Spontaneous bacterial peritonitis risk factors: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
Line 27: | Line 27: | ||
* [[Urinary tract infections]] | * [[Urinary tract infections]] | ||
* Intestinal [[bacterial overgrowth]] <ref name="pmid16782626">{{cite journal |author=van Erpecum KJ |title=Ascites and spontaneous bacterial peritonitis in patients with liver cirrhosis |journal=Scand. J. Gastroenterol. Suppl. |volume= |issue=243 |pages=79–84 |year=2006 |pmid=16782626 |doi=10.1080/00365520600664342 |url=}}</ref> | * Intestinal [[bacterial overgrowth]] <ref name="pmid16782626">{{cite journal |author=van Erpecum KJ |title=Ascites and spontaneous bacterial peritonitis in patients with liver cirrhosis |journal=Scand. J. Gastroenterol. Suppl. |volume= |issue=243 |pages=79–84 |year=2006 |pmid=16782626 |doi=10.1080/00365520600664342 |url=}}</ref> | ||
{| class="wikitable" | |||
! colspan="4" |Risk Factors for SBP | |||
|- | |||
!Biochemical | |||
!Clinical | |||
!Genetic | |||
!Pharmacological | |||
|- | |||
|''Well-established risk factors for developing an initial episode of SBP are'' : | |||
* Low ascitic fluid protein level (<1 g/dL)<ref name="pmid20120777">{{cite journal| author=Mustafa MG, Al Mamun MA, Alam AK| title=Study on ascitic fluid protein level in cirrhotic patients with spontaneous bacterial peritonitis. | journal=Bangladesh Med Res Counc Bull | year= 2009 | volume= 35 | issue= 2 | pages= 41-3 | pmid=20120777 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20120777 }} </ref> | |||
* Elevated serum bilirubin level (>4 mg/dL) | |||
* Advanced Cirrhosis | |||
* Low levels of 25-hydroxy vitamin D | |||
* Serum albumin level <2.85 g/dL | |||
|* Patients with Vatical hemorrhage and GI bleeding associated with Cirrhosis are more prone to develop SBP irrespective of the presence of ascites. | |||
|* The Toll-like receptor 2 (TLR2) proteins<ref name="pmid21356257">{{cite journal| author=Nischalke HD, Berger C, Aldenhoff K, Thyssen L, Gentemann M, Grünhage F et al.| title=Toll-like receptor (TLR) 2 promoter and intron 2 polymorphisms are associated with increased risk for spontaneous bacterial peritonitis in liver cirrhosis. | journal=J Hepatol | year= 2011 | volume= 55 | issue= 5 | pages= 1010-6 | pmid=21356257 | doi=10.1016/j.jhep.2011.02.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21356257 }} </ref> variants of the NOD2 (nucleotide-binding oligomerisation domain containing gene and Farnesoid X were known to cause SBP. | |||
|* Proton pump inhibitors (PPI) has been associated with a three-fold increase in the risk and identified as an independent risk factor for SBP in patients with advanced cirrhosis. | |||
* Beta-adrenergic antagonists namely nonselective beta-blocker (NSBB) therapy was found to be protective for SBP. | |||
|} | |||
== References == | == References == |
Revision as of 20:56, 16 January 2017
Spontaneous bacterial peritonitis Microchapters |
Differentiating Spontaneous bacterial peritonitis from other Diseases |
Diagnosis |
Treatment |
Spontaneous bacterial peritonitis risk factors On the Web |
American Roentgen Ray Society Images of Spontaneous bacterial peritonitis risk factors |
Directions to Hospitals Treating Spontaneous bacterial peritonitis |
Risk calculators and risk factors for Spontaneous bacterial peritonitis risk factors |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Common risk factors in the development of spontaneous bacterial peritonitis include
- liver cirrhosis
- renal failure
- Low protein levels in the ascitic fluid
- Low complement concentration (complement 3) in ascitic fluid
- urinary tract infections, and
- Intestinal bacterial overgrowth.
Risk Factors
Risk factors include:[1]
- All cirrhotic patients with ascites
- Severe liver disease (Cirrhosis)
- Additional factors which can further increase susceptibility include:
- Low protein level in ascitic fluid [2]
- Upper GI bleeding poses a risk of bacteremia and SBP in a cirrhotic patient with rates of infection ranging from 17 to 21%
- Ischemia- reperfusion of the gut during variceal hemorrhage has also been proposed to interfere with the normal function of the reticuloendothelial system and to increase permeability of the intestinal mucosa.
- Survivors of a prior episode of SBP are at an increased risk of recurrence with a one-year probability of almost 70%.
- Minimally invasive procedures such as intravenous and urinary bladder catheterization likely predisposes to bacteremia and SBP in the cirrhotics.
- Low complement concentration (complement 3) in ascitic fluid [2]
- Renal failure
- Urinary tract infections
- Intestinal bacterial overgrowth [3]
Risk Factors for SBP | |||
---|---|---|---|
Biochemical | Clinical | Genetic | Pharmacological |
Well-established risk factors for developing an initial episode of SBP are :
|
* Patients with Vatical hemorrhage and GI bleeding associated with Cirrhosis are more prone to develop SBP irrespective of the presence of ascites. | * The Toll-like receptor 2 (TLR2) proteins[4] variants of the NOD2 (nucleotide-binding oligomerisation domain containing gene and Farnesoid X were known to cause SBP. | * Proton pump inhibitors (PPI) has been associated with a three-fold increase in the risk and identified as an independent risk factor for SBP in patients with advanced cirrhosis.
|
References
- ↑ Sheer TA, Runyon BA (2005). "Spontaneous bacterial peritonitis". Dig Dis. 23 (1): 39–46. doi:10.1159/000084724. PMID 15920324.
- ↑ 2.0 2.1 2.2 Mustafa MG, Al Mamun MA, Alam AK (2009). "Study on ascitic fluid protein level in cirrhotic patients with spontaneous bacterial peritonitis". Bangladesh Med Res Counc Bull. 35 (2): 41–3. PMID 20120777. Unknown parameter
|month=
ignored (help) - ↑ van Erpecum KJ (2006). "Ascites and spontaneous bacterial peritonitis in patients with liver cirrhosis". Scand. J. Gastroenterol. Suppl. (243): 79–84. doi:10.1080/00365520600664342. PMID 16782626.
- ↑ Nischalke HD, Berger C, Aldenhoff K, Thyssen L, Gentemann M, Grünhage F; et al. (2011). "Toll-like receptor (TLR) 2 promoter and intron 2 polymorphisms are associated with increased risk for spontaneous bacterial peritonitis in liver cirrhosis". J Hepatol. 55 (5): 1010–6. doi:10.1016/j.jhep.2011.02.022. PMID 21356257.