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; Lum, Lionel; Tan, Eunice Xiang Xuan; Kew, Guan Sen; Lee, Guan Huei; Muthiah, Mark

doi:10.3389/fmed.2021.693652

Cited by 29 publications

(29 citation statements)

References 130 publications

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“…The overall cultural positivity rate of our cohort was 26%, which is equivalent to rates reported previously [48]. We could amplify and identify bacteria in 36 (72%) samples.…”

Section: Discussionsupporting

confidence: 82%

Next- and Third-Generation Sequencing Outperforms Culture-Based Methods in the Diagnosis of Ascitic Fluid Bacterial Infections of ICU Patients

Goelz

Wetzel

Mehrbarzin

et al. 2021

Cells

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Objectives: Infections of the ascitic fluid are serious conditions that require rapid diagnosis and treatment. Ascites is often accompanied by other critical pathologies such as gastrointestinal bleeding and bowel perforation, and infection increases the risk of mortality in intensive care patients. Owing to a relatively low success rate of conventional culture methods in identifying the responsible pathogens, new methods may be helpful to guide antimicrobial therapy and to refine empirical regimens. Here, we aim to assess outcomes and to identify responsible pathogens in ascitic fluid infections, in order to improve patients’ care and to guide empirical therapy. Methods: Between October 2019 and March 2021, we prospectively collected 50 ascitic fluid samples from ICU patients with suspected infection. Beside standard culture-based microbiology methods, excess fluid underwent DNA isolation and was analyzed by next- and third-generation sequencing (NGS) methods. Results: NGS-based methods had higher sensitivity in detecting additional pathogenic bacteria such as E. faecalis and Klebsiella in 33 out of 50 (66%) ascitic fluid samples compared with culture-based methods (26%). Anaerobic bacteria were especially identified by sequencing-based methods in 28 samples (56%), in comparison with only three samples in culture. Analysis of clinical data showed a correlation between sequencing results and various clinical parameters such as peritonitis and hospitalization outcomes. Conclusions: Our results show that, in ascitic fluid infections, NGS-based methods have a higher sensitivity for the identification of clinically relevant pathogens than standard microbiological culture diagnostics, especially in detecting hard-to-culture anaerobic bacteria. Patients with such infections may benefit from the use of NGS methods by the possibility of earlier and better targeted antimicrobial therapy, which has the potential to lower the high morbidity and mortality in critically ill patients with ascitic bacterial infection.

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“…The overall cultural positivity rate of our cohort was 26%, which is equivalent to rates reported previously [48]. We could amplify and identify bacteria in 36 (72%) samples.…”

Section: Discussionsupporting

confidence: 82%

Next- and Third-Generation Sequencing Outperforms Culture-Based Methods in the Diagnosis of Ascitic Fluid Bacterial Infections of ICU Patients

Goelz

Wetzel

Mehrbarzin

et al. 2021

Cells

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“…A total of 173 (16.7%) of the patients developed SBP, and positive ascites fluid cultures were demonstrated in 47.4% of the SBP cases[ 68 ]. A recent meta-analysis including 99 studies comprising 5861142 patients with cirrhosis summarized the prevalence, resistance, and outcomes of SBP in cirrhosis worldwide[ 69 ]. The pooled global prevalence of SBP was 17.12% (95%CI 13.63%-21.30%), with Africa having the highest prevalence (68.20%) and North America having the lowest (10.81%).…”

Section: Epidemiology Of Major Complicationsmentioning

confidence: 99%

Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions

Liu¹,

Chen²

2022

World J Gastroenterol

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Cirrhosis causes a heavy global burden. In this review, we summarized up-to-date epidemiological features of cirrhosis and its complications. Recent epidemiological studies reported an increase in the prevalence of cirrhosis in 2017 compared to in 1990 in both men and women, with 5.2 million cases of cirrhosis and chronic liver disease occurring in 2017. Cirrhosis caused 1.48 million deaths in 2019, an increase of 8.1% compared to 2017. Disability-adjusted life-years due to cirrhosis ranked 16th among all diseases and 7th in people aged 50-74 years in 2019. The global burden of hepatitis B virus and hepatitis C virus-associated cirrhosis is decreasing, while the burden of cirrhosis due to alcohol and nonalcoholic fatty liver disease (NAFLD) is increasing rapidly. We described the current epidemiology of the major complications of cirrhosis, including ascites, variceal bleeding, hepatic encephalopathy, renal disorders, and infections. We also summarized the epidemiology of hepatocellular carcinoma in patients with cirrhosis. In the future, NAFLD-related cirrhosis will likely become more common due to the prevalence of metabolic diseases such as obesity and diabetes, and the prevalence of alcohol-induced cirrhosis is increasing. This altered epidemiology should be clinically noted, and relevant interventions should be undertaken.

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“…A patogênese da peritonite bacteriana aguda na cirrose ainda é obscura, porém, há uma forte base teórica sobre a translocação bacteriana intestinal que é demonstrada no constante isolamento de bactérias nos pacientes ascíticos (TAY et al, 2021). Mais de 60 % dos episódios dessa patologia possuem relação com organismos entéricos gram-negativos principalmente Escherichia coli e Klebsiella pneumoniae (ALMEIDA et al, 2018).…”

Section: Fisiopatologiaunclassified

“…Entretanto, permanecer com a profilaxia de maneira inadequada em pacientes com melhora clínica pode contribuir na seleção de organismos multirresistentes. Por esse motivo é defendido pelas diretrizes da Associação Europeia para o Estudo do Fígado (EASL), que o perfil de risco adequado deve ser realizado para determinar a necessidade de profilaxia de SBP, a fim de garantir a administração segura e adequada de antibióticos (TAY et al, 2021) A terapia profilática com antibióticos como norfloxacina, ciprofloxacina ou trimetoprima-sulfametoxazol pode ser benéfica para pacientes de alto risco, que apresentaram sangramento gastrointestinal associado ou líquido ascítico com baixa contagem de proteínas (<1 g / dl) ou episódio anterior de PBE. No caso de pacientes com resistência antibiótica à fluoroquinolonas, o tratamento a ser implementado é a cefotaxima.…”

Section: Prevençãounclassified

“…A PBE representa uma importante causa de hospitalização por descompensação da cirrose hepática, estando associada a alta morbidade e mortalidade (MARCIANO et al, 2019). Deve-se levar em consideração que o fator socioeconômico e o uso indevido de antibióticos estão diretamente associados à prevalência de PBE (TAY et al, 2021). Logo, a prevenção a partir do uso de antibióticos é de grande interesse quando indicada (PIMENTEL et al, 2021).…”

Section: Introductionunclassified

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Antibioticoterapia Como Prevenção De Peritonite Bacteriana Espontânea Em Pacientes Críticos

Leonetti¹,

Carneiro²,

Kato³

et al. 2022

Teoria E Prática Trauma E Emergência - Ed. 3ª Vol. 1

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An Epidemiological Meta-Analysis on the Worldwide Prevalence, Resistance, and Outcomes of Spontaneous Bacterial Peritonitis in Cirrhosis

Cited by 29 publications

References 130 publications

Next- and Third-Generation Sequencing Outperforms Culture-Based Methods in the Diagnosis of Ascitic Fluid Bacterial Infections of ICU Patients

Next- and Third-Generation Sequencing Outperforms Culture-Based Methods in the Diagnosis of Ascitic Fluid Bacterial Infections of ICU Patients

Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions

Antibioticoterapia Como Prevenção De Peritonite Bacteriana Espontânea Em Pacientes Críticos

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