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 Diagnostic value of serum procalcitonin level in the diagnosis of the spontaneous bacterial peritonitis

2020 ◽  
Vol 6 (2) ◽  
pp. e19-e19
Author(s):  
Rasoul Estakhri ◽  
Lachin Bartari ◽  
Morteza Ghojazadeh
Keyword(s):  
Ascitic Fluid ◽  
Sensitivity And Specificity ◽  
Spontaneous Bacterial Peritonitis ◽  
White Blood Cells ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

Introduction: Spontaneous bacterial peritonitis (SBP) is an infectious ascitic fluid with an unknown intraabdominal source. Rapid diagnosis of infection can improve prognosis in cirrhotic patients. Objectives: We aim to determine the diagnostic value of serum procalcitonin (PCT) and C-reactive protein (CRP) in SBP. Patients and Methods: In this cross-sectional study, we included 120 cirrhotic patients with possible diagnosis of SBP asities. Serum and ascitic fluid samples were taken from the patient before initiating antibiotics. The ascitic fluid parameters, serum levels of CRP, PCT and white blood cells were measured and the diagnostic value of the CRP and PCT were evaluated. Results: Of 120 patients, 59.16% had confirmed SBP. PCT with a cutoff of 0.8 ng/mL and CRP with cutoff of 10.5 mg/L had a sensitivity of 90.91% and 86.11% and specificity of 91.5% and 81.25% respectively in diagnosing of SBP. Considering PCT above 0.8 ng/mL and CRP above 10.5 mg/L both, they had the sensitivity and specificity of 96.87% and 83.92% in detecting SBP in cirrhotic patients. Conclusion: Serum PCT and CRP levels could predict SBP in cirrhotic patients while PCT had the most sensitivity and specificity. Considering both parameters, the sensitivity will increase, but the specificity is decreasing. Both PCT and CRP levels could be used as a less invasive method compared to ascites fluid analysis in diagnosing SBP.

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 Spontaneous Bacterial Peritonitis and Short-Term Prognosis in a Group of Decompensated Cirrhotic Patients in Yaounde: A Cross-Sectional Study

2020 ◽  
Vol 10 (08) ◽  
pp. 203-213
Author(s):  
Mathurin Pierre Kowo ◽  
Sylvain Raoul Simeni Njonnou ◽  
Nelly Karelle Weyou Noubissi ◽  
Firmin Ankouane Andoulo ◽  
Gabin Ulrich Kenfack ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Short Term ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

scholarly journals SPONTANEOUS BACTERIAL PERITONITIS

2006 ◽  
Vol 13 (02) ◽  
pp. 201-205
Author(s):  
MUHAMMAD IMRAN ◽  
Haroon-ur- Rashid ◽  
SHOAIB NAIYAR HASHMI ◽  
Assawar Hussain ◽  
ASHFAQ ALTAF
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Military Hospital ◽  
Routine Examination ◽  
E Coli ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Culture Positive ◽  
Culture Negative

Objective: To evaluate the prevalence, diagnostic criteria and microbialspectrum of spontaneous bacterial peritonitis (SBP) and its variants in cirrhotic patients with ascites. Design: A hospitalbased prospective study carried out in cirrhotic patients with ascites. Place and duration of Study: The study wasconducted in the Department of Medicine Military Hospital Rawalpindi during October 2000 to March 2002. Subjectand Methods: One hundred and eighty consecutive patients of cirrhotic liver between the ages of 20-65 yearspresenting with ascites reporting to outdoor patient department of Military Hospital Rawalpindi were included in thestudy. The diagnosis of cirrhosis was made on history, clinical examination and the ultrasonographic findings. Thesepatients were subjected to ascites fluid tap and the patients were divided into SBP and non-SBP groups in the light ofresults of ascitic fluid routine examination and culture. The SBP group was further categorized into culture positive SBP,culture negative neutrocytic ascites (CNNA) and bacterascites (BA) on the basis of culture results and total leukocytecount, absolute polymorphonuclear leukocyte count per cubic mm of ascitic fluid. Results: The study included 144males and 36 females having cirrhosis with ascites. The mean age of these patients was 52.32±7.87 years. On thebasis of routine examination and culture of tapped ascitic fluid from these cases 57 of 180(31.66%) patients werediagnosed to have SBP or its variants. In addition to classic SBP in 18(31.58%) patients, its variants namely culturenegative neutrocytic ascites and bacterascites were detected in 37(64.92%) and two (3.5%) cases respectively. E. coliwas the most frequently cultured organism. It was isolated in 12 cases of SBP (60%). In 4 cases (20%) Klebsiella wascultured whereas Proteus mirabilus and Streptococcus were reported in two cases (10%) each. Conclusion: This studyindicates that spontaneous bacterial peritonitis is common and potentially fatal complication in cirrhotic patients withascites. E. coli is the most frequent offending organism.

