scholarly journals Prospective study of bedside inoculation of blood culture bottles with ascitic fluid versus delayed inoculation for the detection of spontaneous bacterial peritonitis

2017 ◽  
Vol 6 (1) ◽  
pp. 139
Author(s):  
Girish Iyyanna ◽  
Manjunath F. V. ◽  
Taruni Ng
Keyword(s):  
Blood Culture ◽  
Ascitic Fluid ◽  
Bacterial Infections ◽  
Spontaneous Bacterial Peritonitis ◽  
Culture Media ◽  
Positive Culture ◽  
Culture Methods ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Bacterial Yield

Background: Spontaneous bacterial peritonitis (SBP) is the most common bacterial infection in cirrhosis, accounting for 10%-30% of all reported bacterial infections in the patients admitted to hospital. Spontaneous bacterial peritonitis (SBP) is the most frequent and life-threatening infection in patients with liver cirrhosis. All forms of cirrhosis have been reported to be complicated by SBP. A delay in the time period between the collection of the ascitic fluid sample, and its inoculation into the blood culture media, has been one of the reasons implicated to account for low-test positivity. There was lack of studies for comparing the bacterial yield between bedside inoculated blood culture bottles with ascitic fluid over delayed inoculation in the detection of SBP. Hence this study is done to compare the bacterial yield between bedside inoculated blood culture bottles with ascitic fluid over delayed inoculation for the detection of SBP.Methods: Cross sectional study.Results: Maximum number of cases of cirrhosis with ascites with SBP was seen in the age group of 31-40years (54.4%) with mean age of study population being 39.66years, more common in males, bed side inoculation yielded more positive culture reports compared to delayed inoculation and E. coli and klebsilla being the common organisms.Conclusions: Difference between 2 culture methods in isolating organism in SBP cases was not statically significant. But, among culture positive cases, this study demonstrates that bedside inoculation of blood culture bottles is superior to delayed laboratory inoculation.

scholarly journals EVALUATION OF LEUKOCYTE ESTERASE REAGENT STRIPS TEST IN THE DIAGNOSIS OF SPONTANEOUS BACTERIAL PERITONITIS IN CHILDREN WITH CIRRHOSIS

2015 ◽  
Vol 52 (3) ◽  
pp. 195-199 ◽  
Author(s):  
Naser HONAR ◽  
Bita GERAMIZADEH ◽  
Seyed-Mohsen DEHGHANI ◽  
Gholamreza KALVANDI ◽  
Iraj SHAHRAMIAN ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Ascitic Fluid ◽  
Predictive Value ◽  
Spontaneous Bacterial Peritonitis ◽  
Rapid Test ◽  
Dipstick Test ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Strip Test

BackgroundSpontaneous bacterial peritonitis is defined as an ascetic fluid infection without an evident intra-abdominal surgically treatable source. Spontaneous bacterial peritonitis is one of the severe complications in patients with cirrhosis and ascites. Without early antibiotic treatment, this complication is associated with high mortality rate; therefore, early diagnosis and treatment of spontaneous bacterial peritonitis is necessary for survival. Leukocyte esterase reagent can rapidly diagnose the spontaneous bacterial peritonitis.ObjectiveThis study aimed to find out the diagnostic accuracy of leukocyte esterase dipstick test for the diagnosis of spontaneous bacterial peritonitis.MethodsA single centered hospital-based cross-sectional study was conducted during July 2013 to August 2014 on children with cirrhotic liver disease and ascites who were admitted in the Department of Pediatric Gastroenterology in Nemazee Hospital affiliated to Shiraz University of Medical Sciences (Iran). All patients underwent abdominal paracentesis, and the ascitic fluid was processed for cell count, leukocyte esterase reagent strip test (Combiscreen SL10) and culture. Spontaneous bacterial peritonitis was defined as having a polymorphonuclear count (PMN ≥250/m3) in ascitic fluid. Sensitivity, specificity, positive predictive value and negative predictive value of leukocyte esterase test were calculated according to the formula.ResultsTotally, 150 ascitic fluid sample of cirrhotic male patients (53.2%) and their mean age (4.33±1.88 years) were analyzed. Biliary atresia (n=44, 29.4%) and idiopathic neonatal hepatitis (n=29, 19.3%) were the most frequent etiology of cirrhosis. Also, abdominal pain (68.6%) and distension (64%) were the most common presenting complaint. Of all cases, 41patients (27.35%) were diagnosed to have spontaneous bacterial peritonitis (PMN ≥250/mm3). Sensitivity and specificity of leukocyte esterase reagent test according to PMNs ≥250mm3 were 87.80% and 91.74%, also on ascitic fluid culture results were 88.23% and 77.44%. Positive predictive value and negative predictive value of this test in PMNs ≥250mm3 were 80% and 95.23% and in cases with positive culture 33.33% and 98.09% were obtained, respectively. Efficiency of leukocyte esterase reagent test in diagnosing spontaneous bacterial peritonitis, according to PMNs ≥250mm3 and culture results were 90.66% and 78.66%.ConclusionThe leukocyte esterase strip test may be used as rapid test for diagnosis of spontaneous bacterial peritonitis due to its high diagnostic validity.

