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Peritonitis NOT "spontaneous bacterial peritonitis"

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https://www.readbyqxmd.com/read/28213164/carvedilol-use-is-associated-with-improved-survival-in-patients-with-liver-cirrhosis-and-ascites
#1
Rohit Sinha, Khalida A Lockman, Nethmee Mallawaarachchi, Marcus Robertson, John N Plevris, Peter C Hayes
BACKGROUND AND AIMS: Carvedilol, a non-selective beta-blocker (NSBB) with additional anti-alpha 1 receptor activity, is a potent portal hypotensive agent. It has been used as prophylaxis against variceal bleed. However, its safety in decompensated liver cirrhosis with ascites is still disputed. In this study, we examined whether long-term use of carvedilol in the presence of ascites is a risk factor for mortality. METHODS: This was a single-centre retrospective analysis of 325 consecutive patients with liver cirrhosis and ascites presenting to our Liver Unit between 1(st) of January 2009 to 31(st) August 2012...
February 14, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28147426/-spontaneous-bacterial-peritonitis
#2
Ľubomír Skladaný, Silvia Kasová, Anna Purgelová, Natália Bystrianska, Svetlana Adamcová-Selčanová
AIM OF STUDY: Spontaneous bacterial peritonitis (SBP) is the most frequent infectious complication of liver cirrhosis with serious consequences. Initially, SBP is always treated with empirical, not targeted, antibiotic therapy. Since a retrospective study performed in our department showed suboptimal effectiveness (only 40 %) of empirical antibiotic therapy in accordance with the EASL guidelines, a decision was made to change the protocol. The aims of this prospective study were to determine: (1) the incidence and characteristics of SBP in real clinical practice - in a liver unit of a tertiary hospital, (2) the effectiveness of new antibiotic therapy selected based on analysis of the spectrum of pathogens and their resistance to antibiotics as identified in a retrospective cohort study on SBP carried out in our department, (3) mortality, and to compare these findings with the literature data...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28118177/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#3
Philipp Solbach, Christoph Höner Zu Siederdissen, Richard Taubert, Szilvia Ziegert, Kerstin Port, Andrea Schneider, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIM: Refractory ascites has a poor prognosis. Recurrent large-volume paracentesis is the current standard of care; however, it results in circulatory dysfunction and renal dysfunction, and hospitalization is commonly required. Transjugular intrahepatic portosystemic shunt placement is not an option in a substantial number of patients because of contraindications. The placement of a tunneled peritoneal drainage catheter has been shown to be effective in patients with malignant ascites...
January 21, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28074870/microrna-155-is-upregulated-in-ascites-in-patients-with-spontaneous-bacterial-peritonitis
#4
Philipp Lutz, Mohamed M Haimid, Alessandra Pohlmann, Jennifer Lehmann, Christian Jansen, Robert Schierwagen, Sabine Klein, Christian P Strassburg, Ulrich Spengler, Jonel Trebicka
MircoRNA's (miR) have been recognised as important modulators of gene expression and potential biomarkers. However, they have been rarely investigated in bio fluids apart from blood. We investigated the association of miR-125b and miR-155 with complications of cirrhosis. Ascites was prospectively collected from patients with cirrhosis undergoing paracentesis at our department. miR's were determined in the supernatant using qPCR and normalized by SV-40. Clinical parameters were assessed at paracentesis and during follow-up...
January 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27929923/impact-of-pre-transplant-bacterial-infections-on-post-operative-outcomes-in-patients-after-liver-transplantation
#5
Im-Kyung Kim, Joon Seong Park, Man Ki Ju
BACKGROUND: In contrast to studies evaluating the negative effect of bacterial infections on clinical outcomes after liver transplantation, there is little evidence with regard to pre-transplant bacterial infections. We aimed to investigate the impact of pre-transplant bacterial infections on post-transplant outcomes in patients after liver transplantation. PATIENTS AND METHODS: We retrospectively analyzed clinical data from 33 consecutive patients who underwent primary liver transplantations...
