Background and aim: Spontaneous bacterial peritonitis (SBP) is one of the most frequent bacterial infections in cirrhotic patients, its mortality without specific treatment is high. Within the first choice of empirical therapy, cephalosporins and quinolones are recommended. However recent studies have shown an increase in the prevalence of infections caused by multiresistant bacteria, especially in nosocomial episodes, which has caused a change in practice. The national literature present only a few data regard this subject, thus its study is important. Aim: To describe the reported resistance to different antibiotics in cirrhotic patients with SBP.
Material and methods: Observational, descriptive, transversal, retrolective study. Procedure: We reviewed the clinical records of patients admitted to the Gastroenterology Department in hospitalization area with diagnosis of SBP from March 2018 to December 2019, taking in count the bacterial culture result and the reported sensitivity or resistance to different antibiotics included in the antibiogram. The qualitative variables were expressed as frequencies and percentages. The numerical variables were expressed as mean and standard deviation.
Results: The study included 70 patients of whom 61.4% were men. The main age was 52.2±12.2 years-old. About 20% of patients were Child Pugh B, and 80% Child Pugh C. Of all patients, 55.7% corresponded to neutrocytic ascites, a gram-negative microorganism was isolated in 25.7% of the cultures, and a gram-positive microorganism was isolated in 18.6%. The most frequently isolated bacterium was Escherichia coli. Acquisition of SBP: 56% of infections were acquired in the community, 33% related to health care and 11% nosocomial. The sensitivity and resistance to different antibiotics obtained in the cultures are shown in the following graphs.
Conclusions: There is increasing resistance to different antibiotics, especially in hospital-acquired infections. In the case of spontaneous bacterial peritonitis, resistance to cehalo-sporins and quinolones is observed in more than half of the cases, so we must be careful with its prescription.
Conflicts of interest: The authors have no conflicts of interest to declare.