scholarly journals The pattern of microbial flora in Spontaneous bacterial peritonitis in Cirrhotic patients

2020 ◽  
pp. 62-67
Author(s):  
Sehrish Jahan Asif ◽  
Murataza Gondal ◽  
Shahida Parveen ◽  
Sumera Mushtaq ◽  
Shumaila Awan ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
E Coli ◽  
Bacterial Peritonitis ◽  
Serious Infection ◽  
Culture Sensitivity ◽  
Cirrhotic Patients ◽  
Biochemical Examination

Background: Spontaneous bacterial peritonitis (SBP) is the bacterial infection of ascitic fluid in the absence of other apparent causes. It is the most prevalent and serious infection in cirrhosis and leads to significant morbidity and mortality. The frequency of SBP in hospitalized patients with cirrhosis varies from 7 to 23% in the west and it is around 33% in Pakistan. Our study aim was to determine the frequency of microbial organisms isolated from spontaneous bacterial peritonitis in cirrhotic patients. Material and Methods: We did a cross-sectional study at the Department of Medicine, Fauji Foundation Hospital Rawalpindi for 6 months. Cirrhosis was diagnosed on the bases of clinical, biochemical and ultrasonography findings. Peripheral blood samples were obtained for the evaluation of complete blood cell count, polymorphonuclear leukocyte count, albumin and coagulation parameters. At the same time, the patients underwent paracentesis and a 20ml ascitic fluid sample was taken for culture sensitivity along with routine biochemical examination from the pathology department lab at our hospital. Results: A total of 150 patients were enrolled according to the inclusion criteria of the study. The mean age (yrs) of patients was 32.3+9.31. The frequency and percentages of male and female patients were 70 (46.7) and 80 (53.3) respectively. Frequency and percentages of E Coli and streptococcal pneumonia were 94 (62.7) and 34 (22.7) respectively, whereas frequency and percentages of staph aureus and Klebsiella were 22 (14.7). Conclusion: SBP is quite common in patients with cirrhosis. It should be suspected in all such cases presenting with typical or atypical features. E Coli was the most common causative organisms in our study but gram-positive organisms were quite frequent as well. Keywords: SBP, Cirrhosis, Peritonitis.

scholarly journals SPONTANEOUS BACTERIAL PERITONITIS;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Sana Jafri ◽  
Riaz Hussain Awan ◽  
SEEMA Nayab ◽  
Khadim Hussain Awan
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Cross Sectional Study ◽  
Total Leukocyte Count ◽  
Total Leucocyte Count ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Patient’S Information ◽  
Culture Positive ◽  
Culture Negative

Objectives: To determine the frequency of culture positive (SBP) and culture negative spontaneous bacterial peritonitis (neutrocytic ascites) in cirrhotic population. Period: The six months (November 08th 2012 to May 07th 2013). Study Design: Descriptive cross-sectional study. Setting: Department of Gastroenterology at Liaquat National Hospital. Total 107 patients of liver cirrhosis with ascites admitted in our hospital. All the specific patients had ascitic fluid DR and C/S were enrolled and evaluated. Patient’s information was recorded on proforma and analyzed by using SPSS-20.0. Results: SBP was detected in 10 7 patients aged between 18 and 67 years included in study. Out of 107 patients with SBP 23 (21.5%) were culture positive while 84 (78.5%) were culture negative. In the culture positive group,19 (82.6%) were male and 4 (17.4%) were female while in culture negative group 46 (54.76%) were male and 38 (45.24%) were female. The ascitic fluid mean total leukocyte count in patients with culture positive ascites was 5140.39 /mm3 and in culture negative ascites was 2654.26 / mm3. The ascitic fluid mean neutrophils count in subjects with culture positive ascites was 75.57% and in culture negative ascites was 76.02%. The ascitic fluid mean lymphocyte count in individuals had culture positive ascites was 26.09 % and in subjects had culture negative ascites was 23.97%. Conclusion: Frequency of culture negative ascites is greater than culture positive ascites in SBP. The ascitic fluid mean total leucocyte count for culture positive ascites is greater than culture negative ascites. Mortality is high in culture positive ascites.

