{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:38:24Z","timestamp":1787063904288,"version":"build-2736575974"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Bacterial infections are common in patients with decompensated liver cirrhosis and a leading cause of death. Reliable data on antibiotic resistance are required to initiate effective empiric therapy. We here aim to assess the antimicrobial resistance profile of bacteria among patients with liver cirrhosis and infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Overall, 666 cirrhotic patients admitted to Hannover Medical School between January 2012 and April 2018 with ascites were assessed for bacterial infection. In case of infection, bacteria cultured from microbiological specimens of ascites, blood or urine were identified and analyzed for resistances against common antibiotic agents. Furthermore, analyses compared two periods of time and community-acquired vs. nosocomial infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 281 patients with infection, microbiological sampling was performed and culture-positive results were obtained in 56.9%. Multidrug-resistant (MDR)-bacteria were found in 54 patients (19.2%). Gram-positive organisms were more common (n\u2009=\u2009141\/261, 54.0%) and detected in 116\/192 culture-positive infections (60.4%). Comparing infections before and after 2015, a numerical decline for MDR-bacteria (23.8% vs. 15.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08) was observed with a significant decline in meropenem resistance (34.9% vs. 19.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). MDR-bacteria were more frequent in the case of nosocomial infections. Of note, in ascites the majority of the tested bacteria were resistant against ceftriaxone (73.8%) whereas significantly less were resistant against meropenem (27.0%) and vancomycin (25.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our tertiary center, distinct ratios of gram-positive infection with overall low ratios of MDR-bacteria were found. Adequate gram-positive coverage in the empiric therapy should be considered. Carbapenem treatment may be omitted even in nosocomial infection. In contrast, 3rd generation cephalosporins cannot be recommended even in community-acquired infection in our cirrhotic population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-021-01871-w","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T04:03:03Z","timestamp":1626753783000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Antimicrobial resistance in patients with decompensated liver cirrhosis and bacterial infections in a tertiary center in Northern Germany"],"prefix":"10.1186","volume":"21","author":[{"given":"Annika","family":"Hillert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Schultalbers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammo L.","family":"Tergast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf-Peter","family":"Vonberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Rademacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiner","family":"Wedemeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Cornberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Ziesing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Maasoumy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"H\u00f6ner zu Siederdissen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"issue":"4","key":"1871_CR1","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1053\/j.gastro.2010.06.019","volume":"139","author":"V Arvaniti","year":"2010","unstructured":"Arvaniti V, D\u2019Amico G, Fede G, Manousou P, Tsochatzis E, Pleguezuelo M, et al. Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis. Gastroenterology. 2010;139(4):1246\u201355.","journal-title":"Gastroenterology"},{"key":"1871_CR2","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/S0168-8278(12)60002-6","volume":"56","author":"J Fern\u00e1ndez","year":"2012","unstructured":"Fern\u00e1ndez J, Gustot T. Management of bacterial infections in cirrhosis. J Hepatol. 