BACTERIOLOGY OF SPONTANEOUS BACTERIAL PERITONITIS

Abstract

Cirrhosis is a major cause of mortality worldwide and is the most common non neoplastic cause of
death among hepatobiliary and digestive diseases. Ascites is often among the first signs of de-compensation in patients
with chronic liver disease. Spontaneous Bacterial Peritonitis (SBP) (with out any source of infection) occurs in 30% of
patients with ascites. Common causative organisms include escherichia coli, pneumococcus, Klebsiella and anaerobes.
It has a 25% mortality and recurs in 70% of patients within a year. Objective: To determine the pathological agents
causing SBP in patients with liver cirrhosis. Design: Descriptive study. Setting: Medical Ward Allied and K.M. Hospitals
Faisalabad. Period: From 17 Nov 2004 to 15 May 2005. Patients & Materials. Fifty patients of either sex having
cirrhosis of liver and ascites were included according to the criteria i.e ascitic fluid leukocyte count of >500 cells/L or
>250 PMN, while results of bacterial cultures of ascitic fluid were pending. Results: Out of 50 patients, 27 (54%) were
males and 23 (46%) females. Mean age of whole the population was found to be 51±12.49) yrs. Classical spontaneous
bacterial peritonitis was present in 27 patients and Culture Negative Neutrocytic Ascites (CNNA) in 23(46%) patients.
Out of 50 patients, 27(54%) samples of ascitic fluid showed positive culture reports. E Coli was isolated in 9(18%)
cases. Klebsiella pneumoniae in 6(12%), streptococcus pneumoniae 4(8%), staphylococcus aureus 2(4%),
pseudomonas aeruginosa 2(4%). Acinobacter 2(4%) and proteus mirabilis 2(4%). E.Coli is the commonest organism
followed by klebsiella pneumoniae.