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Microbiological Characteristics and Antibiotic Sensitivity in Patients with Nosocomial Spontaneous Bacterial Peritonitis Caused by Escherichia coli: A Multicenter Study

Escherichia coli is a prevalent causative pathogen of spontaneous bacterial peritonitis (SBP). In this retrospective study, we investigated the microbiological characteristics and antibiotic susceptibility of E. coli clinical isolates obtained from liver cirrhosis patients suffering from nosocomial...

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Autores principales: Tu, Bo, Zhang, Yuening, Bi, Jingfeng, Xu, Zhe, Shi, Lei, Zhang, Xin, Zhao, Peng, Zhang, Dawei, Yang, Guang, Qin, Enqiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769054/
http://dx.doi.org/10.1097/IM9.0000000000000035
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author Tu, Bo
Zhang, Yuening
Bi, Jingfeng
Xu, Zhe
Shi, Lei
Zhang, Xin
Zhao, Peng
Zhang, Dawei
Yang, Guang
Qin, Enqiang
author_facet Tu, Bo
Zhang, Yuening
Bi, Jingfeng
Xu, Zhe
Shi, Lei
Zhang, Xin
Zhao, Peng
Zhang, Dawei
Yang, Guang
Qin, Enqiang
author_sort Tu, Bo
collection PubMed
description Escherichia coli is a prevalent causative pathogen of spontaneous bacterial peritonitis (SBP). In this retrospective study, we investigated the microbiological characteristics and antibiotic susceptibility of E. coli clinical isolates obtained from liver cirrhosis patients suffering from nosocomial SBP. Our results showed that extended-spectrum β-lactamase (ESBL)-producing E. coli accounted for 47% of the cases, while 62% of the isolates were multi-drug resistant (MDR) pathogens. ESBL-producing and MDR isolates showed high incidences of resistance to third-generation cephalosporins, but they displayed susceptibility to carbapenems, β-lactamase inhibitors, and aminoglycosides. Importantly, liver cirrhosis patients with MDR E. coli SBP showed a significantly higher death rate than patients with non-MDR infections (P = 0.021). The 30-day mortality of nosocomial SBP was independently correlated with female gender [odds ratio (OR) = 5.200, 95% confidence interval (CI) = 1.194–22.642], liver failure (OR = 9.609, 95% CI = 1.914–48.225), hepatocellular carcinoma (OR = 8.176, 95% CI = 2.065–32.364), hepatic encephalopathy (OR = 8.176, 95% CI = 2.065–32.364), model of end-stage liver disease score (OR = 1.191, 95% CI = 1.053–1.346), white blood cell count (OR = 0.847, 95% CI = 0.737–0.973), and ascites polymorphonuclear (OR = 95.903, 95% CI = 3.410–2697.356). In conclusion, third-generation cephalosporins may be inappropriate for empiric treatment of nosocomial SBP caused by E. coli, due to the widespread presence of ESBLs and high incidence of MDR pathogens.
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spelling pubmed-77690542020-12-28 Microbiological Characteristics and Antibiotic Sensitivity in Patients with Nosocomial Spontaneous Bacterial Peritonitis Caused by Escherichia coli: A Multicenter Study Tu, Bo Zhang, Yuening Bi, Jingfeng Xu, Zhe Shi, Lei Zhang, Xin Zhao, Peng Zhang, Dawei Yang, Guang Qin, Enqiang Infectious Microbes & Diseases Original Article Escherichia coli is a prevalent causative pathogen of spontaneous bacterial peritonitis (SBP). In this retrospective study, we investigated the microbiological characteristics and antibiotic susceptibility of E. coli clinical isolates obtained from liver cirrhosis patients suffering from nosocomial SBP. Our results showed that extended-spectrum β-lactamase (ESBL)-producing E. coli accounted for 47% of the cases, while 62% of the isolates were multi-drug resistant (MDR) pathogens. ESBL-producing and MDR isolates showed high incidences of resistance to third-generation cephalosporins, but they displayed susceptibility to carbapenems, β-lactamase inhibitors, and aminoglycosides. Importantly, liver cirrhosis patients with MDR E. coli SBP showed a significantly higher death rate than patients with non-MDR infections (P = 0.021). The 30-day mortality of nosocomial SBP was independently correlated with female gender [odds ratio (OR) = 5.200, 95% confidence interval (CI) = 1.194–22.642], liver failure (OR = 9.609, 95% CI = 1.914–48.225), hepatocellular carcinoma (OR = 8.176, 95% CI = 2.065–32.364), hepatic encephalopathy (OR = 8.176, 95% CI = 2.065–32.364), model of end-stage liver disease score (OR = 1.191, 95% CI = 1.053–1.346), white blood cell count (OR = 0.847, 95% CI = 0.737–0.973), and ascites polymorphonuclear (OR = 95.903, 95% CI = 3.410–2697.356). In conclusion, third-generation cephalosporins may be inappropriate for empiric treatment of nosocomial SBP caused by E. coli, due to the widespread presence of ESBLs and high incidence of MDR pathogens. Lippincott Williams & Wilkins 2020-08-07 /pmc/articles/PMC7769054/ http://dx.doi.org/10.1097/IM9.0000000000000035 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.
spellingShingle Original Article
Tu, Bo
Zhang, Yuening
Bi, Jingfeng
Xu, Zhe
Shi, Lei
Zhang, Xin
Zhao, Peng
Zhang, Dawei
Yang, Guang
Qin, Enqiang
Microbiological Characteristics and Antibiotic Sensitivity in Patients with Nosocomial Spontaneous Bacterial Peritonitis Caused by Escherichia coli: A Multicenter Study
title Microbiological Characteristics and Antibiotic Sensitivity in Patients with Nosocomial Spontaneous Bacterial Peritonitis Caused by Escherichia coli: A Multicenter Study
title_full Microbiological Characteristics and Antibiotic Sensitivity in Patients with Nosocomial Spontaneous Bacterial Peritonitis Caused by Escherichia coli: A Multicenter Study
title_fullStr Microbiological Characteristics and Antibiotic Sensitivity in Patients with Nosocomial Spontaneous Bacterial Peritonitis Caused by Escherichia coli: A Multicenter Study
title_full_unstemmed Microbiological Characteristics and Antibiotic Sensitivity in Patients with Nosocomial Spontaneous Bacterial Peritonitis Caused by Escherichia coli: A Multicenter Study
title_short Microbiological Characteristics and Antibiotic Sensitivity in Patients with Nosocomial Spontaneous Bacterial Peritonitis Caused by Escherichia coli: A Multicenter Study
title_sort microbiological characteristics and antibiotic sensitivity in patients with nosocomial spontaneous bacterial peritonitis caused by escherichia coli: a multicenter study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769054/
http://dx.doi.org/10.1097/IM9.0000000000000035
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