Clinical characteristics and prognostic analysis of spontaneous peritonitis in liver cirrhosis infected with Gram negative and Gram positive bacteria
YANG Jia-li
BAI Xue
HE Fang
ZHANG Li-na
MIAO Yu
YANG Shao-qi
Abstract：Objective To analyze and compare the clinical characteristics and prognosis of patients with spontaneous peritonitis(SBP)infected with Gram negative bacteria(GNC)and Gram positive bacteria(GPC).Methods A retrospective analysis was conducted on the clinical data of 159 patients with SBP who tested positive for ascites culture at the General Hospital of Ningxia Medical University from January 2018 to December 2022.Based on the Gram staining results of ascites culture,the patients were divided into GNC group and GPC group.The clinical characteristics and prognosis differences of SBP caused by GNC and GPC were analyzed and compared.Results A total of 181 beads of pathogenic bacteria were detected in 159 patients,including 98 beads of GPC(54.1％),81 beads of GNC(44.7％),2 beads of fungi(1.2％),and 32 beads of Escherichia coli(17.6％),which were the highest proportion strains.The proportion of GPC showed an upward trend.Drug sensitivity analysis shows that the resistance rate of Escherichia coli to third-generation cephalosporins in GNC is about 20％,while coagulase negative staphylococci in GPC have strong resistance to penicillin.GNC infected patients were more likely to be complicated with hepatic encephalopathy,hepatorenal syndrome and liver failure than GPC patients,and the proportion of patients with diabetes was lower(P＜0.05).The CTP,MELD,iMELD scores and inflammatory markers(CRP,PCT,NLR,CAR)of GNC group patients were significantly higher than those of GPC group,with longer hospital stay and higher mortality rate(P＜0.05).However,there was no significant difference in the recurrence rate of SBP between the two groups of patients within one year(P＞0.05).Conclusion GNC infection is the main infection in SBP patients,but the constituent ratio of GPC tends to increase,and the proportion of patients with diabetes is higher than that of GNC patients.Compared with GPC patients,GNC patients have the characteristics of poor liver function,severe inflammatory reaction,long hospital stay,and high mortality.
Keywords：spontaneous bacterial peritonitisgram negative bacteriagram positive bacteriaclinical characteristicsprognostic
Publication Date：2025-04-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 315-320,335 )