Bacteriologic study of cirrhotic patients with non-neutrocytic ascites (original) (raw)
Related papers
2018
Objective: Our aim of this research was to investigate the incidence of spontaneous bacterial peritonitis (SBP) in cirrhotic ascites patients. Methods: We completed this particular research on a total of one hundred cirrhotic ascites patients at Bahawal Victoria Hospital Bahawalpur from March to December 2017. History and clinical assessment helped in the study of SBP. The diagnosis was possible through cell PMN count of ascitic fluid (more than 250 / mm 3) OR. There was an absence of primary infection source and positive culturing of ascitic fluid. Results: We reported Cirrhosis after Alcoholism with dominance in the male participants as only 14 females reported against 86 males with a male to female respective proportion 86% and 14%. The only male population had the incidence of SBP. The mean age of patients and SBP diagnosed patients was respectively 49.10 years and 50.58 years. In the total eighteen positive cases of SBP, fourteen had a count of PMN above 250 / mm 3. E. Coli and positive staph aureus were respectively in three and one participants. During the SBP diagnosis research vomiting and fever was among 66% of the SBP diagnosed cases. Every case of abdomen pain and altered sensorium was SBP positive. No fever was in about 2.5% SBP positive cases. During the investigations of SBP associated clinical symptoms, every patient had abdominal tenderness. While making a comparison of positive Child-Pugh grading with an increase in the severity SBP also increased and there were 13 cases out of 18 with a proportion of (85.71%) who had an association with Child-Pugh Class-C; whereas, in Class-B only five cases with a proportion of (7.8%). About forty-four percent cases had a level of Ascitic Fluid Protein under (1 g/dl). The most common type of SBP was CNNA as it was available in fifteen cases (83.3 %). Conclusion: About eighteen percent of cirrhotic ascites patients had the infection of ascitic fluid which was a possible reason for SBP incidence. All the patients who presented general condition deterioration were commonly due to higher liver function derangement as the chances of SBP also increase. Level of Ascitic Protein less than (1 g/dl) in the patients may likely present the incidence of SBP than the patients having AF protein more than (1 g/dl). Cirrhosis severity increases with an increased development of SBP and also with the judged cirrhotic severity with Child-Pugh Class.
Frequency of spontaneous bacterial peritonitis in liver cirrhosis patients with ascites
International journal of health sciences
Background: When cirrhosis and ascites are present, a very common bacterial infection known as spontaneous bacterial peritonitis (SBP) often develops. This condition must be early diagnosed and treated to reduce morbidity and mortality. Objective: To assess the frequency of Spontaneous Bacterial Peritonitis in Liver Cirrhosis patients with Ascites. Methodology: This cross sectional study was carried out at the department of gastroenterology, Lady Reading Hospital Peshawar. The duration of study was two years from January 2018 to December 2019. Spontaneous bacterial peritonitis was diagnosed as positive when the ascitic fluid bacterial culture was positive. Ascitic fluid was taken in aseptic condition and send to the hospital diagnostic laboratory for the culture test. All the information’s were recorded in a proforma designed for this research. Data was analyzed by using SPSS version 24. Results: In the current research, totally 150 liver cirrhosis patients with ascites were enroll...
Kathmandu University medical journal (KUMJ)
Spontaneous bacterial peritonitis (SBP) is one of the potentially lethal complications of cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. Objective was to study the occurrence of SBP, clinical and laboratory characteristics and the response to antibiotics. We had prospectively evaluated 81 cirrhotic patients with ascites during one-year period. All SBP patients were treated with cefotaxime, 2gm IV, every 12h for 5days. Of these 81 patients, 24.67% of patients (n=20) had SBP and its variants (classical SBP n= 4, CNNA n=13 and bacterascites n=3). There were thirteen males and 7 females in the study.85% of the cases had Child;s class C cirrhosis. UGI bleeding and abdominal pain were the most common presenting symptoms of SBP. Culture positives were 35% (n=7). The most frequent organisms were Escherichia coli (n=3) and Streptococcus pneumoniae (n=2). 94% of the patients responded to therapy after 48 hours of treatment. Total ...
