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An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis
Background and Aims: Spontaneous bacterial peritonitis (SBP) is a common and potentially fatal complication of liver cirrhosis. This study aims to analyze the prevalence of SBP among liver cirrhotic patients according to geographical location and income level, and risk factors and outcomes of SBP. M...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375592/ https://www.ncbi.nlm.nih.gov/pubmed/34422858 http://dx.doi.org/10.3389/fmed.2021.693652 |
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author | Tay, Phoebe Wen Lin Xiao, Jieling Tan, Darren Jun Hao Ng, Cheng Lye, Yan Nerng Lim, Wen Hui Teo, Vanessa Xin Yi Heng, Ryan Rui Yang Yeow, Marcus Wei Xuan Lum, Lionel Hon Wai Tan, Eunice Xiang Xuan Kew, Guan Sen Lee, Guan Huei Muthiah, Mark D. |
author_facet | Tay, Phoebe Wen Lin Xiao, Jieling Tan, Darren Jun Hao Ng, Cheng Lye, Yan Nerng Lim, Wen Hui Teo, Vanessa Xin Yi Heng, Ryan Rui Yang Yeow, Marcus Wei Xuan Lum, Lionel Hon Wai Tan, Eunice Xiang Xuan Kew, Guan Sen Lee, Guan Huei Muthiah, Mark D. |
author_sort | Tay, Phoebe Wen Lin |
collection | PubMed |
description | Background and Aims: Spontaneous bacterial peritonitis (SBP) is a common and potentially fatal complication of liver cirrhosis. This study aims to analyze the prevalence of SBP among liver cirrhotic patients according to geographical location and income level, and risk factors and outcomes of SBP. Methods: A systematic search for articles describing prevalence, risk factors and outcomes of SBP was conducted. A single-arm meta-analysis was performed using generalized linear mix model (GLMM) with Clopper-Pearson intervals. Results: Ninety-Nine articles, comprising a total of 5,861,142 individuals with cirrhosis were included. Pooled prevalence of SBP was found to be 17.12% globally (CI: 13.63–21.30%), highest in Africa (68.20%; CI: 12.17–97.08%), and lowest in North America (10.81%; CI: 5.32–20.73%). Prevalence of community-acquired SBP was 6.05% (CI: 4.32–8.40%), and 11.11% (CI: 5.84–20.11%,) for healthcare-associated SBP. Antibiotic-resistant microorganisms were found in 11.77% (CI: 7.63–17.73%) of SBP patients. Of which, methicillin-resistant Staphylococcus aureus was most common (6.23%; CI: 3.83–9.97%), followed by extended-spectrum beta-lactamase producing organisms (6.19%; CI: 3.32–11.26%), and lastly vancomycin-resistant enterococci (1.91%; CI: 0.41–8.46%). Subgroup analysis comparing prevalence, antibiotic resistance, and outcomes between income groups was conducted to explore a link between socioeconomic status and SBP, which revealed decreased risk of SBP and negative outcomes in high-income countries. Conclusion: SBP remains a frequent complication of liver cirrhosis worldwide. The drawn link between income level and SBP in liver cirrhosis may enable further insight on actions necessary to tackle the disease on a global scale. |
format | Online Article Text |
id | pubmed-8375592 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83755922021-08-20 An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis Tay, Phoebe Wen Lin Xiao, Jieling Tan, Darren Jun Hao Ng, Cheng Lye, Yan Nerng Lim, Wen Hui Teo, Vanessa Xin Yi Heng, Ryan Rui Yang Yeow, Marcus Wei Xuan Lum, Lionel Hon Wai Tan, Eunice Xiang Xuan Kew, Guan Sen Lee, Guan Huei Muthiah, Mark D. Front Med (Lausanne) Medicine Background and Aims: Spontaneous bacterial peritonitis (SBP) is a common and potentially fatal complication of liver cirrhosis. This study aims to analyze the prevalence of SBP among liver cirrhotic patients according to geographical location and income level, and risk factors and outcomes of SBP. Methods: A systematic search for articles describing prevalence, risk factors and outcomes of SBP was conducted. A single-arm meta-analysis was performed using generalized linear mix model (GLMM) with Clopper-Pearson intervals. Results: Ninety-Nine articles, comprising a total of 5,861,142 individuals with cirrhosis were included. Pooled prevalence of SBP was found to be 17.12% globally (CI: 13.63–21.30%), highest in Africa (68.20%; CI: 12.17–97.08%), and lowest in North America (10.81%; CI: 5.32–20.73%). Prevalence of community-acquired SBP was 6.05% (CI: 4.32–8.40%), and 11.11% (CI: 5.84–20.11%,) for healthcare-associated SBP. Antibiotic-resistant microorganisms were found in 11.77% (CI: 7.63–17.73%) of SBP patients. Of which, methicillin-resistant Staphylococcus aureus was most common (6.23%; CI: 3.83–9.97%), followed by extended-spectrum beta-lactamase producing organisms (6.19%; CI: 3.32–11.26%), and lastly vancomycin-resistant enterococci (1.91%; CI: 0.41–8.46%). Subgroup analysis comparing prevalence, antibiotic resistance, and outcomes between income groups was conducted to explore a link between socioeconomic status and SBP, which revealed decreased risk of SBP and negative outcomes in high-income countries. Conclusion: SBP remains a frequent complication of liver cirrhosis worldwide. The drawn link between income level and SBP in liver cirrhosis may enable further insight on actions necessary to tackle the disease on a global scale. Frontiers Media S.A. 2021-08-05 /pmc/articles/PMC8375592/ /pubmed/34422858 http://dx.doi.org/10.3389/fmed.2021.693652 Text en Copyright © 2021 Tay, Xiao, Tan, Ng, Lye, Lim, Teo, Heng, Yeow, Lum, Tan, Kew, Lee and Muthiah. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Tay, Phoebe Wen Lin Xiao, Jieling Tan, Darren Jun Hao Ng, Cheng Lye, Yan Nerng Lim, Wen Hui Teo, Vanessa Xin Yi Heng, Ryan Rui Yang Yeow, Marcus Wei Xuan Lum, Lionel Hon Wai Tan, Eunice Xiang Xuan Kew, Guan Sen Lee, Guan Huei Muthiah, Mark D. An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis |
title | An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis |
title_full | An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis |
title_fullStr | An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis |
title_full_unstemmed | An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis |
title_short | An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis |
title_sort | epidemiological meta-analysis on the worldwide prevalence, resistance, and outcomes of spontaneous bacterial peritonitis in cirrhosis |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375592/ https://www.ncbi.nlm.nih.gov/pubmed/34422858 http://dx.doi.org/10.3389/fmed.2021.693652 |
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