Clinical Findings, Bacterial Agents, and Antibiotic Resistance in Children with Spontaneous Peritonitis in Southern Iran: An Academic Tertiary Referral Center's Experience.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL
Sara Salehi, Naser Honar, Gholamreza Pouladfar, Marzieh Davoodi, Hamid Reihani, Mahmood Haghighat, Mohammad Hadi Imanieh, Seyed Mohsen Dehghani, Maryam Ataollahi, Narges Ansari-Charsoughi, Iraj Shahramian, Amin Abbasian
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引用次数: 0

Abstract

Background: Spontaneous bacterial peritonitis (SBP) is a fatal complication of ascites fluid infection. The causes of SBP in children differ from those in adults, and these bacteria are frequently resistant to antibiotics. Therefore, this study investigated the clinical findings, bacterial etiology, and antimicrobial resistance in children with SBP.

Methods: This study was conducted on all new pediatric ascites patients, who were admitted to the Department of Pediatric Gastroenterology, Namazi Hospital, affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from 2021 to 2022. Required data such as demographic information, and clinical information such as complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Gram staining, blood culture by Automated Blood Culture System (BACTEC), and antibiogram of ascites fluids by disc diffusion method were all collected. Finally, the data were statistically analyzed using SPSS Software (version 26). Besides, the t test, Fisher's exact, Mann-Whitney, and Chi square tests were used for data analysis. In all tests, P≤0.05 was considered statistically significant.

Results: The present study examined 62 children with ascites of which 18 (29%) had SBP. The median (IQR) age was 2.5 (8.1) years. Thirty-four (54.8%) of the participants were girls. Abdominal pain was the most common clinical manifestation in patients (54%), and there was a significant association between abdominal pain and SBP (P=0.02). In 12 positive ascites fluid cultures, coagulase-negative staphylococci had the highest frequency (25%), followed by Escherichia coli (16.7%). Third-generation cephalosporins had a 25% sensitivity in the total positive cultures. This sensitivity was 33.3% for Gram-negative cultures and 16.6% for Gram-positive cultures.

Conclusion: Although third-generation cephalosporins are recommended as the primary antibiotic for the empirical treatment of SBP, the present study found high bacterial resistance. Finally, empirical therapy should be tailored to each region's bacterial resistance features.

伊朗南部自发性腹膜炎患儿的临床表现、细菌病原体和抗生素耐药性:一家学术三级转诊中心的经验。
背景:自发性细菌性腹膜炎(SBP自发性细菌性腹膜炎(SBP)是腹水感染的致命并发症。儿童 SBP 的病因与成人不同,而且这些细菌经常对抗生素产生耐药性。因此,本研究调查了 SBP 患儿的临床表现、细菌病因和抗菌药耐药性:本研究的对象是 2021 年至 2022 年期间在伊朗设拉子医科大学附属纳马齐医院小儿消化科住院的所有新发小儿腹水患者。研究人员收集了所需数据,如人口统计学信息,以及临床信息,如全血计数(CBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)、革兰氏染色、自动血液培养系统(BACTEC)血液培养和盘式扩散法腹水液抗生素图谱。最后,使用 SPSS 软件(26 版)对数据进行统计分析。此外,数据分析还采用了 t 检验、费雪精确检验、曼-惠特尼检验和卡方检验。所有检验均以 P≤0.05 为差异有统计学意义:本研究共调查了 62 名腹水患儿,其中 18 人(29%)患有 SBP。年龄中位数(IQR)为 2.5(8.1)岁。34名(54.8%)参与者为女孩。腹痛是患者最常见的临床表现(54%),腹痛与 SBP 之间存在显著关联(P=0.02)。在 12 份阳性腹水培养液中,凝固酶阴性葡萄球菌的出现频率最高(25%),其次是大肠埃希菌(16.7%)。在所有阳性培养物中,第三代头孢菌素的敏感性为 25%。对革兰氏阴性培养物的敏感性为 33.3%,对革兰氏阳性培养物的敏感性为 16.6%:结论:尽管第三代头孢菌素被推荐为经验性治疗 SBP 的主要抗生素,但本研究发现细菌耐药性很高。最后,经验性治疗应根据每个地区的细菌耐药性特点量身定制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
0.00%
发文量
84
审稿时长
12 weeks
期刊介绍: The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of com­muni­cation for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science re­search experiences on prevalent diseases in the region and analysis of various regional problems.
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