自发性细菌性腹膜炎(SBP)是肝硬化患者的严重并发症和常见死亡原因。在2017年1月至2024年3月之间,进行了一项回顾性研究,涉及在波兰东南部三级转诊中心治疗的302例腹水患者(>18岁)。对所有患者进行了腹水的微生物学分析。在17名患者的样本中发现了微生物的存在,分离出21种病原体,其中革兰氏阳性菌15株,革兰氏阴性菌6株。表皮葡萄球菌,MRCNS(耐甲氧西林凝固酶阴性葡萄球菌,对所有β-内酰胺抗生素具有抗性:青霉素,青霉素与β-内酰胺酶抑制剂,头孢菌素和碳青霉烯类抗生素)是检出的主要病原体(19.05%,4/21),其次是粪肠球菌(9.52%,2/21),屎肠球菌(9.52%,2/21),溶血葡萄球菌,MRCNS(4.76%,1/21),链球菌(9.52%,2/21),副血链球菌(9.52%,2/21),黄体微球菌(4.76%,1/21)和芽孢杆菌属。(4.76%,1/21).在检查的标本中还发现了以下革兰氏阴性菌:大肠杆菌,ESBL(产超广谱β-内酰胺酶大肠杆菌)(4.76%,1/21),大肠杆菌(4.76%,1/21),铜绿假单胞菌(4.76%,1/21),氧化克雷伯菌(9.52%,2/21)和梭菌单胞菌(4.76%,1/21).革兰阳性菌引起9例SBP患者医院感染,2例革兰阴性菌引起医院感染。在6名SBP患者中,在3例病例中发现了由革兰氏阴性菌引起的社区获得性感染,革兰氏阳性菌2例,在一个案例中,社区获得性感染是由革兰氏阳性和革兰氏阴性混合引起的.从医院获得性SBP患者中分离出的细菌比非医院性SBP患者中发现的细菌具有更高的耐药性。合并并发症的肝硬化患者的细菌感染可能是其健康状况恶化的原因。及时干预对于降低死亡率至关重要。
Spontaneous Bacterial Peritonitis (SBP) is a serious complication and a common cause of death in patients with liver cirrhosis. Between January 2017 and March 2024, a retrospective study was conducted involving 302 patients (>18 years old) with ascites treated at a tertiary referral center in south-eastern Poland. Microbiological analysis of the ascitic fluids was performed in all patients. The presence of microorganisms was found in samples from 17 patients, and 21 pathogens were isolated, including 15 Gram-positive bacteria and 6 Gram-negative bacteria. Staphylococcus epidermidis, MRCNS (methicillin-resistant coagulase-negative staphylococci, resistant to all beta-lactam antibiotics: penicillins, penicillins with beta-lactamase inhibitor, cephalosporins and carbapenems) was the main pathogen detected (19.05%, 4/21), followed by Enterococcus faecalis (9.52%, 2/21), Enterococcus faecium (9.52%, 2/21), Staphylococcus haemolyticus, MRCNS (4.76%, 1/21), Streptococcus mitis (9.52%, 2/21), Streptococcus parasanguinis (9.52%, 2/21), Micrococcus luteus (4.76%, 1/21) and Bacillus spp. (4.76%, 1/21). The following Gram-negative bacteria were also found in the specimens examined: Escherichia coli, ESBL (extended-spectrum β-lactamase producing E. coli) (4.76%, 1/21), Escherichia coli (4.76%, 1/21), Pseudomonas aeruginosa (4.76%, 1/21), Klebsiella oxytoca (9.52%, 2/21) and Sphingomonas paucimobilis (4.76%, 1/21). Gram-positive bacteria caused nosocomial infections in nine patients with SBP, Gram-negative bacteria caused nosocomial infections in two patients. In six patients with SBP, community-acquired infections caused by Gram-negative bacteria were found in three cases, Gram-positive bacteria in two cases, and in one case, community-acquired infection was caused by mixed Gram-positive and Gram-negative. Bacteria isolated from patients with hospital-acquired SBP showed higher drug resistance than those found in patients with non-hospital SBP. Bacterial infections in cirrhotic patients with complications may be responsible for their deteriorating health. Prompt intervention is critical to reducing mortality.