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Asymptomatic Spontaneous Bacterial Peritonitis in Adult Egyptian Patients with Decompensated Liver Cirrhosis: A Prospective Cohort Study |
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PP: 5-09 |
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Author(s) |
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Abdelhalim Assem Elsherif,
Magdy Abdelkarim Eldahshan,
Mohammed Salah Hussein,
Assem Mahmoud Mohamed,
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Abstract |
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| Spontaneous bacterial peritonitis (SBP) is an infection of the previously sterile ascitic fluid, without any apparent
intra-abdominal source of infection. SBP is the most frequent bacterial infection in cirrhosis, accounting for 10-30% of all
reported bacterial infections in hospitalized patients. We aimed to determine the frequency of SBP in asymptomatic
cirrhotic patients with ascites and to assess the common causative Organisms responsible for the development of SBP and
its variants in decompensated cirrhotic Egyptian Patients. We prospectively enrolled 720 cirrhotic patients who admitted to
the Tropical Medicine Department, Al-Hussein University Hospitals, Al Azhar University, Cairo, Egypt over a period of
six months from June 2014 to December 2014, only one hundred and sixty (160) adult decompensated cirrhotic patients
with ascites and without symptoms suggestive of SBP were included in the study. Out of 160 cirrhotic patients with ascites,
only 21(13%) patients fulfill criteria of having ascetic fluid infection including 3cases have SBP (PMNs count ≥ 250
cells/mm3 and positive ascetic fluid culture), 16 cases (76.1%) have Monomicrobial non neutrocyticbacterascites (MNB)
(PMNs < 250 cells/mm3 and Positive ascetic fluid culture) and only 2 cases (9.5%) have Culture negative neutrocytic
ascites (CNNA) (PMNs count ≥ 250 cells/mm3 and Negative ascetic fluid culture). Our study concluded that the
prevalence of SBP in asymptomatic patients with liver cirrhosis and ascites is low and serum ESR level could be used as a
predictor of SBP episode in the studied group of patients. Bacterial culture & sensitivity of ascetic fluid were
predominantly resistant to Cefotaxime antibiotic therapy. |
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