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

F1000Research ◽  
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.

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

F1000Research ◽  
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.

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 SPONTANEOUS BACTERIAL PERITONITIS

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.

scholarly journals Predictors of Development of Hepatorenal Syndrome in Hospitalized Cirrhotic Patients with Acute Kidney Injury

2021 ◽  
Vol 10 (23) ◽  
pp. 5621
Author(s):  
Roula Sasso ◽  
Ahmad Abou Yassine ◽  
Liliane Deeb
Keyword(s):  
Acute Kidney Injury ◽  
Spontaneous Bacterial Peritonitis ◽  
Hepatorenal Syndrome ◽  
Kidney Injury ◽  
Alcoholic Cirrhosis ◽  
Clinical Feature ◽  
Decompensated Liver Cirrhosis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
End Stage

Hepatorenal syndrome (HRS) is a type of acute kidney injury (AKI), occurring in patients with decompensated liver cirrhosis and is associated with high mortality. We aim to describe the predictors associated with the development of HRS in cirrhotic patients with AKI. We retrospectively analyzed 529 cirrhotic patient encounters with AKI across all Northwell Health institutions between 1 January 2015 and 31 December 2018. We performed multivariate analyses to determine independent predictors of development of HRS. Alcoholic cirrhosis was the most common identified etiology of cirrhosis. The mean Model for End-Stage Liver Disease Scorewas18 (±7). Ascites was the most commonly identified clinical feature of portal hypertension. Infection was identified in 38.4% of patients with urinary tract infection/pyelonephritis being the most common. Spontaneous bacterial peritonitis occurred in 5.9% of patients. The most common cause of AKI was pre-renal. Hepatorenal syndrome was identified in 9.8% of patient encounters. Predictors of HRS were history of ascites, serum creatinine >2.5 mg/dL, albumin <3 g/dL, bilirubin >2 mg/dL and spontaneous bacterial peritonitis. We demonstrate strong predictors for the development of HRS which can aid clinicians to attain an early diagnosis of HRS, leading to prompt and targeted management and improving outcomes.

scholarly journals The bacterial spectrum of spontaneous bacterial peritonitis in patients with cirrhosis of liver.

2020 ◽  
Vol 27 (10) ◽  
pp. 2099-2103
Author(s):  
Ahmad Nawaz Babar ◽  
Shahid Rasool ◽  
Salman Azhar ◽  
Javeria Komal ◽  
Sofia Hanif
Keyword(s):  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Bacterial Spectrum ◽  
Study Results ◽  
Cirrhotic Patients ◽  
Cirrhosis Of Liver ◽  
Study Setting ◽  
Symptoms And Signs

Objectives: To identify the bacterial spectrum of SBP in patients with cirrhosis of liver. Study Design: Descriptive Cross-sectional study. Setting: Department of Gastroenterology and Hepatology, Madina Teaching Hospital, Faisalabad. Period: 1st November, 2018 – 30th June, 2019. Material & Methods: Two hundred and fifty cirrhotic patients having ascites and clinical symptoms and signs of SBP, consecutively admitted in the ward or presented to OPD were included in the study. Results: A total of 250 patients included in this study. SBP was diagnosed according to the predetermined criteria in 140 patients.  The culture-negative ascites was found in 77 (55%) and culture-positive ascites was found in 63 (45%) patients. The most common organism was E.Coli 28 (47.45%) followed by Enterococcus 10 (16.94%), Klebsiella Pneumoniae 6 (10.17%), Streptococcal Pneumoniae 5 (8.47%), S.aureus 5 (8.47%), Acinetobacter 3 (5.08%) and miscellaneous 2 (3.38%). Conclusion: The percentage of SBP is quite high among patients having cirrhosis and ascites and the Gram-negative bacterial spectrum is still much common in our region.

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.

Sign in / Sign up

Export Citation Format

Share Document