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dc.contributor.authorHillert, Annika
dc.contributor.authorSchultalbers, Marie
dc.contributor.authorTergast, Tammo L
dc.contributor.authorVonberg, Ralf-Peter
dc.contributor.authorRademacher, Jessica
dc.contributor.authorWedemeyer, Heiner
dc.contributor.authorCornberg, Markus
dc.contributor.authorZiesing, Stefan
dc.contributor.authorMaasoumy, Benjamin
dc.contributor.authorHöner Zu Siederdissen, Christoph
dc.date.accessioned2021-09-13T09:40:15Z
dc.date.available2021-09-13T09:40:15Z
dc.date.issued2021-07-20
dc.identifier.citationBMC Gastroenterol. 2021 Jul 20;21(1):296. doi: 10.1186/s12876-021-01871-w.en_US
dc.identifier.pmid34284732
dc.identifier.doi10.1186/s12876-021-01871-w
dc.identifier.urihttp://hdl.handle.net/10033/623023
dc.description.abstractBackground and aims: Bacterial infections are common in patients with decompensated liver cirrhosis and a leading cause of death. Reliable data on antibiotic resistance are required to initiate effective empiric therapy. We here aim to assess the antimicrobial resistance profile of bacteria among patients with liver cirrhosis and infection. Methods: Overall, 666 cirrhotic patients admitted to Hannover Medical School between January 2012 and April 2018 with ascites were assessed for bacterial infection. In case of infection, bacteria cultured from microbiological specimens of ascites, blood or urine were identified and analyzed for resistances against common antibiotic agents. Furthermore, analyses compared two periods of time and community-acquired vs. nosocomial infections. Results: In 281 patients with infection, microbiological sampling was performed and culture-positive results were obtained in 56.9%. Multidrug-resistant (MDR)-bacteria were found in 54 patients (19.2%). Gram-positive organisms were more common (n = 141/261, 54.0%) and detected in 116/192 culture-positive infections (60.4%). Comparing infections before and after 2015, a numerical decline for MDR-bacteria (23.8% vs. 15.6%, p = 0.08) was observed with a significant decline in meropenem resistance (34.9% vs. 19.5%, p = 0.03). MDR-bacteria were more frequent in the case of nosocomial infections. Of note, in ascites the majority of the tested bacteria were resistant against ceftriaxone (73.8%) whereas significantly less were resistant against meropenem (27.0%) and vancomycin (25.9%). Conclusions: In our tertiary center, distinct ratios of gram-positive infection with overall low ratios of MDR-bacteria were found. Adequate gram-positive coverage in the empiric therapy should be considered. Carbapenem treatment may be omitted even in nosocomial infection. In contrast, 3rd generation cephalosporins cannot be recommended even in community-acquired infection in our cirrhotic population.en_US
dc.language.isoenen_US
dc.publisherBMCen_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectAntibiotic resistanceen_US
dc.subjectAscitesen_US
dc.subjectBacterial infectionen_US
dc.subjectLiver cirrhosisen_US
dc.subjectMultiresistant bacteriaen_US
dc.titleAntimicrobial resistance in patients with decompensated liver cirrhosis and bacterial infections in a tertiary center in Northern Germany.en_US
dc.typeArticleen_US
dc.identifier.eissn1471-230X
dc.contributor.departmentCiiM, Zentrum für individualisierte Infektionsmedizin, Feodor-Lynen-Str.7, 30625 Hannover.en_US
dc.identifier.journalBMC gastroenterologyen_US
dc.source.volume21
dc.source.issue1
dc.source.beginpage296
dc.source.endpage
refterms.dateFOA2021-09-13T09:40:16Z
dc.source.journaltitleBMC gastroenterology
dc.source.countryEngland


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Attribution 4.0 International
Except where otherwise noted, this item's license is described as Attribution 4.0 International