Title: A Study on Clinical and Laboratory Features of Spontaneous Bacterial Peritonitis in Chronic Liver Disease
Author: Dr Archana Bhat
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.202
Abstract
Objective: To determine the clinical and laboratory features, bacterial profile and antibiotic sensitivity pattern of Spontaneous Bacterial Peritonitis (SBP) in Chronic Liver Disease (CLD) patients presenting at a tertiary care hospital of Goa medical college hospital
Study Design: Cross-sectional study. This study was done in department of medicine Goa medical college hospital, Panaji, Goa.
Methodology: CLD patients with ascites were recruited from Goa medical college hospital. Basic demographics, symptoms and clinical signs of patients were recorded. Patients with the history of antibiotic use within last 3 days or any intra-abdominal source of infection were excluded. Diagnostic paracentesis was done for ascitic fluid detailed report (D/R) and culture. Blood sample was collected for total leukocyte count, serum proteins and billirubin levels.
Results: Out of a total 100 CLD patients, 27 (27%) were diagnosed with SBP, Nine (33.7%) patients presented with classical SBP, 12 (44.4%) had culture negative neutrocytic ascites and 6 (22.2%) had bacterascites. Fever, abdominal tenderness and constipation were common in SBP patients. Ascitic fluid culture was positive in 15 (55.5%) patients. E. coli (63%) was the predominant pathogen followed by Enterococcus species (15%). Resistance was high against cephalosporins (78%) and fluoroquinolones (69.6%) and least against amikacin (13%) and meropenem (12%).
Conclusion: Ascitic fluid D/R and culture together can lead to the accurate diagnosis of SBP and can guide for the right antibiotic choice as resistance to commonly prescribed antibiotic is common in such patients.
Keywords: Chronic liver disease. Spontaneous bacterial peritonitis. Ascitic fluid. CNNA. Bacterascites. SAAG.
