Related Experiment Videos
Spontaneous bacterial peritonitis caused by Listeria monocytogenes: two case reports and literature review
Abstract:
Two new cases of spontaneous bacterial peritonitis (SBP) caused by Listeria monocytogenes are reported. Listeria monocytogenes was recovered from the ascitic fluid but not from the blood cultures of two adult diabetic inpatients with hepatic cirrhosis and SBP that had been treated empirically with cefotaxime. These two cases add to the 17 cases of Listeria monocytogenes SBP reported previously, stressing the relevance of this microorganism to this clinical condition. The recovery of Listeria monocytogenes from blood has been achieved in only half of the cases reported, suggesting the possibility of a direct translocation mechanism. Combinations of amino- or ureidopenicillins with beta-lactamase inhibitors or carbapenems might be more effective as empiric therapy of SBP in cirrhotic patients.
Insights
Two new cases of spontaneous bacterial peritonitis (SBP) in diabetic patients with hepatic cirrhosis were caused by Listeria monocytogenes. Current empirical antibiotic therapy may require revision to improve outcomes for this serious infection.
Area of Science:
- Infectious Diseases
- Hepatology
- Microbiology
Background:
- Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with advanced liver disease.
- Listeria monocytogenes is an opportunistic pathogen that can cause SBP, particularly in immunocompromised individuals.
Observation:
- Two new cases of SBP caused by Listeria monocytogenes in adult diabetic patients with hepatic cirrhosis are presented.
- Listeria monocytogenes was identified in ascitic fluid but not in blood cultures in these patients, despite empirical cefotaxime treatment.
Findings:
- These cases increase the total reported instances of Listeria monocytogenes SBP to 19.
- Bloodstream recovery of Listeria monocytogenes in SBP cases occurs in only about 50% of instances, suggesting potential direct translocation into the peritoneal fluid.
Implications:
- The findings highlight the importance of considering Listeria monocytogenes in SBP, especially in diabetic cirrhotic patients.
- Current empirical antibiotic regimens for SBP may need adjustment.
- Combinations of extended-spectrum penicillins or carbapenems could be more effective empiric treatments for SBP in cirrhotic patients.