S3393 Assessing the Epidemiology and Microbiology of Spontaneous Bacterial Peritonitis at a Canadian Institution. a Retrospective Analysis
Bibliographic record
Abstract
Introduction: Spontaneous bacterial peritonitis (SBP) is an infection of ascitic fluid that commonly occurs in patients with liver cirrhosis. Antibiotic prophylaxis is recommended for patients who are at high risk of developing SBP or to prevent a recurrent infection in patients previously diagnosed with SBP. However, much concern has risen regarding the changing landscape of the microbiology of SBP, antibiotic resistance patterns and the initiation and length of treatment. The microbiological characteristics of SBP are changing worldwide. The objectives of this study are to evaluate the changes to the epidemiology of the bacteria causing SBP in the West Coast of Canada and the appropriateness of the current treatment regimen with regards to local resistance patterns. Methods: The study conducted was a single center, retrospective chart review of patients diagnosed with spontaneous bacterial peritonitis at our center in Vancouver, Canada. Cases were identified retrospectively over a 10-year period ranging from Jan 1st, 2010 to Jan 31st, 2020. Clinical and laboratory and microbiological data were collected and calculated within 3 days of the diagnosis of SBP. Patient outcomes of infection were tracked. Results: From January 1st, 2010 to January 31st, 2020, 56 cases of spontaneous bacterial peritonitis were identified. Mean age was 59. 70% of patients were male, 30% were female. Ascitic fluid cultures were positive in 31 cases (56%) and negative in 25 cases (45%). The prevalence of microorganisms in ascitic fluid cultures in descending order were E. faecalis (16%), E. coli (12%), S. aureus (10%) and K. pneumoniae (4%). The prevalence of antibiotic resistance to vancomycin was 7.14%. Resistance rates for ceftriaxone and quinolones was 3.57% and for both pip-tazo and oxacillin was 1.79%. There was no resistance identified with TMP-SMX. Our study found a significant difference in length of hospital stay in patients with antibiotic resistance versus those without. Conclusion: Our study reveals that there are not any concerning rates of resistance seen with current antibiotic treatment of spontaneous bacterial peritonitis at our center. However, they provide insight into the regional epidemiological and microbiological trends of infection pertaining to our center and a basis for the ongoing monitoring of the effectiveness of antibiotic treatments for spontaneous bacterial peritonitis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.008 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".