A study of Ascitic Fluid of Cirrhotic patients with Spontaneous Bacterial Peritonitis; common microorganisms and their antibiotic Senstivity

Abstract

Background: Spontaneous bacterial peritonitis (SBP) is an acute infection of otherwise sterile ascitic fluid in patients with decompensated liver cirrhosis. Gram negative bacteria are considered the main causative microorganisms of SBP. However, widespread use of antibiotics in cirrhotic patients has changed the microbial spectrum and the sensitivity patterns. Aim: To determine the frequency of different microorganisms and their sensitivity patterns in ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis and to see the impact of age, gender and duration of SBP on these patterns. Study design and duration: It was a prospective observational study conducted at Fatima Memorial Hospital, Lahore from December 2015 to December 2016. Methods: A total of 200 patients with clinical suspicion of SBP were enrolled in the study. Ascitic fluid sample was obtained within 6 hours of hospitalization and was sent to hospital laboratory. Culture reports were reviewed to determine the frequency of different microorganism as well as their sensitivity patterns to different antibiotics. Results: Out of 200 patients, the culture was positive in 113(56.53%) patients. Escherichia coli was seen in 35 (31.2%) patients, Acinobacter Spp was present in 18 (15.3%), Streptococcus in 15 (13.4%), Enterococcus in 14 (12.1%), Staphylococcus aureus in 13 (11.4%), MRSA in 12 (10.8%), and K. Pneumonia in 6 (5.7%) patients. Ceftazidime was sensitive in 73 (64.9%) cases, Cefotaxime was sensitive in 55 (49%), Ceftriaxone was sensitive in 50 (43.9%), Ciprofloxacin was sensitive in 49 (43.3%), Amikacin was sensitive in 36 (31.8%) Conclusion: The most frequent organism in ascitic fluid of SBP patients was E Coli, and the most sensitive antibiotic was ceftazidime. Keywords: Microbial Spectrum, Sensitivity Pattern,Spontaneous Bacterial Peritonitis (SBP), Ascitic Fluid