Primary peritonitis is almost always monomicrobial, so growth of more than one organism should raise the suspicion for secondary peritonitis. Gram-negative enteric organisms make up about 60% of SBP infections, with Escherichia coli and Klebsiella pneumoniae being most frequently isolated. Gram-positive organisms, most often Streptococcus pneumoniae and other streptococcal species, account for about 25% of episodes. Patients receiving selective intestinal decontamination (SID), usually with fluoroquinolone antibiotics, may have a higher frequency of gram-positive SBP episodes. Despite the predominantly anaerobic flora of the colon, anaerobic organisms are rarely isolated from peritoneal fluid and, when present, correlate strongly with polymicrobial infection. Bacteremia occurs in up to 75% of SBP cases when the infection is due to a single aerobic species, but it is rare in patients with peritonitis due to anaerobes.The most common infecting organisms in children with primary peritonitis are S. pneumoniae and group A streptococci. Uncommon organisms isolated in cases of primary peritonitis include N. gonorrhoeae, C. trachomatis, Mycobacterium tuberculosis, and Coccidioides immitis.*87/348/5*
PRIMARY PERITONITIS: FLORA
Posted: under Anti-Infectives.
April 11th, 2011
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