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. 2009 Sep;3(3):197-204.
doi: 10.5009/gnl.2009.3.3.197. Epub 2009 Sep 30.

Clinical features and prognosis of spontaneous bacterial peritonitis in korean patients with liver cirrhosis: a multicenter retrospective study

Jeong Heo  1 , Yeon Seok Seo, Hyung Joon Yim, Taeho Hahn, Sang Hoon Park, Sang Hoon Ahn, Jun Yong Park, Ji Young Park, Moon Young Kim, Sung Keun Park, Mong Cho, Soon Ho Um, Kwang Hyub Han, Hong Soo Kim, Soon Koo Baik, Byung Ik Kim, Se Hyun Cho
Affiliations

Clinical features and prognosis of spontaneous bacterial peritonitis in korean patients with liver cirrhosis: a multicenter retrospective study

Jeong Heo et al. Gut Liver. 2009 Sep.

Abstract

Background/aims: Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea.

Methods: This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of >250 cells/mm(3) in the absence of data compatible with secondary peritonitis.

Results: The mean age of the cohort was 56 years, and 121 (77%) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42%): Gram-negative bacteria in 54 (81.8%), Gram-positive in 11 (16.7%), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17%), to ciprofloxacin in 11 (20.8%), and to penicillin in 33 (62.3%). The treatment failure and in-hospital mortality rates were 12.1% and 21%, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum beta-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality.

Conclusions: SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score.

Keywords: Liver cirrhosis; Peritonitis; Prognosis; Resistance.

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Figures

Fig. 1
Fig. 1
Treatment response and in-hospital mortality of enrolled cirrhotic patients with spontaneous bacterial peritonitis (SBP).
Fig. 2
Fig. 2
The cumulative incidence of recurrence of spontaneous bacterial peritonitis after resolution.
Fig. 3
Fig. 3
The cumulative incidence of mortality in all enrolled patients with spontaneous bacterial peritonitis.
See this image and copyright information in PMC

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