scholarly journals Evaluation of Serum Presepsin in the Diagnosis and the Prognosis of Cirrhotic Patients with Ascites

2021 ◽  
pp. 62-69
Author(s):  
Aziza Mohamed Hamed Zian ◽  
Mervat Abd El-Hameed Elkhateeb ◽  
Amira Youssef Ahmed ◽  
AL Zahraa Abd El-Azeam Allam
Keyword(s):  
Internal Medicine ◽  
Bacterial Infections ◽  
Spontaneous Bacterial Peritonitis ◽  
Hepatorenal Syndrome ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Clinical Value ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

Background: Liver cirrhosis is a serious problem associated with spontaneous bacterial peritonitis and renal dysfunction. Presepsin is a soluble Cluster of Differentiation 14 (CD14) Protein subtype that has been implicated as an important biomarker in many diseases. Objective: To assess the clinical value of presepsin as a diagnostic and prognostic marker for spontaneous bacterial peritonitis in cirrhotic patients.  Patients and Methods: This cross-sectional study was carried out on 60 cirrhotic patients with ascites. The data were collected from Internal Medicine Hospital Inward and ICUs of Internal Medicine. Results: Serum presepesin had a significant negative correlation with serum albumin (rs = -0.350, p = 0.006) and a significant positive correlation with platelet count (rs =0.547, p < 0.001). In the Spontaneous bacterial peritonitis (SBP) group, presepesin correlated significantly positively with total leukocytic count (rs =0.547, p < 0.001). The level of serum presepsin significantly increased with the group suffering from Hepatorenal syndrome (HRS) than the ascites group after adjusting for age, C-reactive Protein (CRP) level, and total leukocytic count. Similarly, the level of serum presepsin significantly increased with the SBP group than the ascites group after adjusting for age, CRP level, and total leukocytic count. Conclusion: presepsin is a promising biomarker in the diagnosis of bacterial infections and hepatorenal syndrome in cirrhosis. However, the diagnostic and prognostic value of presepsin needs further studies.

scholarly journals BACTERIOLOGY OF SPONTANEOUS BACTERIAL PERITONITIS

2020 ◽  
Vol 14 (04) ◽  
pp. 551-555
Author(s):  
DILSHAD MUHAMMAD ◽  
Aamir Husain ◽  
MASOOD JAVED ◽  
Abdul Qayyum ◽  
MUHAMMAD NAEEM IQBAL
Keyword(s):  
Klebsiella Pneumoniae ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Positive Culture ◽  
E Coli ◽  
Bacterial Peritonitis ◽  
Source Of Infection ◽  
Digestive Diseases ◽  
Study Setting ◽  
Culture Negative

Cirrhosis is a major cause of mortality worldwide and is the most common non neoplastic cause ofdeath among hepatobiliary and digestive diseases. Ascites is often among the first signs of de-compensation in patientswith chronic liver disease. Spontaneous Bacterial Peritonitis (SBP) (with out any source of infection) occurs in 30% ofpatients 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 agentscausing SBP in patients with liver cirrhosis. Design: Descriptive study. Setting: Medical Ward Allied and K.M. HospitalsFaisalabad. Period: From 17 Nov 2004 to 15 May 2005. Patients & Materials. Fifty patients of either sex havingcirrhosis 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%) weremales and 23 (46%) females. Mean age of whole the population was found to be 51±12.49) yrs. Classical spontaneousbacterial 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 organismfollowed by klebsiella pneumoniae.

scholarly journals Spontaneous Bacterial Peritonitis among Cirrhotic Patients: Prevalence, Clinical Characteristics, and Outcomes

2021 ◽  
Vol 11 (1) ◽  
pp. 227
Author(s):  
Naim Abu-Freha ◽  
Tal Michael ◽  
Liat Poupko ◽  
Asia Estis-Deaton ◽  
Muhammad Aasla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Cox Regression ◽  
Positive Culture ◽  
Multidrug Resistant ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
Escherichia Coli Bacteria

