摘要
AIM:Toevaluatetheepidemiologyandoutcomesofculture-positivespontaneousbacterialperitonitis(SBP)andspontaneousbacteremia(SB)indecompensatedcirrhosis.METHODS:Weprospectivelycollectedclinical,laboratorycharacteristics,typeofadministeredantibiotic,susceptibilityandresistanceofbacteriatoantibioticsinonehundredthirtycases(68.5%males)withpositiveasciticfluidand/orbloodculturesduringtheperiodfromJanuary1,2012toMay30,2014.AllpatientswithSBPhadpolymorphonuclearcellcountinasciticfluid>250/mm3.InpatientswithSBathoroughstudydidnotrevealanyothercauseofbacteremia.Thepatientswerefollowed-upfora30-dperiodfollowingdiagnosisoftheinfection.Thefinaloutcomeofthepatientswasrecordedintheendoffollow-upandcomparisonamong3groupsofpatientsaccordingtothepatternofdrugresistancewasperformed.RESULTS:Gram-positive-cocci(GPC)werefoundinhalfofthecases.ThemostprevalentorganismsinadescendingorderwereEscherichiacoli(33),Enterococcusspp(30),Streptococcusspp(25),Klebsiellapneumonia(16),S.aureus(8),Pseudomanasaeruginosa(5),otherGram-negative-bacteria(GNB)(11)andanaerobes(2).Overall,20.8%ofisolatesweremultidrug-resistant(MDR)and10%extensivelydrugresistant(XDR).Health-care-associated(HCA)and/ornosocomialinfectionswerepresentin100%ofMDR/XDRandin65.5%ofnon-DRcases.MeropenemwastheempiricallyprescribedantibioticinHCA/nosocomialinfectionsshowingadrug-resistancerateof30.7%whilethirdgenerationcephalosporinsof43.8%.MeropenemwasineffectiveonbothXDRbacteriaandEnterococcusfaecium(E.faecium).AllbutoneXDRweresusceptibletocolistinwhileallGPC(includingE.faecium)andthe86%ofGNBtotigecycline.Overall30-dmortalitywas37.7%(69.2%forXDRand34.2%fortherestofthepatients)(logrank,P=0.015).Inmultivariateanalysis,factorsadverselyaffectingoutcomeincludedXDRinfection(HR=2.263,95%CI:1.005-5.095,P=0.049),creatinine(HR
出版日期
2016年12月22日（中国期刊网平台首次上网日期，不代表论文的发表时间）
