A Clinical Study of Spontaneous Bacterial Peritonitis in Cirrhosis of Liver With Ascites in Teritiary Care Hospital

Background: Spontaneous bacterial peritonitis (SBP) is the most common infection and a lethal complication in patients with liver cirrhosis and ascites. It has high mortality and recurrence rates and poor long-term prognosis. Objective: This study was done to determine the prevalence of spontaneous bacterial peritonitis and its variants in patients of liver cirrhosis with ascites. Patients and Methods: This was a prospective, randomized, cross-sectional clinical study, included 100 adult patients of decompensated liver cirrhosis with ascites in Aswan University Hospital during the period from January 2019 to December 2019. Results: Diagnosis of SBP is based on ascitic fluid analysis as well as culture and sensitivity. The diagnostic criteria are PMNL > 250/mm³ and or positive culture. Mean of age of patients was 63.06 ± 9.67 years old. Majority of patients were males (63%) and 37 % were females. In Our study, 62% of patients were diagnosed SBP. Classic SBP in 30.6%, Culture Negative Neutrocytic Ascites (CNNA) in 59.7% and MNB in 9.7% of patients. Of 25 patients who have positive culture ascetic fluid, 60% were positive for gram-negative bacteria predominantly E. coli. Conclusion: SpontaneousBacteria Peritonitis is the most common and life-threatening infection in patients who have liver cirrhosis and ascites. It is diagnosed by a) Ascitic fluid PMNL > 250/mm³. b) Positive ascetic fluid culture. c) Both a and b. It is found that SBP has recently increased in prevalence with predominantly causative organism gram negative E Coli.

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Prevalence of Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascites and Its Pattern in Aswan University Hospital

Hafez

Abdallah

Abdellatif

2020

The Egyptian Journal of Hospital Medicine

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A Study of Spontaneous Bacterial Peritonitis in Cirrhosis of Liver with Ascites at a Tertiary Care Hospital in North India: Prevalence, Clinical, and Microbiological Profile

Mohan,

Kumar,

Singh

2023

Apollo Medicine

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Background and Objectives: In patients with chronic liver disease and ascites, spontaneous bacterial peritonitis (SBP) is a common complication. This can progress gradually and subtly or go undiagnosed until signs start to show. Early diagnosis is essential for effective treatment and the prevention of subsequent episodes because the mortality rate following a single episode varies from 20% to 40%. The goal was to study the incidence, clinical profile, and microbiological characteristics of SBP and its variants in people with liver cirrhosis and ascites. Materials and Methods: This observational study was done on 104 cirrhotic patients with ascites admitted at a tertiary care hospital. Basic demographics, symptoms, and clinical signs of patients were recorded. Diagnostic paracentesis was done aseptically and immediately sent for ascitic fluid cytology, biochemistry, and culture. Bacterial examination and antibiotic sensitivity tests were carried out by standard microbiological techniques. Results: Out of a total of 104 cirrhotic patients, 28 (26.9%) were diagnosed with SBP. Alcohol was the most common etiological factor, followed by hepatitis C infection. Among the SBP patients, the most common presentation was culture-negative neutrocytic ascites (71.4%), followed by classical SBP (17.8%), then mono bacterial non neutrocytic bacterascites MNB (10.7%). Among the symptoms, the most common was abdominal distension, followed by icterus, pedal edema, and abdominal pain. Majority of the patients belonged to Child–Pugh’s Grade C. Of 28 cases of SBP, 8 were culture positive. Gram-negative isolates were predominant (75%) and Escherichia coli were the most common isolate. Interpretation and Conclusion: The prevalence of SBP in cirrhotic patients was 26.9%, and Gram-negative isolates were predominant. Ascitic fluid culture and susceptibility testing can lead to accurate diagnosis of SBP and can guide for treatment as resistance to antibiotics is common.

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A Clinical Study of Spontaneous Bacterial Peritonitis in Cirrhosis of Liver With Ascites in Teritiary Care Hospital

Cited by 2 publications

References 9 publications

Prevalence of Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascites and Its Pattern in Aswan University Hospital

Prevalence of Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascites and Its Pattern in Aswan University Hospital

A Study of Spontaneous Bacterial Peritonitis in Cirrhosis of Liver with Ascites at a Tertiary Care Hospital in North India: Prevalence, Clinical, and Microbiological Profile

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