Aeromonas spontaneous bacterial peritonitis: A highly fatal infectious disease in patients with advanced liver cirrhosis

研究成果: Article

11 引文 (Scopus)

摘要

Background/Purpose: Aeromonas infections, rarely reported in Western countries, are not uncommon infectious diseases in Taiwan. The clinical manifestations and prognostic factors of Aeromonas spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis were investigated. Methods: We reviewed the medical charts and microbiological records of liver cirrhosis patients with Aeromonas SBP between January 1990 and December 2005, in a medical center in southern Taiwan. Results: Thirty-one liver cirrhosis patients developed Aeromonas SBP within a 16-year period. The majority (26, 84%) had concurrent Aeromonas bacteremia. A. sobria (55%) and A. hydrophila (45%) were the causative species. The predominant clinical manifestations included fever (84%), abdominal pain (74%), hypotension on admission (48%), altered mental status (45%), and acute renal failure (42%). Gram-negative bacilli were found in Gram staining of ascitic fluids in 27% of 26 patients, while aeromonads were isolated from ascitic fluids in 55% of 31 patients. The yield rate of ascitic fluid cultures decreased greatly, if paracentesis was performed at > 3 hours after the administration of antimicrobial therapy. All but one patient received in-vivo-active antimicrobial agents within 48 hours, but the all-cause mortality rate was 56%. Initial high Pitt's bacteremia score was independently associated with a fatal outcome in multivariate analysis. Conclusion: Aeromonas SBP is a fatal disease, and must be included in the differential diagnosis of SBP in patients with advanced liver cirrhosis in endemic areas.

原文English
頁(從 - 到)293-300
頁數8
期刊Journal of the Formosan Medical Association
108
發行號4
DOIs
出版狀態Published - 2009 四月

指紋

Aeromonas
Peritonitis
Liver Cirrhosis
Communicable Diseases
Ascitic Fluid
Bacteremia
Taiwan
Paracentesis
Fatal Outcome
Anti-Infective Agents
Acute Kidney Injury
Hypotension
Bacillus
Abdominal Pain
Differential Diagnosis
Fever
Multivariate Analysis
Staining and Labeling
Mortality
Infection

All Science Journal Classification (ASJC) codes

  • Medicine(all)

引用此文

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title = "Aeromonas spontaneous bacterial peritonitis: A highly fatal infectious disease in patients with advanced liver cirrhosis",
abstract = "Background/Purpose: Aeromonas infections, rarely reported in Western countries, are not uncommon infectious diseases in Taiwan. The clinical manifestations and prognostic factors of Aeromonas spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis were investigated. Methods: We reviewed the medical charts and microbiological records of liver cirrhosis patients with Aeromonas SBP between January 1990 and December 2005, in a medical center in southern Taiwan. Results: Thirty-one liver cirrhosis patients developed Aeromonas SBP within a 16-year period. The majority (26, 84{\%}) had concurrent Aeromonas bacteremia. A. sobria (55{\%}) and A. hydrophila (45{\%}) were the causative species. The predominant clinical manifestations included fever (84{\%}), abdominal pain (74{\%}), hypotension on admission (48{\%}), altered mental status (45{\%}), and acute renal failure (42{\%}). Gram-negative bacilli were found in Gram staining of ascitic fluids in 27{\%} of 26 patients, while aeromonads were isolated from ascitic fluids in 55{\%} of 31 patients. The yield rate of ascitic fluid cultures decreased greatly, if paracentesis was performed at > 3 hours after the administration of antimicrobial therapy. All but one patient received in-vivo-active antimicrobial agents within 48 hours, but the all-cause mortality rate was 56{\%}. Initial high Pitt's bacteremia score was independently associated with a fatal outcome in multivariate analysis. Conclusion: Aeromonas SBP is a fatal disease, and must be included in the differential diagnosis of SBP in patients with advanced liver cirrhosis in endemic areas.",
author = "Wu, {Chi Jung} and Lee, {Hsin Chun} and Chang, {Ting Tsung} and Chen, {Chiung Yu} and Lee, {Nan Yao} and Chang, {Chia Ming} and Sheu, {Bor Shyang} and Cheng, {Pin Nan} and Shih, {Hsin I.} and Ko, {Wen Chien}",
year = "2009",
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doi = "10.1016/S0929-6646(09)60069-3",
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pages = "293--300",
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TY - JOUR

