Prevalence, microbiological profile, and outcomes of spontaneous bacterial and fungal peritonitis in Egyptian patients with liver cirrhosis.

BACKGROUND

One of serious side effects of liver cirrhosis is spontaneous bacterial peritonitis (SBP), which is defined by existence of infected ascites without a discernible secondary source of infection. One possible mechanism for development of SBP is microbial translocation.

OBJECTIVE

To ascertain prevalence, microbiological profile and outcomes of spontaneous bacterial and fungal peritonitis in Egyptian patients with liver cirrhosis.

METHODS

Three hundred cirrhotic patients with ascites who were hospitalized for spontaneous peritonitis (SP) participated in cross-sectional research. Laboratory investigations using bacterial and fungal cultures were carried out.

RESULTS

All participants with diagnosis of SP were included. Their mean age was 59.50 years, and 68.7% of them were men. In addition, 13.7% of subjects had spontaneous fungal peritonitis, whereas 47.3% of participants had SBP. Of SBP cases, 50.7% (n = 72) had gram negative (-ve) bacteria isolated from them, whereas 49.3% (n = 70) had gram positive (+ ve) bacteria. Streptococcus 8.5% (n = 12) was the commenest gram-positive isolate, followed by Staphylococcus aureus 33.8%(n = 48). On the other hand, Klebsiella 29.6% (n = 42) was the commenest gram-negative isolate, followed by Escherichia coli 14.4%(n = 19). The outcome of SBP cases with and without multidrug resistance do not differ significantly. On multivariate analysis, femal (p = 0.013), low ascitic protein level and high ascitic lactate dehydrogenase (LDH) (p = 0.018, p = 0.014) were significant independent predictors for SFP.

CONCLUSION

SBP and SFP frequently provide serious life-threatening dangers in cirrhotic patients with ascites. Alertness for SFP is increased with low ascitic protein level and high ascitic LDH.