Clinical Profile of patients with Ascitic Fluid Infection at Ain Shams University Hospitals

Abstract

Background: Ascites is a common problem in patients with chronic liver disease. About 60% of patients with cirrhosis will develop ascites. Patients with chronic liver disease and cirrhosis frequently develop infections of the ascitic fluid. Aim: The aim of this study is to assess the clinical profile of patients with ascetic fluid infection admitted to Tropical Medicine department at Ain Shams University hospitals. Patients and Methods: The current Cross-sectional study was conducted at The Tropical Medicine Department, Ain Shams University on 87 Egyptian patients with chronic liver disease and ascites during the 12-months period from June 2017 to May 2018 by collecting their clinical, laboratory and radiological data. Results: The frequency of infected ascites among the studied patients with chronic liver disease and ascites was 31%. The main presenting symptom of infected ascites was abdominal pain (37%) and the most common clinical sign was lower limb edema (81%). The most frequently isolated micro-organism was E.coli that was detected in 7% of patients with infected ascites. Among the 27 patients with infected ascites, 12 patients responded to the third generation cephalosporins, nine patients responded to Meropenem. Conclusion: Infection of the ascitic fluid is frequent among patients with chronic liver disease and cirrhosis admitted to Ain Shams University Hospitals. Almost one third of the ascitic patients developed at least one attack of spontaneous bacterial peritonitis or bacterascites. Monomicrobialbacterascites is more frequent than polymicrobialbacterascites and E coli is the most common isolated organism. Third-generation, broad-spectrum cephalosporins remain a good initial therapy for patients who do not have allergy to cephalosporins. Alternative antibiotics such as Meropenem and pipercillin-tazobactam should be considered for patients for patients who fail to improve on traditional antibiotic regimens.