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Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
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
PubMed

Insights

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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