T1 - Aeromonas spontaneous bacterial peritonitis

T2 - A highly fatal infectious disease in patients with advanced liver cirrhosis

AU - Wu, Chi Jung

AU - Lee, Hsin Chun

AU - Chang, Ting Tsung

AU - Chen, Chiung Yu

AU - Lee, Nan Yao

AU - Chang, Chia Ming

AU - Sheu, Bor Shyang

AU - Cheng, Pin Nan

AU - Shih, Hsin I.

AU - Ko, Wen Chien

PY - 2009/4

Y1 - 2009/4

N2 - Background/Purpose: Aeromonas infections, rarely reported in Western countries, are not uncommon infectious diseases in Taiwan. The clinical manifestations and prognostic factors of Aeromonas spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis were investigated. Methods: We reviewed the medical charts and microbiological records of liver cirrhosis patients with Aeromonas SBP between January 1990 and December 2005, in a medical center in southern Taiwan. Results: Thirty-one liver cirrhosis patients developed Aeromonas SBP within a 16-year period. The majority (26, 84%) had concurrent Aeromonas bacteremia. A. sobria (55%) and A. hydrophila (45%) were the causative species. The predominant clinical manifestations included fever (84%), abdominal pain (74%), hypotension on admission (48%), altered mental status (45%), and acute renal failure (42%). Gram-negative bacilli were found in Gram staining of ascitic fluids in 27% of 26 patients, while aeromonads were isolated from ascitic fluids in 55% of 31 patients. The yield rate of ascitic fluid cultures decreased greatly, if paracentesis was performed at > 3 hours after the administration of antimicrobial therapy. All but one patient received in-vivo-active antimicrobial agents within 48 hours, but the all-cause mortality rate was 56%. Initial high Pitt's bacteremia score was independently associated with a fatal outcome in multivariate analysis. Conclusion: Aeromonas SBP is a fatal disease, and must be included in the differential diagnosis of SBP in patients with advanced liver cirrhosis in endemic areas.

AB - Background/Purpose: Aeromonas infections, rarely reported in Western countries, are not uncommon infectious diseases in Taiwan. The clinical manifestations and prognostic factors of Aeromonas spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis were investigated. Methods: We reviewed the medical charts and microbiological records of liver cirrhosis patients with Aeromonas SBP between January 1990 and December 2005, in a medical center in southern Taiwan. Results: Thirty-one liver cirrhosis patients developed Aeromonas SBP within a 16-year period. The majority (26, 84%) had concurrent Aeromonas bacteremia. A. sobria (55%) and A. hydrophila (45%) were the causative species. The predominant clinical manifestations included fever (84%), abdominal pain (74%), hypotension on admission (48%), altered mental status (45%), and acute renal failure (42%). Gram-negative bacilli were found in Gram staining of ascitic fluids in 27% of 26 patients, while aeromonads were isolated from ascitic fluids in 55% of 31 patients. The yield rate of ascitic fluid cultures decreased greatly, if paracentesis was performed at > 3 hours after the administration of antimicrobial therapy. All but one patient received in-vivo-active antimicrobial agents within 48 hours, but the all-cause mortality rate was 56%. Initial high Pitt's bacteremia score was independently associated with a fatal outcome in multivariate analysis. Conclusion: Aeromonas SBP is a fatal disease, and must be included in the differential diagnosis of SBP in patients with advanced liver cirrhosis in endemic areas.

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JO - Journal of the Formosan Medical Association

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