Spontaneous Bacterial Peritonitis: Frequency and Microbial Spectrum in a Tertiary Care Centre

Abstract

Objective: To determine the frequency and microbial spectrum of spontaneous bacterial peritonitis ( SBP) in a tertiary care center. Study Design: Descriptive study. Place & Duration: Department of medicine, Peoples University of Medical & Health Sciences, Nawabshah, from January 2013 to December 2015. Material & Methods: A total of 102 already diagnosed patients of cirrhosis of liver with ascites presenting with suspicion of SBP, admitted in all the medical units were included. After informed consent the demographic data of all the patients was collected on a proforma designed for that purpose. About 20-30m1 of fluid was aspirated from each patient, 10 ml of ascitic fluid was immediately inoculated into blood culture bottle at the bed side and sent to the pathology department for bacterial culture, the remaining fluid was sent for detailed report. The subcultures were made from these bottles on blood agar and McConkey's agar plates, the organisms were identified according to morphology of grown colonies and biochemical tests, the organism thus isolated was noted on the respective proforma of the patient. The data collected was tabulated and statistically analyzed. Results: Among the study population 53 (52%) were male and 49 (48%) were female, with ratio 1:1.08. The age ranged from 15 to 70 years (mean 53 ±13).Majority of patients were in group 41-50 years.27 (26.5%) were diagnosed as SBP or its variant and remaining cases were having sterile ascites. From 27 cases of SBP, majority (63%) of cases were belongs to culture negative neutrocytic ascites (CNNA). The positive culture was seen in 10 cases, comprising 9 (33.3%) cases in classic SBP and one (3.7%) case in bacterascites. The Escherichia coli was detected in majority of cases. Conclusion: SBP and its variants were found a common complication of liver cirrhosis, which is prevalent in 26.5% of cases. Escherichia coli was detected the most offending pathogen in these cases.