A Study of Prevalence of Asymptomatic Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascites

Abstract

Abstract:Objectives: To detect the prevalence of asymptomatic Spontaneous Bacterial Peritonitis in Cirrhotic patients with ascites and treat them prior to complication. Study design: Observation study. Place and duration of study: Coimbatore medical college hospital, from July 2014 to July 2015. Methodology: consecutive patients admitted with ascites in the medical and gastroenterology wards for ascites. Results: Of the 50 patients, only 8 of the patients were found to have SBP (16%). Among the study members, about 40 % were non alcoholics and 60 % were alcoholics. 60% of my study population had cirrhosis for more than 5 years and 40 % had cirrhosis for less than 5 years. The ascitic fluid analysis was like only around 5 of the population had cells more than 250 / cu.mm. Culture study trend was like around 12 % of the patients were culture positive. Among the organisms studied, the majority was E. coli and the others were Streptococcus and Klebsiella. The Child Pugh scoring was calculated as per the criteria mentioned earlier and the majority came under Class B, followed by Class A and the least by Class C. There is a correlation between the ascitic fluid and the incidence of SBP. A low protein level of less than 1 g/dl has strong predilection for contracting SBP. The ascitic fluid protein level was correlated with the incidence of SBP and it was also found significant at p < 0.05. Conclusion: Prevalence of asymptomatic SBP is very low at 16%. There is also a strong correlation between low ascitic fluid protein level (<1g/dl) and SBP.