Background/Aims Healthcare-associated (HCA) infection is a recently suggested new category of community-onset infections.The implications of HCA infections in terms of diagnosis, treatment, and outcomes of spontaneous bacterial peritonitis (SBP) are not well understood.We sought to delineate the differences between community-acquired (CA) SBP and HCA SBP with specific interest in the antimicrobial resistance of causative microorganisms and outcomes.
Methods We conducted a retrospective cohort study of all SBP episodes with positive ascitic culture and/or blood culture from June 2000 to August 2011.Community-onset SBP episodes were included when they occurred within 48 hours after admission and were classified as CA SBP and HCA SBP based on MINT SOAP the predefined criteria.Results A total of 188 episodes of community-onset SBP were analyzed (65.
4% HCA SBP and 34.6% CA SBP).HCA SBP had a higher resistance rate to third-generation cephalosporin (6.
8% vs.1.6%, p = 0.
168).The Smart Phone Cases overall 30-day mortality was similar between both groups (37.4% vs.
41.5%, p = 0.638).
The independent risk factors for 30-day all-cause mortality in community-onset SBP included high Child-Pugh score, acute kidney injury, and resistance to third-generation cephalosporins; HCA infection was not associated.Conclusions Hepatic functional status, renal dysfunction, and third-generation cephalosporin resistant pathogens more adversely affected the outcome of cirrhotic patients with community-onset SBP rather than HCA infection.The higher rate of third-generation cephalosporin resistance was notable in HCA SBP, which will require a novel approach to empirical antibiotic treatment selection in this population.