Spontaneous bacterial peritonitis: Pathogenesis, diagnosis, and management

Acta Gastro-Enterologica Belgica

Volumn 69, Issue 3, 2006, Pages 276-282

  Ozmen, Sehmus ^a,c   Dursun, Mehmet ^b   Yilmaz, Serif ^b  

^a Department of Internal Medicine   (Turkey)

^b DICLE UNIVERSITY SCHOOL OF MEDICINE   (Turkey)

^c DICLE UNIVERSITY   (Turkey)

Author keywords

Ascites; Cefotaxime; Cirrhosis; Infection; Spontaneous bacterial peritonitis

Indexed keywords

ANTIBIOTIC AGENT; CEFOTAXIME; NORFLOXACIN;

ANTIBIOTIC THERAPY; ASCITES; BACTERIAL INFECTION; BACTERIAL PERITONITIS; DRUG EFFICACY; GRAM NEGATIVE INFECTION; HUMAN; KIDNEY FAILURE; LIVER CIRRHOSIS; PARACENTESIS; REVIEW; STREPTOCOCCUS; STREPTOCOCCUS INFECTION;

ANTI-BACTERIAL AGENTS; DIAGNOSIS, DIFFERENTIAL; GRAM-NEGATIVE BACTERIAL INFECTIONS; GRAM-POSITIVE BACTERIAL INFECTIONS; HUMANS; PERITONITIS; PREVALENCE; RISK FACTORS;

EID: 33751315038     PISSN: 00015644     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (94)

