1010. Clinical Features and Outcomes of Spontaneous Bacterial Peritonitis Caused by Non-Enteric Gram-Negative Bacilli: A Matched Case-Control Study
Session: Poster Abstract Session: Enteric Infection
Friday, October 9, 2015
Room: Poster Hall
  • 20151004_ poster.pdf (462.7 kB)
  • Background: Although enteric bacteria are the most common organisms causing spontaneous bacterial peritonitis (SBP) in cirrhotic patients, non-enteric gram-negative bacilli are also reported to cause SBP. As cefotaxime or ceftriaxone, the most preferred antibiotics used to treat SBP, are usually not effective for non-enteric gram-negative bacilli, this can be lead to inadequate empirical therapy for SBP. However, limited data are available regarding SBP caused by non-enteric gram-negative bacilli.

    Methods: This study was performed in a 2700-bed, tertiary care hospital in Seoul, Korea. Between January 1997 and December 2013, we identified 45 patients with SBP caused by non-enteric gram-negative bacilli (case): 22 (48.9%) by Pseudomonas species, 17 (37.8%) by Acinetobacter species, and 6 (13.3%) by Stenotrophomonas maltophilia. These patients were age/sex-matched with 90 patients who had SBP caused by E. coli (control).

    Results: Non-enteric gram-negative bacilli were responsible for 3.8% (45/1,172) of all culture-positive SBP episodes. Hospital-acquired SBP was more common in the case group (48.7% vs. 18.9%, P = .001). Significantly more of these patients had pre-existing biliary diseases (31.1% vs. 6.7%, P < .001) and had undergone antimicrobial therapy within the past month (60.0% vs. 26.7%, P < .001). Baseline Child-Pugh class, etiology of their cirrhosis, the model for end-stage liver disease (MELD) score, and concomitant hepatocellular carcinoma were comparable between the two groups. The initial clinical manifestations and laboratory findings also did not differ significantly between the two groups. Concomitant bacteremia was less commonly detected in the case group (26.7% vs. 66.3%, P < .001). Inappropriate initial antimicrobial therapy had been more frequently performed in the case group (75.6% vs. 16.9%, P < .001) and mortalities were significantly higher in the case group (30-day mortality: 37.8% vs. 23.3%, P = .08; 60-day mortality: 48.9% vs. 26.7%, P = .01).  

    Conclusion: Compared to E. coli SBP, SBP caused by non-enteric gram-negative bacilli was more commonly associated with hospital-acquisition, biliary diseases, prior antimicrobial therapy, and a higher mortality rate.

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


    T. Kim, None

    S. Y. Park, None

    S. Bae, None

    Y. P. Chong, None

    S. H. Kim, None

    S. O. Lee, None

    Y. S. Kim, None

    J. H. Woo, None

    S. H. Choi, None

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