2012;56:S1\u201312.","journal-title":"J Hepatol"},{"issue":"5","key":"1871_CR3","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1177\/2050640620913732","volume":"8","author":"M Schultalbers","year":"2020","unstructured":"Schultalbers M, Tergast TL, Simon N, Kabbani A, Kimmann M, Zu Siederdissen CH, et al. Frequency, characteristics and impact of multiple consecutive nosocomial infections in patients with decompensated liver cirrhosis and ascites. United European Gastroenterol J. 2020;8(5):567\u201376.","journal-title":"United European Gastroenterol J"},{"issue":"1","key":"1871_CR4","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1053\/jhep.2002.30082","volume":"35","author":"J Fern\u00e1ndez","year":"2002","unstructured":"Fern\u00e1ndez J, Navasa M, G\u00f3mez J, Colmenero J, Vila J, Arroyo V, et al. Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis. Hepatology. 2002;35(1):140\u20138.","journal-title":"Hepatology"},{"issue":"3","key":"1871_CR5","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1378\/chest.124.3.1016","volume":"124","author":"MG Foreman","year":"2003","unstructured":"Foreman MG, Mannino DM, Moss M. Cirrhosis as a risk factor for sepsis and death: analysis of the National Hospital Discharge Survey. Chest. 2003;124(3):1016\u201320.","journal-title":"Chest"},{"issue":"2","key":"1871_CR6","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1086\/498909","volume":"193","author":"A Kumar","year":"2006","unstructured":"Kumar A, Haery C, Paladugu B, Kumar A, Symeoneides S, Taiberg L, et al. The duration of hypotension before the initiation of antibiotic treatment is a critical determinant of survival in a murine model of Escherichia coli septic shock: association with serum lactate and inflammatory cytokine levels. J Infect Dis. 2006;193(2):251\u20138.","journal-title":"J Infect Dis"},{"issue":"6","key":"1871_CR7","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1053\/bega.2000.0142","volume":"14","author":"J Fern\u00e1ndez","year":"2000","unstructured":"Fern\u00e1ndez J, Bauer TM, Navasa M, Rod\u00e9s J. Diagnosis, treatment and prevention of spontaneous bacterial peritonitis. Baillieres Best Pract Res Clin Gastroenterol. 2000;14(6):975\u201390.","journal-title":"Baillieres Best Pract Res Clin Gastroenterol"},{"issue":"2","key":"1871_CR8","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1007\/s11938-019-00229-2","volume":"17","author":"S Ekpanyapong","year":"2019","unstructured":"Ekpanyapong S, Reddy KR. Infections in cirrhosis. Curr Treat Options Gastroenterol. 2019;17(2):254\u201370.","journal-title":"Curr Treat Options Gastroenterol"},{"issue":"9","key":"1871_CR9","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1038\/ajg.2014.212","volume":"109","author":"JJ Kim","year":"2014","unstructured":"Kim JJ, Tsukamoto MM, Mathur AK, Ghomri YM, Hou LA, Sheibani S, et al. Delayed paracentesis is associated with increased in-hospital mortality in patients with spontaneous bacterial peritonitis. Am J Gastroenterol. 2014;109(9):1436\u201342.","journal-title":"Am J Gastroenterol"},{"issue":"3","key":"1871_CR10","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1053\/j.gastro.2007.06.065","volume":"133","author":"J Fern\u00e1ndez","year":"2007","unstructured":"Fern\u00e1ndez J, Navasa M, Planas R, Montoliu S, Monfort D, Soriano G, et al. Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis. Gastroenterology. 2007;133(3):818\u201324.","journal-title":"Gastroenterology"},{"issue":"2","key":"1871_CR11","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1016\/j.jhep.2018.03.024","volume":"69","author":"P Angeli","year":"2018","unstructured":"Angeli P, Bernardi M, Villanueva C, Francoz C, Mookerjee RP, Trebicka J, et al. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018;69(2):406\u201360.","journal-title":"J Hepatol"},{"issue":"6","key":"1871_CR12","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1016\/j.jhep.2014.01.024","volume":"60","author":"R Jalan","year":"2014","unstructured":"Jalan R, Fernandez J, Wiest R, Schnabl B, Moreau R, Angeli P, et al. Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013. J Hepatol. 