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Updated: May 9, 2026
06:45
Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
Published on: December 18, 2010
Difficult to treat spontaneous bacterial peritonitis
Shalimar1, Subrat Kumar Acharya
1Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Science, New Delhi, India.
Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
|August 8, 2013
Summary
Spontaneous bacterial peritonitis (SBP) in cirrhosis patients is a frequent, deadly infection. Rising multidrug-resistant SBP, especially nosocomial infections, presents a significant therapeutic challenge with increased mortality risk.
Area of Science:
- Hepatology
- Infectious Diseases
- Critical Care Medicine
Background:
- Spontaneous bacterial peritonitis (SBP) is the most common infection in cirrhosis patients, carrying high mortality.
- SBP significantly worsens the prognosis of cirrhosis, leading to increased short-term and long-term mortality.
- Diagnosis is confirmed by >250 polymorphonuclear cells/mm³ in ascitic fluid.
Purpose of the Study:
- To highlight the increasing challenge of multidrug-resistant (MDR) SBP.
- To differentiate community-acquired versus nosocomial MDR SBP.
- To underscore the therapeutic difficulties and increased mortality associated with MDR SBP.
Main Methods:
- Review of current literature on SBP diagnosis and treatment.
- Analysis of SBP occurrence in hospitalized and ICU settings.
- Assessment of the impact of antibiotic prophylaxis on bacterial resistance.
Main Results:
- Multidrug-resistant SBP is increasingly recognized, particularly in nosocomial settings and with antibiotic prophylaxis.
- Bacterial resistance in SBP is associated with a four-fold higher relative risk of mortality.
- Therapeutic options for MDR SBP are limited, posing a clinical challenge.
Conclusions:
- SBP management is complicated by the rise of multidrug-resistant organisms.
- Nosocomial MDR SBP represents a critical subgroup requiring specific attention.
- Effective treatment strategies for MDR SBP are urgently needed to improve patient outcomes.
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