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...

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Main Authors: Kavita Paul, Jasmine Kaur, Harbans Lal Kazal
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2015-07-01
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
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author Kavita Paul
Jasmine Kaur
Harbans Lal Kazal
author_facet Kavita Paul
Jasmine Kaur
Harbans Lal Kazal
author_sort Kavita Paul
collection DOAJ
description 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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spelling doaj.art-a900236182e64625b53b5f98752ee8152022-12-22T00:51:15ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2015-07-0197OC09OC1210.7860/JCDR/2015/14855.6191To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with AscitesKavita Paul0Jasmine Kaur1Harbans Lal Kazal2Assistant Professor, Department of Medicine, GGS Medical College & Hospital, Faridkot, Punjab, India.Former Resident, Department of Medicine, GGS Medical College & Hospital, Faridkot, Punjab, India.Professor, Department of Medicine, GGS Medical College & Hospital, Faridkot, Punjab, India.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.https://jcdr.net/articles/PDF/6191/14855_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdfbacterasciteschild-pugh scoreculture negative neutrocytic ascites
spellingShingle Kavita Paul
Jasmine Kaur
Harbans Lal Kazal
To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites
Journal of Clinical and Diagnostic Research
bacterascites
child-pugh score
culture negative neutrocytic ascites
title To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites
title_full To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites
title_fullStr To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites
title_full_unstemmed To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites
title_short To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites
title_sort to study the incidence predictive factors and clinical outcome of spontaneous bacterial peritonitis in patients of cirrhosis with ascites
topic bacterascites
child-pugh score
culture negative neutrocytic ascites
url https://jcdr.net/articles/PDF/6191/14855_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf
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