February 2017: Surgical Infections
https://www.readbyqxmd.com/read/27741171/gut-microbiota-and-the-liver-a-tale-of-2-cities-a-narrative-view-in-2-acts
#6
Maurizio Koch
Microbes are mostly important for the digestion of food, the absorption of some micronutrients, and the production of vitamins. The microbiota stimulates lymphoid structures in the gastrointestinal mucosa and decrease pathogens by competing for nutrients and space. Bacterial translocation is defined as the escape of gut bacteria and their products through the intestinal mucosa to the outside of the intestine as portovenous or systemic circulation. This is induced by a leaky gut barrier. There is evidence for a role of intestinal permeability in the pathogenesis of nonalcoholic fatty liver disease...
November 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27740524/portal-vein-thrombosis-in-patients-with-cirrhosis-just-a-common-finding-or-a-predictor-of-poor-outcome
#7
Omar D Borjas-Almaguer, Carlos A Cortez-Hernández, Emmanuel I González-Moreno, Francisco J Bosques-Padilla, José A González-González, Aldo A Garza, Juan A Martínez-Segura, Diego García-Compean, Juan V Alejandre-Loya, Jesús García-García, Guillermo Delgado-García, Héctor J Maldonado-Garza
:  Background & Aims. It is unclear whether portal vein thrombosis (PVT) unrelated to malignancy is associated with reduced survival or it is an epiphenomenon of advanced cirrhosis. The objective of this study was to assess clinical outcome in cirrhotic patients with PVT not associated with malignancy and determine its prevalence. MATERIAL AND METHODS: Retrospective search in one center from June 2011 to December 2014. RESULTS: 169 patients, 55 women and 114 men, median age 54 (19-90) years...
November 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27721918/implication-of-the-intestinal-microbiome-in-complications-of-cirrhosis
#8
REVIEW
Mamatha Bhat, Bianca M Arendt, Venkat Bhat, Eberhard L Renner, Atul Humar, Johane P Allard
The intestinal microbiome (IM) is altered in patients with cirrhosis, and emerging literature suggests that this impacts on the development of complications. The PubMed database was searched from January 2000 to May 2015 for studies and review articles on the composition, pathophysiologic effects and therapeutic modulation of the IM in cirrhosis. The following combination of relevant text words and MeSH terms were used, namely intestinal microbiome, microbiota, or dysbiosis, and cirrhosis, encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, variceal bleeding, hepatopulmonary syndrome, portopulmonary hypertension and hepatocellular carcinoma...
September 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27678356/spontaneous-fungal-peritonitis-epidemiology-current-evidence-and-future-prospective
#9
REVIEW
Marco Fiore, Sebastiano Leone
Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease (ESLD); spontaneous fungal peritonitis (SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients, not even the antifungals used for the prophylaxis, neither optimal treatment...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27661968/a-real-world-evaluation-of-repeat-paracentesis-guided-management-of-spontaneous-bacterial-peritonitis
#10
Aparna Goel, Mollie Biewald, Shirish Huprikar, Thomas Schiano, Gene Y Im
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a common infection in cirrhosis associated with high mortality. More than 20% of patients with SBP do not respond to initial antibiotics. Guidelines differ in recommendations to repeat paracentesis (retap) to confirm antibiotic efficacy. We aim to evaluate the effect of retap-guided management of SBP on antibiotic escalation and 30-day transplant-free survival. MATERIALS AND METHODS: Retrospective cohort study of cirrhotic patients with SBP admitted to a single transplant center from 2010 to 2014...
March 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27619833/the-periscreen-strip-is-highly-efficient-for-the-exclusion-of-spontaneous-bacterial-peritonitis-in-cirrhotic-outpatients
#11
Thierry Thévenot, Charline Briot, Vincent Macé, Hortensia Lison, Laure Elkrief, Alexandra Heurgué-Berlot, Christophe Bureau, Caroline Jézéquel, Ghassan Riachi, Alexandre Louvet, Arnaud Pauwels, Isabelle Ollivier-Hourmand, Rodolphe Anty, Nicolas Carbonell, Hélène Labadie, Karim Aziz, Denis Grasset, Eric Nguyen-Khac, Mehdi Kaassis, Sofia Hermann, Florence Tanné, Thomas Mouillot, Olivier Roux, Aurélie Le Thuaut, Jean-Paul Cervoni, Jean-François Cadranel, Matthieu Schnee
OBJECTIVES: We aimed to assess the performance of a new strip (Periscreen) for the rapid diagnosis of spontaneous bacterial peritonitis (SBP). METHODS: Ascitic fluid (AF) of cirrhotic patients hospitalized between March 2014 and August 2015 was independently tested by two readers using the new strip, which has four colorimetric graduations (negative, trace, small, and large). SBP was diagnosed on neutrophils in ascites>250/mm(3). Ascites not related to portal hypertension were excluded...
