{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:55:29Z","timestamp":1779893729180,"version":"3.53.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This study aimed to determine the causative bacterial agents of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and to define antibiotic-resistance patterns in addition to identifying the genetic mutations in the quinolone resistance determining regions (QRDRs).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients and methods<\/jats:title>\n            <jats:p>Twenty milliliters of ascetic fluid was obtained from 51 patients with SBP. The antibiotic-sensitivity patterns of different strains were determined by the Kirby\u2013Bauer method. Extracted bacterial DNA was used to determine the mutations in four different genes in QRDRs (<jats:italic toggle=\"yes\">gyrA<\/jats:italic>, <jats:italic toggle=\"yes\">gyrB<\/jats:italic>, <jats:italic toggle=\"yes\">parC<\/jats:italic>, and <jats:italic toggle=\"yes\">parE<\/jats:italic>) by sequencing after gene amplification by PCR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Gram-negative bacilli were detected in 60.7% of the patients. <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic> was detected in 33.3% of the patients, and <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic> was detected in 21.6%. Gram-negative bacilli showed the best sensitivity to meropenem (90.3%), followed by amikacin (83.9%). Gram-positive cocci were sensitive to vancomycin and oxacillin at 90 and 80%, respectively. Fluoroquinolone resistance was detected in 27% of the bacterial strains. Mutations in the <jats:italic toggle=\"yes\">gyrA<\/jats:italic> and <jats:italic toggle=\"yes\">parC<\/jats:italic> genes were detected in quinolone-resistant strains (64.3 and 35.7%, respectively). Several mutations were found in the <jats:italic toggle=\"yes\">gyrA<\/jats:italic> gene (Ser83Leu, Ser81Phe, and Ser-84Leu). Ser80Ile and Ser79Tyr mutations were detected in the <jats:italic toggle=\"yes\">parC<\/jats:italic> gene. No mutation was detected in the <jats:italic toggle=\"yes\">parE<\/jats:italic> gene.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Frequent use of antibiotics as prophylaxis against SBP leads to an increase in antibiotic resistance and changes the microbial pattern of causative agents. The <jats:italic toggle=\"yes\">gyrA<\/jats:italic> gene mutation was the most common mutation detected in fluoroquinolone-resistant strains.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/meg.0000000000001908","type":"journal-article","created":{"date-parts":[[2020,8,16]],"date-time":"2020-08-16T14:01:05Z","timestamp":1597586465000},"page":"64-68","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Fluoroquinolone-resistant strains in cirrhotic patients with spontaneous bacterial peritonitis: microbiological and molecular aspects"],"prefix":"10.1097","volume":"34","author":[{"given":"Ali A.","family":"Ghweil","sequence":"first","affiliation":[{"name":"Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley University, Qena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamardan Ezzeldin S.","family":"Bazeed","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley University, Qena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.H.","family":"Al Rawy","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf","family":"Khodeary","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa I.","family":"El-Amir","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, South Valley University, Qena, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8,14]]},"reference":[{"key":"R1-20250801","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/S0168-8278(00)80201-9","article-title":"Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. 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