Spontaneous Bacterial Peritonitis

Do Seon Song

doi:10.4166/kjg.2018.72.2.56

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Song: Spontaneous Bacterial Peritonitis

Special Review

Recent Update in the Management for the Complicatins of Portal Hypertension in Liver Cirrhosis

The Korean Journal of Gastroenterology 2018; 72(2): 56-63.

Published online: 23 August 2018

DOI: https://doi.org/10.4166/kjg.2018.72.2.56

Spontaneous Bacterial Peritonitis

Do Seon Song

Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

Correspondence to: Do Seon Song, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea. Tel: +82-31-249-8204, Fax: +82-31-253-8898, dsman@catholic.ac.kr

Received 12 July 2018 Revised 23 July 2018 Accepted 25 July 2018

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Spontaneous bacterial peritonitis, Ascites, Therapy

Figures and Tables

Table 1

Bacteria Causing Spontaneous Bacterial Peritonitis in Korea85

Notes

^{Financial support} None.

^{Conflict of interest} None.

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