2014;60(6):1310\u201324.","journal-title":"J Hepatol"},{"issue":"5","key":"1871_CR13","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1053\/j.gastro.2018.12.005","volume":"156","author":"S Piano","year":"2019","unstructured":"Piano S, Singh V, Caraceni P, Maiwall R, Alessandria C, Fernandez J, et al. Epidemiology and effects of bacterial infections in patients with cirrhosis worldwide. Gastroenterology. 2019;156(5):1368-1380.e10.","journal-title":"Gastroenterology"},{"issue":"3","key":"1871_CR14","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.jhep.2018.10.027","volume":"70","author":"J Fern\u00e1ndez","year":"2019","unstructured":"Fern\u00e1ndez J, Prado V, Trebicka J, Amoros A, Gustot T, Wiest R, et al. Multidrug-resistant bacterial infections in patients with decompensated cirrhosis and with acute-on-chronic liver failure in Europe. J Hepatol. 2019;70(3):398\u2013411.","journal-title":"J Hepatol"},{"issue":"1","key":"1871_CR15","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1007\/s10096-002-0840-z","volume":"22","author":"F Bert","year":"2003","unstructured":"Bert F, Andreu M, Durand F, Degos F, Galdbart J, Moreau R, et al. Nosocomial and community-acquired spontaneous bacterial peritonitis: comparative microbiology and therapeutic implications. Eur J Clin Microbiol Infect Dis. 2003;22(1):10\u20135.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"1","key":"1871_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1086\/340617","volume":"35","author":"B Campillo","year":"2002","unstructured":"Campillo B, Richardet J, Kheo T, Dupeyron C. Nosocomial spontaneous bacterial peritonitis and bacteremia in cirrhotic patients: impact of isolate type on prognosis and characteristics of infection. Clin Infect Dis. 2002;35(1):1\u201310.","journal-title":"Clin Infect Dis"},{"issue":"6","key":"1871_CR17","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1111\/jgh.13266","volume":"31","author":"K Friedrich","year":"2016","unstructured":"Friedrich K, N\u00fcssle S, Rehlen T, Stremmel W, Mischnik A, Eisenbach C. Microbiology and resistance in first episodes of spontaneous bacterial peritonitis: implications for management and prognosis. J Gastroenterol Hepatol. 2016;31(6):1191\u20135.","journal-title":"J Gastroenterol Hepatol"},{"issue":"5","key":"1871_CR18","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1002\/hep.25532","volume":"55","author":"J Fern\u00e1ndez","year":"2012","unstructured":"Fern\u00e1ndez J, Acevedo J, Castro M, Garcia O, de Lope CR, Roca D, et al. Prevalence and risk factors of infections by multiresistant bacteria in cirrhosis: a prospective study. Hepatology. 2012;55(5):1551\u201361.","journal-title":"Hepatology"},{"issue":"8","key":"1871_CR19","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1046\/j.1440-1746.2003.03086.x","volume":"18","author":"YH Park","year":"2003","unstructured":"Park YH, Lee HC, Song HG, Jung S, Ryu SH, Shin JW, et al. Recent increase in antibiotic-resistant microorganisms in patients with spontaneous bacterial peritonitis adversely affects the clinical outcome in Korea. J Gastroenterol Hepatol. 2003;18(8):927\u201333.","journal-title":"J Gastroenterol Hepatol"},{"issue":"6","key":"1871_CR20","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1055\/s-0031-1273404","volume":"49","author":"AL Gerbes","year":"2011","unstructured":"Gerbes AL, Sauerbruch T, Dathe K. Method report: German S3-guideline \u201cascites, spontaneous bacterial peritonitis, hepatorenal syndrome.\u201d Z Gastroenterol. 2011;49(6):780\u20137.","journal-title":"Z Gastroenterol"},{"key":"1871_CR21","unstructured":"Leitlinienprogramm DGU A. Interdisziplin\u00e4re S3 Leitlinie: Epidemiologie, Diagnostik, Therapie, Pr\u00e4vention und Management unkomplizierter, bakterieller, ambulant erworbener Harnwegsinfektionen bei erwachsenen Patienten. Langversion 1.1-2, 2017 AWMF Registernummer: 043\/044. Available at: https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/043-044l_S3_Harnwegsinfektionen_2017-05.pdf. Accessed 27.10., 2020."},{"key":"1871_CR22","unstructured":"Nationales Referenzzentrum f\u00fcr Surveillance von nosokomialen Infektionen, Robert Koch-Institut. Definitionen nosokomialer Infektionen f\u00fcr die Surveillance im Krankenhaus-Infektions- Surveillance-System (KISS-Definitionen). 2017:6."