Comparative Study of Community Acquired and Nosocomial Spontaneous Bacterial Peritonitis and its Variants in 150 Patients

Girisha Balaraju, Mallikarjun Patil, Adarsh C. Krishnamurthy, Dheeraj Karanth, Harshad Devarbhavi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Nosocomial acquisition of spontaneous bacterial peritonitis (SBP) is debated as having a different microbial etiology and prognosis. Identification of clinical, laboratory predictors of mortality and appropriate empirical antimicrobial selection is necessary to prevent early mortality and morbidity. We aimed to find the clinical and bacteriological profile in nosocomial and community acquired SBP and its variants, and the predictors of mortality. Material and methods One hundred and fifty patients with 162 discrete episodes of different types of SBP were analyzed. Relevant clinical and laboratory data were analyzed. SBP was diagnosed according to standard criteria and classified as community acquired if the infection detected within 48 h of admission and as nosocomial after 48 h of admission to the hospital. Results Eighty seven percent had community acquired SBP (CSBP), 13% had nosocomial SBP (NSBP). Patients of NSBP were older, had more episodes of GI bleed and higher previous episodes of encephalopathy. Patients who died were older, had worse encephalopathy. NSBP had higher one month mortality. Age, serum sodium, encephalopathy and NSBP predicted mortality. Culture positivity was 22.22%. Escherichia coli was the commonest organism isolated. There was no difference in the bacteriological profile between CSBP and NSBP. E. coli showed up to 48% resistance to third generation cephalosporins. Overall sensitivity to aminoglycosides was more than 75%. Conclusions Overall mortality was 59%. NSBP had significantly high one month mortality. Age, serum sodium, encephalopathy and NSBP were predictors of mortality. Bacteriological profile was similar between CSBP and NSBP.

Original languageEnglish
Pages (from-to)215-221
Number of pages7
JournalJournal of Clinical and Experimental Hepatology
Volume7
Issue number3
DOIs
Publication statusPublished - 01-09-2017

Fingerprint

Community Hospital
Peritonitis
Mortality
Brain Diseases
Sodium
Escherichia coli
Community-Acquired Infections
Aminoglycosides
Cephalosporins
Serum
Morbidity

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Balaraju, Girisha ; Patil, Mallikarjun ; Krishnamurthy, Adarsh C. ; Karanth, Dheeraj ; Devarbhavi, Harshad. / Comparative Study of Community Acquired and Nosocomial Spontaneous Bacterial Peritonitis and its Variants in 150 Patients. In: Journal of Clinical and Experimental Hepatology. 2017 ; Vol. 7, No. 3. pp. 215-221.
@article{f4e6bedf15f349e1838ef721f30b28e4,
title = "Comparative Study of Community Acquired and Nosocomial Spontaneous Bacterial Peritonitis and its Variants in 150 Patients",
abstract = "Background Nosocomial acquisition of spontaneous bacterial peritonitis (SBP) is debated as having a different microbial etiology and prognosis. Identification of clinical, laboratory predictors of mortality and appropriate empirical antimicrobial selection is necessary to prevent early mortality and morbidity. We aimed to find the clinical and bacteriological profile in nosocomial and community acquired SBP and its variants, and the predictors of mortality. Material and methods One hundred and fifty patients with 162 discrete episodes of different types of SBP were analyzed. Relevant clinical and laboratory data were analyzed. SBP was diagnosed according to standard criteria and classified as community acquired if the infection detected within 48 h of admission and as nosocomial after 48 h of admission to the hospital. Results Eighty seven percent had community acquired SBP (CSBP), 13{\%} had nosocomial SBP (NSBP). Patients of NSBP were older, had more episodes of GI bleed and higher previous episodes of encephalopathy. Patients who died were older, had worse encephalopathy. NSBP had higher one month mortality. Age, serum sodium, encephalopathy and NSBP predicted mortality. Culture positivity was 22.22{\%}. Escherichia coli was the commonest organism isolated. There was no difference in the bacteriological profile between CSBP and NSBP. E. coli showed up to 48{\%} resistance to third generation cephalosporins. Overall sensitivity to aminoglycosides was more than 75{\%}. Conclusions Overall mortality was 59{\%}. NSBP had significantly high one month mortality. Age, serum sodium, encephalopathy and NSBP were predictors of mortality. Bacteriological profile was similar between CSBP and NSBP.",
author = "Girisha Balaraju and Mallikarjun Patil and Krishnamurthy, {Adarsh C.} and Dheeraj Karanth and Harshad Devarbhavi",
year = "2017",
month = "9",
day = "1",
doi = "10.1016/j.jceh.2017.03.005",
language = "English",
volume = "7",
pages = "215--221",
journal = "Journal of Clinical and Experimental Hepatology",
issn = "0973-6883",
publisher = "Elsevier BV",
number = "3",

}

Comparative Study of Community Acquired and Nosocomial Spontaneous Bacterial Peritonitis and its Variants in 150 Patients. / Balaraju, Girisha; Patil, Mallikarjun; Krishnamurthy, Adarsh C.; Karanth, Dheeraj; Devarbhavi, Harshad.

