Abstract
BackgroundEnterobacter species are important nosocomial pathogens, and there is growing concern about their ability to develop resistance during antimicrobial therapy. However, few data are available on the clinical characteristics and outcomes of Enterobacter spontaneous bacterial peritonitis (SBP).MethodsWe retrospectively identified all patients with SBP caused by Enterobacter species admitted to a tertiary care hospital between January 1997 and December 2013. Each case was age- and sex-matched with four patients with Escherichia coli SBP.ResultsA total of 32 cases with Enterobacter SBP and 128 controls with E. coli SBP were included. Twenty-one (65.6 %) cases and 111 (86.7 %) controls had Child-Pugh class C (P = 0.006). Cases were significantly more likely to have hepatocellular carcinoma (65.6 % vs. 37.5 %, P = 0.004) and upper gastrointestinal bleeding (28.1 % vs. 9.4 %, P = 0.005). The initial response to empirical therapy (81.3 % vs. 81.2 %, P = 0.995) and the 30-day mortality (37.5 % vs. 28.9 %, P = 0.35) were not significantly different between the groups. Drug resistance emerged in one case and in no controls (4.3 % [1/23] vs. 0 % [0/98], P = 0.19).ConclusionsCompared with E. coli SBP, patients with Enterobacter SBP more frequently had hepatocellular carcinoma and upper gastrointestinal bleeding, yet clinical outcomes were comparable. Development of resistance during third-generation cephalosporin therapy was infrequent in patients with Enterobacter SBP.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1595-y) contains supplementary material, which is available to authorized users.
Highlights
Enterobacter species are important nosocomial pathogens, and there is growing concern about their ability to develop resistance during antimicrobial therapy
The 32 Enterobacter spontaneous bacterial peritonitis (SBP) patients were ageand sex-matched with 128 control subjects who had E. coli SBP
Multivariate analysis showed that hospital acquisition (OR, 3.19; 95 % CI, 1.25-8.14; P = 0.02) and prior endoscopic intervention (OR, 3.57; 95 % CI, 1.02-12.44; P = 0.046) were independent factors favoring Enterobacter SBP rather than E. coli SBP
Summary
Enterobacter species are important nosocomial pathogens, and there is growing concern about their ability to develop resistance during antimicrobial therapy. Few data are available on the clinical characteristics and outcomes of Enterobacter spontaneous bacterial peritonitis (SBP). Enterobacter species are known to be part of the microbial etiology for spontaneous bacterial peritonitis (SBP), being the second to fourth most common causative organism among gram-negative bacilli [12,13,14,15]. There is a paucity of clinical data about the prevalence, characteristics, and outcomes of Enterobacter SBP. With a large SBP cohort, we sought to characterize the frequency, clinical manifestations, responses to antimicrobial therapy, emergence of resistance, and outcomes of Enterobacter SBP
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
