Spontaneous bacterial peritonitis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Overview

Spontaneous bacterial peritonitis is one of the variants of ascitic fluid infections.
Classification of ascitic fluid infections is based on neutrophil count and culture report.

Type of Infection	Bacterial Culture Report	Neutrophil Count (cells/mm³)	Comments
Spontaneous bacterial peritonitis	Positive usually for one organism	≥250	Patients with cirrhosis and ascites in the presence or absence of symptoms and signs
Culture negative neutrocytic ascites (CNNA)	Negative	≥250	Poor culture technique and prior antibiotics or low opsonic activity in ascitic fluid. Commonly encountered phenotype and requires antibiotic therapy
Monomicrobial bacterascites	Positive for one organism	<250	Ascitic fluid infection which may resolve spontaneously or progress to SBP. Mortality is similar to SBP and should be treated as SBP.
Secondary bacterial peritonitis	Positive for many microbes	≥250	Intraperitoneal source of infection e.g. diverticulitis
Polymicrobial bacterascites	Positive for many microbes	<250	Usually due to needle perforation