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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bacterial peritonitis is a common complication associated with catheters implanted for intraperitoneal anticancer chemotherapy in patients with extensive ovarian carcinoma. During an ongoing trial of intraperitoneal cisplatin-melphalan vs. cisplatin-gamma interferon, given via an intraperitoneal 'Port-a-cath' catheter, 6 episodes of suspected bacterial peritonitis occurred in 5 patients. Clinical symptoms were present in all episodes and 3 episodes were documented microbiologically. Teicoplanin was given intraperitoneally, 400 mg three times a day on the first day and once daily thereafter. Serum and peritoneal concentrations were measured by bioassay. Despite clinical improvement during therapy, the catheter was removed in 4 out of 5 patients after the end of intraperitoneal teicoplanin, due to the presence of infection. Additional patients are required to evaluate the efficacy of intraperitoneal teicoplanin in the treatment of catheter-related peritonitis associated with anticancer intraperitoneal chemotherapy.
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PMID:Therapy of infections related to intraperitoneal catheters in patients with ovarian cancer. 215 Oct 63

A prospective study was performed to evaluate two culture methods for the diagnosis of bacterial peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD): a total bag volume method, and culture of 50 ml with prior saline wash. Peritonitis was present in 45 patients (47.4%). The wash method was more sensitive (80%) than bag culture method (62.2%), specially in patients with antimicrobial drugs therapy (p < 0.05). Therefore, specificity was greater for the bag procedure (78% vs. 62%).
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PMID:[Microbiological diagnosis of patients undergoing ambulatory peritoneal dialysis]. 215 81

To evaluate the role of bacterial peritonitis in peritoneal macrophage (PM) Beta-2 Microglobulin (B2M) production, and its relationship with PM Interleukin-1 (IL-1) and Leukotriene B4 (LTB4) release, the authors studied 20 CAPD patients (10 with peritonitis): 1. in vivo plasma and peritoneal dialysis effluent (PDE) B2M, IL-1, and LTB4 levels; 2. in vitro B2M, IL-1, and LTB4 release by PM. Values were compared with those seen in the plasma or with peripheral blood monocytes of 30 hemodialysis (HD) patients (10 treated with Cuprophan [CU]; 10 with Polyacrylonitrile [PAN]; and 10 with Cellulose Acetate [CA]). Results showed that in CAPD patients with bacterial peritonitis B2M, IL-1 and LTB4 concentrations in the PDE were significantly higher than those seen in CAPD patients without peritonitis, or in the plasma of HD patients treated with PAN or CA, but were similar to those seen in HD patients treated with CU. At the same time, in vitro PM from CAPD patients with bacterial peritonitis produced more B2M, IL-1, and LTB4, than did PM from CAPD patients without peritonitis, or peripheral blood monocytes from HD patients treated with PAN or CA. The authors conclude that in CAPD patients, bacterial peritonitis is able to induce PM B2M production, probably via a cytokine mediated process, which may be analogous to what occurs with peripheral blood monocytes of HD patients treated with CU.
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PMID:Peritoneal macrophage beta-2 microglobulin production and bacterial peritonitis in CAPD patients. 155 20

Spontaneous bacterial peritonitis rarely complicates high-protein (greater than 2.5 g/dl) ascites. The relatively high endogenous antimicrobial (opsonic) activity of the ascitic fluid in this setting appears to protect the patient from infection. We report two patients with high-protein, noncirrhotic ascites complicated by spontaneous peritonitis due to Salmonella species. One patient had ascites due to heart failure, whereas the other patient's ascites was due to peritoneal carcinomatosis. The ascitic fluid total protein concentrations were 3.1 and 3.3 g/dl, respectively, and the opsonic activity of the ascitic fluid specimens were 2.03 and 2.00 log kill, respectively, indicating a high degree of bacterial killing. We hypothesize that the virulence of the Salmonella species was able to overcome the high opsonic activity in the ascitic fluid, resulting in infection in these two patients. Fever, abdominal pain, or encephalopathy in a patient with high-protein ascites may suggest the presence of an unusual organism causing spontaneous bacterial peritonitis.
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PMID:Spontaneous Salmonella infection of high-protein noncirrhotic ascites. 220 53

An approximately steady state of bacterial density intraperitoneally has been observed in bacterial peritonitis. This state, which follows an initial (0-4 h) phase of rapid elimination of bacteria, was now studied in a model of porcine peritonitis. Twelve pigs were intra-abdominally infected with 10(10) CFU each of Escherichia coli and Bacteroides fragilis. Six of the pigs received no antibiotic and six were given two doses of fosfomycin (anti-aerobic), 1 g i.v., with the aim of disturbing possible equilibrium between rapid proliferation and destruction of the sensitive E. coli. Levels of fosfomycin up to 90 times the minimum inhibitory concentration (1 mg/l) were detected in the peritoneal exudate, but the antibiotic had no discernible effect on E. coli density or elimination pattern compared with B. fragilis in the same pig or with observations in controls. The results favoured the concept of slow-replicating E. coli and hence declining activity of the defence mechanisms a few hours after the induction of peritonitis.
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PMID:Host defence and bacterial growth in fosfomycin-treated peritonitis. Experimental observations in pigs. 223 53

