Spontaneous Bacterial Peritonitis: The Bug Matters

Excerpt

Bacterial infections contribute to the morbidity and mortality of patients with cirrhosis, with infection rates up to 34% in hospitalized patients [1]. Spontaneous bacterial peritonitis (SBP) is defined as bacterial infection of the ascitic fluid in the absence of a proven or suspected intra-abdominal source of infection. Despite improvement in treatments, SBP remains associated with a mortality as high as 20%, as well as high recurrence rates after initial infection [2]. Its pathogenesis involves bacterial translocation, likely through specialized epithelial M cells located in the intestinal Peyer’s patches overlying specialized subepithelial mesenteric lymphatic tissue, with bacteria entering the lymphatic circulation and ultimately, the bloodstream in the setting of impaired host defenses and compromised immune function [3]. …