Frequency and types of spontaneous bacterial peritonitis in cirrhosis liver due to viral hepatitis-revisited
Keywords:Peritonitis; Liver Cirrhosis; Ascites; Ascitic Fluid; Hepatitis.
OBJECTIVES: To determine the bacterial yield of ascitic fluid cultures in patients with cirrhosis liver with clinical suspicion of spontaneous bacterial peritonitis
MATERIAL AND METHODS: This study was conducted in the Department of Medicine, at Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar from July 2021 to June 2022. Fifty patients with liver cirrhosis suspected of having spontaneous bacterial peritonitis were included in the study. Diagnostic paracentesis was performed at the time of admission before commencing them on appropriate antibiotics. Ascitic fluid was inoculated in culture bottles, Sub cultures were performed, followed by identification of bacteria and their antibiotic sensitivity.
RESULTS: Out of the 50 patients with mean age 48±7.5 years with 27(54%) males and 23 (46%) females, 20 were HBs Ag positive, 28 for Anti HCV and two were positive for both. We observed 29 cases were having SBP. We reported 11(22%) cases of classical SBP, 16(55.17%) of Culture Negative Neutrocytic Ascites and 1 (2%) from the Bactericides group. Escherichia Coli was the commonest organism isolated, followed by Streptococcus.
CONCLUSION: SBP is a common complication of cirrhosis liver with ascites. It is easily overlooked and calls for a high index of suspicion for the diagnosis. Ascitic fluid culture along with the cytology remains the ideal method to effectively diagnose SBP.