Remarkable Antimicrobial Resistance in Nosocomial Spontaneous Bacterial Peritonitis
Introduction: The aim of this prospective observational study was to investigate the causative agents and their susceptibility to antimicrobial drugs in patients with nosocomial spontaneous bacterial peritonitis (SBP) in order to clarify empirical antimicrobial treatment. Materials and Methods: Pat...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | Turkish |
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Galenos Yayinevi
2019-12-01
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| Series: | Mediterranean Journal of Infection, Microbes and Antimicrobials |
| Subjects: | |
| Online Access: | http://mjima.org/text.php?&id=166 |
| _version_ | 1797923579904393216 |
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| author | Filiz KIZILATEŞ Nefise ÖZTOPRAK Ferda AKBAY HARMANDAR Hande BERK Derya SEYMAN Yasin ŞAHİNTÜRK Ayhan Hilmi ÇEKİN Yeşim ÇEKİN |
| author_facet | Filiz KIZILATEŞ Nefise ÖZTOPRAK Ferda AKBAY HARMANDAR Hande BERK Derya SEYMAN Yasin ŞAHİNTÜRK Ayhan Hilmi ÇEKİN Yeşim ÇEKİN |
| author_sort | Filiz KIZILATEŞ |
| collection | DOAJ |
| description | Introduction: The aim of this prospective observational study was to investigate the causative agents and their susceptibility to antimicrobial drugs in patients with nosocomial spontaneous bacterial peritonitis (SBP) in order to clarify empirical antimicrobial treatment.
Materials and Methods: Patients who were admitted to the Gastroenterology Department of Antalya Training and Research Hospital with prediagnosis of SBP during the period of January 2011 to December 2014 were enrolled in the study. Spontaneous bacterial peritonitis was defined as ascitic fluid with polymorphonuclear leukocyte count ≥250 cells/mm³. Spontaneous bacterial peritonitis was considered to be nosocomial if diagnosed after >48 hours of hospitalization. During the study period, cefotaxime was the preferred empirical antimicrobial therapy in our center. If there was no clinical recovery after 48 hours or cefotaxime-resistant bacteria was identified in culture, antimicrobial therapy was switched.
Results: The proportion of culture-positive SBP was 13% (57/439). In total, 46% (202/439) of the cases were neutrocytic ascites and 52.6% (30/57) were evaluated as nosocomial SBP. Candida spp. was the causative agent in one case, which was not included in the calculation. The overall natural/acquired cefotaxime resistance was 51.8% (29/56). The rate of cefotaxime resistance was 66.7% (20/30) in nosocomial SBP, significantly higher than in non-nosocomial infections (34.6%; 9/26, p=0.04). Resistance to gentamicin, trimethoprim-sulfamethoxazole, and carbapenems were also significantly higher in nosocomial infections (p=0.04, p=0.04, p=0.02).
Conclusion: Cefotaxime resistance was found to be higher in nosocomial SBP than non-nosocomial cases. Therefore, determining whether an infection is nosocomial is beneficial when selecting empirical antibiotic therapy. |
| first_indexed | 2024-04-10T14:49:38Z |
| format | Article |
| id | doaj.art-fda4a33ca76e4cad989db77c6624dd8d |
| institution | Directory Open Access Journal |
| issn | 2147-673X |
| language | Turkish |
| last_indexed | 2024-04-10T14:49:38Z |
| publishDate | 2019-12-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Mediterranean Journal of Infection, Microbes and Antimicrobials |
| spelling | doaj.art-fda4a33ca76e4cad989db77c6624dd8d2023-02-15T16:07:41ZturGalenos YayineviMediterranean Journal of Infection, Microbes and Antimicrobials2147-673X2019-12-01810.4274/mjima.galenos.2019.2019.11Remarkable Antimicrobial Resistance in Nosocomial Spontaneous Bacterial PeritonitisFiliz KIZILATEŞ0https://orcid.org/0000-0002-8985-893XNefise ÖZTOPRAK1https://orcid.org/0000-0001-6382-2229Ferda AKBAY HARMANDAR2https://orcid.org/0000-0002-7897-6658Hande BERK3https://orcid.org/0000-0002-2820-1731Derya SEYMAN4https://orcid.org/0000-0002-7451-8537Yasin ŞAHİNTÜRK5https://orcid.org/0000-0003-4907-0766Ayhan Hilmi ÇEKİN6https://orcid.org/0000-0001-7464-8297Yeşim ÇEKİN7https://orcid.org/0000-0003-4393-5618University