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

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.

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SPONTANEOUS BACTERIAL PERITONITIS

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.02.461 ◽

2018 ◽

Vol 25 (02) ◽

pp. 302-306

Author(s):

Noor Gul ◽

Tahir Habib Rizvi ◽

Memoona Alam

Keyword(s):

Liver Cirrhosis ◽

Frequency Distribution ◽

Spontaneous Bacterial Peritonitis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Bacterial Peritonitis ◽

Medical Wards ◽

Study Setting

Objectives: To record frequency of spontaneous bacterial peritonitis in patientsof liver cirrhosis with low ascitic protein contents. Methodology: This study included 81 patientswith liver cirrhosis with low ascitic proteins level. All the patients were evaluated for the presenceof spontaneous bacterial peritonitis which was described as frequency distribution table. StudyDesign: Cross Sectional Study. Setting: Medical wards of DHQ and Allied Hospitals (PunjabMedical College) Faisalabad. Duration of Study: 11th May 2011 to 10th November 2011.Results: Spontaneous bacterial peritonitis was present among 29 (35.8%) patients and wasnot present among 52 (64.2%) patients. Conclusion: All the patients with low ascitic proteinlevel should be evaluated for the presence of spontaneous bacterial peritonitis and antibioticprophylaxis should be considered.

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

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2031105 ◽

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.

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Clinical and Microbiologic Profile of Spontaneous Bacterial Peritonitis-A Cross-Sectional Study

International Journal of Contemporary Medicine ◽

10.5958/2321-1032.2018.00006.2 ◽

2018 ◽

Vol 6 (1) ◽

pp. 26

Author(s):

Manisha Panchal ◽

Harsha Jivarajani

Keyword(s):

Spontaneous Bacterial Peritonitis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Bacterial Peritonitis

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

Immunopathologia Persa ◽

10.34172/ipp.2020.19 ◽

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.

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Platelet count can predict the grade of esophageal varices in cirrhotic patients: a cross-sectional study

F1000Research ◽

10.12688/f1000research.28005.2 ◽

2021 ◽

Vol 10 ◽

pp. 101

Author(s):

Anum Afsar ◽

Muhammad Nadeem ◽

Syed Asim Ali Shah ◽

Huma Hussain ◽

Aysha Rani ◽

...

Keyword(s):

Platelet Count ◽

Negative Correlation ◽

Esophageal Varices ◽

Significant Negative Correlation ◽

Cross Sectional Study ◽

Variceal Hemorrhage ◽

Sectional Study ◽

Cross Sectional ◽

Grade Ii ◽

Cirrhotic Patients

Background: Bleeding from esophageal varices is a life-threatening complication in cirrhosis. Screening endoscopy is recommended in cirrhotic patients to identify patients at risk of variceal hemorrhage, but this is an invasive procedure and has limitations. Therefore, thrombocytopenia has been proposed to predict the existence and grade of esophageal varices. The aim of the current study was to determine a correlation between platelet count and grades of esophageal varices in patients with liver cirrhosis. Methods: This cross-sectional study was conducted at the POF Hospital, Wah Cantt from 1st October, 2017 to 30th May, 2018. Newly diagnosed cases of cirrhosis having varices of any grade on endoscopy were included. Endoscopic findings of patients were standardized using Paquet grading system. On the basis of platelet count, patients were divided into four subgroups. Platelet count groups were correlated with grading of esophageal varices using Spearman rank correlations. Chi Square test was used to see association between the platelet count and grade of esophageal varices. Results: 110 patients were included in the study, 55.5% (n=61) were male. Mean age of the patients was 59.89±9.01 years. Platelet count was <50,000/uL in 35.5% patients, 50,000-99,000/uL in 26.4%, 100,000-150000 in 12.7%, and >150,000/uL in 25.5% patients. Grade I esophageal varices were found in 23.6% of patients, whereas grade II, III and IV were found in 24.5%, 33.6% and 18.2% of patients, respectively. Mean platelet count was 213884.62/mm3 in patients with grade I varices, whereas it was 119518.52/mm3, 58386.49/mm3 and 21600.00/mm3 in patients with grade II, III and IV varices, respectively (p=<0.0001). A significant negative correlation between platelet count and grades of esophageal varices was found (p<0.001). Conclusion: Platelet count can predict the grade of esophageal varices in cirrhotic patients. There is significant negative correlation between platelet count and grades of esophageal varices.

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