Spontaneous Bacterial Peritonitis.
- Author:
Do Seon SONG
1
Author Information
- Publication Type:Review
- Keywords: Spontaneous bacterial peritonitis; Ascites; Therapy
- MeSH: Ascites; Bacteria; Bacterial Infections; Community-Acquired Infections; Cross Infection; Diagnosis; Escherichia coli; Fibrosis; Gram-Negative Bacteria; Gram-Positive Bacteria; Hemorrhage; Humans; Klebsiella; Liver Cirrhosis; Paracentesis; Peritonitis*; Primary Prevention; Secondary Prevention
- From:The Korean Journal of Gastroenterology 2018;72(2):56-63
- CountryRepublic of Korea
- Language:Korean
- Abstract: Spontaneous bacterial peritonitis (SBP) is defined as bacterial infections that occur in patients with cirrhosis and ascites without any significant intraperitoneal infection, accounting for approximately 10–30% of bacterial infections in hospitalized patients. SBP develops in patients with liver cirrhosis because bacterial translocations are increased by changes in the intestinal bacteria and mucosal barriers. In addition, the decreased host immune response cannot remove the bacteria and their products. The most common cause of SBP is Gram-negative bacteria, such as Escherichia coli and Klebsiella species, and infections by Gram-positive bacteria are increasing. SBP is diagnosed by the presence of >250 polymorphonuclear leukocyte/mm³ in ascites after paracentesis. If SBP is diagnosed, empirical antibiotic therapy should be started immediately. Empirical antibiotic treatment should distinguish between community acquired infections and nosocomial infections. Cirrhotic patients with gastrointestinal bleeding or low ascitic protein concentrations should consider primary prevention and those who recover from SBP should consider secondary prevention. This review describes the pathophysiology, diagnosis, treatment, and prevention of SBP.
