Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Spontaneous bacterial peritonitis (<jats:styled-content style="fixed-case">SBP</jats:styled-content>) can be life threatening in patients with liver cirrhosis. In contrast to community‐acquired <jats:styled-content style="fixed-case">SBP</jats:styled-content>, no standard treatment has been established for healthcare‐related and nosocomial <jats:styled-content style="fixed-case">SBP</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Materials and methods</jats:title><jats:p>We prospectively collected healthcare‐related and nosocomial <jats:styled-content style="fixed-case">SBP</jats:styled-content> cases from March 2012 till February 2016 at the Department of Internal Medicine I of the University of Bonn and analysed the prevalence of antibiotic resistance among the isolated bacteria. <jats:styled-content style="fixed-case">SBP</jats:styled-content> was diagnosed according to international guidelines. Ciprofloxacin, ceftriaxone and meropenem were used as reference substance for resistance to quinolones, third‐generation cephalosporins and carbapenems, respectively.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Ninety‐two <jats:styled-content style="fixed-case">SBP</jats:styled-content> episodes in 86 patients were identified: 63 episodes (69%) were nosocomial. <jats:italic>Escherichia coli</jats:italic>,<jats:italic> Klebsiella</jats:italic> species, enterococci and streptococci were most frequently isolated. Frequencies of these microorganisms were comparable for healthcare‐related and nosocomial <jats:styled-content style="fixed-case">SBP</jats:styled-content> (14% vs. 11%, 14% vs. 8%, 14% vs. 5% and 10% vs. 6%, respectively). In general, antibiotic resistance was higher in isolates from nosocomial than from healthcare‐related <jats:styled-content style="fixed-case">SBP</jats:styled-content> (50% vs. 18% for quinolones, 30% vs. 11% for piperacillin–tazobactam; <jats:italic>P</jats:italic> > 0·05), but comparable concerning third‐generation cephalosporins (30% vs. 33%). All microorganisms were sensitive to carbapenems apart from nosocomial infections with <jats:italic>Enterococcus faecium</jats:italic> (<jats:italic>n</jats:italic> = 3) and <jats:italic>Candida albicans</jats:italic> (<jats:italic>n</jats:italic> = 1) due to intrinsic resistance or lack of microbiological efficacy, respectively. No multidrug‐resistant microorganisms were detected. Resistance to initial antibiotic treatment affected 30‐day survival negatively (18% vs. 68%; <jats:italic>P</jats:italic> = 0·002).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Resistance to initial antibiotic treatment was associated with increased mortality. With resistance to cephalosporins being frequent, piperacillin–tazobactam or carbapenems might be preferred as treatment of <jats:styled-content style="fixed-case">SBP</jats:styled-content>.</jats:p></jats:sec>