To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites
Objective: To study the prevalence and predictive factors of spontaneous bacterial peritonitis (SBP) in patients of cirrhosis with ascites and to study the clinical characteristics and prognosis of patients with SBP. Materials and Methods: The present study was conducted on 122 cases admitted i...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/6191/14855_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Objective: To study the prevalence and predictive factors of
spontaneous bacterial peritonitis (SBP) in patients of cirrhosis
with ascites and to study the clinical characteristics and prognosis
of patients with SBP.
Materials and Methods: The present study was conducted
on 122 cases admitted in Department of Medicine, through
emergency, in Guru Gobind Singh Medical College and Hospital,
Faridkot, Punjab, India. Cases of cirrhosis (irrespective of
aetiology) with ascites between the ages of 18-75 years were
included in this study. Ascitic fluid of every patient was aspirated
under all aseptic measures, before initiation of antibiotic therapy
and was sent for biochemical analysis, culture and cytological
analysis.
Results: Mean age of patients enrolled was 50.30± 10.98 years.
85% were male and 15% were female. Alcohol (73.8%) was
the leading cause of cirrhosis followed by HCV (37.7%) and
HBV (4.9%). Of the 122 patients studied, 27 (20.4%) patients
were diagnosed as having SBP and its variants. Monomicrobial
Bacterascites (BA) was present in 5 patients and Culture
Negative Neutrocytic Ascites (CNNA) was present in 22 patients.
Escherichia coli were the most common isolated organism followed
by Klebsiella. The various factors that predispose to development
of SBP include low ascitic fluid protein concentration, a high level
of serum bilirubin, deranged serum creatinine, high Child-Pugh
score and high MELD score.
Conclusion: Ascitic fluid analysis remains the single most
important test for identifying and assessing a course of SBP.
Bedside inoculation of 10-20ml of ascitic fluid into culture bottle
at patient bedside will yield better results. Early diagnosis and
treatment will reduce the mortality rate in these patients. |
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| ISSN: | 2249-782X 0973-709X |