1. GUARNER C., RUNYON B.A. Spontaneous bacterial peritonitis: pathogenesis, diagnosis, and management. Gastroenterologist, 1995, 3: 311-28.
2. RUNYON B.A. Management of adult patients with ascites caused by cirrhosis. Hepatology, 1998, 27: 264-72.
3. RIMOLA A., GARCIA-TSAO G., NAVASA M. et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club. J. Hepatol., 2000, 32: 142-53.
4. RUNYON B.A., HOEFS J.C. Culture-negative neutrocytic ascites: a variant of spontaneous bacterial peritonitis. Hepatology, 1984, 4: 1209-11.
5. TOLEDO C., SALMERON J.M., RIMOLA A. et al. Spontaneous bacterial peritonitis in cirrhosis: predictive factors of infection resolution and survival in patients treated with cefotaxime. Hepatology, 1993, 17: 251-7.
6. NAVASA M., FOLLO A., LLOVET J.M. et al. Randomized, comparative study of oral ofloxacin versus intravenous cefotaxime in spontaneous bacterial peritonitis. Gastroenterology, 1996, 111: 1011-7.
7. BERNARD B., GRANGE J.D., KHAC E.N., AMIOT X., OPOLON P., POYNARD T. Antibiotic prophylaxis for the prevention of bacterial infections tions in cirrhotic patients with gastrointestinal bleeding: a meta-analysis. Hepatology, 1999, 29: 1655-61.
8. RUNYON B.A. Low-protein-concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis. Gastroenterology, 1986, 91: 1343-6.
9. RUNYON B.A. Patients with deficient ascitic fluid opsonic activity are predisposed to spontaneous bacterial peritonitis. Hepatology, 1988, 8: 632-5.
10. TITO L., RIMOLA A., GINES P., LLACH J., ARROYO V., RODES J. Recurrence of spontaneous bacterial peritonitis in cirrhosis: frequency and predictive factors. Hepatology, 1988, 8: 27-31.
11. ANDREU M., SOLA R., SITGES-SERRA A. et al. Risk factors for spontaneous bacterial peritonitis in cirrhotic patients with ascites. Gastroenterology, 1993, 104: 1133-8.
12. RIMOLA A., SOTO R., BORY F., ARROYO V., PIERA C., RODES J. Reticuloendothelial system phagocytic activity in cirrhosis and its relation to bacterial infections and prognosis. Hepatology, 1984, 4: 53-8.
13. LLACH J., RIMOLA A., NAVASA M. et al. Incidence and predictive factors of first episode of spontaneous bacterial peritonitis in cirrhosis with ascites: relevance of ascitic fluid protein concentration. Hepatology, 1992, 16: 724-7.
14. BERNARD B., CADRANEL J.F., VALLA D., ESCOLANO S., JARLIER V., OPOLON P. Prognostic significance of bacterial infection in bleeding cirrhotic patients: a prospective study. Gastroenterology, 1995, 108: 1828-34.
15. HSIEH W.J., LIN H.C., HWANG S.J. et al. The effect of ciprofloxacin in the prevention of bacterial infection in patients with cirrhosis after upper gastrointestinal bleeding. Am. J. Gastrpenterol., 1998, 93: 962-6.
16. SORELL W.T., QUIGLEY E.M., JIN G., JOHNSON T.J., RIKKERS L.F. Bacterial translocation in the portal-hypertensive rat: studies in basal conditions and on exposure to hemorrhagic shock. Gastroenterology, 1993, 104: 1722-6.
17. CADRANEL J.F., DENIS J., PAUWELS A. et al. Prevalence and risk factors of bacteriuria in cirrhotic patients: a prospective case-control multicenter study in 244 patients. J. Hepatol., 1999, 31: 464-8.
18. RUNYON B.A. Paracentesis of ascitic fluid. A safe procedure. Arch. Intern. Med., 1986, 146: 2259-61.
19. GUARNER C., SOLA R., SORIANO G. et al. Risk of a first community-acquired spontaneous bacterial peritonitis in cirrhotics with low ascitic fluid protein levels. Gastroenterology, 1999, 117: 414-9.
20. RIMOLA A. Infections in Liver Disease. In: BIRCHERM J., BENHAMOU J.P., MCINTYRE N., RIZETTO M., RODÉS J. (eds). Oxfort Textbook of Clinical Hepatology, 1999, 1861-74.
21. HOEFS J.C., RUNYON B.A. Spontaneous bacterial peritonitis. Dis. Mon., 1985, 31: 1-48.
22. GARCIA-TSAO G. Spontaneous bacterial peritonitis. Gastroenterol. Clin. North Am., 1992, 21: 257-75.
23. FILIK L., UNAL S. Clinical and laboratory features of spontaneous bacterial peritonitis. East Afr. Med. J., 2004, 81: 474-9.
24. FELISART J., RIMOLA A., ARROYO V. et al. Cefotaxime is more effective than is ampicillin-tobramycin in cirrhotics with severe infections. Hepatology, 1985, 5: 457-62.
25. RICART E., SORIANO G., NOVELLA M.T. et al. Amoxicillin-clavulanic acid versus cefotaxime in the therapy of bacterial infections in cirrhotic patients. J. Hepatol., 2000, 32: 596-602.
