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

• Published in: Gut and liver Vol. 3; no. 3; pp. 197 - 204
• Main Authors: Heo, Jeong, Seo, Yeon Seok, Yim, Hyung Joon, Hahn, Taeho, Park, Sang Hoon, Ahn, Sang Hoon, Park, Jun Yong, Park, Ji Young, Kim, Moon Young, Park, Sung Keun, Cho, Mong, Um, Soon Ho, Han, Kwang Hyub, Kim, Hong Soo, Baik, Soon Koo, Kim, Byung Ik, Cho, Se Hyun
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Society of Pancreatobiliary Diseases 01.09.2009; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: liver cirrhosis; Original; peritonitis; prognosis; resistance; 내과학; Resistance; Prognosis; Liver cirrhosis; Peritonitis
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl.2009.3.3.197

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. 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. 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 beta-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality. SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.