Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea

Detalhes bibliográficos
Autor(a) principal: Yamashiro, Fabio da Silva [UNESP]
Data de Publicação: 2015
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://hdl.handle.net/11449/142967
http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/05-07-2016/000865665.pdf
Resumo: Spontaneous bacterial peritonitis (SBP) are common infectious complications in patients with liver cirrhosis and ascites. The diagnosis is made by collecting ascites and counting nuclear polymorph (PMN). Values above 250 PMN / mm³ are sufficient for the start of empirical treatment with antibiotics. The SBP are usually caused by Gram-negative enterobacteria, however currently observed changes in the profile of the pathogens, an increase of Gram-positive bacteria and emerging multi-resistant strains. The sensitivity of ascitic fluid bedside seeded in culture bottles culture is about only 20 to 40%. The main objective was to evaluate the positive ascites cultures using larger volume (50ml) centrifugation and seeding the liquid in the laboratory. The secondary objective was to evaluate the correlation between C-reactive protein levels (CRP) in the blood and in the ascites PMN of patients being treated for PBE. The observational study of 51 cases of SBP in adults comparing results obtained by analysis of the amount of PMN in ascites, serum CRP, cultures at the bedside and cultures obtained after centrifugation. In the sample 90% of the cases were male, being the main cause of cirrhosis the alcohol abuse (55%). The average value of PCR in diagnosis was 10.5 +/- 8.23. The positivity of culture at the bedside was 31%, but using centrifugation this rate increased to 69%. There was also a good correlation between the serum CRP levels in ascites and PMN (R = 0.505, P <0.001). The area ratio obtained under the curve of 0.9545 to 0.8677 to 1.041 confidence interval and P <0.001, with the cutoff delta PCR for correlation with treatment response to a decrease of at least 24% the value of the initial PCR. Observed in our study cases antibiotic resistance, Escherichia coli resistant trimethropim sulfamethoxazole and levofloxacin used for the primary and secondary prophylaxis EBP frame or the treatment thereof. The collection method associated with ...
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spelling Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontâneaCentrification on ascitic fluid to the diagnostic etiologic of spontaneous bacterial peritonitisPeritoniteAsciteFígado - CirroseLiquido asciticoInfecçãoPeritonitisSpontaneous bacterial peritonitis (SBP) are common infectious complications in patients with liver cirrhosis and ascites. The diagnosis is made by collecting ascites and counting nuclear polymorph (PMN). Values above 250 PMN / mm³ are sufficient for the start of empirical treatment with antibiotics. The SBP are usually caused by Gram-negative enterobacteria, however currently observed changes in the profile of the pathogens, an increase of Gram-positive bacteria and emerging multi-resistant strains. The sensitivity of ascitic fluid bedside seeded in culture bottles culture is about only 20 to 40%. The main objective was to evaluate the positive ascites cultures using larger volume (50ml) centrifugation and seeding the liquid in the laboratory. The secondary objective was to evaluate the correlation between C-reactive protein levels (CRP) in the blood and in the ascites PMN of patients being treated for PBE. The observational study of 51 cases of SBP in adults comparing results obtained by analysis of the amount of PMN in ascites, serum CRP, cultures at the bedside and cultures obtained after centrifugation. In the sample 90% of the cases were male, being the main cause of cirrhosis the alcohol abuse (55%). The average value of PCR in diagnosis was 10.5 +/- 8.23. The positivity of culture at the bedside was 31%, but using centrifugation this rate increased to 69%. There was also a good correlation between the serum CRP levels in ascites and PMN (R = 0.505, P <0.001). The area ratio obtained under the curve of 0.9545 to 0.8677 to 1.041 confidence interval and P <0.001, with the cutoff delta PCR for correlation with treatment response to a decrease of at least 24% the value of the initial PCR. Observed in our study cases antibiotic resistance, Escherichia coli resistant trimethropim sulfamethoxazole and levofloxacin used for the primary and secondary prophylaxis EBP frame or the treatment thereof. The collection method associated with ...As peritonites bacterianas espontâneas (PBE) são complicações infecciosas frequentes em pacientes com cirrose hepática e ascite. O diagnóstico é feito pela coleta de líquido ascítico e contagem de polimorfo nucleares (PMN). Valores acima de 250 PMN/mm³ são suficientes para o início do tratamento empírico com antibióticos. As PBE geralmente são causadas por enterobactérias Gram-negativas, entretanto atualmente observamos mudanças no perfil dos patógenos, com aumento de bactérias Gram-positivas e surgimento de cepas multi-resistentes. A sensibilidade da cultura do líquido ascítico semeado em frascos de cultura à beira do leito encontra-se em torno de apenas 20 a 40 %. O objetivo principal foi avaliar a positividade de culturas de líquido ascítico utilizando volume maior (50ml) com centrifugação e semeadura do líquido em laboratório. O objetivo secundário foi avaliar a correlação entre os valores de proteína C reativa (PCR) no sangue e PMN no líquido ascítico de pacientes em tratamento de PBE. O estudo observacional de 51 casos de PBE em adultos comparando resultados obtidos pelas análises da quantidade de PMN no líquido ascítico, da PCR sérica, das culturas à beira do leito e das culturas obtidas após centrifugação. Na amostra 90% dos casos foram do sexo masculino, sendo a principal etiologia da cirrose o uso abusivo de álcool (55%). O valor médio da PCR no diagnóstico foi 10,5 +/- 8,23. A positividade da cultura à beira do leito foi de 31%, porém utilizando a centrifugação essa taxa aumentou para 69%. Também houve boa correlação entre os valores de PCR sérica e PMN no líquido ascítico (R= 0,505 e P < 0,001). Obtivemos uma relação de área sob a curva de 0,9545 com intervalo de confiança de 0,8677-1,041 e P<0,001, sendo o ponto de corte para o delta PCR com correlação a resposta ao tratamento com uma queda de pelo menos 24% do valor do PCR inicial. Observamos no nosso estudo casos de...Universidade Estadual Paulista (Unesp)Silva, Giovanni Faria [UNESP]Universidade Estadual Paulista (Unesp)Yamashiro, Fabio da Silva [UNESP]2016-08-12T18:48:40Z2016-08-12T18:48:40Z2015-02-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis69 f.application/pdfYAMASHIRO, Fabio da Silva. Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea. 2015. 69 f. Tese (doutorado) - Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2015.http://hdl.handle.net/11449/142967000865665http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/05-07-2016/000865665.pdf33004064020P06322604200510676Alephreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPporinfo:eu-repo/semantics/openAccess2023-10-09T06:02:30Zoai:repositorio.unesp.br:11449/142967Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462023-10-09T06:02:30Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea
Centrification on ascitic fluid to the diagnostic etiologic of spontaneous bacterial peritonitis
title Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea
spellingShingle Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea
Yamashiro, Fabio da Silva [UNESP]
Peritonite
Ascite
Fígado - Cirrose
Liquido ascitico
Infecção
Peritonitis
title_short Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea
title_full Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea
title_fullStr Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea
title_full_unstemmed Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea
title_sort Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea
author Yamashiro, Fabio da Silva [UNESP]
author_facet Yamashiro, Fabio da Silva [UNESP]
author_role author
dc.contributor.none.fl_str_mv Silva, Giovanni Faria [UNESP]
Universidade Estadual Paulista (Unesp)
dc.contributor.author.fl_str_mv Yamashiro, Fabio da Silva [UNESP]
dc.subject.por.fl_str_mv Peritonite
Ascite
Fígado - Cirrose
Liquido ascitico
Infecção
Peritonitis
topic Peritonite
Ascite
Fígado - Cirrose
Liquido ascitico
Infecção
Peritonitis
description Spontaneous bacterial peritonitis (SBP) are common infectious complications in patients with liver cirrhosis and ascites. The diagnosis is made by collecting ascites and counting nuclear polymorph (PMN). Values above 250 PMN / mm³ are sufficient for the start of empirical treatment with antibiotics. The SBP are usually caused by Gram-negative enterobacteria, however currently observed changes in the profile of the pathogens, an increase of Gram-positive bacteria and emerging multi-resistant strains. The sensitivity of ascitic fluid bedside seeded in culture bottles culture is about only 20 to 40%. The main objective was to evaluate the positive ascites cultures using larger volume (50ml) centrifugation and seeding the liquid in the laboratory. The secondary objective was to evaluate the correlation between C-reactive protein levels (CRP) in the blood and in the ascites PMN of patients being treated for PBE. The observational study of 51 cases of SBP in adults comparing results obtained by analysis of the amount of PMN in ascites, serum CRP, cultures at the bedside and cultures obtained after centrifugation. In the sample 90% of the cases were male, being the main cause of cirrhosis the alcohol abuse (55%). The average value of PCR in diagnosis was 10.5 +/- 8.23. The positivity of culture at the bedside was 31%, but using centrifugation this rate increased to 69%. There was also a good correlation between the serum CRP levels in ascites and PMN (R = 0.505, P <0.001). The area ratio obtained under the curve of 0.9545 to 0.8677 to 1.041 confidence interval and P <0.001, with the cutoff delta PCR for correlation with treatment response to a decrease of at least 24% the value of the initial PCR. Observed in our study cases antibiotic resistance, Escherichia coli resistant trimethropim sulfamethoxazole and levofloxacin used for the primary and secondary prophylaxis EBP frame or the treatment thereof. The collection method associated with ...
publishDate 2015
dc.date.none.fl_str_mv 2015-02-25
2016-08-12T18:48:40Z
2016-08-12T18:48:40Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv YAMASHIRO, Fabio da Silva. Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea. 2015. 69 f. Tese (doutorado) - Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2015.
http://hdl.handle.net/11449/142967
000865665
http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/05-07-2016/000865665.pdf
33004064020P0
6322604200510676
identifier_str_mv YAMASHIRO, Fabio da Silva. Centrifugação do líquido ascítico para diagnóstico etiológico de peritonite bacteriana espontânea. 2015. 69 f. Tese (doutorado) - Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2015.
000865665
33004064020P0
6322604200510676
url http://hdl.handle.net/11449/142967
http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/05-07-2016/000865665.pdf
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dc.format.none.fl_str_mv 69 f.
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dc.publisher.none.fl_str_mv Universidade Estadual Paulista (Unesp)
publisher.none.fl_str_mv Universidade Estadual Paulista (Unesp)
dc.source.none.fl_str_mv Aleph
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
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instname_str Universidade Estadual Paulista (UNESP)
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