From the Guidelines
Escherichia coli is the most common organism causing Spontaneous Bacterial Peritonitis (SBP).
Causative Organisms
- The most common pathogens include Gram-negative bacteria (GNB), usually Escherichia coli and Gram-positive cocci (mainly streptococcus species and enterococci) 1.
- Escherichia coli, Klebsiella pneumoniae, and Streptococcus are the most commonly identified bacteria in culture 1.
Treatment
- Third-generation cephalosporin antibiotics, such as cefotaxime and ceftriaxone, are recommended as they are effective for most causative bacterial pathogens, including Escherichia coli 1.
- The standard treatment duration is 5 to 10 days, but may vary according to symptoms and/or results of antimicrobial susceptibility testing 1.
From the Research
Causative Organisms of Spontaneous Bacterial Peritonitis (SBP)
The most common organisms causing SBP are:
- Gram-negative bacteria, such as Escherichia coli and Klebsiella species 2, 3, 4
- Specifically, E. coli is the major pathogen, followed by Klebsiella pneumoniae and Enterococcus faecium 3
- Gram-positive bacteria, such as Enterococcus, are also increasingly involved in SBP, particularly in nosocomial infections 3, 5
Variation in Causative Organisms by Population
- In children with liver disease and ascites, the most common cause of SBP is Streptococcus pneumoniae, followed by E. coli and other organisms 6
- In adults, the most common causes of SBP are E. coli, Klebsiella pneumoniae, and Enterococcus faecium 2, 3, 4
Antibiotic Resistance and Treatment
- The increasing involvement of multi-drug resistant bacteria in SBP is a concern, and treatment regimens should take into account the acquisition site of infection and local epidemiological situation 3, 5
- Empirical antibiotic therapy should be started immediately in patients with SBP, and third-generation cephalosporins, such as cefotaxime or ceftriaxone, are recommended as first-line treatment 2, 4, 6