简介：Spontaneousbacterialperitonitisisacomplicationofasciticpatientswithend-stageliverdisease(ESLD);spontaneousfungalperitonitis(SFP)isacomplicationofESLDlessknownanddescribed.ESLDisassociatedtoimmunodepressionandtheresultingincreasedsusceptibilitytoinfections.RecentperspectivesofthemanagementofthecriticallyillpatientwithESLDdonotspecifytherateofisolationoffungiincriticallyillpatients,noteventheantifungalsusedfortheprophylaxis,neitheroptimaltreatment.Wereviewed,inordertofocustheepidemiology,characteristics,and,consideringthehighmortalityrateofSFP,theuseofoptimalempiricalantifungaltherapythecurrentliterature.

简介：Recurrentepisodesofperitonitiswiththesameorganismculturedatthecatheterexitsitesuggestthatearlytunnelcolonizationisassociatedwithatransferoftheseorganismsthroughthecathetertunneldirectlyfromtheskinintotheperi-tonealcavity.Inthiscircumstancethecatheterhasfailedinitsfundamentaldesigntoestablishandmaintainabacteriologicalbarrier.AthreepartstudywasconductedusingtheMoncrief-PopovichCatheterandImplantationTechnique.Thefirstpartof

简介：对不完全的肠的阻塞的评估的主要诊断挑战是在传染、恶意的病原学之间区分。我们在场抱怨伴有恶心的腹的疼痛并且呕吐的一个老女人的一个案例，和到通行证气体或凳子的失败。反肺结核药被用来减轻她的腹的疼痛，并且腹洞的针活体检视显示出腹膜(PSCP)的主要的乳突的浆液的癌的证据。这是对在PSCP的背景的肺结核的稀罕描述。这份报告为恶意与风险因素说明恶意的潜在的复杂性质，并且强调需要在病人考虑恶意和感染的共存，特别在那些与抗菌素治疗失败。

简介：AIM:Toevaluatetheepidemiologyandoutcomesofculture-positivespontaneousbacterialperitonitis(SBP)andspontaneousbacteremia(SB)indecompensatedcirrhosis.METHODS:Weprospectivelycollectedclinical,laboratorycharacteristics,typeofadministeredantibiotic,susceptibilityandresistanceofbacteriatoantibioticsinonehundredthirtycases(68.5%males)withpositiveasciticfluidand/orbloodculturesduringtheperiodfromJanuary1,2012toMay30,2014.AllpatientswithSBPhadpolymorphonuclearcellcountinasciticfluid>250/mm3.InpatientswithSBathoroughstudydidnotrevealanyothercauseofbacteremia.Thepatientswerefollowed-upfora30-dperiodfollowingdiagnosisoftheinfection.Thefinaloutcomeofthepatientswasrecordedintheendoffollow-upandcomparisonamong3groupsofpatientsaccordingtothepatternofdrugresistancewasperformed.RESULTS:Gram-positive-cocci(GPC)werefoundinhalfofthecases.ThemostprevalentorganismsinadescendingorderwereEscherichiacoli(33),Enterococcusspp(30),Streptococcusspp(25),Klebsiellapneumonia(16),S.aureus(8),Pseudomanasaeruginosa(5),otherGram-negative-bacteria(GNB)(11)andanaerobes(2).Overall,20.8%ofisolatesweremultidrug-resistant(MDR)and10%extensivelydrugresistant(XDR).Health-care-associated(HCA)and/ornosocomialinfectionswerepresentin100%ofMDR/XDRandin65.5%ofnon-DRcases.MeropenemwastheempiricallyprescribedantibioticinHCA/nosocomialinfectionsshowingadrug-resistancerateof30.7%whilethirdgenerationcephalosporinsof43.8%.MeropenemwasineffectiveonbothXDRbacteriaandEnterococcusfaecium(E.faecium).AllbutoneXDRweresusceptibletocolistinwhileallGPC(includingE.faecium)andthe86%ofGNBtotigecycline.Overall30-dmortalitywas37.7%(69.2%forXDRand34.2%fortherestofthepatients)(logrank,P=0.015).Inmultivariateanalysis,factorsadverselyaffectingoutcomeincludedXDRinfection(HR=2.263,95%CI:1.005-5.095,P=0.049),creatinine(HR