MICROBIOLOGICAL PROFILE OF SPONTANEOUS BACTERIAL PERITONITIS IN PATIENTS WITH CIRRHOSIS OF LIVER IN SOUTHERN ASSAM.

Abstract

Liver cirrhosis is a common disorder which can have a wide range of aetiologies. Anatomically, it is characterised as a widespread process of nodule formation and fibrosis in the liver. Without any obvious intra-abdominal source of infection, spontaneous bacterial peritonitis (SBP) is characterised by infection of the previously sterile ascitic fluid (AF). SBP is a primary cause of death in decompensated liver disease and requires quick identification and care. In recent years, Assam has seen an increase in the prevalence of alcoholic liver disease and associated complications. Aims and Objectives: This study was undertaken with an idea to evaluate the significance of AF analysis with AF culture and sensitivity to determine microbiological profile and prognosis in cirrhotic patients with SBP in this region. Materials and Methods: Patients admitted with liver cirrhosis with ascites were studied during the period from June 2021 to May 2022. All patients included in the study were confirmed liver cirrhosis by ultrasound. Basic demographics, symptoms and clinical signs of patients were recorded. Patients with the history of antibiotic use within last 3 days or any intraabdominal source of infection were excluded. Diagnostic paracentesis was done for ascitic fluid detailed report and culture. Out of 100 SBP patients, 60 (60%) had culture negative neutrocytic ascites and 40 (40%) had Results: bacterascites. Fever, abdominal tenderness and constipation were common in SBP patients. Ascitic fluid culture was positive in 26 (52%) patients. E. coli (28%) was the predominant pathogen followed by Klebsiella species (8%), Staphylococcus aureus (2%) and acetinobacter (2%). 33 (82.5%) cases showed sensitivity to cefotaxim. In rest 17.5% cases, organism is mildly sensitive or resistant to 3rd generation cephalosporins