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Spontaneous bacterial peritonitis

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https://www.readbyqxmd.com/read/28906399/characteristics-of-infection-and-its-impact-on-short-term-outcome-in-patients-with-acute-on-chronic-liver-failure
#1
Junjun Cai, Mengchen Zhang, Tao Han, Hui-Qing Jiang
Bacterial infections are an important cause of mortality in liver failure. However, the type of infection, predictors of infection, and their impact on outcomes in patients with acute-on-chronic liver failure (ACLF) are limited.A total of 389 patients with ACLF were admitted in this retrospective, corhort study. Once admitted, clinical data including first infection site, type (community-acquired, healthcare-associated, or nosocomial), and second infection occurrence during hospitalization were collected. The outcome was mortality within 90 days...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28902040/long-term-rifaximin-therapy-as-a-primary-prevention-of-hepatorenal-syndrome
#2
El-Sayed Ibrahim, Ayman Alsebaey, Hassan Zaghla, Sabry Moawad Abdelmageed, Khalid Gameel, Eman Abdelsameea
BACKGROUND: Hepatorenal syndrome (HRS) is a severe complication of liver cirrhosis, with poor survival. Rifaximin is a gut-selective broad-spectrum antibiotic. AIM: The aim of this study was to evaluate the role of rifaximin as a primary prevention of HRS. PATIENTS AND METHODS: Eighty patients with liver cirrhosis and ascites were enrolled. They were randomized into two groups: control (n=40) and rifaximin group (n=40). Baseline liver function tests, renal function tests, complete blood count, international normalized ratio, urine analysis, and abdominal ultrasonography were carried out...
September 8, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28895701/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-2-electrolyte-disturbances-nonelectrolyte-disturbances-therapeutic-options
#3
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamscha, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Alvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of a pediatric patient with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to diagnostic and therapeutic aspects, and preventive care...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28890902/pasteurella-multocida-bacteremia-and-peritonitis-in-a-patient-with-cirrhosis-a-life-threatening-case-from-a-prick-of-a-cactus
#4
Jodi-Anne Wallace, Jonathan Hussain, Alberto Unzueta, Giuseppe Morelli
A 58-year-old male with nonalcoholic steatohepatitis cirrhosis presents with right lower extremity cellulitis, abdominal tenderness, and severe sepsis after sustaining puncture injury from a cactus on a property with feral cats. Blood cultures and diagnostic paracentesis were consistent with spontaneous bacterial peritonitis due to Pasteurella multocida, a gram-negative coccobacillus found in the respiratory tract of domestic animals. The patient received timely antibiotic coverage with resolution of spontaneous bacterial peritonitis and sepsis after 14-day treatment...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28847867/bacterial-and-fungal-infections-in-acute-on-chronic-liver-failure-prevalence-characteristics-and-impact-on-prognosis
#5
Javier Fernández, Juan Acevedo, Reiner Weist, Thierry Gustot, Alex Amoros, Carme Deulofeu, Enric Reverter, Javier Martínez, Faouzi Saliba, Rajiv Jalan, Tania Welzel, Marco Pavesi, María Hernández-Tejero, Pere Ginès, Vicente Arroyo
Bacterial infection is a frequent trigger of acute-on-chronic liver failure (ACLF), syndrome that could also increase the risk of infection. This investigation evaluated prevalence and characteristics of bacterial and fungal infections causing and complicating ACLF, predictors of follow-up bacterial infections and impact of bacterial infections on survival. PATIENTS: 407 patients with ACLF and 235 patients with acute decompensation (AD). RESULTS: 152 patients (37%) presented bacterial infections at ACLF diagnosis; 46%(n=117) of the remaining 255 patients with ACLF developed bacterial infections during follow-up (4 weeks)...
