Prevalence of culture negative ascitic fluid infection among patients with chronic liver disease.

Abstract

Objectives: To determine prevalence of patients with chronic liver disease having culture negative ascitic fluid infection. Study Design: Cross sectional study. Setting: Gastroenterology and medicine ward of DHQ Teaching Hospital Gujranwala. Period: January 2018 August 2018 having total duration of 8 months. Material & Methods: All patients irrespective of age and gender, having ascites due to chronic liver disease and showing signs and symptoms of ascitic fluid infection like fever, abdominal pain and tenderness, admitted in the medical unit of study hospital underwent ascitic tap and fluid was sent for culture examination to the hospital laboratory. Patients with chronic liver disease having no bacterial growth found on culture of ascitic fluid were placed in one group and who had culture positive ascites were placed in separate group. Patients who have taken any antibiotic in last one month or having any intra abdominal source of infection were excluded from the study. All cases in study group were already diagnosed with CLD. Results: There were 160 cases included in this study having chronic liver disease and ascitic fluid infection with 62.5% male and 37.5% female cases. Out of 160 cases, 22.5% were having culture positive ascites while 77.5% cases were having culture negative ascites among them 61% were male and 39% were female in positive group and 62.9% were male and 37.1% were female cases in negative group. Age range of patients was 25-75 years with mean age of 50±25 years. Mean duration of chronic liver disease was 9.5±2.4 months with minimum duration of 6 months and maximum duration of 15 months. There were 72.6% cases with culture negative ascites and 69.4% with positive culture were having age above 45 years. There was majority of male patients (62.9%) having culture negative ascites due to CLD. Conclusion: Ascitic fluid infection among patients with chronic liver disease is usually culture negative. In our study prevalence of culture negative ascitic flud infection was 77.5%, more common among male patients having age above 45 years.