1011. Comparison between spontaneous bacterial peritonitis caused by Enterobacter species and Escherichia coli
Session: Poster Abstract Session: Enteric Infection
Friday, October 9, 2015
Room: Poster Hall
Posters
  • Poster_IDweek_2015_Seongman Bae.pdf (396.4 kB)
  • Background: Enterobacter species are important nosocomial pathogens, and there is growing concern about their ability to develop resistance upon exposure to broad-spectrum cephalosporins. However, very limited data are available on the clinical characteristics and treatment outcomes of Enterobacter spontaneous bacterial peritonitis (SBP).

    Methods: We identified all patients with SBP caused by Enterobacter species admitted to our tertiary care hospital between January 1997 and December 2013. A retrospective, matched case-control study design was used. Each Enterobacter SBP patient was age- and sex-matched with four Escherichia coli SBP patients.

    Results: During the study period, 32 Enterobacter SBP and 536 E. coli SBP cases were admitted to our hospital. A total 160 SBP patients, 32 Enterobacter (cases) and 128 E. coli (controls), were included in this study. Twenty-one (65.6%) case and 111 (86.7%) control patients were classified as Child-Pugh class C (P = 0.005). Cases were more likely than controls to have hepatocellular carcinoma (65.6% vs. 37.5%, P = 0.004) and to present upper gastrointestinal bleeding episodes (28.1% vs. 9.4%, P = 0.02). The majority of patients in both groups were empirically treated with 3rd-generation cephalosporins (84.4% vs. 91.4%, P = 0.31). Although the rate of susceptibility tended to be lower in the cases compared to the E. coli SBP controls (68.8% vs. 82.8%, P = 0.07), the initial response to empirical therapy, defined as ascitic neutrophil decrease > 25% at 48‒72 hours after initial antimicrobial therapy, was not significantly different (81.3% vs. 74.2%, P = 0.41). Emergence of resistance was identified in one case patient but in none of the control patients (3.7% [1/27] vs. 0% [0/117], P = 0.20). Thirty-day mortalities were not significantly different between the two groups (37.5% vs. 28.9%, P = 0.35).

    Conclusion: Hepatocellular carcinoma and upper gastrointestinal bleeding were more commonly associated with Enterobacter SBP than with E. coli SBP. Clinical outcomes were not significantly different between these two groups. Development of resistance during 3rd-generation cephalosporin therapy was only rarely encountered in patients with Enterobacter SBP.

    Seongman Bae, MD, Taeeun Kim, MD, Se Yoon Park, MD, Yong Pil Chong, MD, Sung-Han Kim, MD, Sang-Oh Lee, MD, Sang-Ho Choi, MD, Yang Soo Kim, MD and Jun Hee Woo, MD, Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Disclosures:

    S. Bae, None

    T. Kim, None

    S. Y. Park, None

    Y. P. Chong, None

    S. H. Kim, None

    S. O. Lee, None

    S. H. Choi, None

    Y. S. Kim, None

    J. H. Woo, None

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