August 28, 2017: Gut
https://www.readbyqxmd.com/read/28836723/rifaximin-treatment-is-associated-with-reduced-risk-of-cirrhotic-complications-and-prolonged-overall-survival-in-patients-experiencing-hepatic-encephalopathy
#6
S H Kang, Y B Lee, J-H Lee, J Y Nam, Y Chang, H Cho, J-J Yoo, Y Y Cho, E J Cho, S J Yu, M Y Kim, Y J Kim, S K Baik, J-H Yoon
BACKGROUND: Rifaximin might decrease the risk of portal hypertension-related complications by controlling small intestinal bacterial overgrowth. AIM: To evaluate whether rifaximin was associated with the risk of death and cirrhotic complications. METHODS: We conducted a retrospective study that included 1042 patients experiencing hepatic encephalopathy (HE): 421 patients without hepatocellular carcinoma (HCC; the non-HCC cohort) and 621 patients with HCC (the HCC cohort)...
August 24, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28836115/management-of-ascites-and-hepatorenal-syndrome
#7
REVIEW
Salvatore Piano, Marta Tonon, Paolo Angeli
Ascites represents the most common decompensating event in patients with liver cirrhosis. The appearance of ascites is strongly related to portal hypertension, which leads to splanchnic arterial vasodilation, reduction of the effective circulating volume, activation of endogenous vasoconstrictor systems, and avid sodium and water retention in the kidneys. Bacterial translocation further worsens hemodynamic alterations of patients with cirrhosis and ascites. The first-line treatment of uncomplicated ascites is a moderate sodium-restricted diet combined with diuretic treatment...
August 23, 2017: Hepatology International
https://www.readbyqxmd.com/read/28818628/a-prospective-multicentre-study-of-the-epidemiology-and-outcomes-of-bloodstream-infection-in-cirrhotic-patients
#8
Michele Bartoletti, Maddalena Giannella, Russell Lewis, Paolo Caraceni, Sara Tedeschi, Mical Paul, Christoph Schramm, Tony Bruns, Manuela Merli, Nazaret Cobos-Trigueros, Elena Seminari, Pilar Retamar, Patricia Muñoz, Mario Tumbarello, Patrizia Burra, Maria Torrani Cerenzia, Bruno Barsic, Ester Calbo, Alberto Enrico Maraolo, Nicola Petrosillo, Maria Angeles Galan-Ladero, Giampiero D'Offizi, Noa Bar Sinai, Jesus Rodríguez-Baño, Gabriella Verucchi, Mauro Bernardi, Pierluigi Viale
OBJECTIVE: The aim of this study was to describe the current epidemiology of BSI in patients with cirrhosis, analyse predictors of 30-day mortality, and risk factors for antibiotic resistance. METHODS: Cirrhotic patients developing a BSI episode were prospectively included at 19 centres in five countries from September 2014 to December 2015. The discrimination of mortality risk scores for 30-day mortality were compared by area under the receiver operator-risk and Cox-regression models...
August 14, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28812000/diagnostic-imaging-features-of-necrotizing-enterocolitis-a-narrative-review
#9
REVIEW
Francesco Esposito, Rosanna Mamone, Marco Di Serafino, Carmela Mercogliano, Valerio Vitale, Gianfranco Vallone, Patrizia Oresta
Necrotizing enterocolitis (NEC) is an inflammatory process, characterized by intestinal necrosis of variable extension, leading to perforation, generalized peritonitis and death. The classical pathogenetic theory focuses on mucosal damage related to a stress induced intestinal ischemia leading to mucosal injury and bacterial colonization of the wall. A more recent hypothesis emphasizes the role of immaturity of gastrointestinal and immune system, particularly of the premature, responsible of bowel wall vulnerability and suffering...
