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Nosocomial and Community-Acquired Spontaneous Bacterial Peritonitis in patients with liver cirrhosis in China: Comparative Microbiology and Therapeutic Implications.

Nosocomial and Community-Acquired Spontaneous Bacterial Peritonitis in patients with liver cirrhosis in China: Comparative Microbiology and Therapeutic Implications.
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Shi L, Wu D, Wei L, Liu S, Zhao P, Tu B, Xie Y, Liu Y, Wang X, Liu L, Zhang X, Xu Z, Wang F, Qin E,


Shi L, Wu D, Wei L, Liu S, Zhao P, Tu B, Xie Y, Liu Y, Wang X, Liu L, Zhang X, Xu Z, Wang F, Qin E, (click to view)

Shi L, Wu D, Wei L, Liu S, Zhao P, Tu B, Xie Y, Liu Y, Wang X, Liu L, Zhang X, Xu Z, Wang F, Qin E,

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Scientific reports 2017 04 067() 46025 doi 10.1038/srep46025
Abstract

Spontaneous bacterial peritonitis (SBP) is a common complication of liver cirrhosis. This study was performed to compare the microbiological characteristics of nosocomial and community-acquired episodes of bacterial peritonitis in China. Five hundred and seventy-five strains were isolated from the ascitic fluid of cirrhotic patients from the Beijing 302 Hospital from January 2014 to December 2014. The patients in the community-acquired SBP (n = 311) and the nosocomial SBP (n = 264) groups exhibited significant differences in clinical symptoms (P < 0.01). In both groups, most of the bacteria were Escherichia coli, Klebsiella pneumoniae, coagulase-negative staphylococcus and Enterococcus. There were more frequent gram-positive cocci (G(+) C) in the nosocomial group (n = 170). Compared with the community-acquired group, the proportion of Enterococcus was significantly increased in the nosocomial group (9.0% vs. 16.6%, P < 0.05). The resistance rate of the main pathogenic bacteria to the recommended first-line drug in the guideline was very high. Community-acquired and nosocomial SBP groups exhibited differences in clinical symptoms and antibiotic susceptibility tests. Optimal treatments should be provided for these patients. We recommend that cefoperazone/sulbactam or piperacillin/tazobactam should be used for the empirical treatment of SBP.

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