■自发性细菌性腹膜炎(SBP)是腹水感染的致命并发症。儿童SBP的原因与成人不同,这些细菌经常对抗生素有抗药性。因此,这项研究调查了临床发现,细菌病因,SBP患儿的耐药性。
■这项研究是对所有新的小儿腹水患者进行的,他们被送进小儿胃肠病科,纳马齐医院,附属于设拉子医科大学(设拉子,伊朗)从2021年到2022年。所需数据,如人口统计信息,和临床信息,如全血细胞计数(CBC),红细胞沉降率(ESR),C反应蛋白(CRP),革兰氏染色,通过自动血液培养系统(BACTEC)进行血液培养,并通过圆盘扩散法收集腹水的抗菌图。最后,数据采用SPSS软件(26版)进行统计分析.此外,t检验,费希尔的精确,Mann-Whitney,数据分析采用卡方检验。在所有测试中,P≤0.05被认为具有统计学意义。
■本研究检查了62例腹水儿童,其中18例(29%)患有SBP。中位年龄(IQR)为2.5(8.1)岁。34(54.8%)的参与者是女孩。腹痛是患者最常见的临床表现(54%),腹痛与SBP之间存在显著关联(P=0.02)。在12个阳性腹水培养物中,凝固酶阴性葡萄球菌的频率最高(25%),其次是大肠杆菌(16.7%)。在总阳性培养物中,第三代头孢菌素的敏感性为25%。对于革兰氏阴性培养物,该灵敏度为33.3%,对于革兰氏阳性培养物,该灵敏度为16.6%。
■尽管第三代头孢菌素被推荐作为经验治疗SBP的主要抗生素,本研究发现细菌耐药性高。最后,经验性治疗应针对每个地区的细菌耐药性特征进行调整。
UNASSIGNED: Spontaneous bacterial peritonitis (SBP) is a fatal complication of ascites fluid infection. The causes of SBP in children differ from those in adults, and these bacteria are frequently resistant to antibiotics. Therefore, this study investigated the clinical findings, bacterial etiology, and antimicrobial resistance in children with SBP.
UNASSIGNED: This study was conducted on all new pediatric ascites patients, who were admitted to the Department of Pediatric Gastroenterology, Namazi Hospital, affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from 2021 to 2022. Required data such as demographic information, and clinical information such as complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Gram staining, blood culture by Automated Blood Culture System (BACTEC), and antibiogram of ascites fluids by disc diffusion method were all collected. Finally, the data were statistically analyzed using SPSS Software (version 26). Besides, the t test, Fisher\'s exact, Mann-Whitney, and Chi square tests were used for data analysis. In all tests, P≤0.05 was considered statistically significant.
UNASSIGNED: The present study examined 62 children with ascites of which 18 (29%) had SBP. The median (IQR) age was 2.5 (8.1) years. Thirty-four (54.8%) of the participants were girls. Abdominal pain was the most common clinical manifestation in patients (54%), and there was a significant association between abdominal pain and SBP (P=0.02). In 12 positive ascites fluid cultures, coagulase-negative staphylococci had the highest frequency (25%), followed by Escherichia coli (16.7%). Third-generation cephalosporins had a 25% sensitivity in the total positive cultures. This sensitivity was 33.3% for Gram-negative cultures and 16.6% for Gram-positive cultures.
UNASSIGNED: Although third-generation cephalosporins are recommended as the primary antibiotic for the empirical treatment of SBP, the present study found high bacterial resistance. Finally, empirical therapy should be tailored to each region\'s bacterial resistance features.