墨西哥总医院自发性细菌性腹膜炎患者的抗菌素耐药性和敏感性模式“Eduardo Liceaga博士”

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-04-01 DOI:10.1016/j.aohep.2025.101862

Gabriela Rangel-Zavala, Paloma M. Diego-Salazar, Karina Cazarín-Chávez, José L. Pérez-Hernández, Fatima Higuera-de-de-Tijera

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引用次数: 0

摘要

简介与目的自发性细菌性腹膜炎（SBP）是肝硬化患者的一种严重并发症，发病率和死亡率都很高。抗微生物药物耐药性使治疗复杂化并增加并发症。本研究旨在确定收缩压中微生物的耐药模式，以提高治疗效果。材料和患者：在2022年1月至2024年1月期间，墨西哥总医院Eduardo Liceaga博士对自发性细菌性腹膜炎患者的抗菌素耐药性和敏感性进行了一项描述性、观察性和回顾性研究。临床资料收集自胃肠病学服务的记录。微生物学结果来自微生物学处的报告。诊断为肝硬化并符合收缩压标准的患者被纳入研究。收集临床和微生物数据，分析年龄、性别、肝病病因和相关代偿失代偿，如胃肠道出血和肝性脑病等变量。研究了收缩压患者的抗微生物药物耐药性模式以及临床和微生物学特征。该分析旨在为SBP的优化管理和开发更有效的抗菌治疗策略做出贡献。结果共纳入48例患者，男性占52.1%，平均年龄52.4±12.7岁。肝硬化的主要病因是酒精，占56.3%。其中，大肠杆菌（56.25%）、肺炎克雷伯菌（12.5%）、粪肠球菌（6.25%）、链球菌（6.25%）、表皮葡萄球菌（4.16%）、金黄色葡萄球菌（4.16%）、鸡肠球菌（4.16%）、粘质葡萄球菌（2.08%）、sobria不动杆菌（2.08%）、溶血葡萄球菌（2.08%）最为突出。不同抗菌素的敏感性和耐药性表见图1。结论收缩压患者的抗生素耐药性正在增加，有效的治疗方案很少，推荐的头孢菌素和喹诺酮类药物不再有效，这在经验治疗的背景下是危险的，因为治疗反应失败的风险很高。

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Patterns of antimicrobial resistance and susceptibility in patients with spontaneous bacterial peritonitis at the General Hospital of Mexico "Dr. Eduardo Liceaga"

Introduction and Objectives

Spontaneous bacterial peritonitis (SBP) is a serious complication in cirrhotic patients, with high morbidity and mortality. Antimicrobial resistance complicates treatment and increases complications. This study aims to determine resistance patterns in microorganisms in SBP to improve treatment efficacy.

Materials and Patients

A descriptive, observational, and retrospective study on patterns of antimicrobial resistance and susceptibility in patients with spontaneous bacterial peritonitis was conducted at the General Hospital of Mexico “Dr. Eduardo Liceaga” between January 2022 and January 2024. Clinical information was collected from the records of the Gastroenterology Service. Microbiological results were obtained from reports from the Microbiology Service. Patients diagnosed with hepatic cirrhosis and meeting the criteria for SBP were included. Clinical and microbiological data were collected, analyzing variables such as age, sex, etiology of liver disease, and associated decompensations, such as gastrointestinal bleeding and hepatic encephalopathy. Antimicrobial resistance patterns, as well as clinical and microbiological characteristics of patients with SBP, were examined. This analysis aims to contribute to the optimal management of SBP and the development of more effective antimicrobial treatment strategies.

Results

A total of 48 patients were included, 52.1% were men, with a mean age of 52.4 ± 12.7 years. The predominant etiology of cirrhosis was alcohol, present in 56.3% of cases. Among the isolated bacteria, Escherichia coli (56.25%), Klebsiella pneumoniae (12.5%), Enterococcus faecalis (6.25%), Streptococcus spp. (6.25%), Staphylococcus epidermidis (4.16%), Staphylococcus aureus (4.16%), Enterococcus gallinarum (4.16%), Staphylococcus marcescens (2.08%), Acinetobacter sobria (2.08%), and Staphylococcus haemolyticus (2.08%) were prominent. The sensitivity and resistance table to different antimicrobials are presented in Graph 1.

Conclusions

Antimicrobial resistance is increasing in patients with SBP, leaving few effective alternatives, where cephalosporins and quinolones, recommended treatments, are no longer sufficiently useful, which is dangerous in the context of empirical therapy given the high risk of therapeutic response failure.

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.