@article{3093357,
    title = "Increasing frequency of Gram-positive bacteria in spontaneous bacterial
peritonitis",
    author = "Cholongitas, E and Papatheodoridis, GV and Lahanas, A and Xanthaki, A and and Kontou-Kastellanou, C and Archimandritis, AJ",
    journal = "Liver International",
    year = "2005",
    volume = "25",
    number = "1",
    pages = "57-61",
    publisher = "Wiley",
    issn = "1478-3223, 1478-3231",
    doi = "10.1111/j.1478-3231.2004.0985.x",
    keywords = "cirrhosis; Gram-negative bacteria; Gram-positive bacteria; quinolone
resistance; spontaneous bacterial peritonitis",
    abstract = "Aim: To evaluate the characteristics and possible recent changes of the
microbial causes of spontaneous bacterial peritonitis (SBP) in cirrhotic
patients. Methods: We retrospectively evaluated 42 cirrhotic patients
with positive ascitic fluid culture and without evidence of secondary
peritonitis who were admitted consecutively to our Department between
1998 and 2002. Results: Twenty (48%) of 42 patients with positive
ascitic fluid culture were diagnosed during 1998-1999 (period A) and the
remaining 22 (52%) patients during 2000-2002 (period B). Gram-negative
bacteria were the cause of SBP in 15 (75%) of the 20 patients during
period A and in only nine (41%) of the 22 patients during period B
(P=0.026). SBP patients with Gram-positive bacteria compared with those
with Gram-negative bacteria were less frequently in Child class C
(P=0.058) and had significantly higher ascitic fluid protein (P=0.014)
and albumin concentrations (P=0.009) and lower ascitic fluid neutrophil
count (P=0.008). Resistance to quinolones was detected significantly
more frequently in the isolated Gram-positive than Gram-negative
bacteria (P<0.001). Conclusion: Culture-positive SBP in cirrhotic
patients are caused more frequently by Gram-positive bacteria during the
recent years, which are, in their vast majority, resistant to
quinolones."
}