Etiology of spontaneous bacterial peritonitis and determination of their antibiotic susceptibility patterns in Iran

Abstract

ObjectiveTo determine the causative agents of spontaneous bacterial peritonitis (SBP) in patients with liver disease and ascites who referred to the pediatrics ward of Tehran Imam Khomeini Hospital in Iran during January to December 2008. MethodsIn this study, from 85 patients with liver disease and ascites, ascite samples were taken and the causative bacterial agents were determined by direct microscopy, culture and biochemical tests. Subsequently, antibiotic susceptibility tests by disk diffusion method (Kirby-Bauer test) were performed on each bacterial isolate. ResultsAmong 85 examined samples, 32 bacterial and 2 yeast agents were isolated. Among bacterial cases, Escherichia coli (31.3%) and coagulase negative Staphylococci (18.8%) were the most predominant and Streptococci and Enterobacteriaceae were the next common agents, respectively. Antibiogram tests revealed that most of isolated coagulase negative Staphylococci were resistant to ampicillin, penicillin, cotrimoxazole and cephalosporin (first generation); and most of the gram negative isolates were resistant to amikacin, gentamicin and vancomycin. ConclusionsIn total agreement with similar studies performed previously in other parts of the world, the present survey indicates that, Escherichia coli and coagulase negative Staphylococci are the most common causes of SBP in children and a third generation of cephalosporin such as ceftriaxone and cefoxitin can be a suitable antibiotic for empirical therapy of children with SBP.