Video Experimental Relacionado

Updated: Feb 19, 2026

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

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

Published on: December 18, 2010

Espectro alterado de patógenos de peritonitis bacteriana espontánea en pacientes tratados con inhibidores de la bomba

Philip Kitchen¹, Sarah L Schütte², Tammo L Tergast²

¹Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Alimentary pharmacology & therapeutics

|February 18, 2026

Abstracto

Background:

Proton pump inhibitor (PPI) treatment leads to significant changes in the gut microbiota composition. We hypothesized that these alterations may transfer into distinct changes in the causative agents of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis.

Aims:

To investigate the impact of PPI treatment on the pathogen spectrum of SBP.

Methods:

A total of 227 cirrhosis patients with culture-positive SBP from two German tertiary care centers were included and the pathogen spectrum of SBP was analysed with respect to PPI treatment.

Results:

In the PPI-group, gram-positive bacteria were significantly more common compared to the non-PPI-group (62.1% vs. 34.0%, p < 0.001). This involved increased abundances of Enterococcus spp. (22.0% vs. 8.0%), Streptococcus spp. (14.7% vs. 6.0%) and Staphylococcus aureus (15.8% vs. 8.0%). Importantly, more than half of the Enterococcus isolates were susceptible only to antibiotics with extended gram-positive activity. Conversely, gram-negative bacteria were significantly more frequent in the non-PPI-group compared to the PPI-group (64.0% vs. 40.7%, p = 0.003), primarily due to a higher prevalence of E. coli (40.0% vs. 20.3%). In uni- and multivariable logistic regression analyses, PPI use was an independent predictor of gram-positive SBP (OR 2.719, 95% CI 1.343-5.506, p = 0.005), adjusted for nosocomial infection (OR 2.609, 95% CI 1.464-4.650, p = 0.001) and Child-Pugh score (OR 0.684, 0.552-0.848, p < 0.001).

Conclusions:

PPI treatment is associated with increased abundances of gram-positive pathogens, including Enterococcus spp., in culture-positive SBP. This result can help guide empiric antibiotic therapy of SBP.

Palabras clave:

cirrosis descompensación infección

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