October 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27558198/clinical-course-and-short-term-mortality-of-cirrhotic-patients-with-infections-other-than-spontaneous-bacterial-peritonitis
#12
Javier Fernández, Juan Acevedo, Verónica Prado, Mario Mercado, Miriam Castro, Marco Pavesi, Mireya Arteaga, Lydia Sastre, Adria Juanola, Pere Ginès, Vicente Arroyo
: Clinical course and risk factors of death in non-SBP infections are poorly known. We assessed the prevalence of AKI and type-1 HRS, hospital, 30-d and 90-d mortality and risk factors of death in 441 decompensated patients. METHODS: Analysis of 615 non-SBP infections (161 urinary infections, 95 cellulitis, 92 suspected infections, 92 bacteremias, 84 pneumonias, 21 bronchitis, 18 cholangitis, 15 spontaneous empyema, 13 secondary peritonitis, 24 other). RESULTS: 96% of infections solved...
August 25, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27525599/prognosis-of-refractory-ascites-in-cirrhosis
#13
Rym Ennaifer, Nour Elleuch, Hayfa Romdhane, Rania Hefaiedh, Maryem Cheikh, Sonda Chaabouni, Houda Ben Nejma, Najet Bel Hadj
BACKGROUND: Ascitic decompensation is a common major complication of cirrhosis and is associated with a poor outcome. In 5-10% of patients, ascites become resistant to treatment (either do not respond to a high dose of diuretics or because these drugs induce complications), which is called refractory ascites (RA). RA is associated with poor survival: 20-50% at 1 year. The aim of this study was to investigate the outcome of RA. METHODS: Retrospective study including consecutive cirrhotic patients admitted for controlling ascites between January 2010 and April 2013...
January 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27512927/randomized-controlled-trial-of-rifaximin-versus-norfloxacin-for-secondary-prophylaxis-of-spontaneous-bacterial-peritonitis
#14
Asem Elfert, Lobna Abo Ali, Samah Soliman, Shimaa Ibrahim, Sherief Abd-Elsalam
BACKGROUND AND AIMS: Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis with a high recurrence rate and a marked increase in mortality. Norfloxacin is used widely for the secondary prophylaxis of SBP; however, its extensive long-term use has led to an increase in the incidence of quinolone-resistant and Gram-positive SBP. Rifaximin is a nonabsorbable broad-spectrum antibiotic and does not appear to promote emergence of resistance. The aim of this study was to compare the safety and efficacy of rifaximin versus norfloxacin for the secondary prevention of SBP in patients with liver cirrhosis and ascites...
December 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27485874/factors-affecting-illness-in-the-developing-world-chronic-disease-mental-health-and-traditional-medicine-cures
#15
Nathan T Douthit, Hailemariam Alemu Astatk
This is a case report of a 24-year-old Ethiopian woman with a medical history of hepatosplenic schistosomiasis. She suffers from chronic liver failure and portal hypertension. She has been hospitalised for 'hysteria' in the past but did not receive follow-up, outpatient treatment or psychiatric evaluation. After discontinuing her medications and leaving her family to use holy water, a religious medicine used by many Ethiopians, she was found at a nearby monastery. She was non-communicative and difficult to arouse...
