Dupeyron C, Campillo B, Mangeney N, Richardet J P, Leluan G
Hôpital Albert Chenevier, Créteil, France.
J Clin Pathol. 1998 Aug;51(8):614-6. doi: 10.1136/jcp.51.8.614.
To assess all clinically and bacteriologically documented episodes of spontaneous bacterial peritonitis diagnosed in a single unit over a 20 year period, to identify changes in the nature and antibiotic resistance of the causative bacteria.
A specialist liver disease unit in a tertiary care centre.
Cultured ascitic fluid obtained in the course of 240 consecutive episodes of clinically and bacteriologically proven spontaneous bacterial peritonitis. Patient recruitment remained stable during the 20 year period in terms of the number of cirrhotic patients admitted and the severity of their condition.
78.7% of isolates were Enterobacteriaceae (Escherichia coli in 51%) and 19% were Gram positive cocci. Until 1979 all the Enterobacteriaceae had the wild phenotype, compared with only 50% at the end of the study period. Since 1993, 22% of Enterobacteriaceae have been resistant to third generation cephalosporins. Methicillin resistant staphylococci were only isolated after 1989.
Changes in the epidemiology and antibiotic resistance of bacteria causing spontaneous bacterial peritonitis must be monitored for optimal treatment.
评估在一个单位20年期间诊断的所有临床和细菌学记录的自发性细菌性腹膜炎发作，以确定致病菌的性质和抗生素耐药性的变化。
一家三级护理中心的专科肝病科。
在240例连续的临床和细菌学证实的自发性细菌性腹膜炎发作过程中获得的培养腹水。在20年期间，肝硬化患者的入院人数及其病情严重程度方面，患者招募保持稳定。
78.7%的分离株为肠杆菌科（51%为大肠杆菌），19%为革兰氏阳性球菌。直到1979年，所有肠杆菌科细菌都具有野生表型，而在研究期结束时这一比例仅为50%。自1993年以来，22%的肠杆菌科细菌对第三代头孢菌素耐药。耐甲氧西林葡萄球菌仅在1989年后才被分离出来。
为了进行最佳治疗，必须监测引起自发性细菌性腹膜炎的细菌的流行病学和抗生素耐药性变化。
