Prevalence of spontaneous bacterial peritonitis in liver cirrhosis with ascites in kims hospital Bengaluru

Aims and objectives: To determine the prevalence of spontaneous bacterial peritonitis in liver cirrhosis with ascites in KIMS hospital Bengaluru. Materials and methods: 58 patients with liver cirrhosis with ascites, who were admitted to KIMS hospital Bengaluru from March 2017 to August 2018) were studied retrospectively. The diagnosis of liver cirrhosis was established on the basis of clinical evaluation, biochemical parameters, abdominal ultrasound and viral markers. All the patients had abdominal paracentesis done within 48 hours of admission under aseptic condition and the data obtained were analysed. Results: The mean age of the studied population was 52±12 years (age range 32-66 years). Of the 58 patients 9 patients had SPB (15.5%), Among SBP patients culture is positive in 44.4%, while CNNA was found in 55.6% patients. The prevalence of MNB was 13.8% (8/58) in this study. Of those with SBP, 83.3% had monomicrobial infection with E.coli (60%) being the predominant organism followed by Klebsiella species (20%). Gram positive organisms Streptococcal species and Staphylococcus aureus both together contributing for 20 % of SBP. Patients with SBP had significantly lower platelet count when compared with those without SBP (p < 0.05). Also, international normalization ratio (INR) was significantly higher in those patients with SBP compared with those without SBP, (p< 0.05). Conclusion: Patients with cirrhosis of liver with ascites are at increased risk of developing SBP. Hence it is imperative to do diagnostic abdominal paracentesis in any cirrhotic patients with ascites and suggestive symptoms compatible or suggestive of SBP.