In: Journal of Clinical and Experimental Hepatology, Vol. 7, No. 3, 01.09.2017, p. 215-221.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparative Study of Community Acquired and Nosocomial Spontaneous Bacterial Peritonitis and its Variants in 150 Patients

AU - Balaraju, Girisha

AU - Patil, Mallikarjun

AU - Krishnamurthy, Adarsh C.

AU - Karanth, Dheeraj

AU - Devarbhavi, Harshad

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Background Nosocomial acquisition of spontaneous bacterial peritonitis (SBP) is debated as having a different microbial etiology and prognosis. Identification of clinical, laboratory predictors of mortality and appropriate empirical antimicrobial selection is necessary to prevent early mortality and morbidity. We aimed to find the clinical and bacteriological profile in nosocomial and community acquired SBP and its variants, and the predictors of mortality. Material and methods One hundred and fifty patients with 162 discrete episodes of different types of SBP were analyzed. Relevant clinical and laboratory data were analyzed. SBP was diagnosed according to standard criteria and classified as community acquired if the infection detected within 48 h of admission and as nosocomial after 48 h of admission to the hospital. Results Eighty seven percent had community acquired SBP (CSBP), 13% had nosocomial SBP (NSBP). Patients of NSBP were older, had more episodes of GI bleed and higher previous episodes of encephalopathy. Patients who died were older, had worse encephalopathy. NSBP had higher one month mortality. Age, serum sodium, encephalopathy and NSBP predicted mortality. Culture positivity was 22.22%. Escherichia coli was the commonest organism isolated. There was no difference in the bacteriological profile between CSBP and NSBP. E. coli showed up to 48% resistance to third generation cephalosporins. Overall sensitivity to aminoglycosides was more than 75%. Conclusions Overall mortality was 59%. NSBP had significantly high one month mortality. Age, serum sodium, encephalopathy and NSBP were predictors of mortality. Bacteriological profile was similar between CSBP and NSBP.

AB - Background Nosocomial acquisition of spontaneous bacterial peritonitis (SBP) is debated as having a different microbial etiology and prognosis. Identification of clinical, laboratory predictors of mortality and appropriate empirical antimicrobial selection is necessary to prevent early mortality and morbidity. We aimed to find the clinical and bacteriological profile in nosocomial and community acquired SBP and its variants, and the predictors of mortality. Material and methods One hundred and fifty patients with 162 discrete episodes of different types of SBP were analyzed. Relevant clinical and laboratory data were analyzed. SBP was diagnosed according to standard criteria and classified as community acquired if the infection detected within 48 h of admission and as nosocomial after 48 h of admission to the hospital. Results Eighty seven percent had community acquired SBP (CSBP), 13% had nosocomial SBP (NSBP). Patients of NSBP were older, had more episodes of GI bleed and higher previous episodes of encephalopathy. Patients who died were older, had worse encephalopathy. NSBP had higher one month mortality. Age, serum sodium, encephalopathy and NSBP predicted mortality. Culture positivity was 22.22%. Escherichia coli was the commonest organism isolated. There was no difference in the bacteriological profile between CSBP and NSBP. E. coli showed up to 48% resistance to third generation cephalosporins. Overall sensitivity to aminoglycosides was more than 75%. Conclusions Overall mortality was 59%. NSBP had significantly high one month mortality. Age, serum sodium, encephalopathy and NSBP were predictors of mortality. Bacteriological profile was similar between CSBP and NSBP.

UR - http://www.scopus.com/inward/record.url?scp=85016570808&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016570808&partnerID=8YFLogxK

U2 - 10.1016/j.jceh.2017.03.005

DO - 10.1016/j.jceh.2017.03.005

M3 - Article

VL - 7

SP - 215

EP - 221

JO - Journal of Clinical and Experimental Hepatology

JF - Journal of Clinical and Experimental Hepatology

SN - 0973-6883

IS - 3

ER -