August 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27474889/proton-pump-inhibitors-as-a-risk-factor-for-hepatic-encephalopathy-and-spontaneous-bacterial-peritonitis-in-patients-with-cirrhosis-with-ascites
#16
Gitte Dam, Hendrik Vilstrup, Hugh Watson, Peter Jepsen
UNLABELLED: Proton pump inhibitors (PPIs) may be a risk factor for hepatic encephalopathy (HE) in patients with cirrhosis, possibly through translocation of gut bacteria, which can also lead to spontaneous bacterial peritonitis (SBP). We examined the associations between PPIs and development of HE or SBP in patients with cirrhosis with ascites. We used data from three 1-year trials of satavaptan for ascites control. We used Cox regression to compare HE and SBP rates between users and nonusers of PPIs...
October 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27446840/the-palliative-management-of-refractory-cirrhotic-ascites-using-the-pleurx-%C3%A2-catheter
#17
Jason Reinglas, Kayvan Amjadi, Bill Petrcich, Franco Momoli, Thomas Shaw-Stiffel
Background. Treatment options are limited for patients with refractory cirrhotic ascites (RCA). As such, we assessed the safety and effectiveness of the PleurX catheter for RCA. Methods. A retrospective analysis was performed on all patients with RCA who have undergone insertion of the PleurX catheter between 2007 and 2014 at our clinic. Results. Thirty-three patients with RCA were included in the study; 4 patients were lost to follow-up. All patients were still symptomatic despite bimonthly large volume paracentesis and were not candidates for TIPS or PV shunt...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27390856/fungal-peritonitis-underestimated-disease-in-critically-ill-patients-with-liver-cirrhosis-and-spontaneous-peritonitis
#18
Tobias Lahmer, Andreas Brandl, Sebastian Rasch, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Spontaneous peritonitis, especially spontaneous fungal peritonitis (SFP), is an important and potentially fatal complication in patients with endstage liver disaese. We evaluated potential risk factors, microbiological findings, and outcome of patients with SFP compared to spontaneous bacterial peritonitis (SBP) in critically ill patients. METHODS: Retrospective analyses of critically ill patients with suspected spontaneous peritonitis. RESULTS: Out of 205 patients, 20 (10%) had SFP, 28 (14%) had SBP, 48 (24%) had peritonitis without microbiological findings (SP) and 109 (52%) had no-peritonitis (NP)...
2016: PloS One
https://www.readbyqxmd.com/read/27364035/the-impact-of-infection-by-multidrug-resistant-agents-in-patients-with-cirrhosis-a-multicenter-prospective-study
#19
Francesco Salerno, Mauro Borzio, Claudia Pedicino, Rosa Simonetti, Angelo Rossini, Sergio Boccia, Irene Cacciola, Andrew K Burroughs, Matteo A Manini, Vincenzo La Mura, Paolo Angeli, Mauro Bernardi, Daniela Dalla Gasperina, Elena Dionigi, Clara Dibenedetto, Milena Arghittu
BACKGROUND & AIMS: Bacterial strains resistant to antibiotics are a serious clinical challenge. We assessed the antibiotic susceptibility of bacteria isolated from infections in patients with cirrhosis by a multicentre investigation. RESULTS: Three hundred and thirteen culture-positive infections (173 community acquired [CA] and 140 hospital acquired [HA]) were identified in 308 patients. Urinary tract infections, spontaneous bacterial peritonitis and bacteremias were the most frequent...
January 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27267044/clinical-characteristics-and-outcomes-of-spontaneous-bacterial-peritonitis-caused-by-enterobacter-species-versus-escherichia-coli-a-matched-case-control-study
#20
Seongman Bae, Taeeun Kim, Min-Chul Kim, Yong Pil Chong, Sung-Han Kim, Heungsup Sung, Young-Suk Lim, Sang-Oh Lee, Mi-Na Kim, Yang Soo Kim, Jun Hee Woo, Sang-Ho Choi
BACKGROUND: Enterobacter species are important nosocomial pathogens, and there is growing concern about their ability to develop resistance during antimicrobial therapy. However, few data are available on the clinical characteristics and outcomes of Enterobacter spontaneous bacterial peritonitis (SBP). METHODS: We retrospectively identified all patients with SBP caused by Enterobacter species admitted to a tertiary care hospital between January 1997 and December 2013...
2016: BMC Infectious Diseases
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