EC Gastroenterology and Digestive System, 2021
Spontaneous bacterial peritonitis (SBP) is a serious and frequent complication of cirrhosis. The aim of our study was to assess the predictive factors of recurrence and mortality after a first episode of SBP. We perform a retrospective monocentric study, in Gastroenterology department of Sahloul Hospital, Sousse-Tunisia. we include all patients with first SBP episode in a cirrhosis wich defined by the presence of more than 250 neutrophils/mm 3 in ascitic fluid. Secondary peritonitis and positive culture of ascitic fluid and neutrophils < 250/mm3 were excluded from this study including 49 cirrhotic patients with first episode of SBP between January 2005 and December 2015.they were 32 men and 17 women, with a mean age of 58 years old. Virus B hepatitis was the most frequent etiology of cirrhosis (57%). Fever (69%) and abdominal (67%) were the most revealing symptoms of SBP. Thirty five patients were Child C cirrhosis. Renal impairment was observed in one third of patients. A germ was identified in ascitic fluid in 18% of cases. For treatment, Cefotaxime was prescribed in most cases (87%). 30-day mortality rate was 16%. The principle predictive factors of mortality were: sepsis, creatinine level > 120 micmol/l, Prothrombin time < 40% and hyperkalemia (> 5 mmol/l). Predictive factors of recurrence of SBP after first episode were: Absence of antibioprophylaxis and protein levels in ascitic fluid < 10 g/l. During the course of cirrhosis, 10% of patients developed hepatorenal syndrome and 24% had and hepatocellular carcinoma (HCC). Overall 5-year survival rate after first episode of SBP was 44%.
Journal of Medical Microbiology, 2008
The detection of bacterial DNA in serum and ascitic fluid (AF) from patients with liver cirrhosis and ascites is interpreted as molecular evidence of intestinal bacterial translocation (BT) and considered sufficient to activate the cellular immune response leading to greater cytokine synthesis. We studied 34 patients with liver cirrhosis and culture-negative, non-neutrocytic ascites [22 patients without bacterial DNA (group I) and 12 patients with bacterial DNA (group II)]. History and clinical examination were done with the following investigations at first admission and followed up for 24 weeks: serum and AF tumour necrosis factor-alpha (TNF-a), AF polymorphonuclear leukocytes, AF cultivation and detection of blood and AF bacterial DNA. Serum and AF TNF-a were significantly higher in patients with bacterial DNA compared to those without bacterial DNA at first admission [54.5±22.56 vs 35.2±17.97 pg ml "1 (P50.02) and 123.2±49.32 vs 82.6±29.58 pg ml "1 (P ,0.005), respectively]. These changes became highly significant at the end of follow-up of both groups [119.3±27.19 vs 40.2±16.08 pg ml "1 (P ,0.001) and 518.8±91.11 vs 97.6±17.81 pg ml "1 (P ,0.001), respectively]. In group II, there was a significant increase in serum and AF TNF-a at the end of follow-up compared to at first admission (P ,0.001). The relative risk of death, hepatorenal syndrome (HRS) and spontaneous bacterial peritonitis (SBP) was higher in patients with bacterial DNA compared to those without bacterial DNA. We conclude that cirrhotic patients with culture-negative, nonneutrocytic ascites and bacterial DNA have a significantly higher level of serum and AF TNF-a and higher risk of HRS, SBP and mortality compared to those without bacterial DNA, suggesting that bacterial DNA and TNF-a are implicated in these complications of liver cirrhosis.
A Profile of Spontaneous Bacterial Peritonitis and Its Variants in Cases of Liver Cirrhosis
2017
notorious for its high recurrence rates and is frequently associated with short term as well as long term mortality in the affected patients. Objective: To analyse the incidence, clinical and bacteriological profile of patients with spontaneous bacterial peritonitis or its variants such as culture negative neutrocytic ascites and bacterascites in cases of liver cirrhosis. Patients with SBP or its variants were compared to patients with Non SBP Ascites in order to assess the predictive factors for the development of SBP or its variants and thereby relate the in hospital mortality in these patients with various possible parameters. Methods: The present study was a prospective, cross sectional, comparative study conducted among 60 patients with ascites due to liver cirrhosis fulfilling the proposed inclusion and exclusion criteria, admitted at MGM Medical College and Hospital, Navi Mumbai, between November 2014 and November 2016. Ascitic fluid routine and culture analysis with antibiot...