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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.

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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) 975981
30 July 2013

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