To prospectively assess the value of an algorithm in differentiating spontaneous from secondary bacterial peritonitis, we performed serial paracenteses in 43 episodes of ascitic fluid infection (28 spontaneous and 15 secondary) in 40 patients. The algorithm involved identification of (a) secondary peritonitis associated with gut perforation, based on previously proposed criteria in patients with neutrocytic ascites (ascitic fluid total protein greater than 1 g/dl, glucose less than 50 mg/dl, and lactate dehydrogenase greater than the upper limit of normal for serum) and (b) separation of spontaneous from secondary peritonitis (unassociated with perforation) based on the response of the ascitic fluid cell count to antibiotic therapy. The perforation criteria had 100% sensitivity in detecting episodes of actual gut perforation; their specificity, however, was low (45%). After 48 h of treatment the concentration of ascitic fluid neutrophils was below the baseline pretreatment value in all episodes of spontaneous peritonitis but in only two thirds of the patients with secondary peritonitis. This algorithm is useful in (a) identifying patients who have infected ascites associated with perforation of an intraabdominal viscus, and (b) differentiating spontaneous from nonperforation secondary peritonitis on the basis of the response of the ascitic fluid cell count to appropriate antibiotic therapy. The optimal time for repeat paracentesis in patients with infected ascites appears to be 48 h after initiation of treatment.
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PMID:Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis. 240 29

The analysis of ascitic fluid has been complicated by several recently reported new tests. To simplify this assessment, we evaluated nine parameters prospectively and simultaneously in blood and ascitic fluid from 285 patients with ascites to determine which were the most reliable for immediate diagnosis of the etiology of the ascites and of its complications. Subjects were first divided into four groups: sterile cirrhotic ascites (n = 201), spontaneous bacterial peritonitis (n = 41), malignant ascites (n = 34), and miscellaneous ascites (n = 9). An ascitic fluid polymorphonuclear count greater than 500/microliters was the test with the greatest accuracy (96%) for the diagnosis of spontaneous bacterial peritonitis. Neither the most precise cutoff values for ascitic fluid pH (less than 7.32) and ascitic fluid lactate (greater than 32 mg/dl), nor their respective blood-ascitic fluid gradients (greater than 0.11 and less than -20 mg/dl) were more reliable indexes of spontaneous bacterial peritonitis, mainly due to the decreased ascitic fluid pH and increased ascitic fluid lactate observed in malignant ascites, tuberculous peritonitis, and pancreatic ascites. A blood-ascitic fluid albumin gradient less than 1.1 g/dl was the most accurate parameter for the diagnosis of malignant ascites (diagnostic efficacy, 93%). Therefore, the etiologic analysis of ascitic fluid might be simplified and the single practice of two tests, ascitic fluid polymorphonuclear cell count and blood-ascitic fluid albumin gradient, provides immediately useful information.
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PMID:Ascitic fluid polymorphonuclear cell count and serum to ascites albumin gradient in the diagnosis of bacterial peritonitis. 240 29

Although it is a relatively rare cause of peritonitis, Listeria monocytogenes must be considered in cirrhotic patients with ascites and a suggestive clinical presentation. We believe this is the first report of a case of peritonitis due to L monocytogenes in a patient without sepsis, and the sixth reported case of bacterial peritonitis in a patient with cirrhosis.
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PMID:Secondary bacterial peritonitis due to Listeria monocytogenes after paracentesis. 230 4

Acid phoshatase (AcP), beta-glucuronidase (GR) and N-acetyl-beta-D-glucosaminidase (NAG) activity in neutrophils obtained from the peritoneal fluid of 50 patients with terminal renal failure treated by intermittent peritoneal dialysis, and of 30 control subjects with normal renal function was semiquantitatively scored using a cytochemical method. This study was repeated in 22 dialyzed patients during the course of bacterial peritonitis. A significant decrease in the AcP score and an increase in the GR score were found in the neutrophils from dialyzed patients. In dialyzed patients with peritonitis, the GR and NAG scores were higher that in those without this complication.
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PMID:Acid phosphatase, beta-glucuronidase and N-acetyl-beta-D-glucosaminidase activity of peritoneal neutrophils in patients with terminal renal failure treated by intermittent peritoneal dialysis. 233 Aug 8

Three cases of spontaneous peritonitis caused by Enterococcus faecium are presented. The underlying condition was alcoholic cirrhosis in each case. This enterococcal species has never before been reported as a cause of spontaneous bacterial peritonitis. Two patients responded to therapy. The development of enterococcal peritonitis and the cases documented in the literature are briefly reviewed. Taxonomic problems with pathogenic, clinical, and therapeutic implications are discussed.
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PMID:Spontaneous peritonitis caused by Enterococcus faecium. 238 Mar 71


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