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Nosocomial spontaneous bacterial peritonitis antibiotic treatment in the era of multi-drug resistance pathogens: A systematic review

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World Journal of Gastroenterology 2017年第25期23卷 4654-4660页

作者： Marco Fiore Alberto Enrico Maraolo Ivan Gentile Guglielmo Borgia Sebastiano Leone Pasquale Sansone Maria Beatrice Passavanti caterina aurilio Maria caterina Pace Department of Anaesthesiological Surgical and Emergency SciencesUniversity of Campania“Luigi Vanvitelli” Department of Clinical Medicine and Surgery Section of Infectious DiseasesUniversity of Naples Federico II Division of Infectious Diseases “San Giuseppe Moscati”Hospital

To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis (N-SBP) given the rising importance of multidrug-resistant (MDR) bacteria. METHODSA literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15th of November 2016, using the following search strategy: “spontaneous” AND “peritonitis”. RESULTSThe initial search through electronic databases retrieved 2556 records. After removing duplicates, 1958 records remained. One thousand seven hundred and thirty-five of them were excluded on the basis of the screening of titles and abstract, and the ensuing number of remaining articles was 223. Of these records, after careful evaluation, only 9 were included in the qualitative analysis. The overall proportion of MDR bacteria turned out to be from 22% to 73% of cases across the studies. CONCLUSIONN-SBP is caused, in a remarkable proportion, by MDR pathogens. This should prompt a careful re-assessment of guidelines addressing the treatment of this clinical entity.

关键词： Hospital-acquired infections Nosocomial spontaneous bacterial peritonitis Multidrug resistant bacteria Cirrhosis Critically ill patient

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Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis

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World Journal of Hepatology 2017年第30期9卷 1166-1175页

作者： Marco Fiore Alberto Enrico Maraolo Ivan Gentile Guglielmo Borgia Sebastiano Leone Pasquale Sansone Maria Beatrice Passavanti caterina aurilio Maria caterina Pace Department of Anesth-esiological Surgical and Emergency SciencesUniversity of Campania 'Luigi Vanvitelli' Department of Clinical Medicine and Surgery Section of Infectious DiseasesUniversity of Naples Federico Ⅱ Division of Infectious Diseases 'San Giuseppe Moscati' Hospital

Spontaneous bacterial peritonitis(SBP) is the most common infection in end-stage liver disease *** is defined as an ascitic fluid infection with a polymorphonuclear leucocyte count ≥ 250/mm^3 without an evident intra-abdominal surgically treatable *** mechanisms contribute to SBP occurrence,including translocation of gut bacteria and their products,reduced intestinal motility provoking bacterial overgrowth,alteration of the gut's barrier function and local immune ***,Gram-negative enteric bacteria have been the main causative agents of SBP,thereby guiding the empirical therapeutic ***,over the last decade,a worryingly increasing prevalence of Gram-positive and multi-drug resistant(MDR) SBP has been ***,the microbiological spectrum of SBP seems to have changed in Europe due to a high prevalence of Gram-positive bacteria(48%-62%).The overall proportion of MDR bacteria is up to 22%-73% of ***,empirical therapy based on thirdgeneration cephalosporins or amoxicillin/clavulanic acid,can no longer be considered the standard of care,as these drugs are associated with poor *** of this review is to describe,with an epidemiological focus,the evidence behind this rise in Gram-positive and MDR SBP from 2000 to present,and illustrate potential targeted therapeutic *** appropriate treatment protocol should include daptomycin plus ceftaroline and meropenem,with prompt stepdown to a narrower spectrum when cultures and sensitivity data are available in order to reduce both cost and potential antibiotic resistance development.

关键词： Spontaneous bacterial peritonitis Multi-drug resistant bacteria End-stage liver disease Cirrhosis Critically ill patient

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First Italian outbreak of VIM-producing Serratia marcescens in an adult polyvalent intensive care unit, August-October 2018: A case report and literature review

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World Journal of Clinical Cases 2019年第21期7卷 3535-3548页

作者： Maria Rosaria Iovene Vincenzo Pota Massimiliano Galdiero Giusy Corvino Federica Maria Di Lella Debora Stelitano Maria Beatrice Passavanti Maria caterina Pace Aniello Alfieri Sveva Di Franco caterina aurilio Pasquale Sansone Vettakkara Kandy Muhammed Niyas Marco Fiore Department of Experimental Medicine University of Campania"Luigi Vanvitelli"Naples 80138Italy Department of Women Child and General and Specialized SurgeryUniversity of Campania"Luigi Vanvitelli"Naples 80138Italy Department of Medicine All India Institute of Medical SciencesNew Delhi 110029India

BACKGROUND Carbapenem-resistant Enterobacteriaceae has become a significant public health concern as hospital outbreaks are now being frequently reported and these organisms are becoming difficult to treat with the available *** SUMMARY An outbreak of VIM-producing Serratia marcescens occurred over a period of 11 wk(August,1 to October,18)in patients admitted to the adult polyvalent intensive care unit of the University of Campania“Luigi Vanvitelli”located in *** episodes occurred in three patients(two patients infected,and one patient colonized).All the strains revealed the production of *** After three decades of carbapenem antibiotics use,the emergence of carbapenemresistance in Enterobacteriaceae has become a significant concern and a stricter control to preserve its clinical application is *** is,to our knowledge,the first outbreak of VIM-producing Serratia marcescens in *** policies must be implemented to avoid future outbreaks.

关键词： Serratia marcescens Carbapenamase VIM Intensive care unit Outbreak Case report

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