{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T02:04:26Z","timestamp":1788833066358,"version":"build-2803163510"},"reference-count":58,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>(1) Background: Spontaneous bacterial peritonitis (SBP) is associated with a 20% mortality and is mainly caused by Gram-negative bacteria (GNB); Gram-positive bacteria (GPB) were predominant in some areas; and increased antibiotic resistance was recorded. (2) Methods: A retrospective study was performed between 2018 and 2024. The type of isolated strains, antibiotic susceptibility, and mortality (in-hospital; 30-day; 90-day; and 1-year) were estimated; multivariate analyses evaluated predictive factors for in-hospital mortality risk. (3) Results: 45 culture-positive SBP, 28 culture-negative SBP, 6 bacterascites, and 670 control ascites were diagnosed; GPB represented 60%; two Candida peritonitis and 11 polymicrobial peritonitis (21.6%) were noted (without surgery; peritoneal dialysis; or tegumentary lesion). High resistance rates to cephalosporins and quinolones, and high carbapenem resistance for nosocomial GNB were recorded. A low resistance rate to Tigecycline was noted in all infection types; GPB was susceptible to Linezolid and Vancomycin; and GNB was susceptible to Aztreonam and Colistin. In-hospital mortality was 26.7% (40% for GNB-SBP; 20% for GPB-SBP), similar to culture-negative SBP (21.3%), and higher than in the control group (9%); long-term mortality remained higher. (4) Conclusions: microbial changes to GPB etiology and increasing resistance were noted, but with a lower mortality compared to GNB; higher mortality rates up to 1 year for culture-positive and culture-negative SBP were recorded<\/jats:p>","DOI":"10.3390\/life15060855","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T04:49:52Z","timestamp":1748234992000},"page":"855","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predominant Gram-Positive Etiology May Be Associated with a Lower Mortality Rate but with Higher Antibiotic Resistance in Spontaneous Bacterial Peritonitis: A 7-Year Study in a Tertiary Center in Romania"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9623-7683","authenticated-orcid":false,"given":"Sergiu Marian","family":"Cazacu","sequence":"first","affiliation":[{"name":"Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street no 2-4, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-3838","authenticated-orcid":false,"given":"Ovidiu Mircea","family":"Zlatian","sequence":"additional","affiliation":[{"name":"Microbiology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street no 2-4, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Leocadia","family":"Plesea","sequence":"additional","affiliation":[{"name":"Microbiology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street no 2-4, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru Ioan","family":"Vacariu","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy Craiova, Petru Rares Street no 2-4, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai","family":"Cimpoeru","sequence":"additional","affiliation":[{"name":"Emergency Clinic Hospital Craiova, 200642 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ion","family":"Rogoveanu","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street no 2-4, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camelia Cristiana","family":"Bigea","sequence":"additional","affiliation":[{"name":"Microbiology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street no 2-4, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6280-6136","authenticated-orcid":false,"given":"Sevastita","family":"Iordache","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street no 2-4, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2018). 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