Role of immunosuppression in the development of quinolone‐resistant <i>Escherichia coli</i> spontaneous bacterial peritonitis and in the mortality of <i>E. coli</i> spontaneous bacterial peritonitis

Cereto, Ferran; Molina, Isabel; González, Antonio; Valle, Oscar del; Esteban, Rafael; Guàrdia, J; Genescà, Joan

doi:10.1046/j.1365-2036.2003.01491.x

Cited by 31 publications

(25 citation statements)

References 37 publications

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“…In patients who develop resistance to quinolones, trimethoprim/sulfamethoxazole has been suggested as an alternative to norfloxacin [78] . However, there is a high rate of SBP caused by trimethoprimsulfamethoxazole resistant Gram-negative bacteria (44%-72%), suggesting that this antibiotic is not a suitable alternative to norfloxacin [79,80] . Data supporting the use of trimethoprim/sulfamethoxazole are weak, while its side effects are potentially dangerous and probably under-reported [81] .…”

Section: Secondary Prophylaxis In Patients With Prior Sbpmentioning

confidence: 99%

Diagnosis and management of bacterial infections in decompensated cirrhosis

Pleguezuelo

Benítez²,

Jurado³

et al. 2013

WJH

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Bacterial infections are one of the most frequent complications in cirrhosis and result in high mortality rates. Patients with cirrhosis have altered and impaired immunity, which favours bacterial translocation. Episodes of infections are more frequent in patients with decompensated cirrhosis than those with compensated liver disease. The most common and life-threatening infection in cirrhosis is spontaneous bacterial peritonitis followed by urinary tract infections, pneumonia, endocarditis and skin and soft-tissue infections. Patients with decompensated cirrhosis have increased risk of developing sepsis, multiple organ failure and death. Risk factors associated with the development of infections are severe liver failure, variceal bleeding, low ascitic protein level and prior episodes of spontaneous bacterial peritonitis (SBP). The prognosis of these patients is closely related to a prompt and accurate diagnosis. An appropriate treatment decreases the mortality rates. Preventive strategies are the mainstay of the management of these patients. Empirical antibiotics should be started immediately following the diagnosis of SBP and the first-line antibiotic treatment is third-generation cephalosporins. However, the efficacy of currently recommended empirical antibiotic therapy is very low in nosocomial infections including SBP, compared to community-acquired episodes. This may be associated with the emergence of infections caused by Enterococcus faecium and extended-spectrum β-lactamaseproducing Enterobacteriaceae, which are resistant to the first line antimicrobial agents used for treatment. The emergence of resistant bacteria, underlines the need to restrict the use of prophylactic antibiotics to patients with the greatest risk of infections. Nosocomial infections should be treated with wide spectrum antibiotics. Further studies of early diagnosis, prevention and treatment are needed to improve the outcomes in patients with decompensated cirrhosis.

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Section: Secondary Prophylaxis In Patients With Prior Sbpmentioning

confidence: 99%

Diagnosis and management of bacterial infections in decompensated cirrhosis

Pleguezuelo

Benítez²,

Jurado³

et al. 2013

WJH

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“…Patients with liver cirrhosis suffer from decreased phagocytic activity of neutrophilic granulocytes and the mononuclear phagocytic system, deteriorated humoral immunity and decreased opsonin activity of AF [23] . Neutrophilic granulocytes of patients with hepatic cirrhosis show not only a decrease in the phagocytic activity, but also intracellular destruction of bacteria, deteriorated metabolic activities, frequent apoptosis and considerably reduced chemotaxis.…”

Section: Immunosuppressionmentioning

confidence: 99%

Spontaneous bacterial peritonitis: A severe complication ofliver cirrhosis

Lata¹,

Stibůrek²,

Kopáčová³

2009

WJG

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“…AF opsonization capacity is correlated with total protein levels in AF. It is a well-established fact that patients with reduced total proteins in AF have a greater risk for SBP (20).…”

Section: Pathophysiologymentioning

confidence: 99%