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

Abstract

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.

Bacteriological Profile and Antimicrobial Resistance in Ascitic Fluid of Patients with Community Acquired and Nosocomial Spontaneous Bacterial Peritonitis

“…The prevalence of SBP in this study was nearly similar to that reported by different local studies in Egypt as it was 57% in Kasr Alaini [27], 50% [28] and 76.7% [29] by two different studies in Mansoura, 56.1% in Zagazig [24] and 62% in Aswan [30]. While other Egyptian studies reported a lower prevalence of SBP as it was 13% in Al-Hussein University hospital [31], 31% in Sohag [32], 44.3% in Assuit [33], 31% in Ain Shams [34], 19.6% in Menoufia [35],…”

Ascitic Fluid Micro RNA 155 as a Biomarker for Spontaneous Bacterial Peritonitis

“…That result was agreed by Oladimeji et al 26 while, Hafez et al . 3 found only 40.3% of patients had culture-positive ascitic fluid. This may be due to different culture methods .Our study found that there was 1 case of bactascitis., Hafez et al 3) found that 6 patients (9.7% of SBP patients) were bacterascites.…”

“…2 It is usually monomicrobial infection and majority of cases are caused by enteric gram-negative organisms, mostly Escherichia coli. 3 The gold standard test to diagnose SBP is a polymorphonuclear neutrophil count of ≥ 250/μl in ascitic fluid using a manual counting chamber, regardless of the outcome of ascitic fluid culture 4. In the past two decades, several studies have examined the bedside diagnosis of SBP such as the use of leukocyte esterase reagent strips 5. The concentration of C reactive protein (CRP) in serum has been found to be helpful in the diagnosis and management of patients with a wide variety of inflammatory conditions.…”

Is Vitamin D Deficiency a Risk Factor for Spontaneous Bacterial Peritonitis?

“…SBP is an AF infection that develops on its own when there is no intra-abdominal infection source. SBP is present in 1.5-3.5% of cirrhotic patients with ascites and around 10-30% of hospitalised patients [9] . The 1year survival rate with SBP is just 30-40%, and the death rate is significant, ranging from 20 to 30% [10] .…”