Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis: A literature review

Shizuma, Toru

doi:10.4254/wjh.v10.i2.254

Cited by 65 publications

(87 citation statements)

References 156 publications

(360 reference statements)

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“…Culture was positive in 51/259 (19.7%) of the sample; this is lower than the incidences previous reports [ 29 – 32 ]. E. coli , K. pneumoniae , and other Enterobacteriaceae are most likely to cause SBP by bacterial translocation [ 3 ].…”

Section: Discussioncontrasting

confidence: 66%

Combination of PCT, sNFI and dCHC for the diagnosis of ascites infection in cirrhotic patients

Wang

Zhang

et al. 2018

BMC Infect Dis

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BackgroundIt is difficult to diagnose ascites infection early in cirrhotic patients. The present study was to create and evaluate a new bioscore combined with PCT, sNFI and dCHC in the diagnosis of ascites infection in cirrhotic patients.MethodsTwo hundred and fifty-nine consecutive patients were enrolled; of which 51 patients were culture-positive spontaneous bacterial peritonitis (culture-positive SBP) and 58 patients were culture-negative SBP. The efficacy of procalcitonin(PCT), c-reactive protein (CRP), white blood cell (WBC), mean fluorescence intensity of mature neutrophils(sNFI) and difference in hemoglobin concentration between newly formed and mature red blood cells(dCHC) for diagnosing ascites infection was examined. These parameters were used to create a scoring system. The scoring system was analyzed by logistic regression analysis to determine which parameters were statistically different between ascites infection and non-ascites infection patients. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic ability of bioscore for ascites infection.ResultsIn ROC analysis, the area under the curves (AUC) for PCT was 0.852 (95% CI 0.803–0.921, P < 0.001), dCHC 0.837 (95% CI 0.773–0.923, P < 0.001), CRP 0.669 (95% CI 0.610–0.732, P = 0.0624), sNFI 0.838 (95% CI 0.777–0.903, P < 0.001), and WBC 0.624 (95% CI 0.500–0.722, P = 0.0881). Multivariate analysis revealed PCT, dCHC and sNFI to be statistically significant. The combination of these three parameters in the bioscore had an AUC of 0.937 (95% CI 0.901–0.994, P < 0.001). A bioscore of ≥3.40 was considered to be statistically significant in making a positive diagnosis of ascites infection. In different groups of ascites infection, bioscore also shown a high diagnostic value of AUC was 0.947(95% CI 0.882–0.988, P < 0.001) and 0.929 (95% CI 0.869–0.974, P < 0.001) for culture-positive SBP and culture-negative SBP group respectively.ConclusionThe composite markers of combining PCT, dCHC and sNFI could be a valuable diagnostic score to early diagnose ascites infection in patients with cirrhosis.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3308-1) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 66%

Combination of PCT, sNFI and dCHC for the diagnosis of ascites infection in cirrhotic patients

Wang

Zhang

et al. 2018

BMC Infect Dis

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“…This is mostly guided by the prior knowledge of the microbial spectrum in these patient groups. 29 In our study, the mean age of patients was 32.3+9.31 with ranges from 25 to 70 years similar to a study done by D'Amico G et al 30 31 Recognition of risk factors can determine the patients requiring the primary prophylaxis. 32 In addition to the conventional risk factors mentioned above, increased ascetic fluid polymorph (PMN) count is also considered a risk factor for SBP 32 .…”

Section: Discussionsupporting

confidence: 84%

The pattern of microbial flora in Spontaneous bacterial peritonitis in Cirrhotic patients

Asif¹,

Gondal

Parveen³

et al. 2020

JRMC

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Background: Spontaneous bacterial peritonitis (SBP) is the bacterial infection of ascitic fluid in the absence of other apparent causes. It is the most prevalent and serious infection in cirrhosis and leads to significant morbidity and mortality. The frequency of SBP in hospitalized patients with cirrhosis varies from 7 to 23% in the west and it is around 33% in Pakistan. Our study aim was to determine the frequency of microbial organisms isolated from spontaneous bacterial peritonitis in cirrhotic patients. Material and Methods: We did a cross-sectional study at the Department of Medicine, Fauji Foundation Hospital Rawalpindi for 6 months. Cirrhosis was diagnosed on the bases of clinical, biochemical and ultrasonography findings. Peripheral blood samples were obtained for the evaluation of complete blood cell count, polymorphonuclear leukocyte count, albumin and coagulation parameters. At the same time, the patients underwent paracentesis and a 20ml ascitic fluid sample was taken for culture sensitivity along with routine biochemical examination from the pathology department lab at our hospital. Results: A total of 150 patients were enrolled according to the inclusion criteria of the study. The mean age (yrs) of patients was 32.3+9.31. The frequency and percentages of male and female patients were 70 (46.7) and 80 (53.3) respectively. Frequency and percentages of E Coli and streptococcal pneumonia were 94 (62.7) and 34 (22.7) respectively, whereas frequency and percentages of staph aureus and Klebsiella were 22 (14.7). Conclusion: SBP is quite common in patients with cirrhosis. It should be suspected in all such cases presenting with typical or atypical features. E Coli was the most common causative organisms in our study but gram-positive organisms were quite frequent as well. Keywords: SBP, Cirrhosis, Peritonitis.

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“…However, serum procalcitonin is significantly higher, which justifies its use as a primary marker for peritonitis. The usefulness of peritonitic fluid procalcitonin to diagnose primary peritonitis has not been demonstrated (33). Laparoscopic exploration of the peritoneal cavity is the best possible option, as it may exclude a perforation as the cause of a secondary peritonitis and it also allows the bacteriological analysis of the peritoneal liquid.…”

Section: Resultsmentioning

confidence: 99%

Acute Abdomen in Diabetic Patients - What Should We Do?

Doran¹,

Pătraşcu²

2018

chr

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Diabetul zaharat este o afecţiune metabolică bine cunoscută, a cărei incidenţă este în creştere în întreaga lume. Particularităţile anatomo-patologice şi clinice ale multor afecţiuni, inclusiv ale abdomenului acut, sunt modificate semnificativ la pacienţii diabetici, ceea ce impune o strategie terapeutică nuanţată. În principal, două atitudini pot fi eronate, ambele cu efect negativ asupra evoluţiei pacienţilor: o intervenţie chirurgicală întârziată în cazul unei peritonite, datorită aspectului său clinic şi biologic atipic, sau o laparotomie inutilă la un pacient diabetic cu cetoacidoză, ceea ce va agrava suplimentar o stare generală precară. De aceea, pentru a evita confuziile şi erorile diagnostice, utilizarea frecventă a tehnicilor imagistice avansate (TC, RMN) sau explorarea laparoscopică a cavităţii peritoneale se pot dovedi necesare în multe situaţii.

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Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis: A literature review

Cited by 65 publications

References 156 publications

Combination of PCT, sNFI and dCHC for the diagnosis of ascites infection in cirrhotic patients

Combination of PCT, sNFI and dCHC for the diagnosis of ascites infection in cirrhotic patients

The pattern of microbial flora in Spontaneous bacterial peritonitis in Cirrhotic patients

Acute Abdomen in Diabetic Patients - What Should We Do?

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