26. RUIZ-DEL-ARBOL L., URMAN J., FERNANDEZ J. et al. Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitis. Hepatology, 2003, 38: 1210-8.
27. LLOVET J.M., PLANAS R., MORILLAS R. et al. Short-term prognosis of ciirhotics with spontaneous bacterial peritonitis: multivariate study. Am. J. Gastroenterol., 1993, 88: 388-92.
28. CHOLONGITAS E., PAPATHEODORIDIS G.V., LAHANAS A., XANTHAKI A., KONTOU-KASTELLANOU C., ARCHIMANDRITIS A.J. Increasing frequency of Gram-positive bacteria in spontaneous bacterial peritonitis. Liver Int., 2005, 25: 57-61.
29. FERNANDEZ J., NAVASA M., GOMEZ J. et al. Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis. Hepatology, 2002, 35: 140-8.
30. GARCIA-TSAO G., ALBILLOS A., BARDEN G.E., WEST A.B. Bacterial translocation in acute and chronic portal hypertension. Hepatology, 1993, 17: 1081-5.
31. GUARNER C., RUNYON B.A., YOUNG S., HECK M., SHEIKH M.Y. Intestinal bacterial overgrowth and bacterial translocation in cirrhotic rats with ascites. J. Hepatol., 1997, 26: 1372-8.
32. LLOVET J.M., BARTOLI R., MARCH F. et al. Translocated intestinal bacteria cause spontaneous bacterial peritonitis in cirrhotic rats: molecular epidemiologic evidence. J. Hepatol., 1998, 28: 307-13.
33. LLOVET J.M., BARTOLI R., PLANAS R. et al. Bacterial translocation in cirrhotic rats. Its role in the development of spontaneous bacterial peritonitis. Gut, 1994, 35: 1648-52.
34. RUNYON B.A., SQUIER S., BORZIO M. Translocation of gut bacteria in rats with cirrhosis to mesenteric lymph nodes partially explains the pathogenesis of spontaneous bacterial peritonitis. J. Hepatol., 1994, 21: 792-6.
35. CIRERA I., BAUER T.M., NAVASA M. et al. Bacterial translocation of enteric organisms in patients with cirrhosis. J. Hepatol., 2001, 34: 32-7.
36. VIGGIANO T.R., GOSTOUT C.J. Portal hypertensive intestinal vasculopathy: a review of the clinical, endoscopic, and histopathologic features. Am. J. Gastroenterol., 1992, 87: 944-54.
37. MOWAT C., STANLEY A.J. Review article: spontaneous bacterial peritonitis - diagnosis, treatment and prevention. Aliment Pharmacol. Ther., 2001, 15: 1851-9.
38. THANOPOULOU A.C., KOSKINAS J.S., HADZIYANNIS S.J. Spontaneous bacterial peritonitis (SBP): clinical, laboratory, and prognostic features. A single-center experience. Eur. J. Intern. Med., 2002, 13: 194-198.
39. RUNYON B.A. Ascites and Spontaneous Bacterial Peritonitis. In: FELDMAN M., FRIEDMAN L.S., SLEISENGER M.H. (eds). Gastrointestinal and Liver Disease. Vol. 2: Saunders, 2002: 1517.
40. RUNYON B.A., HOEFS J.C. Ascitic fluid chemical analysis before, during and after spontaneous bacterial peritonitis. Hepatology, 1985, 5: 257-9.
41. SUCH J., FRANCES R., MUNOZ C. et al. Detection and identification of bacterial DNA in patients with cirrhosis and culture-negative, nonneutrocytic ascites. Hepatology, 2002, 36: 135-41.
42. WAGNER H. Interactions between bacterial CpG-DNA and TLR9 bridge innate and adaptive immunity. Curr. Opin. Microbiol., 2002, 5: 62-9.
43. RUNYON B.A. Early events in spontaneous bacterial peritonitis. Gut, 2004, 53: 782-4.
44. BILLIAU A., VANDEKERCKHOVE F. Cytokines and their interactions with other inflammatory mediators in the pathogenesis of sepsis and septic shock. Eur. J. Clin. Invest., 1991, 21: 559-73.
45. BONE R.C. The pathogenesis of sepsis. Ann. Intern. Med., 1991, 115: 457-69.
46. NAVASA M., FOLLO A., FILELLA X. et al. Tumor necrosis factor and interleukin-6 in spontaneous bacterial peritonitis in cirrhosis: relationship with the development of renal impairment and mortality. Hepatology, 1998, 27: 1227-32.
47. SUCH J., RUNYON B.A. Spontaneous bacterial peritonitis. Clin. Infect. Dis., 1998, 27: 669-74, quiz 675-6.
48. ALMDAL T.P., SKINHOJ P. Spontaneous bacterial peritonitis in cirrhosis. Incidence, diagnosis, and prognosis. Scand. J. Gastroenterol., 1987, 22: 295-300.
49. KLINE M.M., MC CALLUM R.W., GUTH P.H. The clinical value of ascitic fluid culture and leukocyte count studies in alcoholic cirrhosis. Gastroenterology, 1976, 70: 408-12.
50. WILSON J.A., SUGUITAN E.A., CASSIDY W.A., PARKER R.H., CHAN C.H. Characteristics of ascitic fluid in the alcoholic cirrhotic. Dig. Dis. Sci., 1979, 24: 645-8.
51. HOEFS J.C. Increase in ascites white blood cell and protein concentrations during diuresis in patients with chronic liver disease. Hepatology, 1981, 1: 249-54.