(1) Background: Spontaneous bacterial peritonitis (SBP) is a feared complication of liver cirrhosis. We investigated the prevalence of SBP, positive ascitic fluid cultures, and risk factors for mortality. (2) Methods: A retrospective analysis of all patients with cirrhosis hospitalized or in follow-up in a single center between 1996 and 2020. The clinical data, long-term complications, and mortality of SBP patients were compared with those of non-SBP patients. Ascitic fluid positive culture was compared with those without growth. (3) Results: We included 1035 cirrhotic patients, of which 173 (16.7%) developed SBP. Ascitic fluid culture growth was found in 47.4% of the SBP cases, with Escherichia coli bacteria detected in 38%, 24.4% grew ESBL-producing bacteria, and 14.5% displayed multidrug resistance. In a Cox regression model, SBP, male sex, prolonged INR at diagnosis, and hepatocellular carcinoma were found to be risk factors for mortality in cirrhotic patients. The long-term all-cause mortality was 60% in non-SBP and 90% in SBP patients. (4) Conclusions: Only a minority of cirrhotic patients developed SBP, 47.4% of which had positive ascitic fluid cultures with high antibiotic resistance. Growth of ESBL and multidrug resistant organisms is becoming more frequent in the clinical setting, reaching SBP mortality of 90%.

Prevalence of Spontaneous Bacteria Peritonitis in Patients with Hypoalbuminemia and Cirrhosis

2021 ◽  
Vol 15 (9) ◽  
pp. 2943-2947
Author(s):  
Muhammad Siddique ◽  
Muhammad Abdul Quddus ◽  
Tahir Iqbal ◽  
Hefsa Qamar ◽  
Muhammad Ikram Shah ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Bacterial Infections ◽  
Spontaneous Bacterial Peritonitis ◽  
Operational Definition ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Number Of Patients ◽  
Class B ◽  
Pugh Class ◽  
Class C

Background and Aim: Spontaneous bacterial peritonitis (SBP) is one of the most serious complications of ascites, resulting in liver cirrhosis infection, accounting for approximately 25% of all bacterial infections. Within a diagnostic year, the mortality rate for spontaneous bacterial peritonitis ranges from 30% to 90%. The current study attempted to determine the prevalence of spontaneous bacterial peritonitis in patients with hypoalbuminemia and cirrhosis. Materials and Methods: This cross-sectional study was conducted on 112 cirrhosis with hypoalbuminemia patients at Medical Unit A, Hayatabad Medical Complex Peshawar and department of Gastroenterology AK CMH / Sheikh Khalifa bin Zaid Al Nahyan Hospital, Rawalakot Azad Kashmir. The duration of the study was six months from 5th January 2021 to 5th June 2021. All patients of either gender with liver cirrhosis and hypoalbuminemia aged 20 to 60 years were included in the study. Each individual was asked to provide written informed consent. Each patient's creatinine, albumin, and sodium levels were measured in the laboratory using urine and blood sample tests. Each patient's absence or presence of SBP was recorded according to the operational definition. For data analysis, SPSS version 20 was used. Results: Of the total 112 patients, 59 (52.7%) were male and 53 (473%) were female. The overall mean age of the patients was 43.51±4.58 years whereas male and female patients had 47.36±5.62 and 39.66±3.54 years respectively. The number of patients falling in class B and Child Push class C was 50 (44.6%) and 62 (55.4%) respectively. The prevalence of spontaneous bacterial peritonitis was 48 (42.9%). Out of 48 SBP patients, 29 (60.4%) were male and 19 (39.6%) were female. The prevalence of SBP was seen in 13 (27.1%) cases of Class B and 35 (72.9%) of Class C (Child-Pugh Class) respectively. Hypertension and diabetes mellitus as comorbidities were present in 11 (9.8%) and 25 (22.3%) cases respectively. Conclusion: In the current study, the prevalence of SBP was 42.9%. Our study revealed a higher prevalence of spontaneous bacterial peritonitis in cirrhosis patients. Also, a significant association has been found between spontaneous bacterial peritonitis and child Pugh Class C and Class B whereas SBP had no substantial connotation with gender, etiology, and even age but with disease duration. Keywords: Cirrhosis; Spontaneous Bacterial Peritonitis; Hypoalbuminemia

Sign in / Sign up

Export Citation Format

Share Document