Analysis Of Correlation Factors Of Prognosis Of Liver Cirrhosis Complicated With Spontaneous Bacterial Peritonitis And The Study Of Mutant Selection Window Of Escherichia.coli

Objective (1)To investigate the relationship of correlation factors of liver cirrhosis complicated with spontaneous bacterial peritonitis (SBP) and prognosis of disease,for clinical diagnosis, and provide a reliable basis to treatment of SBP. (2)To study the mutant selection window(MSW) of Escherichia.coli, one of the commom pathogenic bacterium of SBP, and provide the basis of its drug treatment. (3) To study the drug-resistant genes of drug-resistant mutants of Escherichia.coli, and provide the basis of further research of its drug-resistant mechanism.Methods (1)Correlation factors of prognosis of 48 hospitalized patients with etiological positive diagnosis of SBP was analyzed. (2)The minimal inhibitory concentration(MIC), minimal inhibitory concentration of 99% strains(MIC99) and mutation prevent concentration(MPC) of levofloxacin to E.coli was etermined, and the MSW was profiled. (3)Two genes related to fluoroquinolones, gyrA and parC, were amplified by polymerase chain reaction(PCR).Results (1)SBP patients had a higher mortality rate, related with the type of bacterium, PMN value, ascites albumin and Cr value, etc. (2)According to in virto experiment, MIC, MIC99 and MPC of levofloxacin to E.coli was 0.25μg/ml, 0.2μg/ml, 1μg/ml, quite close to the data reported abroad. (3) E.coli was more likely to mutate at the gene gyrA and generate drug-resistant mutants when the concentration of levofloxacin was in the range of MSW.Conclusion (1)The prognosis of SBP patients were closely related with their liver and kidney function, laboratory test results could predict the therapeutic effect of patients. (2)MPC of levofloxacin was higher than its peak concentration(Cmax), antibacterial agents with other mechanisms were constantly used in the joint medication of clinical practice. (3)MSW was the range of concentration of enrich amplify selectively of drug-resistant mutants of bacterium, there could be multiple drug-resistant mechanism when the concentration of antibacterial agents was in the range of MSW.