52. PELLETIER G., SALMON D., INK O. et al. Culture-negative neutrocytic ascites: a less severe variant of spontaneous bacterial peritonitis. J. Hepatol., 1990, 10: 327-31.
53. FONG T.L., AKRIVIADIS E.A., RUNYON B.A., REYNOLDS T.B. Polymorphonuclear cell count response and duration of antibiotic therapy in spontaneous bacterial peritonitis. Hepatology, 1989, 9: 423-6.
54. AL AMRI S.M., ALLAM A.R., AL MOFLEH I.A. Spontaneous bacterial peritonitis and culture negative neutrocytic ascites in patients with non-alcoholic liver cirrhosis. J. Gastroenterol. Hepatol., 1994, 9: 433-6.
55. SOYLU A.R., DOKMECI G., TEZEL A. et al. Predictors of short-term outcome of spontaneous bacterial peritonitis in Turkish cirrhotic patients. J. Gastroenterol. Hepatol., 2005, 20: 657-60.
56. GILBERT J.A., KAMATH P.S. Spontaneous bacterial peritonitis: an update. Mayo Clin. Proc., 1995, 70: 365-70.
57. SORT P., NAVASA M., ARROYO V. et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N. Engl J. Med., 1999, 341: 403-9.
58. RIMOLA A., SALMERON J.M., CLEMENTE G. et al. Two different dosages of cefotaxime in the treatment of spontaneous bacterial peritonitis in cirrhosis: results of a prospective, randomized, multicenter study. Hepatology, 1995, 21: 674-9.
59. ANGELONI S., NICOLINI G., MERLI M. et al. Validation of automated blood cell counter for the determination of polymorphonuclear cell count in the ascitic fluid of cirrhotic patients with or without spontaneous bacterial peritonitis. Am. J. Gastroenterol., 2003, 98: 1844-8.
60. TERG R., LEVI D., LOPEZ P. et al. Analysis of clinical course and prognosis of culture-positive spontaneous bacterial peritonitis and neutrocytic ascites. Evidence of the same disease. Dig. Dis. Sci., 1992, 37: 1499-504.
61. RUNYON B.A., CANAWATI H.N., AKRIVIADIS E.A. Optimization of ascitic fluid culture technique. Gastroenterology, 1988, 95: 1351-5.
62. BOBADILLA M., SIFUENTES J., GARCIA-TSAO G. Improved method for bacteriological diagnosis of spontaneous bacterial peritonitis. J. Clin. Microbiol., 1989, 27: 2145-7.
63. AKRIVlADIS E.A., RUNYON B.A. Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis. Gastroenterology, 1990, 98: 127-33.
64. RUNYON B.A. Ascitic fluid bilirubin concentration as a key to choleperitoneum. J. Clin. Gastroenterol., 1987, 9: 543-5.
65. WU S.S., LIN O.S., CHEN Y.Y., HWANG K.L., SOON M.S., KEEFFE E.B. Ascitic fluid carcinoembryonic antigen and alkaline phosphatase levels for the differentiation of primary from secondary bacterial peritonitis with intestinal perforation. J. Hepatol., 2001, 34: 215-21.
66. RUNYON B.A., MCHUTCHISON J.G., ANTILLON M.R., AKRIVIADIS E.A., MONTANO A.A. Short-course versus long-course antibiotic treatment of spontaneous bacterial peritonitis. A randomized controlled study of 100 patients. Gastroenterology, 1991, 100: 1737-42.
67. TASKIRAN B., COLAKOǦLU O., SOZMEN B., UNSAL B., ASLAN S., BUYRAÇ Z. Comparison of cefotaxime and ofloxacin in treatment of spontaneous bacterial peritonitis. Turk. J. Gastroenterol., 2004, 15: 34-38.
68. LLOVET J.M., RODRIGUEZ-IGLESIAS P., MOITINHO E. et al. Spontaneous bacterial peritonitis in patients with cirrhosis undergoing selective intestinal decontamination. A retrospective study of 229 spontaneous bacterial peritonitis episodes. J. Hepatol., 1997, 26: 88-95.
69. PARK Y.H., LEE H.C., SONG H.G. et al. Recent increase in antibiotic-resistant microorganisms in patients with spontaneous bacterial peritonitis adversely affects the clinical outcome in Korea. J. Gastroenterol. Hepatol., 2003, 18: 927-933.
70. SINGH N., WAGENER M.M., GAYOWSKI T. Changing epidemiology and predictors of mortality in patients with spontaneous bacterial peritonitis at a liver transplant unit. Clin. Microbiol. Infect., 2003, 9: 531-7.
71. ARIZA J., XIOL X., ESTEVE M. et al. Aztreonam vs. cefotaxime in the treatment of gram-negative spontaneous peritonitis in cirrhotic patients. Hepatology, 1991, 14: 91-8.
72. ARIZA J., GUDIOL F., DOLZ C. et al. Evaluation of aztreonam in the treatment of spontaneous bacterial peritonitis in patients with cirrhosis. Hepatology, 1986, 6: 906-10.
73. GOMEZ-JIMENEZ J., RIBERA E., GASSER I. et al. Randomized trial comparing ceftriaxone with cefonicid for treatment of spontaneous bacterial peritonitis in cirrhotic patients. Antimicrob. Agents Chemother., 1993, 37: 1587-92.