June 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28796076/factors-affecting-mortality-and-resource-use-for-hospitalized-patients-with-cirrhosis-a-population-based-study
#10
Phunchai Charatcharoenwitthaya, Ngamphol Soonthornworasiri, Khemajira Karaketklang, Kittiyod Poovorawan, Wirichada Pan-Ngum, Watcharasak Chotiyaputta, Tawesak Tanwandee, Kamthorn Phaosawasdi
Hospitalizations for advanced liver disease are costly and associated with significant mortality. This population-based study aimed to evaluate factors associated with in-hospital mortality and resource use for the management of hospitalized patients with cirrhosis.Mortality records and resource utilization for 52,027 patients hospitalized with cirrhosis and/or complications of portal hypertension (ascites, hepatic encephalopathy, variceal bleeding, spontaneous bacterial peritonitis, or hepatorenal syndrome) were extracted from a nationally representative sample of Thai inpatients covered by Universal Coverage Scheme during 2009 to 2013...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28792999/clinical-features-of-refractory-ascites-in-outpatients
#11
Wanda Regina Caly, Rodrigo Martins Abreu, Bernardo Bitelman, Flair José Carrilho, Suzane Kioko Ono
OBJECTIVES: To present the clinical features and outcomes of outpatients who suffer from refractory ascites. METHODS: This prospective observational study consecutively enrolled patients with cirrhotic ascites who submitted to a clinical evaluation, a sodium restriction diet, biochemical blood tests, 24 hour urine tests and an ascitic fluid analysis. All patients received a multidisciplinary evaluation and diuretic treatment. Patients who did not respond to the diuretic treatment were controlled by therapeutic serial paracentesis, and a transjugular intrahepatic portosystemic shunt was indicated for patients who required therapeutic serial paracentesis up to twice a month...
July 2017: Clinics
https://www.readbyqxmd.com/read/28764217/performance-of-disease-specific-scoring-models-in-intensive-care-patients-with-severe-liver-diseases
#12
Maged T El-Ghannam, Moataz H Hassanien, Mohamed D El-Talkawy, Abdel Aziz A Saleem, Amal I Sabry, Hoda M Abu Taleb
INTRODUCTION: Egypt has the highest prevalence of Hepatitis C Virus (HCV) in the world, estimated nationally at 14.7%. HCV treatment consumes 20% ($80 million) of Egypt's annual health budget. Outcomes of cirrhotic patients admitted to the ICU may, in fact, largely depend on differences in the state of the disease, criteria and indications for admission, resource utilization, and intensity of treatment. AIM: The aim of the present study was to evaluate the efficacy of liver specific scoring models in predicting the outcome of critically ill cirrhotic patients in the ICU as it may help in prioritization of high risk patients and preservation of ICU resources...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28763340/rifaximin-for-the-prevention-of-spontaneous-bacterial-peritonitis-and-hepatorenal-syndrome-in-cirrhosis-a-systematic-review-and-meta-analysis
#13
Faisal Kamal, Muhammad Ali Khan, Zubair Khan, George Cholankeril, Tariq A Hammad, Wade M Lee, Aijaz Ahmed, Bradford Waters, Colin W Howden, Satheesh Nair, Sanjaya K Satapathy
Prophylactic antibiotics have been recommended in patients with a previous history of spontaneous bacterial peritonitis (SBP). Recently, there has been interest in the use of rifaximin for the prevention of SBP and hepatorenal syndrome (HRS). We conducted a meta-analysis to evaluate this association of rifaximin. We searched several databases from inception through 24 January 2017, to identify comparative studies evaluating the effect of rifaximin on the occurrence of SBP and HRS. We performed predetermined subgroup analyses based on the type of control group, design of the study, and type of prophylaxis...
October 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28751655/corrigendum-nosocomial-and-community-acquired-spontaneous-bacterial-peritonitis-in-patients-with-liver-cirrhosis-in-china-comparative-microbiology-and-therapeutic-implications
#14
Lei Shi, Dan Wu, Lei Wei, Suxia Liu, Peng Zhao, Bo Tu, Yangxin Xie, Yanan Liu, Xinhua Wang, Liying Liu, Xin Zhang, Zhe Xu, Fusheng Wang, Enqiang Qin
This corrects the article DOI: 10.1038/srep46025.
July 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28740354/nosocomial-spontaneous-bacterial-peritonitis-antibiotic-treatment-in-the-era-of-multi-drug-resistance-pathogens-a-systematic-review
#15
Marco Fiore, Alberto Enrico Maraolo, Ivan Gentile, Guglielmo Borgia, Sebastiano Leone, Pasquale Sansone, Maria Beatrice Passavanti, Caterina Aurilio, Maria Caterina Pace
AIM: To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis (N-SBP) given the rising importance of multidrug-resistant (MDR) bacteria. METHODS: A literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15(th) of November 2016, using the following search strategy: "spontaneous" AND "peritonitis". RESULTS: The initial search through electronic databases retrieved 2556 records...
