A Study on Clinical and Laboratory Features of Spontaneous Bacterial Peritonitis in Chronic Liver Disease

Author Dr Archana Bhat Assistant Professor, Department of Medicine, Fr Mullers College Mangalore India Abstract Objective: To determine the clinical and laboratory features, bacterial profile and antibiotic sensitivity pattern of Spontaneous Bacterial Peritonitis (SBP) in Chronic Liver Disease (CLD) patients presenting at a tertiary care hospital of Goa medical college hospital Study Design: Cross-sectional study. This study was done in department of medicine Goa medical college hospital, Panaji, Goa. Methodology: CLD patients with ascites were recruited from Goa medical college hospital. Basic demographics, symptoms and clinical signs of patients were recorded. Patients with the history of antibiotic use within last 3 days or any intra-abdominal source of infection were excluded. Diagnostic paracentesis was done for ascitic fluid detailed report (D/R) and culture. Blood sample was collected for total leukocyte count, serum proteins and billirubin levels. Results: Out of a total 100 CLD patients, 27 (27%) were diagnosed with SBP, Nine (33.7%) patients presented with classical SBP, 12 (44.4%) had culture negative neutrocytic ascites and 6 (22.2%) had bacterascites. Fever, abdominal tenderness and constipation were common in SBP patients. Ascitic fluid culture was positive in 15 (55.5%) patients. E. coli (63%) was the predominant pathogen followed by Enterococcus species (15%). Resistance was high against cephalosporins (78%) and fluoroquinolones (69.6%) and least against amikacin (13%) and meropenem (12%). Conclusion: Ascitic fluid D/R and culture together can lead to the accurate diagnosis of SBP and can guide for the right antibiotic choice as resistance to commonly prescribed antibiotic is common in such patients.