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.
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

Cervical spinal epidural abscess, caused by fish bone injury and a secondary infection by Eikenella corrodens which is part of the normal flora, has not been reported. A 72-yr-old man came to the hospital with pain in his posterior neck and both shoulders for 2 months. He also was experiencing weakness on his right side for 3 days. A fish bone had been stuck in his throat for about 2 months. Neurological examination revealed right hemiparesis, hypesthesia on the left extremities and neck stiffness. Laboratory findings showed an elevated ESR/CRP and leukocytosis, and magnetic resonance imaging revealed a retropharyngeal abscess and cervical myelitis. The patient was treated with emergency surgical decompression and antibiotics. A fish bone was removed from the C3-C4 intervertebral disc space. In the culture of chocolate blood agar and 5% sheep blood agar plate, E. corrodens was detected as a causative organism.
Male ; Humans ; Gram-Negative Bacterial Infections/diagnosis/*etiology/prevention & control ; Foreign Bodies/*complications/*surgery ; Food/*adverse effects ; Fishes ; Epidural Abscess/diagnosis/*etiology/*surgery ; Eikenella corrodens/*isolation & purification ; Decompression, Surgical ; Bone and Bones ; Anti-Bacterial Agents/administration & dosage ; Animals ; Aged

Porcine proliferative enteropathy(PPE) is an enteric disease been caused by Lawsonia intracellularis. It has become one of the critical problems in the pig industry. To investigate the prevalence of PPE in Korea, serum samples of 828 pigs from 65 herds were tested using indirect immunofluorescence antibody technique(IFA). The infection rate in individual pigs varied from 44 to 69%, whereas 100% in pig farms. The infection frequency was 57, 44.9, and 59.4% according to age respectively. Administration of tylosin in feed at a concentration of 110 ppm for 14 days reduced the infection rate of the farms. These data indicated that the high prevalence of PPE may be controlled by tylosin.
Administration, Oral ; Animal Feed ; Animals ; Anti-Bacterial Agents/*therapeutic use ; Antibodies, Bacterial/blood ; Enteritis/epidemiology/prevention&control/*veterinary ; Fluorescent Antibody Technique, Indirect/veterinary ; Gram-Negative Bacterial Infections/prevention&control/*veterinary ; Korea/epidemiology ; *Lawsonia Bacteria/drug effects/growth&development/immunology ; Seroepidemiologic Studies ; Swine ; Swine Diseases/*epidemiology/microbiology/prevention&control ; Tylosin/*therapeutic use

Specific immunoglobulin (IgY) from egg yolk against Aeromonas hydrophila was produced by immunization of White Leghorn hens with formalin-killed whole cells of A. hydrophila. ELISA test using A. hydrophila as the coating antigen revealed that the specific antibody titer started to increase in the egg yolk at the 13th day post-immunization (P/N=2.18), reached the peak at the 56th day (P/N=13.82), and remained at high level until day 133 (P/N=7.03). The antibody was purified by saturated ammonium sulphate with a recovery rate of 63.5%. The specific IgY inhibited the growth of A. hydrophila at a concentration of 1.0 mg/ml during the 18 h incubation. Pre-treatment of polyploid gibel carps Carassius auratus Gibelio with specific IgY had a protection rate of 60% (6/10) against challenge with A. hydrophila, while none of the fishes in the control groups receiving sterile phosphate buffered saline (PBS) or non-specific IgY survived the challenge. Treatment of fishes with the specific IgY 4 h after the challenge also had lower mortality (70%, 7/10), a 30% reduction against the control PBS or non-specific IgY groups (10/10). These results indicate that specific IgY antibodies could be obtained easily from hens immunized with an inactivated A. hydrophila and could provide a novel alternative approach to control of diseases in fishes caused by this organism.
Aeromonas hydrophila ; drug effects ; growth & development ; immunology ; Animals ; Antibody Specificity ; Antigen-Antibody Reactions ; Chickens ; immunology ; Dose-Response Relationship, Drug ; Egg Yolk ; chemistry ; Goldfish ; immunology ; microbiology ; Gram-Negative Bacterial Infections ; immunology ; prevention & control ; Immunoglobulins ; pharmacology ; therapeutic use ; Microbial Sensitivity Tests ; Survival Rate ; Time Factors