},{"key":"1871_CR23","doi-asserted-by":"crossref","unstructured":"KRINKO. Hygienema\u00dfnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen St\u00e4bchen. Bundesgesundheitsblatt 2012;55:1311\u201354.","DOI":"10.1007\/s00103-012-1549-5"},{"key":"1871_CR24","doi-asserted-by":"crossref","unstructured":"Magiorakos A-, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18(3):268\u201381.","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"issue":"4","key":"1871_CR25","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1055\/s-2007-1007209","volume":"17","author":"M Navasa","year":"1997","unstructured":"Navasa M, Rimola A, Rod\u00e9s J. Bacterial infections in liver disease. Semin Liver Dis. 1997;17(4):323\u201333.","journal-title":"Semin Liver Dis"},{"issue":"3","key":"1871_CR26","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/S0168-8278(05)80280-6","volume":"18","author":"WR Caly","year":"1993","unstructured":"Caly WR, Strauss E. A prospective study of bacterial infections in patients with cirrhosis. J Hepatol. 1993;18(3):353\u20138.","journal-title":"J Hepatol"},{"issue":"8","key":"1871_CR27","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1080\/00365521.2019.1647280","volume":"54","author":"F Wellh\u00f6ner","year":"2019","unstructured":"Wellh\u00f6ner F, D\u00f6scher N, Tergast TL, Vital M, Plumeier I, Kahl S, et al. The impact of proton pump inhibitors on the intestinal microbiota in chronic hepatitis C patients. Scand J Gastroenterol. 2019;54(8):1033\u201341.","journal-title":"Scand J Gastroenterol"},{"issue":"9","key":"1871_CR28","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1038\/nrgastro.2017.72","volume":"14","author":"L Yu","year":"2017","unstructured":"Yu L, Schwabe RF. The gut microbiome and liver cancer: mechanisms and clinical translation. Nat Rev Gastroenterol Hepatol. 2017;14(9):527\u201339.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"1","key":"1871_CR29","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1111\/eci.12701","volume":"47","author":"P Lutz","year":"2017","unstructured":"Lutz P, Nischalke HD, Kr\u00e4mer B, Goeser F, Kaczmarek DJ, Schlabe S, et al. Antibiotic resistance in healthcare-related and nosocomial spontaneous bacterial peritonitis. Eur J Clin Invest. 2017;47(1):44\u201352.","journal-title":"Eur J Clin Invest"},{"issue":"1","key":"1871_CR30","first-page":"142","volume":"32","author":"A Rimola","year":"2000","unstructured":"Rimola A, Garc\u00eda-Tsao G, Navasa M, Piddock LJ, Planas R, Bernard B, et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. Int Ascites Club J Hepatol. 2000;32(1):142\u201353.","journal-title":"Int Ascites Club J Hepatol"},{"issue":"1","key":"1871_CR31","first-page":"51","volume":"15","author":"FA C\u0103runtu","year":"2006","unstructured":"C\u0103runtu FA, Benea L. Spontaneous bacterial peritonitis: pathogenesis, diagnosis, treatment. J Gastrointestin Liver Dis. 2006;15(1):51\u20136.","journal-title":"J Gastrointestin Liver Dis"},{"issue":"1","key":"1871_CR32","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s15010-008-8060-9","volume":"37","author":"A Umgelter","year":"2009","unstructured":"Umgelter A, Reindl W, Miedaner M, Schmid RM, Huber W. Failure of current antibiotic first-line regimens and mortality in hospitalized patients with spontaneous bacterial peritonitis. Infection. 2009;37(1):2\u20138.","journal-title":"Infection"},{"issue":"9","key":"1871_CR33","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1086\/597585","volume":"48","author":"HS Cheong","year":"2009","unstructured":"Cheong HS, Kang C, Lee JA, Moon SY, Joung MK, Chung DR, et al. Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis. Clin Infect Dis. 2009;48(9):1230\u20136.","journal-title":"Clin Infect Dis"},{"issue":"17","key":"1871_CR34","doi-asserted-by":"publisher","first-page":"2757","DOI":"10.3748\/wjg.14.2757","volume":"14","author":"S Angeloni","year":"2008","unstructured":"Angeloni S, Leboffe C, Parente A, Venditti M, Giordano A, Merli M, et al. Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice. World J Gastroenterol. 