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News

Multidrug-resistant bacteria in spontaneous bacterial peritonitis

A study in the latest issue of Liver International reports an increasing frequency of gram-positive cocci and gram-negative multidrug-resistant bacteria in spontaneous bacterial peritonitis.

News image

Dr Alexandra Alexopulou and colleagues from Greece assessed possible recent changes of the bacteria causing spontaneous bacterial peritonitis in cirrhotic patients.

The team retrospectively recorded 47 cases during a 4-year-period.

The research team reported that 28 patients had healthcare-associated infections while 15 received prophylactic quinolone treatment.

Gram-positive cocci were found to be the most frequent cause.

The researchers evaluated the most prevalent organisms in a descending order were Streptococcus spp, Enterococcus spp, Escherichia coli, Klebsiella pneumonia methicillin-sensitive Staphylococcus aureus and coagulase-negative Staphylococcus spp.

third-generation cephalosporin resistance was observed in 49%
Liver International

The team found that 9 of the isolated bacteria were multidrug-resistant, including carbapenemase-producing K. pneumonia, followed by extended-spectrum beta-lactamase-producing E. coli and Pseudomonas aeruginosa.

Multidrug-resistant bacteria were more frequently isolated in healthcare-associated than in community-acquired infections, in patients receiving long-term quinolone prophylaxis and in those with advanced liver disease as suggested by higher MELD score.

More infections with gram-negative bacteria than gram-positive cocci were healthcare-associated third-generation cephalosporin resistance was observed in 49%, and quinolone resistance in 47%.

Dr Alexopulou's team comments, "Gram-positive cocci were the most frequent bacteria in culture-positive Spontaneous bacterial peritonitis and a variety of drug-resistant microorganisms have emerged."

"As a result of high rates of resistance in currently recommended therapy and prophylaxis, the choice of optimal antibiotic therapy is vital in the individual patient."

Liver International 2013: 33(7) 975–981
30 July 2013

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