Prevalence and predictors of spontaneous bacterial peritonitis due to ceftriaxone-resistant organisms at a large tertiary centre in the USA
•Ceftriaxone-resistant spontaneous bacterial peritonitis (SBP) was not uncommon in a US tertiary centre.•Increased usage of previous β-lactam therapy was an independent predictor of ceftriaxone-resistant SBP.•Recent invasive gastrointestinal procedure was an independent predictor of ceftriaxone-resi...
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| Veröffentlicht in: | Journal of global antimicrobial resistance. 2018-12, Vol.15, p.41-47 |
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| container_title | Journal of global antimicrobial resistance. |
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| creator | Sofjan, Amelia K. Musgrove, Rachel J. Beyda, Nicholas D. Russo, Hannah P. Lasco, Todd M. Yau, Raymond Restrepo, Alejandro Garey, Kevin W. |
| description | •Ceftriaxone-resistant spontaneous bacterial peritonitis (SBP) was not uncommon in a US tertiary centre.•Increased usage of previous β-lactam therapy was an independent predictor of ceftriaxone-resistant SBP.•Recent invasive gastrointestinal procedure was an independent predictor of ceftriaxone-resistant SBP.
The epidemiology of spontaneous bacterial peritonitis (SBP) due to ceftriaxone-resistant organisms has not been well studied in the USA. The primary objective of this study was to assess the prevalence and predictors of ceftriaxone-resistant SBP at a large US tertiary-care centre.
This 1:1:4 case–case–control study included 141 adults with liver cirrhosis admitted from November 2011 to March 2016. Case group 1 were patients with SBP with a ceftriaxone-resistant organism (n=21). Case group 2 were patients with SBP with a ceftriaxone-susceptible organism (n=26). The control group were patients without SBP (n=94). Multiple logistic regression analysis was used to identify predictors of ceftriaxone-resistant SBP.
Fifty isolates were identified from 47 patients with culture-positive SBP (case groups 1 and 2). Of these 50 isolates, 32 (64%) were Gram-negatives [mostly Enterobacteriaceae (91%)], 15 (30%) were Gram-positives and 3 (6%) were Candida spp. The prevalence of ceftriaxone resistance in patients with culture-positive SBP was 45% (21/47). The most common ceftriaxone-resistant organisms were ESBL-producing Enterobacteriaceae (45%). Independent predictors of ceftriaxone-resistant SBP included duration of β-lactam therapy in the past 90days (aOR=1.07, 95% CI 1.01–1.13) and recent invasive gastrointestinal procedure (aOR=12.47, 95% CI 2.74–56.67).
The prevalence of ceftriaxone-resistant SBP was significant at a US tertiary centre. Local epidemiological data and identification of risk factors associated with ceftriaxone-resistant SBP, e.g. increased usage of previous β-lactam therapy and invasive gastrointestinal procedure, may help clinicians identify patients requiring alternative empirical antibiotics. |
| doi_str_mv | 10.1016/j.jgar.2018.05.015 |
| format | Article |
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The epidemiology of spontaneous bacterial peritonitis (SBP) due to ceftriaxone-resistant organisms has not been well studied in the USA. The primary objective of this study was to assess the prevalence and predictors of ceftriaxone-resistant SBP at a large US tertiary-care centre.
This 1:1:4 case–case–control study included 141 adults with liver cirrhosis admitted from November 2011 to March 2016. Case group 1 were patients with SBP with a ceftriaxone-resistant organism (n=21). Case group 2 were patients with SBP with a ceftriaxone-susceptible organism (n=26). The control group were patients without SBP (n=94). Multiple logistic regression analysis was used to identify predictors of ceftriaxone-resistant SBP.
Fifty isolates were identified from 47 patients with culture-positive SBP (case groups 1 and 2). Of these 50 isolates, 32 (64%) were Gram-negatives [mostly Enterobacteriaceae (91%)], 15 (30%) were Gram-positives and 3 (6%) were Candida spp. The prevalence of ceftriaxone resistance in patients with culture-positive SBP was 45% (21/47). The most common ceftriaxone-resistant organisms were ESBL-producing Enterobacteriaceae (45%). Independent predictors of ceftriaxone-resistant SBP included duration of β-lactam therapy in the past 90days (aOR=1.07, 95% CI 1.01–1.13) and recent invasive gastrointestinal procedure (aOR=12.47, 95% CI 2.74–56.67).
