Spontaneous bacterial peritonitis causes
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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];Luke Rusowicz-Orazem, B.S.;Shivani Chaparala M.B.B.S [3]
Overview
Spontaneous bacterial peritonitis is a blood-borne infection caused by Enteric organisms in 70% of cases (Mono-microbial origin in 90% of cases). Aerobic gram-negative bacteria like Escherichia coli account for half of the cases.Gram-positive cocci Streptococcus sp in 20% cases with enterococcus accounting for 5% of the cases. Staphylococcus aureus and Streptococcus salivarius are less frequent causes.Poly-microbial infection is mostly because of Iatrogenic cause (more likely associated with abdominal paracentesis) or intra-abdominal source of infection.The cause of SBP has not been established definitively but is believed to involve hematogenous spread of organisms in a patient in whom a diseased liver and altered portal circulation result in a defect in the usual filtration function.In adults, spontaneous bacterial peritonitis occurs most commonly in conjunction with cirrhosis of the liver and portal hypertension (frequently as a result of alcoholism and hepatitis).
Causes
Common Causes
- Spontaneous bacterial peritonitis is often a blood-borne infection caused by Enteric organisms-70% (Mono-microbial in 90%).
- Aerobic gram-negative bacteria like Escherichia coli account for half of the cases.
- Gram-positive cocci Streptococcussp in 20% cases with enterococcus accounting for 5% of the cases
- Staphylococcus aureus and Streptococcus salivarius are less frequent causes.
- Poly-microbial infection is mostly because of Iatrogenic cause (more likely associated with abdominal paracentesis) or intra-abdominal source of infection.
A variety of abnormalities contributing to the infection were identified which include:
- GI bleeding
- ↑Colonization of the small bowel with prominent bacterial translocation
- ↓Opsonic activity in blood and ascitic fluid
- Impaired Complement
- Leukocyte dysfunction
- ↓Antibodies
- ↑Immunosuppressive cytokines, endotoxin, TNF