{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T16:30:52Z","timestamp":1788193852697,"version":"build-2803163510"},"reference-count":38,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2021,11,20]],"date-time":"2021-11-20T00:00:00Z","timestamp":1637366400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Spontaneous bacterial peritonitis (SBP) is a common complication in patients with liver cirrhosis, with an increased risk of mortality. For this reason, a diagnostic paracentesis should be performed in all patients with ascites and clinical features with high diagnostic suspicion. Although literature data abound in identifying new diagnostic markers in serum or ascites, they have not yet been validated. The final diagnosis requires the analysis of ascites and the presence of &gt; 250 mm\n                    <jats:sup>3<\/jats:sup>\n                    neutrophil polymorphonuclear (PMN) in ascites. If previous data showed that the most common microorganisms identified were represented by gram-negative bacteria, we are currently facing an increase in gram-positive bacteria and multidrug-resistant bacteria. Although prompt and effective treatment is required to prevent outcomes, this becomes challenging as first-line therapies may become ineffective leading to worsening prognosis and increased in-hospital mortality. In this paper we will make a brief review of existing data on the diagnosis and treatment of SBP.\n                  <\/jats:p>","DOI":"10.2478\/rjim-2021-0024","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T19:21:25Z","timestamp":1624908085000},"page":"345-350","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous bacterial peritonitis: update on diagnosis and treatment"],"prefix":"10.2478","volume":"59","author":[{"given":"Roxana-Emanuela","family":"Popoiag","sequence":"first","affiliation":[{"name":"Ovidius University Faculty of Medicine , Department of Internal Medicine , Constan\u021ba , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Fierbin\u021beanu-Braticevici","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest , Romania"},{"name":"University Emergency Hospital , Gastroenterology Department , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2021,11,20]]},"reference":[{"key":"2026042914161560712_j_rjim-2021-0024_ref_001","doi-asserted-by":"crossref","unstructured":"1. 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J Hepatol. 2018;69(2):406\u2013460.10.1016\/j.jhep.2018.08.00930172388","DOI":"10.1016\/j.jhep.2018.08.009"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_004","doi-asserted-by":"crossref","unstructured":"4. MARCIANO S, DIAZ JM, DIRCHWOLF M, GADANO A. Spontaneous bacterial peritonitis in patients with cirrhosis: incidence, outcomes, and treatment strategies. Hepat Med. 2019;11:13\u201322.10.2147\/HMER.S164250633601930666172","DOI":"10.2147\/HMER.S164250"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_005","doi-asserted-by":"crossref","unstructured":"5. GAETANO JN, MICIC D, ARONSOHN A, REDDY G, TE H, REAU NS, et al. The benefit of paracentesis on hospitalized adults with cirrhosis and ascites. J Gastroenterol Hepatol. 2016;31:1025\u20131030.10.1111\/jgh.1325526642977","DOI":"10.1111\/jgh.13255"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_006","doi-asserted-by":"crossref","unstructured":"6. 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Ultrasound guidance decreases complications and improves the cost of care among patients undergoing thoracentesis and paracentesis.Chest. 2013;143:532\u2013538.10.1378\/chest.12-044723381318","DOI":"10.1378\/chest.12-0447"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_009","doi-asserted-by":"crossref","unstructured":"9. CHINNOCK B, AFARIAN H, MINNIGAN H, BUTLER J, HENDEY GW. Physician clinical impression does not rule out spontaneous bacterial peritonitis in patients undergoing emergency department paracentesis.Ann Emerg Med. 2008;52:268\u2013273.10.1016\/j.annemergmed.2008.02.01618433932","DOI":"10.1016\/j.annemergmed.2008.02.016"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_010","doi-asserted-by":"crossref","unstructured":"10. DEVER JB, SHEIKH MY. Review article: spontaneous bacterial peritonitis \u2013 bacteriology, diagnosis, treatment, risk factors and prevention. 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Diagnostic Accuracy of Serum Procalcitonin for Spontaneous Bacterial Peritonitis Due to End-stage Liver Disease: A Meta-analysis. Medicine (Baltimore). 