The prevalence of ceftriaxone-resistant SBP was significant at a US tertiary centre. Local epidemiological data and identification of risk factors associated with ceftriaxone-resistant SBP, e.g. increased usage of previous β-lactam therapy and invasive gastrointestinal procedure, may help clinicians identify patients requiring alternative empirical antibiotics.</description><identifier>ISSN: 2213-7165</identifier><identifier>EISSN: 2213-7173</identifier><identifier>DOI: 10.1016/j.jgar.2018.05.015</identifier><identifier>PMID: 29842975</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Antimicrobial resistance ; Chronic liver disease ; Epidemiology</subject><ispartof>Journal of global antimicrobial resistance., 2018-12, Vol.15, p.41-47</ispartof><rights>2018 International Society for Chemotherapy of Infection and Cancer</rights><rights>Copyright © 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-731349270a9bde002d08c22f740ffc241946497f1bf48367bd72439d9eea0dc43</citedby><cites>FETCH-LOGICAL-c356t-731349270a9bde002d08c22f740ffc241946497f1bf48367bd72439d9eea0dc43</cites><orcidid>0000-0002-1349-7242</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29842975$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sofjan, Amelia K.</creatorcontrib><creatorcontrib>Musgrove, Rachel J.</creatorcontrib><creatorcontrib>Beyda, Nicholas D.</creatorcontrib><creatorcontrib>Russo, Hannah P.</creatorcontrib><creatorcontrib>Lasco, Todd M.</creatorcontrib><creatorcontrib>Yau, Raymond</creatorcontrib><creatorcontrib>Restrepo, Alejandro</creatorcontrib><creatorcontrib>Garey, Kevin W.</creatorcontrib><title>Prevalence and predictors of spontaneous bacterial peritonitis due to ceftriaxone-resistant organisms at a large tertiary centre in the USA</title><title>Journal of global antimicrobial resistance.</title><addtitle>J Glob Antimicrob Resist</addtitle><description>•Ceftriaxone-resistant spontaneous bacterial peritonitis (SBP) was not uncommon in a US tertiary centre.•Increased usage of previous β-lactam therapy was an independent predictor of ceftriaxone-resistant SBP.•Recent invasive gastrointestinal procedure was an independent predictor of ceftriaxone-resistant SBP.
The epidemiology of spontaneous bacterial peritonitis (SBP) due to ceftriaxone-resistant organisms has not been well studied in the USA. The primary objective of this study was to assess the prevalence and predictors of ceftriaxone-resistant SBP at a large US tertiary-care centre.
This 1:1:4 case–case–control study included 141 adults with liver cirrhosis admitted from November 2011 to March 2016. Case group 1 were patients with SBP with a ceftriaxone-resistant organism (n=21). Case group 2 were patients with SBP with a ceftriaxone-susceptible organism (n=26). The control group were patients without SBP (n=94). Multiple logistic regression analysis was used to identify predictors of ceftriaxone-resistant SBP.
Fifty isolates were identified from 47 patients with culture-positive SBP (case groups 1 and 2). Of these 50 isolates, 32 (64%) were Gram-negatives [mostly Enterobacteriaceae (91%)], 15 (30%) were Gram-positives and 3 (6%) were Candida spp. The prevalence of ceftriaxone resistance in patients with culture-positive SBP was 45% (21/47). The most common ceftriaxone-resistant organisms were ESBL-producing Enterobacteriaceae (45%). Independent predictors of ceftriaxone-resistant SBP included duration of β-lactam therapy in the past 90days (aOR=1.07, 95% CI 1.01–1.13) and recent invasive gastrointestinal procedure (aOR=12.47, 95% CI 2.74–56.67).
The prevalence of ceftriaxone-resistant SBP was significant at a US tertiary centre. Local epidemiological data and identification of risk factors associated with ceftriaxone-resistant SBP, e.g. increased usage of previous β-lactam therapy and invasive gastrointestinal procedure, may help clinicians identify patients requiring alternative empirical antibiotics.</description><subject>Antimicrobial resistance</subject><subject>Chronic liver disease</subject><subject>Epidemiology</subject><issn>2213-7165</issn><issn>2213-7173</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kU1qHDEQhUWIiY3tC2QRtMym2_rrVguyMSZOAoYEbK-FWipNNPRIHUljnDPk0tEwjpepTRXoe48qPYTeU9JTQserbb_dmNwzQqeeDD2hwxt0xhjlnaSSv32dx-EUXZayJa2UoGyU79ApU5NgSg5n6M-PDE9mgWgBm-jwmsEFW1MuOHlc1hSriZD2Bc_GVsjBLHhtraYYaijY7QHXhC342t6eU4QuQwmlqSpOeWNiKLuCTcUGLyZvGg25BpN_N02sGXCIuP4E_Hh_fYFOvFkKXL70c_R4-_nh5mt39_3Lt5vru87yYayd5JQLxSQxanZACHNksox5KYj3lgmqxCiU9HT2YuKjnJ1kgiunAAxxVvBz9PHou-b0aw-l6l0oFpbleKlmREgmRy6nhrIjanMqJYPXaw67tr2mRB9y0Ft9yEEfctBk0C2HJvrw4r-fd-BeJf9-vQGfjgC0K58CZF1sOETgQgZbtUvhf_5_AdXVm4I</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Sofjan, Amelia K.