尼日利亚西南部肝硬化和肝细胞癌患者自发性细菌性腹膜炎的特征分析。

Abosede G Adeyeye, Adeyemi T Adeyemo, Victor O Adeyeye, Temitope O Ojo, Olusegun Adekanle, Anthony C Anuforo, Aaron O Aboderin, Dennis A Ndububa
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引用次数: 0

摘要

目的:本研究确定失代偿期肝硬化和肝细胞癌(HCC)患者自发性细菌性腹膜炎(SBP)及其变异的概况。设计:描述性横断面研究。环境:本研究在某三级医院进行。参与者:18岁以上失代偿期肝硬化和HCC患者。干预措施:取腹水(AF)样本进行细胞计数,并用BACTEC培养瓶进行培养。敏感性模式和腹水总蛋白和白蛋白水平也进行了评估。主要观察指标:收缩压的临床表现、腹水中分离的微生物以及分离的微生物对抗生素的敏感性。结果:共招募了106名参与者。70例(66%)为肝硬化,36例(34%)为HCC。平均年龄50.08±12.66岁。89人(84%)为男性,17人(16%)为女性。收缩压的总患病率为29.2% (n = 31)。经典SBP为5(4.7%),CNNA为20(18.9%),单菌腹水为6(5.7%)。革兰氏阳性菌为金黄色葡萄球菌5(45.5%)- MRSA 2(18.2%), MSSA 3(27.3%),革兰氏阴性菌为大肠杆菌3(27.3%)、不动杆菌2(18.2%)和洋葱Bulkholderia 1(9.1%)。革兰氏阴性菌对头孢菌素有绝对耐药,但对美罗培南均敏感。革兰氏阳性菌对利奈唑胺、万古霉素和达托霉素的敏感性为100%。革兰氏阳性菌对氟喹诺酮类药物的耐药性也很低(20%)。报告了MRSA、鲍曼不动杆菌和洋葱Bulkholderia的多重耐药模式。结论:收缩压是失代偿性CLD患者常见的并发症。应鼓励有指导的抗生素治疗,特别是在出现多药耐药模式的情况下。资金:未宣布。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterising spontaneous bacterial peritonitis in liver cirrhosis and hepatocellular carcinoma in southwestern Nigeria.

Objectives: This study determined the profile of spontaneous bacterial peritonitis (SBP) and its variants in patients with decompensated liver cirrhosis and hepatocellular carcinoma (HCC).

Design: A descriptive cross-sectional study.

Setting: The study was conducted in a tertiary hospital.

Participants: Patients with decompensated liver cirrhosis and HCC above 18 years.

Interventions: Ascitic fluid (AF) samples were taken for cell count and culture using a BACTEC culture bottle. Sensitivity patterns and ascitic fluid total protein and albumin levels were also assessed.

Main outcome measures: Clinical profile of SBP, organisms isolated from the ascitic fluid and sensitivity of isolated organisms to antibiotics.

Results: One hundred and six (106) participants were recruited. Seventy (66%) had liver cirrhosis, and 36 (34%) had HCC. The mean age was 50.08±12.66 years. Eighty-nine (84%) were males and 17(16%) were females. The overall prevalence of SBP was 29.2% (n = 31). Classical SBP was 5(4.7%), CNNA 20(18.9%) and monobacterial ascites 6(5.7%). The Gram-positive isolates were Staphylococcus aureus 5(45.5%) - [2(18.2%) MRSA, 3(27.3%) MSSA] while the Gram-negative organisms were E. coli 3(27.3%), Acinectobacter 2(18.2%) and Bulkholderia cepacia 1 (9.1%). Gram-negative bacteria showed absolute resistance to cephalosporins but were all susceptible to meropenem. Gram-positive bacteria showed 100% susceptibility to linezolid, vancomycin and daptomycin. Gram-positive bacteria also showed low resistance to fluoroquinolones (20%). Multi-drug resistance pattern was reported for MRSA, Acinetobacter baumannii and Bulkholderia cepacia.

Conclusion: SBP is a common complication in patients with decompensated CLD. Guided antibiotic treatment should be encouraged, particularly in light of the emergence of multidrug resistance patterns.

Funding: None declared.

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