July 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28737869/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-1-pathophysiology-diagnostic-evaluation-hospitalization-criteria-treatment-nutritional-management
#16
REVIEW
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamsch, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Álvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of pediatric patients with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to its diagnostic and therapeutic aspects, and preventive care...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28721347/peliosis-hepatis-complicating-pregnancy-a-rare-entity
#17
Muhammad Osama Butt, Nasir Hassan Luck, Syed Mujahid Hassan, Zaigham Abbas, Muhammed Mubarak
Peliosis hepatis (PH) is a rare, benign condition of the liver characterized by the presence of blood-filled lacunar spaces in the parenchyma. It usually has a chronic presentation and is a rare cause of portal hypertension reported in adult patients. Its etiology is diverse and ranges from infectious agents to tumors to toxic substances and anabolic steroids; however, the cause remains unclear in 25-50% of patients. Similarly, the symptomatology and imaging findings are diverse. Biopsy is the definitive test to diagnose the condition...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28703134/genetic-variants-underlying-vitamin-d-metabolism-and-vdr-tgf%C3%AE-1-smad3-interaction-may-impact-on-hcv-progression-a-study-based-on-dbgap-data-from-the-halt-c-study
#18
Laura A de Azevedo, Ursula Matte, Themis R da Silveira, Mário R Álvares-da-Silva
Vitamin D deficiency is prevalent in liver disease and vitamin D has been shown to decrease hepatic fibrosis through an anti-TGFβ-1/SMAD3 effect mediated by the vitamin D receptor. Thus, we hypothesized that genetic variants involved in vitamin D metabolism and/or VDR/TGFβ-1/SMAD3 interaction could impact on the progression of chronic HCV. We obtained or imputed genotypes for 40 single nucleotide polymorphisms (SNPs) located in genes implicated in vitamin D metabolism from the HALT-C cohort via dbGaP. The HALT-C study followed 692 chronic HCV patients over 4 years, evaluating clinical outcomes including worsening of fibrosis, hepatic decompensation (gastric/esophageal bleeding, CTP>7, ascites, spontaneous bacterial peritonitis and encephalopathy), development of hepatocellular carcinoma, and liver death...
July 13, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28697716/case-series-of-10-patients-with-cirrhosis-undergoing-emergent-repair-of-ruptured-umbilical-hernias-natural-history-and-predictors-of-outcomes
#19
Miguel Malespin, Christopher M Moore, Andre Fialho, Silvio W de Melo, Tamara Benyashvili, Anai N Kothari, Diego di Sabato, Eric R Kallwitz, Scott J Cotler, Amy D Lu
OBJECTIVES: Ascites represents an important event in the natural history of cirrhosis, portending increased 1-year mortality. Umbilical herniation with rupture is an uncommon complication of large-volume ascites that is associated with significant morbidity and mortality. The aim of this study was to describe predictors of outcomes in patients undergoing emergent repair for spontaneous umbilical hernia rupture. MATERIALS AND METHODS: We report a case series of 10 patients with decompensated cirrhosis (mean age 66 ± 9 years, mean Model for End-Stage Liver Disease score of 21 ± 7) who presented with a ruptured umbilical hernia and had emergent repair...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28687809/genetic-variants-of-traf6-modulate-peritoneal-immunity-and-the-risk-of-spontaneous-bacterial-peritonitis-in-cirrhosis-a-combined-prospective-retrospective-study
#20
Martina Mai, Sven Stengel, Eihab Al-Herwi, Jack Peter, Caroline Schmidt, Ignacio Rubio, Andreas Stallmach, Tony Bruns
Alterations of the innate immunity contribute to the development of spontaneous bacterial peritonitis (SBP) in liver cirrhosis. Given its role in immune signaling, antimicrobial function, and macrophage differentiation, we hypothesized that genetic polymorphisms of TRAF6 modulate the risk of SBP. Thus, we determined theTRAF6 haplotype in 432 patients with cirrhosis and ascites using the haplotype-tagging single nucleotide polymorphisms rs331457 and rs5030419. In addition, peritoneal macrophages were immunomagnetically isolated and characterized...
July 7, 2017: Scientific Reports
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