īecause of the significant morbidity and mortality related to SBP, identifying predisposing factors is of great importance.
Uncontrolled bacterial growth in ascitic fluid then develops as a result of an impaired host immune response. Intestinal permeability to bacteria is increased in patients with cirrhosis, and one mechanism that has been suggested to explain SBP in these patients is that it evolves because bacteria translocate across the leaky gut.
Spontaneous bacterial peritonitis (SBP) is a common and serious infection occurring in cirrhotic patients with ascites. In conclusion, we did not find a positive association between PPI use and spontaneous bacterial peritonitis. Crude and adjusted odds ratios for the development of spontaneous bacterial peritonitis by exposure to PPIs were 1.22 (95% confidence interval: 0.52–2.87) and 1.05 (0.43–2.57), respectively. Patient characteristics were similar between groups with and without infection, with the exception of the Model for End-Stage Liver Disease score (median: 23 and 18, respectively P = 0.002). Of the 116 subjects, 32 had spontaneous bacterial peritonitis. We performed logistic regression to determine the risk of spontaneous bacterial peritonitis by PPI usage. Spontaneous bacterial peritonitis was defined as paracentesis yielding ≥250 polymorphonuclear leukocytes/ml. Our retrospective case-control study included 116 consecutive cirrhotic patients with ascites who underwent diagnostic paracentesis upon hospital admission (2002–2005). We investigated whether PPI usage is associated with spontaneous bacterial peritonitis. Proton pump inhibitors (PPIs) increase enteric bacterial colonization, overgrowth, and translocation, all effects which might predispose to spontaneous bacterial peritonitis.
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