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IMPACT OF MICROBIOLOGICAL CHANGES ON SPONTANEOUS BACTERIAL PERITONITIS IN THREE DIFFERENT PERIODS OVER 17 YEARS

Paulo Roberto Lerias de Almeida1,2, Gabriel Stefani Leão1, Charlles David Gonçalves Gonçalves1

  • 1Hospital Nossa Senhora da Conceição (HNSC), Porto Alegre, RS, Brasil.

Arquivos De Gastroenterologia
|March 22, 2018
PubMed
Abstract

Insights

Changes in spontaneous bacterial peritonitis (SBP) pathogens and antibiotic resistance were observed over 17 years. Gram-positive bacteria increased, and resistance to common antibiotics rose, impacting treatment strategies for cirrhotic patients.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a significant complication in patients with cirrhosis.
  • Evolving microbiological patterns necessitate reassessment of antibiotic choices for SBP treatment.

Purpose of the Study:

  • To analyze shifts in the epidemiology and antibiotic resistance of bacteria causing SBP over a 17-year period.
  • To inform empirical treatment guidelines for SBP.

Main Methods:

  • Retrospective study of cirrhotic patients with SBP and positive ascitic fluid cultures.
  • Evaluation of bacterial isolates and their in vitro antibiotic sensitivities across three distinct time periods (1997-1998, 2002-2003, 2014-2015).

Main Results:

  • A shift in causative organisms was observed, with an initial increase in Gram-positive bacteria (Staphylococci) followed by a decrease.
  • Escherichia coli remained a common pathogen, with increasing resistance observed.
  • The prevalence of resistant E. coli reached 14% in the final study period.

Conclusions:

  • The bacterial landscape of SBP has changed, with a notable rise in Gram-positive organisms.
  • Increased resistance to standard antibiotics underscores the need for updated treatment protocols.
  • Empirical SBP treatment may soon require the inclusion of agents targeting Gram-positive bacteria.

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