Karaciğer sirozlu hastalarda asit enfeksiyonu nedenleri ve tedaviye cevabın değerlendirilmesi
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Date
2012
Authors
Karadayı, Derya
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Spontan bakteriyel peritonit (SBP) dekompanse karaciğer sirozunun sık ve önemli komplikasyonlarından biridir. Yeni gelişmelere rağmen yüksek mortalite oranlarına sahiptir. Klinik spontan bakteriyel peritonit özelliklerine ve yüksek asit polimorfolökosit sayılarına sahip hastaların asit kültürlerinin önemli kısmında etken izole edilememektedir.Bu çalışmada spontan bakteriyel peritonitin klinik ve laboratuvar özelliklerini taşıyan hastaların başvuru ve prognostik özelliklerini, asit kültüründe elde edilen üreme sonuçları ile karşılaştırdık.Retrospektif çalışmamıza Gastroenteroloji Bilim Dalımıza başvuran 107 spontan asit infeksiyonlu siroz hastası (47 kadın, 60 erkek) dahil edildi. Asit kültürü pozitif ve negatif saptanan hastalar bazal değerler, gelişen komplikasyonlar ve hastane içi mortalite açılarından karşılaştırıldı.Asit sıvısı kültürlerinde üreme oranı %47 olarak saptandı. Stafilokoklar %43 ile en fazla üretilen bakteri idi. Hastalar asit sıvısı kültürlerinde üreme durumuna bakılarak iki gruba (üreme olan veya olmayan şeklinde) ayrıldı. Bu iki grup arasında bazal değerler, hastane içi mortalite ve infeksiyon rezolusyonu açısından anlamlı fark bulunamadı.Asit kültürlerinde üreme oranlarımız literatürle benzerdir. Ama en sık üretilen bakteriler açısından literatürle farklı sonuçlar elde edildi. Çalışmamız kültür negatif nötrositik asit ve kültür pozitif SBP'li olgular arasında komplikasyonlar, prognoz, klinik ve laboratuvar bulgular açısından arada fark olmadığını desteklemektedir.
Spontaneous ascites infection (SBP) is a frequently encountered and important complication of decompensated liver cirrhosis. Although new developments occurred it has a high mortality rate Despite the use of sensitive methods, ascites culture is negative in many patients with clinical manifestations suggestive of spontaneous bacterial peritonitis.We compared patients with clinical and laboratory findings suggesting SBP according to ascitic fluid culture results.The study was a retrospective performed in Uludag University Gastroenterology Department. Groups of patients with negative and positive ascitic cultures were compared by means of basal characteristic parameters and complications. Results: Fortyseven of 107 patients included were female and 60 were male.Ascitic fluid culture revealed causative organism in 47% of the patients. Staflococcus was the most common isolate (43%) of ascitic fluid in our study. Patients acid liquid cultures by considering the two groups (with or without the reproductive form) were separated. Bbetween these two groups, no significant difference in baseline values, hospital mortality and infection resolution is found.Bacterial isolation rate was similar to that reported in literature, but the spectrum of isolated bacteria was difference to that in the literature. Our study supports the idea which proposes no difference between SBP and culture-negative neutrocytic-ascites regarding complications, prognosis, and clinical and laboratory findings.
Spontaneous ascites infection (SBP) is a frequently encountered and important complication of decompensated liver cirrhosis. Although new developments occurred it has a high mortality rate Despite the use of sensitive methods, ascites culture is negative in many patients with clinical manifestations suggestive of spontaneous bacterial peritonitis.We compared patients with clinical and laboratory findings suggesting SBP according to ascitic fluid culture results.The study was a retrospective performed in Uludag University Gastroenterology Department. Groups of patients with negative and positive ascitic cultures were compared by means of basal characteristic parameters and complications. Results: Fortyseven of 107 patients included were female and 60 were male.Ascitic fluid culture revealed causative organism in 47% of the patients. Staflococcus was the most common isolate (43%) of ascitic fluid in our study. Patients acid liquid cultures by considering the two groups (with or without the reproductive form) were separated. Bbetween these two groups, no significant difference in baseline values, hospital mortality and infection resolution is found.Bacterial isolation rate was similar to that reported in literature, but the spectrum of isolated bacteria was difference to that in the literature. Our study supports the idea which proposes no difference between SBP and culture-negative neutrocytic-ascites regarding complications, prognosis, and clinical and laboratory findings.
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Keywords
Siroz, Asit, Spontan asit infeksiyonları, Spontan bakteriyel peritonit, Cirrhosis, Ascites, Spontaneous ascites infections, Spontaneous bacterial peritonitis
Citation
Karadayı, D. (2012). Karaciğer sirozlu hastalarda asit enfeksiyonu nedenleri ve tedaviye cevabın değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.