sik

AU - Ahn, Sang Hoon

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Background/Aims: Spontaneous bacterial peritonitis (SBP) is a common complication in patients with end-stage liver disease, but reports comparing community-acquired SBP (CA-SBP) with nosocomial SBP (N-SBP) are rare. This study compared the clinical characteristics, microbiological characteristics, and treatment outcomes of patients with CA-SBP and N-SBP. Methodology: Records for 248 patients (173 men, 75 women) with cirrhosis who experienced SBP were retrospectively reviewed. Results: The study population included 202 (81.5%) patients with CA-SBP and 46 (18.5%) patients with N-SBP. Patients with CA-SBP or N-SBP showed no significant differences in baseline or microbiological characteristics, except for a high frequency of previous SBP history in the N-SBP population (P=0.020). During hospitalization, antibiotic switching and in-hospital mortality were significantly higher for patients with N-SBP than CA-SBP (35.6% vs. 8.9%; P=0.001 and 30.4% vs. 12.9%; P=0.028). There were 202 (81.5%) deaths during the follow-up period, with longer overall survival time in patients with CA-SBP (7.9 vs. 3.9 months; P=0.041). However, time to recurrence was not significantly different between the two groups (4.7 vs. 3.6 months; P=0.910). Conclusions: N-SBP was significantly associated with increased antibiotic switching, higher inhospital mortality and shorter overall survival. Third-generation cephalosporin may be inappropriate as first-line empirical antibiotics for patients with N-SBP.

AB - Background/Aims: Spontaneous bacterial peritonitis (SBP) is a common complication in patients with end-stage liver disease, but reports comparing community-acquired SBP (CA-SBP) with nosocomial SBP (N-SBP) are rare. This study compared the clinical characteristics, microbiological characteristics, and treatment outcomes of patients with CA-SBP and N-SBP. Methodology: Records for 248 patients (173 men, 75 women) with cirrhosis who experienced SBP were retrospectively reviewed. Results: The study population included 202 (81.5%) patients with CA-SBP and 46 (18.5%) patients with N-SBP. Patients with CA-SBP or N-SBP showed no significant differences in baseline or microbiological characteristics, except for a high frequency of previous SBP history in the N-SBP population (P=0.020). During hospitalization, antibiotic switching and in-hospital mortality were significantly higher for patients with N-SBP than CA-SBP (35.6% vs. 8.9%; P=0.001 and 30.4% vs. 12.9%; P=0.028). There were 202 (81.5%) deaths during the follow-up period, with longer overall survival time in patients with CA-SBP (7.9 vs. 3.9 months; P=0.041). However, time to recurrence was not significantly different between the two groups (4.7 vs. 3.6 months; P=0.910). Conclusions: N-SBP was significantly associated with increased antibiotic switching, higher inhospital mortality and shorter overall survival. Third-generation cephalosporin may be inappropriate as first-line empirical antibiotics for patients with N-SBP.

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