2015;94(49):e2077.10.1097\/MD.0000000000002077500847826656333","DOI":"10.1097\/MD.0000000000002077"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_017","doi-asserted-by":"crossref","unstructured":"17. LESINKA M, HARTLEB M, GUTKOWSKI K, NOWAKOWSKA-DULAWA E. Procalcitonin and macrophage inflammatory protein-1 beta (MIP-1 beta) in serum and peritoneal fluid of patients with decompensated cirrhosis and spontaneous bacterial peritonitis. Adv Med Sci. 2014;59:52\u201356.10.1016\/j.advms.2013.07.00624797975","DOI":"10.1016\/j.advms.2013.07.006"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_018","unstructured":"18. GULER K, VATANSEVER S, KAYACAN SM, SALMAYENLI N, AKKAYA V, ERK O, et al. High sensitivity C-reactive protein in spontaneous bacterial peritonitis with nonneutrocytic ascites. Hepatogastroenterology. 2009;56(90):452\u20135."},{"key":"2026042914161560712_j_rjim-2021-0024_ref_019","doi-asserted-by":"crossref","unstructured":"19. KADAM N, ACHARYA S, SHUKLA S, GUPTA K. Ascitic Fluid High Sensitive C-Reactive Protein (hs-CRP). A Prognostic Marker in Cirrhosis with Spontaneous Bacterial Peritonitis. J Clin Diagn Res. 2016;10(4):OC20\u20134.10.7860\/JCDR\/2016\/17931.7610486616027190862","DOI":"10.7860\/JCDR\/2016\/17931.7610"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_020","doi-asserted-by":"crossref","unstructured":"20. SHIZUMA T. Diagnostic Laboratory Markers for Spontaneous Bacterial Peritonitis. Ann Clin Lab Res. 2016; 4:4.10.21767\/2386-5180.1000131","DOI":"10.21767\/2386-5180.1000131"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_021","doi-asserted-by":"crossref","unstructured":"21. LEE SS, MIN HJ, CHOI JY, CHO HC, KIM JJ, LEE JM, et al. Usefulness of ascitic fluid lactoferrin levels in patients with liver cirrhosis. 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Eur J Gastroenterol Hepatol. 2020;32(9):1075\u20131083.10.1097\/MEG.000000000000170932175980","DOI":"10.1097\/MEG.0000000000001709"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_024","doi-asserted-by":"crossref","unstructured":"24. KOULAOUZIDIS A. Diagnosis of spontaneous bacterial peritonitis: an update on leucocyte esterase reagent strips. World J Gastroenterol. 2011;17(9):1091\u20134.10.3748\/wjg.v17.i9.1091306390021448413","DOI":"10.3748\/wjg.v17.i9.1091"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_025","doi-asserted-by":"crossref","unstructured":"25. KOULAOUZIDIS A, LEONTIADIS GI, ABDULLAH M, MOSCHOS J, GASEM J, THARAKAN J, et al. Leucocyte esterase reagent strips for the diagnosis of spontaneous bacterial peritonitis: a systematic review. Eur J Gastroenterol Hepatol. 2008;20:1055\u20131060.10.1097\/MEG.0b013e328300a36319047835","DOI":"10.1097\/MEG.0b013e328300a363"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_026","doi-asserted-by":"crossref","unstructured":"26. ABDEL-RAZIK A, MOUSA N, ELBAZ S, EISSA M, ELHELALY R, ELDARS W. Diagnostic utility of interferon gamma-induced protein 10 kDa in spontaneous bacterial peritonitis: single-center study. Eur J Gastroenterol Hepatol. 2015;27:1087\u20131093.10.1097\/MEG.000000000000040026020377","DOI":"10.1097\/MEG.0000000000000400"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_027","doi-asserted-by":"crossref","unstructured":"27. ICHOU L, CARBONELL N, RAUTOU PE, LAURANS L, BOURCIER S, PICHEREAU C, et al. Ascitic fluid TREM-1 for the diagnosis of spontaneous bacterial peritonitis. Gut. 2016;65:536\u2013538.10.1136\/gutjnl-2015-31016026141143","DOI":"10.1136\/gutjnl-2015-310160"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_028","doi-asserted-by":"crossref","unstructured":"28. 28. KIM JK, CHON CY, KIM JH, KIM YJ, CHO JH, BANG SM, et al. Changes in serum and ascitic monocyte chemotactic protein-1 (MCP-1) and IL-10 levels in cirrhotic patients with spontaneous bacterial peritonitis. 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FRIEDMAN ND, KAYE KS, STOUT JE, MCGARRY SA, TRIVETTE SL, BRIGGS JP, et al. Health care associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med 2002;137:791\u2013797.10.7326\/0003-4819-137-10-200211190-0000712435215","DOI":"10.7326\/0003-4819-137-10-200211190-00007"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_037","doi-asserted-by":"crossref","unstructured":"37. SORT P, NAVASA M, ARROYO V, ALDEGUER X, PLANAS R, RUIZ-DEL-ARBOL L, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med. 1999;341:403\u2013409.10.1056\/NEJM19990805341060310432325","DOI":"10.1056\/NEJM199908053410603"},{"key":"2026042914161560712_j_rjim-2021-0024_ref_038","doi-asserted-by":"crossref","unstructured":"38. GARCIA-MARTINEZ R, CARACENI P, BERNARDI M, GINES P, ARROYO V, JALAN R. 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