Prevalence and Predictors of Ceftriaxone-resistance Pathogens in Spontaneous Bacterial Peritonitis in Pathum Thani Hospital

Abstract

Objective: To determine the prevalence, risk factor and clinical impact on mortality of spontaneous bacterial peritonitis caused by Ceftriaxone-resistance pathogens

    Methods: We conducted a retrospective study of all spontaneous bacterial peritonitis episodes with or without positive blood and/or ascitic culture in hospitalization at Pathum Thani hospital (2016-2021)

    Results: In 125 patients, mostly cirrhosis (41%) were caused by chronic alcohol drinking. About 38% (48 of 125) of infection were culture positive; of these, 35% (17 of 48) were resistant to Ceftriaxone. The prevalence of Ceftriaxone resistance was 21% in community-acquired infections, 43% in healthcare associated infections and 100% in nosocomial acquisition. History of Fluoroquinolone exposure within 30 days (OR 3.61 [95% CI 1.35 to 9.69]) and nosocomial acquisition (OR 2.52 [95% CI 0.94-6.73]) of infection were the predictor of resistance to Ceftriaxone. Thirty-day mortality impacted by infection was 38%. Independent predictors of 30-day mortality were shock, positive culture and high initial MELD-Na score

    Conclusion: The risk of Ceftriaxone resistance pathogens was particularly high in nosocomial-acquired episode of spontaneous bacterial peritonitis, and also occured in healthcare-acquired cases. The adequacy of empirical antibiotics had significant effect on 30 days Fluoroquinolone exposure and Healthcare/nosocomial acquisition. High-risk subgroups (Shock, positive culture,High MELD-Na score) should be identified for reducing mortality.