Program Schedule

832
Predictive Factors of Spontaneous Bacterial Peritonitis Caused by Gram-positive Bacteria in Cirrhotic Patients

Session: Poster Abstract Session: Clinical - Enteric Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background:

Spontaneous bacterial peritonitis (SBP) in cirrhotic patients is known to be mostly caused by Gram-negative bacteria. Although SBP due to Gram-positive bacteria is increasing, less is known about the predictive factors of the infection.

Methods:

We performed a retrospective, observational cohort study consisting of patients, aged 18 years or older, with SBP due to Gram-positive and Gram-negative bacteria from Jan 2006 to Dec2013 at Severance hospital, Seoul, Korea. Only the first episode for each patient was included in the analysis.

Results:

We identified 77 patients with SBP. 27 (35%) patients had Gram-positive infection and 50 (65%) patients had Gram-negative infection. Univariate analysis revealed that low SOFA score (P = 0.001), having catheters or prosthetic devices (OR, 12; 95% CI, 2.36~60.95; P = 0.001) and previous use of antibiotics within 30 days (OR, 3.07; 95% CI, 1.15~8.2; P = 0.023) were associated with Gram-positive infection. Multivariate analysis showed that having catheters or prosthetic devices was a remarkable predictor of Gram-positive bacterial infection (OR, 5.72; 95% CI, 1.01~32.33; P = 0.048). And, previous use of antibiotics within 30 days was also a remained independent predictive factor of Gram-positive infection (OR, 4.04; 95% CI, 1.16~14.13; P = 0.029). Gram-negative infection had higher SOFA score than Gram-positive (6.68 vs 4.93; P = 0.001), but there was no statistically significant difference in 28-day mortality between two groups (48% vs 37%; P = 0.407).

Conclusion:

In the current study, indwelling catheters or prosthetic devices, prior antimicrobial therapy within 30 days and a lower SOFA score were significantly associated with SBP caused by Gram-positive bacteria in patients with cirrhosis.

Jung Ho Kim, MD1, Yong Duk Jeon, MD1, Hae Won Ahn, MD1, Heun Choi, MD1, Min Hyung Kim, M.D.1,2, Je Eun Song, MD1,2, Jin Young Ahn, MD1,2, Sun Bean Kim, MD1,2, Su Jin Jeong, MD/PhD1,2, Nam Su Ku, MD1,2, Sang Hoon Han, MD1,2, Jun Yong Choi1,2, Young Goo Song1,2 and June Myung Kim, MD1,2, (1)Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea, (2)Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea

Disclosures:

J. H. Kim, None

Y. D. Jeon, None

H. W. Ahn, None

H. Choi, None

M. H. Kim, None

J. E. Song, None

J. Y. Ahn, None

S. B. Kim, None

S. J. Jeong, None

N. S. Ku, None

S. H. Han, None

J. Y. Choi, None

Y. G. Song, None

J. M. Kim, None

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