Risk factors and pathogen analysis of spontaneous bacterial peritonitis in patients with liver cirrhosis
Objective To analyze the risk factors,pathogenic bacteria,and antibiotic resistance of spontaneous bacterial peritonitis(SBP)in liver cirrhotic patients with ascites.Methods The clinical data of patients with ascites due to liver cirrhosis hospitalized in the First Hospital of Shanxi Medical University from January 2020 to December 2022 were retrospectively collected,and they were divided into non-SBP group and SBP group according to whether SBP occurred or not.The general data,clinical characteristics,laboratory examination,and pathogenic results of the two groups were compared,and the risk factors,pathogenic bacteria,and drug-resistant antibiotics of patients with liver cirrhosis were analyzed.Results Univariate analysis showed that there were statistical differences in upper gastrointestinal bleeding,hepatic encephalopathy,ALB,TBIL,DBIL,prothrombin time,prothrombin activity,INR,WBC,NEUT％,sodium,urea,creatinine and PCT between the two groups(all P＜0.05).Multivariate Logistic regression analysis showed that upper gastrointestinal bleeding,sodium,urea,and PCT levels were independent risk factors for SBP in liver cirrhosis(P＜0.05).The main pathogen isolated from SBP patients was GPB(61.4％).Erythromycin was the most common antibiotic resistant to GPB,with a resistance rate of 96.0％,but it was not resistant to vancomycin,tigecycline,and linezolid.Levofloxacin was the most common drug-resistant antibiotic in GNB,with a resistance rate of 71.4％,while the resistance rate to ertapenem and meropenem was 14.3％.Conclusion When upper gastrointestinal bleeding,hyponatremia,high urea,and PCT levels rise in patients with ascites due to liver cirrhosis,we should be highly alert to the occurrence of SBP,and intervene as early as possible if necessary to improve the survival rate of patients.The most common pathogen of SBP is GPB,so we should attach great importance to the incidence of GPB in SBP pathogens.Enterococcus faecium is the most common GPB and has no resistance to vancomycin,tigecycline,and linezolid.
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