2008;14(17):2757\u201362.","journal-title":"World J Gastroenterol"},{"key":"1871_CR35","doi-asserted-by":"publisher","first-page":"2047","DOI":"10.2147\/IDR.S172587","volume":"11","author":"PG Ferstl","year":"2018","unstructured":"Ferstl PG, M\u00fcller M, Filmann N, Hogardt M, Kempf VA, Wichelhaus TA, et al. Noninvasive screening identifies patients at risk for spontaneous bacterial peritonitis caused by multidrug-resistant organisms. Infect Drug Resist. 2018;11:2047\u201361.","journal-title":"Infect Drug Resist"},{"issue":"4","key":"1871_CR36","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/S0016-5085(96)70069-0","volume":"111","author":"M Navasa","year":"1996","unstructured":"Navasa M, Follo A, Llovet JM, Clemente G, Vargas V, Rimola A, et al. Randomized, comparative study of oral ofloxacin versus intravenous cefotaxime in spontaneous bacterial peritonitis. Gastroenterology. 1996;111(4):1011\u20137.","journal-title":"Gastroenterology"},{"issue":"2","key":"1871_CR37","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1002\/hep.1840170215","volume":"17","author":"C Toledo","year":"1993","unstructured":"Toledo C, Salmer\u00f3n JM, Rimola A, Navasa M, Arroyo V, Llach J, et al. Spontaneous bacterial peritonitis in cirrhosis: predictive factors of infection resolution and survival in patients treated with cefotaxime. Hepatology. 1993;17(2):251\u20137.","journal-title":"Hepatology"},{"issue":"2","key":"1871_CR38","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1038\/ajg.2011.314","volume":"107","author":"ML Volk","year":"2012","unstructured":"Volk ML, Tocco RS, Bazick J, Rakoski MO, Lok AS. Hospital readmissions among patients with decompensated cirrhosis. Am J Gastroenterol. 2012;107(2):247\u201352.","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"1871_CR39","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1016\/j.jhep.2016.08.006","volume":"65","author":"J Fern\u00e1ndez","year":"2016","unstructured":"Fern\u00e1ndez J, Bert F, Nicolas-Chanoine M. The challenges of multi-drug-resistance in hepatology. J Hepatol. 2016;65(5):1043\u201354.","journal-title":"J Hepatol"},{"issue":"11","key":"1871_CR40","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1016\/j.cgh.2010.06.024","volume":"8","author":"M Merli","year":"2010","unstructured":"Merli M, Lucidi C, Giannelli V, Giusto M, Riggio O, Falcone M, et al. Cirrhotic patients are at risk for health care-associated bacterial infections. Clin Gastroenterol Hepatol. 2010;8(11):979\u201385.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"9","key":"1871_CR41","doi-asserted-by":"publisher","first-page":"1916","DOI":"10.1093\/cid\/ciz540","volume":"70","author":"MM M\u00fccke","year":"2020","unstructured":"M\u00fccke MM, Mayer A, Kessel J, M\u00fccke VT, Bon D, Schwarzkopf K, et al. Quinolone and multidrug resistance predicts failure of antibiotic prophylaxis of spontaneous bacterial peritonitis. Clin Infect Dis. 2020;70(9):1916\u201324.","journal-title":"Clin Infect Dis"},{"issue":"2","key":"1871_CR42","doi-asserted-by":"publisher","first-page":"e13198","DOI":"10.1111\/eci.13198","volume":"50","author":"H Li","year":"2020","unstructured":"Li H, Wieser A, Zhang J, Liss I, Markwardt D, Hornung R, et al. Patients with cirrhosis and SBP: increase in multidrug-resistant organisms and complications. Eur J Clin Invest. 2020;50(2):e13198.","journal-title":"Eur J Clin Invest"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01871-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-021-01871-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01871-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T04:06:35Z","timestamp":1626753995000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-021-01871-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,20]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1871"],"URL":"https:\/\/doi.org\/10.1186\/s12876-021-01871-w","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,20]]},"assertion":[{"value":"26 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The local ethics committee of Hannover Medical School approved the study (ethic no. 7935_BO_K_2018 from June 22nd 2018) and patients provided written informed consent for the scientific use of their clinical data. The study was conducted according to Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"296"}}