Bacteriology of spontaneous bacterial peritonitis

ABSTRACT

Cirrhosis is a major cause of mortality worldwide and is the most common non neoplastic cause of death among hepatobiliary and digestive diseases. Ascites is often among the first signs of de-compensation in patients with chronic liver disease. Spontaneous Bacterial Peritonitis [SBP] [with out any source of infection] occurs in 30% of patients with ascites. Common causative organisms include escherichia coli, pneumococcus, Klebsiella and anaerobes. It has a 25% mortality and recurs in 70% of patients within a year. To determine the pathological agents causing SBP in patients with liver cirrhosis. Descriptive study. Medical Ward Allied and K.M. Hospitals Faisalabad. From 17 Nov 2004 to 15 May 2005. Fifty patients of either sex having cirrhosis of liver and ascites were included according to the criteria i.e ascitic fluid leukocyte count of >500 cells/L or >250 PMN, while results of bacterial cultures of ascitic fluid were pending. Out of 5 0 patients, 27 [54%] were males and 23 [46%] females. Mean age of whole the population was found to be 51 +/- 12.49] yrs. Classical spontaneous bacterial peritonitis was present in 27 patients and Culture Negative Neutrocytic Ascites [CN NA] in 23[46%] patients. Out of 50 patients, 27[54%] samples of ascitic fluid showed positive culture reports. E Coli was isolated in 9[18%] cases. Klebsiella pneumoniae in 6 [12%], streptococcus pneumoniae 4 [8%], staphylococcus aureus 2 [4%], pseudomonas aeruginosa 2 [4%]. Acinobacter 2 [4%] and proteus mirabilis 2 [4%]. E. Coli is the commonest organism followed by klebsiella pneumoniae