Nosocomial spontaneous bacterial peritonitis is associated with high mortality - a systematic review and meta-analysis.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI:10.1080/17474124.2023.2284825

Mubeen Khan Mohammed Abdul, Karim T Osman, Joseph M Cappuccio, Carol Spencer, Sanjaya K Satapathy

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Abstract

Introduction: It is unclear if Nosocomial Spontaneous Bacteria Peritonitis (NSBP) is associated with higher mortality compared with community acquired spontaneous bacterial peritonitis.

Methods: Database search from inception to May 2022 was conducted. The databases included MEDLINE, EMBASE, Cochrane registry of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus. Inclusion criteria were as follows: adult patients, age >18 years, with a diagnosis of NSBP. Pooled estimates of mortality were calculated following the restricted maximum likelihood method. The mortality rate between NSBP and CA-SBP was reported as odds ratio (OR) and 95% confidence interval (CI). Data synthesis was obtained using random effects meta-analysis. Heterogeneity was reported as I².

Results: A total of 482 unique titles were screened. Twenty-two articles were included. A total of 2,145 patients with NSBP were included. Patients were followed for a median of 90 days. The pooled mortality rate of NSBP was 52.51% (95% CI 42.77-62.06%; I² 83.72%). Seven studies compared the mortality outcome of patients with NSBP and CA-SBP. NSBP was significantly associated with a higher rate of mortality (OR 2.78, 95% CI 1.87-4.11; I² 36.00%).

Conclusion: NSBP was associated with higher mortality rate compared to CA-SBP, which could be due to a higher rate of resistance organisms.

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医院源性自发性细菌性腹膜炎与高死亡率相关——一项系统综述和荟萃分析。

与社区获得性自发性细菌性腹膜炎相比，目前尚不清楚院内自发性细菌性腹膜炎(NSBP)是否与更高的死亡率相关。方法:检索自成立至2022年5月的数据库。MEDLINE, EMBASE, Cochrane对照试验注册，Cochrane系统评价数据库和Scopus。纳入标准:成人患者，年龄bb0 - 18岁，诊断为NSBP。死亡率的汇总估计是根据限制最大似然法计算的。以优势比(OR)和95%可信区间(CI)报告NSBP和CA-SBP之间的死亡率。数据综合采用随机效应荟萃分析。异质性报告为I2。结果:共筛选出482种独特题型。共纳入22篇文章。共有2145名NSBP患者被纳入研究。患者的随访时间中位数为90天。NSBP合并死亡率为52.51% (95%CI 42.77 ~ 62.06%;I2 83.72%)。七项研究比较了NSBP和CA-SBP患者的死亡率结果。NSBP与较高的死亡率显著相关(OR 2.78, 95%CI 1.87-4.11;I2 36.00%)。结论:与CA-SBP相比，NSBP与更高的死亡率相关，这可能是由于更高的耐药菌率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.