Title: Infections caused by<i>escherichia coli</i>resistant to norfloxacin in hospitalized cirrhotic patients
Abstract: HepatologyVolume 29, Issue 4 p. 1064-1069 Original ArticleFree Access Infections caused by escherichia coli resistant to norfloxacin in hospitalized cirrhotic patients Jordi Ortiz, Jordi OrtizSearch for more papers by this authorMaria Carme Vila, Maria Carme Vila Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorGermán Soriano M.D., Corresponding Author Germán Soriano M.D. [email protected] Liver Section, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain. fax: 34-3-2919278Liver Section, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain. fax: 34-3-2919278===Search for more papers by this authorJosep Miñana, Josep MiñanaSearch for more papers by this authorJordi Gana, Jordi Gana Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorBeatriz Mirelis, Beatriz Mirelis Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Barcelona, SpainSearch for more papers by this authorMaria Teresa Novella, Maria Teresa NovellaSearch for more papers by this authorSusana Coll, Susana Coll Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorMiriam Sàbat, Miriam SàbatSearch for more papers by this authorMontserrat Andreu, Montserrat Andreu Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorGuillem Prats, Guillem Prats Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Barcelona, SpainSearch for more papers by this authorRicard Solà, Ricard Solà Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorCarlos Guarner, Carlos GuarnerSearch for more papers by this author Jordi Ortiz, Jordi OrtizSearch for more papers by this authorMaria Carme Vila, Maria Carme Vila Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorGermán Soriano M.D., Corresponding Author Germán Soriano M.D. [email protected] Liver Section, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain. fax: 34-3-2919278Liver Section, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain. fax: 34-3-2919278===Search for more papers by this authorJosep Miñana, Josep MiñanaSearch for more papers by this authorJordi Gana, Jordi Gana Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorBeatriz Mirelis, Beatriz Mirelis Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Barcelona, SpainSearch for more papers by this authorMaria Teresa Novella, Maria Teresa NovellaSearch for more papers by this authorSusana Coll, Susana Coll Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorMiriam Sàbat, Miriam SàbatSearch for more papers by this authorMontserrat Andreu, Montserrat Andreu Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorGuillem Prats, Guillem Prats Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Barcelona, SpainSearch for more papers by this authorRicard Solà, Ricard Solà Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau and Hospital del Mar;Barcelona, SpainSearch for more papers by this authorCarlos Guarner, Carlos GuarnerSearch for more papers by this author First published: 30 December 2003 https://doi.org/10.1002/hep.510290406Citations: 95AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract Selective intestinal decontamination with norfloxacin is useful to prevent bacterial infections in several groups of cirrhotic patients at high risk of infection. However, the emergence of infections caused by Escherichia coli resistant to quinolones has recently been observed in cirrhotic patients undergoing prophylactic norfloxacin. Our aim is to determine the characteristics of the infections caused by E. coli resistant to norfloxacin in hospitalized cirrhotic patients. One hundred and six infections caused by E. coli in 99 hospitalized cirrhotic patients were analyzed and distributed into two groups: group I (n = 67), infections caused by E. coli sensitive to norfloxacin, and group II (n = 39), infections caused by E. coli resistant to norfloxacin. The clinical and analytical characteristics at diagnosis of the infection were similar in both groups. Previous prophylaxis with norfloxacin was more frequent in group II (15/67, 22.4% vs. 32/39, 82%, P < .0001), as a result of a higher number of patients submitted to continuous long-term prophylaxis in this group, whereas previous short-term prophylaxis was similar in both groups. Infections were more frequently nosocomial-acquired in group II than in group I (17/67, 25.3% vs. 20/39, 51.2%, P = .01). The type of infections was similar in both groups: urinary tract infections 38 in group I and 24 in group II, spontaneous bacterial peritonitis 8 and 2, spontaneous bacteremia 4 and 4, and bacterascites 1 and 0, respectively (pNS). Mortality during hospitalization was similar in the two groups (4/67, 5.9% vs. 5/39, 12.8%, pNS). None of the E. coli resistant to norfloxacin were also resistant to cefotaxime and only one of them was resistant to amoxicillin-clavulanic acid. Prophylaxis with norfloxacin, usually continuous long-term prophylaxis, favors the development of infections caused by norfloxacin-resistant E. coli. Long-term antibiotic prophylaxis should therefore be restricted to highly selected groups of cirrhotic patients at high-risk of infection. Infections caused by E. coli resistant to norfloxacin show a severity similar to those caused by sensitive E. coli. No significant associated resistance between norfloxacin and the antibiotics most frequently used in the treatment of bacterial infections in cirrhotic patients has been observed. References 1 Rimola A, Bory F, Planas R, Xaubet A, Bruguera M, Rodés J. Infecciones bacterianas en la cirrosis hepática. Gastroenterol Hepatol 1981; 4: 453–458. 2 Suárez C, Pajares JM. Epidemiología de las infecciones en la cirrosis hepática. Rev Clin Esp 1981; 160: 299–303.MEDLINE 3 Palazón JM, García A, Gómez A. Infecciones hospitalarias en pacientes con cirrosis hepática. 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