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Spontaneous peritonitis caused by Enterococcus faecium
J Pascual1, A Sureda, A Lopez-San Roman
1Department of Gastroenterology, Hospital Ramon y Cajal, Madrid, Spain.
Abstract:
Three cases of spontaneous peritonitis caused by Enterococcus faecium are presented. The underlying condition was alcoholic cirrhosis in each case. This enterococcal species has never before been reported as a cause of spontaneous bacterial peritonitis. Two patients responded to therapy. The development of enterococcal peritonitis and the cases documented in the literature are briefly reviewed. Taxonomic problems with pathogenic, clinical, and therapeutic implications are discussed.
Insights
Enterococcus faecium, a bacterium not previously linked to spontaneous bacterial peritonitis, caused the condition in three patients with alcoholic cirrhosis. Two patients successfully responded to treatment, highlighting a new clinical consideration.
Area of Science:
- Infectious Diseases
- Hepatology
- Microbiology
Background:
- Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with cirrhosis.
- Commonly, SBP is caused by gram-negative bacteria, with Enterococcus species rarely implicated.
- Alcoholic cirrhosis is a significant risk factor for SBP.
Observation:
- Three cases of spontaneous peritonitis caused by Enterococcus faecium were identified.
- All patients had underlying alcoholic cirrhosis.
- This represents the first reported instances of Enterococcus faecium causing SBP.
Findings:
- Two of the three patients with Enterococcus faecium peritonitis responded to antibiotic therapy.
- The study reviews the development of enterococcal peritonitis and existing literature.
- Taxonomic challenges associated with Enterococcus faecium are discussed.
Implications:
- Enterococcus faecium should be considered in the differential diagnosis of SBP, particularly in patients with alcoholic cirrhosis.
- Understanding the pathogen's role may refine diagnostic and therapeutic strategies for SBP.
- Further research into the pathogenicity and treatment of enterococcal SBP is warranted.