P-14 SPONTANEOUS BACTERIAL PERITONITIS IN CIRRHOTIC PATIENTS: PREVALENCE AND ANTIBIOTIC RESISTANCE PATTERNS

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PATTERNS" "tieneTextoCompleto" => 0 "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Bruno Campos, Eliabe Silva, Guilherme Grossi Lopes, Guilherme De Oliveira, Joao Pedro Rocha, Júlia Cunha, Laura Normando, Laura Melo, Laura Carolina Menezes, Luciana Costa, Cláudia Alves" "autores" => array:11 [ 0 => array:3 [ "nombre" => "Bruno" "apellidos" => "Campos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 1 => array:3 [ "nombre" => "Eliabe" "apellidos" => "Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "2" "identificador" => "aff0002" ] ] ] 2 => array:3 [ "nombre" => "Guilherme Grossi" "apellidos" => "Lopes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "2" "identificador" => "aff0002" ] ] ] 3 => array:3 [ "nombre" => "Guilherme" "apellidos" => "De Oliveira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 4 => array:3 [ "nombre" => "Joao Pedro" "apellidos" => "Rocha" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 5 => array:3 [ "nombre" => "Júlia" "apellidos" => "Cunha" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 6 => array:3 [ "nombre" => "Laura" "apellidos" => "Normando" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 7 => array:3 [ "nombre" => "Laura" "apellidos" => "Melo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 8 => array:3 [ "nombre" => "Laura Carolina" "apellidos" => "Menezes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 9 => array:3 [ "nombre" => "Luciana" "apellidos" => "Costa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 10 => array:3 [ "nombre" => "Cláudia" "apellidos" => "Alves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brasil" "etiqueta" => "1" "identificador" => "aff0001" ] 1 => array:3 [ "entidad" => "Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brasil" "etiqueta" => "2" "identificador" => "aff0002" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "Introduction and ObjectivesSpontaneous bacterial peritonitis (SBP) is a leading cause of mortality in cirrhotic patients, and antibiotic resistance poses a significant challenge. This study aimed to assess the prevalence of SBP and the microbial patterns found in peritoneal fluid among hospitalized patients with cirrhosis. Materials and MethodsAll patients with decompensated cirrhosis, aged 18 years or older, who underwent propaedeutic paracentesis between 01/01/2017 and 13/09/2021 at a Brazilian university hospital, were included in the study. ResultsA total of 366 individuals were enrolled [(65.6% male; median age 61 (53-68) years]. The primary causes of cirrhosis were ethanolic (43.7%) and viral hepatitis (24.8%). SBP was diagnosed in 118 patients (18.6%). Only 16.1% of all patients received antibiotic prophylaxis, with norfloxacin being the preferred choice for 78% of them. Among the 34 peritoneal fluid samples with bacterial growth, 58 microorganisms were isolated. These included 50% classified as multi-sensitive (MS), 40% as multidrug-resistant (MDR), and 10% as extensively drug-resistant (XDR) bacteria. Gram-negative bacteria accounted for 62% of the isolates, while gram-positive bacteria made up 38%. The most frequently identified microorganisms were Escherichia coli for gram-negatives and the Staphylococcus ssp. for gram-positives. Meropenem demonstrated the highest overall sensitivity (79%), followed by piperacillin/tazobactam (67%). Conversely, ceftriaxone (48%) and ciprofloxacin (41%) exhibited the highest rates of resistance. Antibiotic prophylaxis did not influence resistance rates and no XDR bacteria were isolated from patients exposed to norfloxacin. ConclusionsOur findings indicate that half of the SBP patients present with MDR or XDR bacteria. Empirical therapies such as meropenem and piperacillin/tazobactam show the greatest effectiveness. Additionally, antibiotic prophylaxis was not associated with an increase in antimicrobial resistance." 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Bruno Campos1, Eliabe Silva2, Guilherme Grossi Lopes2, Guilherme De Oliveira1, Joao Pedro Rocha1, Júlia Cunha1, Laura Normando1, Laura Melo1, Laura Carolina Menezes1, Luciana Costa1, Cláudia Alves1

1 Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brasil

2 Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brasil

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        "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Spontaneous bacterial peritonitis &#40;SBP&#41; is a leading cause of mortality in cirrhotic patients&#44; and antibiotic resistance poses a significant challenge&#46; This study aimed to assess the prevalence of SBP and the microbial patterns found in peritoneal fluid among hospitalized patients with cirrhosis&#46;</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Methods</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">All patients with decompensated cirrhosis&#44; aged 18 years or older&#44; who underwent propaedeutic paracentesis between 01&#47;01&#47;2017 and 13&#47;09&#47;2021 at a Brazilian university hospital&#44; were included in the study&#46;</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">A total of 366 individuals were enrolled &#91;&#40;65&#46;6&#37; male&#59; median age 61 &#40;53-68&#41; years&#93;&#46; The primary causes of cirrhosis were ethanolic &#40;43&#46;7&#37;&#41; and viral hepatitis &#40;24&#46;8&#37;&#41;&#46; SBP was diagnosed in 118 patients &#40;18&#46;6&#37;&#41;&#46; Only 16&#46;1&#37; of all patients received antibiotic prophylaxis&#44; with norfloxacin being the preferred choice for 78&#37; of them&#46; Among the 34 peritoneal fluid samples with bacterial growth&#44; 58 microorganisms were isolated&#46; These included 50&#37; classified as multi-sensitive &#40;MS&#41;&#44; 40&#37; as multidrug-resistant &#40;MDR&#41;&#44; and 10&#37; as extensively drug-resistant &#40;XDR&#41; bacteria&#46; Gram-negative bacteria accounted for 62&#37; of the isolates&#44; while gram-positive bacteria made up 38&#37;&#46; The most frequently identified microorganisms were Escherichia coli for gram-negatives and the Staphylococcus ssp&#46; for gram-positives&#46; Meropenem demonstrated the highest overall sensitivity &#40;79&#37;&#41;&#44; followed by piperacillin&#47;tazobactam &#40;67&#37;&#41;&#46; Conversely&#44; ceftriaxone &#40;48&#37;&#41; and ciprofloxacin &#40;41&#37;&#41; exhibited the highest rates of resistance&#46; Antibiotic prophylaxis did not influence resistance rates and no XDR bacteria were isolated from patients exposed to norfloxacin&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Our findings indicate that half of the SBP patients present with MDR or XDR bacteria&#46; Empirical therapies such as meropenem and piperacillin&#47;tazobactam show the greatest effectiveness&#46; Additionally&#44; antibiotic prophylaxis was not associated with an increase in antimicrobial resistance&#46;</p></span>"
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          0 => array:2 [
            "identificador" => "abss0001"
            "titulo" => "Introduction and Objectives"
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          2 => array:2 [
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            "titulo" => "Results"
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            "identificador" => "abss0004"
            "titulo" => "Conclusions"
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