SAT-009-Pharmacokinetics of ertapenem in plasma and ascitic fluid in cirrhotic patients with spontaneous bacterial peritonitis

2019 ◽  
Vol 70 (1) ◽  
pp. e628-e629
Author(s):  
Alberto Amador ◽  
Sara Cobo ◽  
Ariadna Padulles ◽  
Raul Rigo ◽  
Inmaculada Grau ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

scholarly journals High Prevalence of Multidrug Resistant Bacteria in Cirrhotic Patients with Spontaneous Bacterial Peritonitis: Is It Time to Change the Standard Antimicrobial Approach?

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Jerônimo De Conto Oliveira ◽  
Enrique Carrera ◽  
Roberta C. Petry ◽  
Caroline Deutschendorf ◽  
Augusto Mantovani ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Bacterial Peritonitis ◽  
High Prevalence ◽  
Cirrhotic Patients ◽  
End Stage

Introduction. Spontaneous bacterial peritonitis (SBP) has a deleterious clinical impact in end-stage liver disease, and multidrug resistance has increased, raising concern about effectiveness of traditional antibiotic regimens. Patients and Methods. Single-center retrospective study of ascitic fluid infections in cirrhotic patients. Results. We analyzed medical records related to 2129 culture-positive ascitic fluid and found 183 samples from cirrhotic patients. There were 113 monobacterial SBP cases from 97 cirrhotic patients; 57% of patients were male; hepatitis C and alcohol were the main etiologies for cirrhosis. Multidrug resistant bacteria were isolated in 46.9% of SBP samples, and third-generation cephalosporin and quinolone resistant reached 38.9% and 25.7% of SBP cases. Conclusion. SBP due to multidrug resistant bacteria is a growing problem, and one should consider reported resistance profiles for the decision-making process of empirical first-line treatment prescription.

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 Human Amnion-Derived Mesenchymal Stromal Cells in Cirrhotic Patients with Refractory Ascites: A Possible Anti-Inflammatory Therapy for Preventing Spontaneous Bacterial Peritonitis

2021 ◽  
Author(s):  
Mariangela Pampalone ◽  
Simona Corrao ◽  
Giandomenico Amico ◽  
Giampiero Vitale ◽  
Rossella Alduino ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Spontaneous Bacterial Peritonitis ◽  
Refractory Ascites ◽  
M2 Macrophage ◽  
Human Amnion ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
Anti Inflammatory

AbstractCirrhosis is associated with dysregulated immune cell activation and immune dysfunction. These conditions modify gut flora, facilitate bacterial translocation, and increase susceptibility to bacterial peritonitis and consequent systemic infections by dramatically affecting long-term patient survival. Human amnion-derived mesenchymal stromal cells (hA-MSCs) exert immunomodulatory potential benefit, and have the ability to modulate their actions, especially in situations requiring immune activation through mechanisms not fully understood. In this study, we aimed to investigate, in vitro, the immunostimulant or immunosuppressive effects of hA-MSCs on cellular components of ascitic fluid obtained from cirrhotic patients with refractory ascites. We found that hA-MSCs viability is not affected by ascitic fluid and, interestingly, hA-MSCs diminished the pro-inflammatory cytokine production, and promoted anti-inflammatory M2 macrophage polarization. Moreover, we found that there was no simultaneous significant decrease in the M1-like component, allowing a continual phagocytosis activity of macrophages and NK cells to restore a physiological condition. These data highlight the plasticity of hA-MSCs’ immunomodulatory capacity, and pave the way to further understanding their role in conditions such as spontaneous bacterial peritonitis. Graphical abstract

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