关键词: 肝硬化, 腹腔积液, 感染, 病原菌, 耐药

Abstract: Objective The aim of this study was to investigate the distribution and drug resistance of pathogens in patients with decompensated hepatitis B liver cirrhosis (LC) and spontaneous bacterial peritonitis (SBP). Methods A series of 559 patients with decompensated hepatitis B-induced LC were admitted to our hospital between January 2019 and January 2023, and the ascites were obtained for routine bacterial culture. The bacterial characterization and drug susceptibility were conducted by VITEK-2 compact automatic microbial identification system. Results Among the 559 patients with decompensated LC, the ascites bacterial culture was positive in 119 cases (21.3%), including 74 strains (62.2%) of Gram-negative bacteria, 35 strains (29.4%) of Gram-positive bacteria and 10 strains (8.4%) of fungi infection; the Escherichia Coli was resistant to ampicillin up to 97.1%, the resistance to ciprofloxacin and first-generation, second-generation and third-generation cephalosporins greater than 40.0%, and was sensitive to amicacin and ertapenem; the Klebsiella Pneumoniae was resistant to ampicillin up to 100.0%, while sensitive to other commonly administered antibiotics; the Enterobacter Cloacae was resistant to cephalosporins greater than 30.0%, but sensitive to amikacin, gentamicin and ertapenem; the coagulase-negative Staphylococcus, Staphylococcus Aureus and Enterococcus Faecium was resistant to penicillin greater than 80.0%, but sensitive to vancomycin, tigacycline and linezolid; the Fungi we found were all sensitive to common antifungal agents. Conclusion The main pathogens in patients with SBP are Gram-negative bacteria in our hospital, and the drug resistance is common. In clinical practice, the early ascites culture and bacterial characterization are necessary for sensitive antibiotics selection.

Key words: Liver cirrhosis, Spontaneous bacterial peritonitis, Pathogen, Drug resistance