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Spontaneous ascitic infection in different cirrhotic groups: prevalence, risk factors and the efficacy of cefotaxime therapy.
- Source :
-
European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 1997 Jan; Vol. 9 (1), pp. 71-6. - Publication Year :
- 1997
-
Abstract
- Objective: To investigate the prevalence of spontaneous ascitic infection (SAI) in different cirrhotic groups, the risk factors for development of SAI, and the efficacy of cefotaxime therapy.<br />Design: A prospective study.<br />Setting: In-patient clinic of a university hospital.<br />Patients: Eighty cirrhotic patients with ascites were assigned to four groups: hepatitis B or D virus-related 34, alcoholic 18, hepatitis C virus-related 14, miscellaneous 14.<br />Interventions: Paracentesis was performed on 80 patients during 92 consecutive hospitalizations. Ascitic fluid was cultured by the method of bedside inoculation of blood culture bottles with ascites. The patients with SAI were treated with cefotaxime (2 g, three times daily, intravenously) for 5 days.<br />Main Outcome Measures: Frequency of SAI in cirrhotic groups; clinical, bacteriological and biochemical findings of SAI; rate of recovery-from infection.<br />Results: Twenty SAI episodes (22%) were found in 16 patients; 8 episodes were spontaneous bacterial peritonitis, 2 bacterascites, and 10 culture-negative neutrocytic ascites. SAI occurred more frequently in patients with hepatitis B or D virus-related liver cirrhosis (32%) than in the alcoholic (6%, P < 0.05), hepatitis C virus-related (14%) or miscellaneous (14%) cirrhotic groups in multivariate analysis, independent predictive factors associated with the development of SAI are chronic hepatitis B virus infection, ascitic fluid total protein and serum bilirubin. Escherichia coli was obtained in 5 of 10 positive ascitic fluid cultures. Cure of the infection was achieved in 95% of episodes. Hospitalization mortality rate in infected patients was 20%.<br />Conclusion: Spontaneous ascitic infection occurs in approximately 20% of cirrhotic patients hospitalized with ascites. The patients with low ascitic protein concentration, high serum bilirubin level or hepatitis B virus cirrhosis are more predisposed to SAI. Cefotaxime may be an effective first-choice antibiotic for ascitic fluid infection.
- Subjects :
- Adult
Ascitic Fluid microbiology
Bacteria isolation & purification
Bacterial Infections drug therapy
Bacterial Infections epidemiology
Cefotaxime administration & dosage
Cephalosporins administration & dosage
Female
Hospital Mortality
Humans
Infusions, Intravenous
Male
Middle Aged
Peritonitis drug therapy
Peritonitis epidemiology
Prevalence
Prospective Studies
Recurrence
Risk Factors
Treatment Outcome
Turkey epidemiology
Bacterial Infections etiology
Cefotaxime therapeutic use
Cephalosporins therapeutic use
Liver Cirrhosis complications
Peritonitis microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 0954-691X
- Volume :
- 9
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of gastroenterology & hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 9031903
- Full Text :
- https://doi.org/10.1097/00042737-199701000-00017