of Health Sciences, Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, TurkeyUniversity of Health Sciences, Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, TurkeyUniversity of Health Sciences, Antalya Training and Research Hospital, Clinic of Gastroenterology, Antalya, TurkeyUniversity of Health Sciences, Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, TurkeyUniversity of Health Sciences, Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, TurkeyUniversity of Health Sciences, Antalya Training and Research Hospital, Clinic of Internal Medicine, Antalya, TurkeyUniversity of Health Sciences, Antalya Training and Research Hospital, Clinic of Gastroenterology, Antalya, TurkeyUniversity of Health Sciences, Antalya Training and Research Hospital, Clinic of Medical Microbiology, Antalya, TurkeyIntroduction: The aim of this prospective observational study was to investigate the causative agents and their susceptibility to antimicrobial drugs in patients with nosocomial spontaneous bacterial peritonitis (SBP) in order to clarify empirical antimicrobial treatment. Materials and Methods: Patients who were admitted to the Gastroenterology Department of Antalya Training and Research Hospital with prediagnosis of SBP during the period of January 2011 to December 2014 were enrolled in the study. Spontaneous bacterial peritonitis was defined as ascitic fluid with polymorphonuclear leukocyte count ≥250 cells/mm³. Spontaneous bacterial peritonitis was considered to be nosocomial if diagnosed after >48 hours of hospitalization. During the study period, cefotaxime was the preferred empirical antimicrobial therapy in our center. If there was no clinical recovery after 48 hours or cefotaxime-resistant bacteria was identified in culture, antimicrobial therapy was switched. Results: The proportion of culture-positive SBP was 13% (57/439). In total, 46% (202/439) of the cases were neutrocytic ascites and 52.6% (30/57) were evaluated as nosocomial SBP. Candida spp. was the causative agent in one case, which was not included in the calculation. The overall natural/acquired cefotaxime resistance was 51.8% (29/56). The rate of cefotaxime resistance was 66.7% (20/30) in nosocomial SBP, significantly higher than in non-nosocomial infections (34.6%; 9/26, p=0.04). Resistance to gentamicin, trimethoprim-sulfamethoxazole, and carbapenems were also significantly higher in nosocomial infections (p=0.04, p=0.04, p=0.02). Conclusion: Cefotaxime resistance was found to be higher in nosocomial SBP than non-nosocomial cases. Therefore, determining whether an infection is nosocomial is beneficial when selecting empirical antibiotic therapy.http://mjima.org/text.php?&id=166extended-spectrum beta-lactamasesantimicrobial resistancesurveillancecommunity-acquired infectionsculture-negative neutrocytic ascites |
| spellingShingle | Filiz KIZILATEŞ Nefise ÖZTOPRAK Ferda AKBAY HARMANDAR Hande BERK Derya SEYMAN Yasin ŞAHİNTÜRK Ayhan Hilmi ÇEKİN Yeşim ÇEKİN Remarkable Antimicrobial Resistance in Nosocomial Spontaneous Bacterial Peritonitis Mediterranean Journal of Infection, Microbes and Antimicrobials extended-spectrum beta-lactamases antimicrobial resistance surveillance community-acquired infections culture-negative neutrocytic ascites |
| title | Remarkable Antimicrobial Resistance in Nosocomial Spontaneous Bacterial Peritonitis |
| title_full | Remarkable Antimicrobial Resistance in Nosocomial Spontaneous Bacterial Peritonitis |
| title_fullStr | Remarkable Antimicrobial Resistance in Nosocomial Spontaneous Bacterial Peritonitis |
| title_full_unstemmed | Remarkable Antimicrobial Resistance in Nosocomial Spontaneous Bacterial Peritonitis |
| title_short | Remarkable Antimicrobial Resistance in Nosocomial Spontaneous Bacterial Peritonitis |
| title_sort | remarkable antimicrobial resistance in nosocomial spontaneous bacterial peritonitis |
| topic | extended-spectrum beta-lactamases antimicrobial resistance surveillance community-acquired infections culture-negative neutrocytic ascites |
| url | http://mjima.org/text.php?&id=166 |
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