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KMID : 1188320090030030197
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Gut and Liver
2009 Volume.3 No. 3 p.197 ~ p.204
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Clinical Features and Prognosis of Spontaneous Bacterial Peritonitis in Korean Patients with Liver Cirrhosis: A Multicenter Retrospective Study
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Heo Jeong
Park Jun-Yong
Park Ji-Young
Kim Moon-Young
Park Sung-Keun
Cho Mong
Um Soon-Ho
Han Kwang-Hyub
Kim Hong-Soo
Baik Soon-Koo
Kim Byung-Ik
Cho Se-Hyun
Seo Yeon-Seok
Yim Hyung-Joon
Ahn Tae-Ho
Park Sang-Hoon
Ahn Sang-Hoon
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Abstract
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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/mm3 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 ?-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.
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KEYWORD
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Liver cirrhosis, Peritonitis, Prognosis, Resistance
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