74. GRANGE J.D., AMIOT X., GRANGE V. et al. Amoxicillin-clavulanic acid therapy of spontaneous bacterial peritonitis: a prospective study of twenty-seven cases in cirrhotic patients. Hepatology, 1990, 11: 360-4.
75. TERG R., COBAS S., FASSIO E. et al. Oral ciprofloxacin after a short course of intravenous ciprofloxacin in the treatment of spontaneous bacterial peritonitis: results of a multicenter, randomized study. J. Hepatol., 2000, 33: 564-9.
76. FERNANDEZ J., NAVASA M., GARCIA-PAGAN J.C. et al. Effect of intravenous albumin on systemic and hepatic hemodynamics and vasoactive neurohormonal systems in patients with cirrhosis and spontaneous bacterial peritonitis. J. Hepatol., 2004, 41: 384-90.
77. FOLLO A., LLOVET J.M., NAVASA M. et al. Renal impairment after spontaneous bacterial peritonitis in cirrhosis: incidence, clinical course, predictive factors and prognosis. Hepatology, 1994, 20: 1495-501.
78. GARCIA-TSAO G. Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroenterology, 2001, 120: 726-48.
79. GINES P., RIMOLA A., PLANAS R. et al. Norfloxacin prevents spontaneous bacterial peritonitis recurrence in cirrhosis: results of a double-blind, placebo-controlled trial. Hepatology, 1990, 12: 716-24.
80. JALAN R., HAYES P.C. UK guidelines on the management of variceal haemorrhage in cirrhotic patients. British Society of Gastroenterology. Gut, 2000, 46 Suppl. 3-4: III1-III15.
81. NOVELLA M., SOLA R., SORIANO G. et al. Continuous versus inpatient prophylaxis of the first episode of spontaneous bacterial peritonitis with norfloxacin. Hepatology, 1997, 25: 532-6.
82. GUARNER C., RUNYON B.A., HECK M., YOUNG S., SHEIKH M.Y. Effect of long-term trimethoprim-sulfamethoxazole prophylaxis on ascites formation, bacterial translocation, spontaneous bacterial peritonitis, and survival in cirrhotic rats. Dig. Dis. Sci., 1999, 44: 1957-62.
83. SINGH N., GAYOWSKI T., YU V.L., WAGENER M.M. Trimethoprimsulfamethoxazole for the prevention of spontaneous bacterial peritonitis in cirrhosis: a randomized trial. Ann. Intern. Med., 1995, 122: 595-8.
84. BORZIO M., SALERNO F., SAUDELLI M., GALVAGNO D., PIANTONI L., FRAGIACOMO L. Efficacy of oral ciprofloxacin as selective intestinal decontaminant in cirrhosis. Ital. J. Gastroenterol. Hepatol., 1997, 29: 262-6.
85. TERG R., LLANO K., COBAS S.M. et al. Effects of oral ciprofloxacin on aerobic gram-negative fecal flora in patients with cirrhosis: results of short- and long-term administration, with daily and weekly dosages. J. Hepatol., 1998, 29: 437-42.
86. CERETO F., MOLINA I., GONZALEZ A. et al. Role of immunosuppression in the development of quinolone-resistant Escherichia coli spontaneous bacterial peritonitis and in the mortality of E. coli spontaneous bacterial peritonitis. Aliment Pharmacol. Ther., 2003, 17: 695-701.
87. WIEST R., CHEN F., CADELINA G., GROSZMANN R.J., GARCIA-TSAO G. Effect of Lactobacillus-fermented diets on bacterial translocation and intestinal flora in experimental prehepatic portal hypertension. Dig. Dis. Sci., 2003, 48: 1136-41.
88. LORENZO-ZUNIGA V., BARTOLI R., PLANAS R. et al. Oral bile acids reduce bacterial overgrowth, bacterial translocation, and endotoxemia in cirrhotic rats. Hepatology, 2003, 37: 551-7.
89. LIPKA J.M., ZIBARI G.B., DIES D.F., MC MILLAN R.W., AULTMAN D.F., MC DONALD J.C. Spontaneous bacterial peritonitis in liver failure. Am. Surg., 1998, 64: 1155-7.
90. WEINSTEIN M.P., IANNINI P.B., STRATTON C.W., EICKHOFF T.C. Spontaneous bacterial peritonitis. A review of 28 cases with emphasis on improved survival and factors influencing prognosis. Am. J. Med., 1978, 64: 592-8.
91. HOEFS J.C., CANAWATI H.N., SAPICO F.L., HOPKINS R.R., WEINER J., MONTGOMERIE J.Z. Spontaneous bacterial peritonitis. Hepatology, 1982, 2: 399-407.
92. CAREY W.D., BOAYKE A., LEATHERMAN J. Spontaneous bacterial peritonitis: clinical and laboratory features with reference to hospital-acquired cases. Am. J. Gastroenterol., 1986, 81: 1156-61.
93. DALMAU D., LAYRARGUES G.P., FENYVES D., WILLEMS B., TURGEON F., TURGEON P. Cefotaxime, desacetyl-cefotaxime, and bactericidal activity in spontaneous bacterial peritonitis. J. Infect. Dis., 1999, 180: 1597-602.
94. GIRON-GONZALEZ J.A., RODRIGUEZ-RAMOS C., ELVIRA J. et al. Serial analysis of serum and ascitic fluid levels of soluble adhesion molecules and chemokines in patients with spontaneous bacterial peritonitis. Clin. Exp. Immunol., 2001, 123: 56-61.