Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
2008-12-1
pubmed:abstractText
Spontaneous bacterial peritonitis (SBP) is a severe complication in patients with cirrhosis and ascites. It is predominantly caused by Escherichia coli. The phylogenetic group and virulence genotype of E. coli isolates causing SBP were investigated, and the association of these characteristics with host factors and prognosis was examined. Seventy-six episodes of E. coli SBP that occurred over a 9-year period were studied. The phylogenetic group of the isolates and the presence of 36 virulence factor genes were investigated. The influence of bacterial and host factors on in-hospital mortality was assessed by multiple logistic regression. Phylogenetic groups A, B1, B2 and D were found in 26%, 4%, 46% and 24% of the isolates, respectively. Virulence factor genes were more frequent in B2 isolates than in non-B2 isolates (mean virulence score 15.4 vs. 7.3, p <10(-4)). Ciprofloxacin resistance was significantly associated with non-B2 groups and a low virulence score. Host factors independently associated with a shift from B2 to non-B2 isolates were norfloxacin prophylaxis (OR 13.01, p 0.0213) and prothrombin ratio (OR 1.04 for a 10% decrease, p 0.0211). The model for end-stage liver disease (MELD) score (OR 1.83, p 0.0007) and hospital-acquired SBP (OR 4.13, p 0.0247) were independent predictors of in-hospital mortality. In contrast, outcome was not influenced by the phylogenetic group or the virulence profile. These findings indicate that the characteristics of E. coli isolates causing SBP vary with the severity of liver disease and with fluoroquinolone prophylaxis. Host factors are more important than bacterial factors in predicting in-hospital mortality.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1469-0691
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
14
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1034-40
pubmed:meshHeading
pubmed-meshheading:19040475-Adult, pubmed-meshheading:19040475-Aged, pubmed-meshheading:19040475-Ascites, pubmed-meshheading:19040475-DNA, Bacterial, pubmed-meshheading:19040475-Drug Resistance, Bacterial, pubmed-meshheading:19040475-Escherichia coli, pubmed-meshheading:19040475-Escherichia coli Infections, pubmed-meshheading:19040475-Escherichia coli Proteins, pubmed-meshheading:19040475-Female, pubmed-meshheading:19040475-Fibrosis, pubmed-meshheading:19040475-Genotype, pubmed-meshheading:19040475-Humans, pubmed-meshheading:19040475-Male, pubmed-meshheading:19040475-Microbial Sensitivity Tests, pubmed-meshheading:19040475-Middle Aged, pubmed-meshheading:19040475-Peritonitis, pubmed-meshheading:19040475-Prognosis, pubmed-meshheading:19040475-Virulence, pubmed-meshheading:19040475-Virulence Factors
pubmed:year
2008
pubmed:articleTitle
Genetic background of Escherichia coli isolates from patients with spontaneous bacterial peritonitis: relationship with host factors and prognosis.
pubmed:affiliation
Service de Microbiologie, Hôpital AP-HP Beaujon, Clichy, France. frederic.bert@bjn.aphp.fr
pubmed:publicationType
Journal Article, Research Support, U.S. Gov't, Non-P.H.S.