</creator><creator>Musgrove, Rachel J.</creator><creator>Beyda, Nicholas D.</creator><creator>Russo, Hannah P.</creator><creator>Lasco, Todd M.</creator><creator>Yau, Raymond</creator><creator>Restrepo, Alejandro</creator><creator>Garey, Kevin W.</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1349-7242</orcidid></search><sort><creationdate>201812</creationdate><title>Prevalence and predictors of spontaneous bacterial peritonitis due to ceftriaxone-resistant organisms at a large tertiary centre in the USA</title><author>Sofjan, Amelia K. ; Musgrove, Rachel J. ; Beyda, Nicholas D. ; Russo, Hannah P. ; Lasco, Todd M. ; Yau, Raymond ; Restrepo, Alejandro ; Garey, Kevin W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-731349270a9bde002d08c22f740ffc241946497f1bf48367bd72439d9eea0dc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Antimicrobial resistance</topic><topic>Chronic liver disease</topic><topic>Epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sofjan, Amelia K.</creatorcontrib><creatorcontrib>Musgrove, Rachel J.</creatorcontrib><creatorcontrib>Beyda, Nicholas D.</creatorcontrib><creatorcontrib>Russo, Hannah P.</creatorcontrib><creatorcontrib>Lasco, Todd M.</creatorcontrib><creatorcontrib>Yau, Raymond</creatorcontrib><creatorcontrib>Restrepo, Alejandro</creatorcontrib><creatorcontrib>Garey, Kevin W.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of global antimicrobial resistance.</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sofjan, Amelia K.</au><au>Musgrove, Rachel J.</au><au>Beyda, Nicholas D.</au><au>Russo, Hannah P.</au><au>Lasco, Todd M.</au><au>Yau, Raymond</au><au>Restrepo, Alejandro</au><au>Garey, Kevin W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and predictors of spontaneous bacterial peritonitis due to ceftriaxone-resistant organisms at a large tertiary centre in the USA</atitle><jtitle>Journal of global antimicrobial resistance.</jtitle><addtitle>J Glob Antimicrob Resist</addtitle><date>2018-12</date><risdate>2018</risdate><volume>15</volume><spage>41</spage><epage>47</epage><pages>41-47</pages><issn>2213-7165</issn><eissn>2213-7173</eissn><abstract>•Ceftriaxone-resistant spontaneous bacterial peritonitis (SBP) was not uncommon in a US tertiary centre.•Increased usage of previous β-lactam therapy was an independent predictor of ceftriaxone-resistant SBP.•Recent invasive gastrointestinal procedure was an independent predictor of ceftriaxone-resistant SBP.
The epidemiology of spontaneous bacterial peritonitis (SBP) due to ceftriaxone-resistant organisms has not been well studied in the USA. The primary objective of this study was to assess the prevalence and predictors of ceftriaxone-resistant SBP at a large US tertiary-care centre.
This 1:1:4 case–case–control study included 141 adults with liver cirrhosis admitted from November 2011 to March 2016. Case group 1 were patients with SBP with a ceftriaxone-resistant organism (n=21). Case group 2 were patients with SBP with a ceftriaxone-susceptible organism (n=26). The control group were patients without SBP (n=94). Multiple logistic regression analysis was used to identify predictors of ceftriaxone-resistant SBP.
Fifty isolates were identified from 47 patients with culture-positive SBP (case groups 1 and 2). Of these 50 isolates, 32 (64%) were Gram-negatives [mostly Enterobacteriaceae (91%)], 15 (30%) were Gram-positives and 3 (6%) were Candida spp. The prevalence of ceftriaxone resistance in patients with culture-positive SBP was 45% (21/47). The most common ceftriaxone-resistant organisms were ESBL-producing Enterobacteriaceae (45%). Independent predictors of ceftriaxone-resistant SBP included duration of β-lactam therapy in the past 90days (aOR=1.07, 95% CI 1.01–1.13) and recent invasive gastrointestinal procedure (aOR=12.47, 95% CI 2.74–56.67).
The prevalence of ceftriaxone-resistant SBP was significant at a US tertiary centre. Local epidemiological data and identification of risk factors associated with ceftriaxone-resistant SBP, e.g. increased usage of previous β-lactam therapy and invasive gastrointestinal procedure, may help clinicians identify patients requiring alternative empirical antibiotics.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>29842975</pmid><doi>10.1016/j.jgar.2018.05.015</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1349-7242</orcidid></addata></record> |
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| subjects | Antimicrobial resistance Chronic liver disease Epidemiology |
| title | Prevalence and predictors of spontaneous bacterial peritonitis due to ceftriaxone-resistant organisms at a large tertiary centre in the USA |
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