{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:48:35Z","timestamp":1792432115887,"version":"4.5.0"},"reference-count":19,"publisher":"FapUNIFESP (SciELO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"abstract":"<jats:p>ABSTRACT  BACKGROUND: Spontaneous bacterial peritonitis is a serious complication in cirrhotic patients, and changes in the microbiological characteristics reported in the last years are impacting the choice of antibiotic used for treatment.  OBJECTIVE:  The aim of the present study is to evaluate the changes in the epidemiology and bacterial resistance of the germs causing spontaneous bacterial peritonitis over three different periods over 17 years.  METHODS: All cirrhotic patients with spontaneous bacterial peritonitis and positive culture of ascites fluid were retrospectively studied in a reference Hospital in Southern Brazil. Three periods were ramdomly evaluated: 1997-1998, 2002-2003 and 2014-2015. The most frequent infecting organisms and the sensitivity in vitro to antibiotics were registered.  RESULTS: In the first period (1997-1998) there were 33 cases, the most common were: E. coli in 13 (36.11%), Staphylococcus coagulase-negative in 6 (16.66%), K. pneumoniae in 5 (13.88%), S. aureus in 4 (11.11%) and S. faecalis in 3 (8.33%). In the second period (2002-2003), there were 43 cases, the most frequent were: Staphylococus coagulase-negative in 16 (35.55%), S. aureus in 8 (17.77%), E. coli in 7 (15.55%) and K. pneumoniae in 3 (6.66%). In the third period (2014-2015) there were 58 cases (seven with two bacteria), the most frequent were: E. coli in 15 (23.1%), S. viridans in 12 (18.5%), K. pneumoniae in 10 (15.4%) and E. faecium 5 (7.7%). No one was using antibiotic prophylaxis. Considering all staphylococci, the prevalence increased to rates of the order of 50% in the second period, with a reduction in the third period evaluated. Likewise, the prevalence of resistant E. coli increased, reaching 14%.  CONCLUSION: There was a modification of the bacterial population causing spontaneous bacterial peritonitis, with high frequency of gram-positive organisms, as well as an increase in the resistance to the traditionally recommended antibiotics. This study suggests a probable imminent inclusion of a drug against gram-positive organisms in the empiric treatment of spontaneous bacterial peritonitis.<\/jats:p>","DOI":"10.1590\/s0004-2803.201800000-08","type":"journal-article","created":{"date-parts":[[2018,3,14]],"date-time":"2018-03-14T15:16:35Z","timestamp":1521040595000},"page":"23-27","source":"Crossref","is-referenced-by-count":12,"title":["IMPACT OF MICROBIOLOGICAL CHANGES ON SPONTANEOUS BACTERIAL PERITONITIS IN THREE DIFFERENT PERIODS OVER 17 YEARS"],"prefix":"10.1590","volume":"55","author":[{"given":"Paulo Roberto Lerias de","family":"ALMEIDA","sequence":"first","affiliation":[{"name":"Hospital Nossa Senhora da Concei\u00e7\u00e3o,  Brazil; Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Stefani","family":"LE\u00c3O","sequence":"additional","affiliation":[{"name":"Hospital Nossa Senhora da Concei\u00e7\u00e3o,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlles David Gon\u00e7alves","family":"GON\u00c7ALVES","sequence":"additional","affiliation":[{"name":"Hospital Nossa Senhora da Concei\u00e7\u00e3o,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Veiga","family":"PICON","sequence":"additional","affiliation":[{"name":"Hospital Nossa Senhora da Concei\u00e7\u00e3o,  Brazil; Universidade do Vale do Taquari,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiane Valle","family":"TOVO","sequence":"additional","affiliation":[{"name":"Hospital Nossa Senhora da Concei\u00e7\u00e3o,  Brazil; Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2018,3]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1046\/j.1365-2036.2001.01116.x","article-title":"Spontaneous bacterial peritonitis - diagnosis, treatment and prevention","volume":"15","author":"Mowat C","year":"2001","journal-title":"Aliment Pharmacol Ther"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1053\/bega.2000.0142","article-title":"Diagnosis, treatment and prevention of spontaneous bacterial peritonitis","volume":"14","author":"Fern\u00e1ndez J","year":"2000","journal-title":"Baillieres Best Pract Res Clin Gastroenterol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1053\/jhep.2002.30082","article-title":"Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis","volume":"35","author":"Fern\u00e1ndez 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