A Study on Diagnosis and Treatment of End Stage Liver Disease Complicated With Infection (SESLDIP Study)
A Study on Diagnosis and Treatment of End Stage Liver Disease Complicated With Infection (SESLDIP Study)
Spontaneous bacterial peritonitis (SBP) is a common complication of end-stage liver disease
 due to various causes. The initial anti-infective medication is appropriate and the patient's
 survival rate is closely related. Ascitic fluid bacterial culture takes a long time, the
 positive rate is low, it is difficult to guide the timely use of antimicrobial drugs,
 empirical medicine based on evidence-based medicine for SBP in patients with end-stage liver
 disease is essential. The American College of Hepatology and the European Society of
 Hepatology recommend the use of third-generation cephalosporins as the first choice of
 empirical therapy in patients with end-stage liver disease associated with community-acquired
 SBP. Patients with merger of hospital-acquired SBP with piperacillin / tazobactam or
 carbapenem +/- glycopeptide antibiotics is the first choice for empirical medication. There
 is no clear recommendation in China. In recent years, the conclusions of international
 clinical research in this area have been in disagreement with the recommendations. As a key
 factor in the selection of empirical antibiotics is local bacterial resistance data, these
 findings are difficult to evidence-based medicine for Chinese doctors. This project intends
 to observe the efficacy of different initial anti-infective regimens in Chinese patients with
 end-stage liver disease with SBP and 30-day and 60-day non-liver transplant survival rates,
 providing evidence-based medical evidence for the empirical use of such patients.
Inclusion Criteria:

 1. Meet the end-stage liver disease part of the type of standard (including slow plus
 acute liver failure, chronic liver failure, cirrhosis decompensation);

 2. age> 18 years old

 3. ascites nucleated cell count> 250 × 106 / L;

 4. Unable to obtain ascites specimens or ascites nucleated cells count does not meet the
 conditions of 3) are required abdominal examination tenderness (+), rebound tenderness
 (+), abdominal ultrasound can detect ascites, and procalcitonin (PCT) > 0.5ng / ml,
 hs-CRP> 10ng / ml

 Exclusion Criteria:

 1. history of abdominal surgery within 4 weeks;

 2. secondary peritonitis;

 3. tuberculous peritonitis;

 4. Malignant tumor;

 5. patients who use hormones or immunosuppressants;

 6. AIDS patients;

 7. heart failure or respiratory failure;

 8. merge other parts of the infection;

 9. died within 48h;

 10. liver transplantation during observation;

 11. Diagnosis of spontaneous bacterial peritonitis is the use of carbapenems or
 third-generation cephalosporins / enzyme inhibitors, piperacillin / enzyme inhibitor
 antibiotics