Clinical and bacteriological features and prognosis of ascitic fluid infection in Chinese patients with cirrhosis

BMC Infectious Diseases

Fen Qu¹  Shu-yong Zhang¹  Wei Geng¹  Ju-ling Zhang¹  Chun-mei Bao¹  Wang Huan¹  Jun-liang Fu²  Hui Wang³  Xiong Liu³  Nian-zhi Ning³  Jie Huang³  Zhan Li³  Tao Li³ 

[1] Clinical Diagnostic Center;Research Center for Biological Therapy, Institute of Translational Hepatology;The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology;

关键词: Cirrhosis;    Spontaneous bacterial peritonitis;    Bacterascites;    Causative pathogens;    Mortality;    Risk factor;   

DOI  :  10.1186/s12879-018-3101-1

来源: DOAJ

【 摘 要 】

Abstract Background Spontaneous bacterial peritonitis (SBP) and bacterascites (BA) represent frequent and serious complications in cirrhosis patients with ascites. However, few detailed data are available regarding the clinical and bacteriological feature of SBP or BA patients in China. Methods We retrospectively analyzed bacteriological and clinical characteristics of patients with SBP and BA at Beijing 302 Hospital in China from January 2012 to December 2015. Results A total of 600 patients with SBP (n = 408) or BA (n = 192) were enrolled. Patients with BA appeared to have a less severe clinical manifestation and lower mortality rate than patients with SBP. Gram-negative bacteria formed the majority of pathogens in SBP (73.9%) and BA (55.8%) cases. Higher ascitic fluid polymorphonuclear leucocytes (PMN) count and hepatocellular carcinoma were independent risk factors for BA episode progressing to SBP. The concentration of blood urea nitrogen (BUN) was independent risk factor for 30-day mortality of BA patients. For patients with SBP, the independent risk factors for 30-day mortality were age, Model for End-Stage Liver Disease (MELD) score, septic shock and hepatocellular carcinoma. Patients with third-generation cephalosporin or carbapenems resistant infection had a significantly lower survival probability. There were significant differences in clinical characteristics and outcome among the major bacteria. Multivariate analysis showed that patients infected with Klebsiella spp. had higher hazard ratio of 30-day mortality. Conclusion Our study reported the bacteriological and clinical characteristics of patients with SBP and BA. Higher ascitic fluid PMN count and hepatocellular carcinoma were found to be independent risk factors for BA episode progressed to SBP. Outcome of ascitic fluid infection in patients with cirrhosis was influenced by the type of bacteria and antimicrobial susceptibility.

【 授权许可】

Unknown