What are the most common pathogens causing spontaneous bacterial peritonitis (SBP)?

Updated: Jul 23, 2019
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

More than 90% of cases of SBP are caused by a monomicrobial infection. The most common pathogens include gram-negative organisms (eg, E coli [40%], K pneumoniae [7%], Pseudomonas species, Proteus species, other gram-negative species [20%]) and gram-positive organisms (eg, Streptococcus pneumoniae [15%], other Streptococcus species [15%], and Staphylococcus species [3%]) (see Table 1). However, some data suggest that the percentage of gram-positive infections may be increasing. [7, 8] One study cites a 34.2% incidence of streptococci, ranking in second position after Enterobacteriaceae. [8] Viridans group streptococci (VBS) accounted for 73.8% of these streptococcal isolates. A single organism is noted in 92% of cases, and 8% of cases are polymicrobial.

Anaerobic microorganisms are found in less than 5% of cases, and multiple isolates are found in less than 10%.


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