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Canadian Journal of Gastroenterology and Hepatology
Volume 2019, Article ID 6963910, 6 pages
Research Article

High Prevalence of Multidrug Resistant Bacteria in Cirrhotic Patients with Spontaneous Bacterial Peritonitis: Is It Time to Change the Standard Antimicrobial Approach?

1Post-Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
2World Gastroenterology Organization Porto Alegre Training Center, Porto Alegre, Brazil
3Infectious Disease Control Commission, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
4Division of Gastroenterology and Hepatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

Correspondence should be addressed to Jerônimo De Conto Oliveira; moc.liamg@ocdominorej

Received 9 January 2019; Revised 20 March 2019; Accepted 3 April 2019; Published 13 May 2019

Guest Editor: Eduardo G. Vilela

Copyright © 2019 Jerônimo De Conto Oliveira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Spontaneous bacterial peritonitis (SBP) has a deleterious clinical impact in end-stage liver disease, and multidrug resistance has increased, raising concern about effectiveness of traditional antibiotic regimens. Patients and Methods. Single-center retrospective study of ascitic fluid infections in cirrhotic patients. Results. We analyzed medical records related to 2129 culture-positive ascitic fluid and found 183 samples from cirrhotic patients. There were 113 monobacterial SBP cases from 97 cirrhotic patients; 57% of patients were male; hepatitis C and alcohol were the main etiologies for cirrhosis. Multidrug resistant bacteria were isolated in 46.9% of SBP samples, and third-generation cephalosporin and quinolone resistant reached 38.9% and 25.7% of SBP cases. Conclusion. SBP due to multidrug resistant bacteria is a growing problem, and one should consider reported resistance profiles for the decision-making process of empirical first-line treatment prescription.