“…Our study have shown higher resistance rate of enterococcal isolates to teicoplanin (10.2%) than that of Giacometti et al (2000), Arias et al (2003) and Yakar et al (2010) who reported resistance rates of (2.1%), (5.9%) and (0%) respectively. Our rate (10.2%) is lower than that of Pourakbari et al (2012) and Sharifi et al (2013) who reported resistance rates of (15.3%) and (18.6%) respectively.…”
This study aims to investigate the resistance profile of enterococci to commonly used antibiotics to provide correct treatment of urinary tract infections and to stop the continual emergence of highly resistant species of bacteria. Three hundred and twenty five (325) urine samples were collected from patients in Urinary Tract (UT) Department and Outpatient urinary tract clinic of Zagazig University Hospitals in Zagazig city, Sharkia, Egypt. One hundred and twenty seven enterococcal isolates (39.1%) were isolated from urine samples. Seventy (55.1%) of enterococcal isolates were Enterococcus faecalis and fifty seven (44.9%) of enterococcal isolates were Enterococcus faecium. All the isolates are identified and the sensitivity to a number of antibiotics was determined by disc diffusion method. Using standard breakpoint sensitivity values: the highest percentages of resistance of enterococcal isolates were found for penicillin G, rifampin, erythromycin, doxycycline, ampicillin, lincomycin and amoxicillin. The moderate percentages of resistance were found for ciprofloxacin, azithromycin, clarithromycin and spiramycin, gentamicin and clindamycin, whereas the lowest percentages of resistance were seen for and chloramphenicol, vancomycin, teicoplanin, sulphamethoxazole/trimethoprim and imipenem. These values are seemed to be higher than wide world values. This is probably due to the variation in the bacterial sensitivity pattern over time and between different geographical districts, misusing of antibiotics and not continuing the antibiotic therapy for sufficient period of time. In conclusion, this high resistance rate represents a dangerous alarm that necessitates the search for new therapeutic options.
“…Our study have shown higher resistance rate of enterococcal isolates to teicoplanin (10.2%) than that of Giacometti et al (2000), Arias et al (2003) and Yakar et al (2010) who reported resistance rates of (2.1%), (5.9%) and (0%) respectively. Our rate (10.2%) is lower than that of Pourakbari et al (2012) and Sharifi et al (2013) who reported resistance rates of (15.3%) and (18.6%) respectively.…”
This study aims to investigate the resistance profile of enterococci to commonly used antibiotics to provide correct treatment of urinary tract infections and to stop the continual emergence of highly resistant species of bacteria. Three hundred and twenty five (325) urine samples were collected from patients in Urinary Tract (UT) Department and Outpatient urinary tract clinic of Zagazig University Hospitals in Zagazig city, Sharkia, Egypt. One hundred and twenty seven enterococcal isolates (39.1%) were isolated from urine samples. Seventy (55.1%) of enterococcal isolates were Enterococcus faecalis and fifty seven (44.9%) of enterococcal isolates were Enterococcus faecium. All the isolates are identified and the sensitivity to a number of antibiotics was determined by disc diffusion method. Using standard breakpoint sensitivity values: the highest percentages of resistance of enterococcal isolates were found for penicillin G, rifampin, erythromycin, doxycycline, ampicillin, lincomycin and amoxicillin. The moderate percentages of resistance were found for ciprofloxacin, azithromycin, clarithromycin and spiramycin, gentamicin and clindamycin, whereas the lowest percentages of resistance were seen for and chloramphenicol, vancomycin, teicoplanin, sulphamethoxazole/trimethoprim and imipenem. These values are seemed to be higher than wide world values. This is probably due to the variation in the bacterial sensitivity pattern over time and between different geographical districts, misusing of antibiotics and not continuing the antibiotic therapy for sufficient period of time. In conclusion, this high resistance rate represents a dangerous alarm that necessitates the search for new therapeutic options.
“…The results of the current study, which derive from a single‐center experience with a specific epidemiological pattern of multiresistance, cannot be generalized to any hospital. However, several reports and unpublished observations from other groups indicate that the increased rate of infections by multiresistant bacteria,16‐22 and the failure of the currently recommended empirical antibiotic schedules observed in our hospital,45‐47 is not a single‐center issue, but an emerging problem in cirrhosis. The use of third‐generation cephalosporins and long‐term norfloxacin prophylaxis are probably important factors in its pathogenesis.…”
Epidemiology, risk factors, and clinical effect of infections by multiresistant bacteria in cirrhosis are poorly known. This work was a prospective evaluation in two series of patients with cirrhosis admitted with infection or developing infection during hospitalization. The first series was studied between 2005 and 2007 (507 bacterial infections in 223 patients) and the second between 2010 and 2011 (162 bacterial infections in 110 patients). In the first series, 32% of infections were community acquired (CA), 32% healthcare associated (HCA), and 36% nosocomial. Multiresistant bacteria (92 infections; 18%) were isolated in 4%, 14%, and 35% of these infections, respectively (P < 0.001). Extended-spectrum b-lactamaseproducing Enterobacteriaceae (ESBL-E; n 5 43) was the main multiresistant organism identified, followed by Pseudomonas aeruginosa (n 5 17), methicillin-resistant Staphylococcus aureus (n 5 14), and Enterococcus faecium (n 5 14). The efficacy of currently recommended empirical antibiotic therapy was very low in nosocomial infections (40%), compared to HCA and CA episodes (73% and 83%, respectively; P < 0.0001), particularly in spontaneous bacterial peritonitis, urinary tract infection, and pneumonia (26%, 29%, and 44%, respectively). Septic shock (26% versus 10%; P < 0.0001) and mortality rate (25% versus 12%; P 5 0.001) were significantly higher in infections caused by multiresistant strains. Nosocomial origin of infection (hazard ratio [HR], 4.43), long-term norfloxacin prophylaxis (HR, 2.69), recent infection by multiresistant bacteria (HR, 2.45), and recent use of b-lactams (HR, 2.39) were independently associated with the development of multiresistant infections. Results in the second series were similar to those observed in the first series. Conclusions: Multiresistant bacteria, especially ESBL-producing Enterobacteriaceae, are frequently isolated in nosocomial and, to a lesser extent, HCA infections in cirrhosis, rendering third-generation cephalosporins clinically ineffective. New antibiotic strategies tailored according to the local epidemiological patterns are needed for the empirical treatment of nosocomial infections in cirrhosis. (HEPATOLOGY 2012;55:1551-1561
“…Gram‐positive cocci (GPC) have generally accounted for less than 25% of cases of SBP . Infections with GPC including pneumonia and urinary tract infections have markedly increased in patients with cirrhosis in recent years and have been linked to therapeutic interventions and chronic antibiotic usage .…”
Section: Bacteriologymentioning
confidence: 99%
“…Fluoroquinolones have comparable ascitic fluid penetration to cephalosporins . Levofloxacin has shown similar efficacy compared to (cefotaxime and cefepime) at providing E. coli coverage [71% vs. (82%)] and coagulase‐negative Staphylococcus coverage [90% vs. (44%)] in patients with SBP not receiving fluoroquinolone prophylaxis . In patients with penicillin allergy who are not receiving long‐term fluoroquinolone therapy, levofloxacin is a reasonable and safe alternative treatment for SBP …”
SUMMARY BackgroundSpontaneous bacterial peritonitis (SBP) is a severe and often fatal infection in patients with cirrhosis and ascites.
AimTo review the known and changing bacteriology, risk factors, ascitic fluid interpretation, steps in performing paracentesis, treatment, prophylaxis and evolving perspectives related to SBP.
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