STUDY OF THE MICROBIOLOGICAL PROFILE OF SPONTANEOUS BACTERIAL PERITONITIS IN PATIENTS OF CIRRHOSIS OF LIVER WITH ASCITIS

Abstract

Background: Cirrhosis is a chronic disease of the liver in which diffuse destruction and regeneration of hepatic parenchymal cells occur, with diffuse increase in connective tissue, leading to disorganisation of the lobular architecture1. Spontaneous Bacterial Peritonitis is a frequent infectious complication in patients with cirrhosis and ascites. The most common gram negative bacteria isolated from SBP patients with liver cirrhosis are E coli and Klebsiella spp, while the most common gram positive bacteria are staphylococcus spp, streptococci spp and enterococci 2. Early antibiotic treatment of spontaneous bacterial peritonitis is critical. However, as the landscape of microbiological resistance is continuously changing in recent times, with an increasing number of multidrug-resistant organisms, the current management of SBP is more challenging. Objective: To nd out the pathogens causing Spontaneous bacterial peritonitis and their antimicrobial susceptibility pattern. Materials and Methods:AHospital based prospective observational study was carried out on 109 patients diagnosed with liver cirrhosis and ascites, admitted in the department of General Medicine. Those patients that t the inclusion and exclusion criteria were chosen as participants and diagnostic abdominal paracentesis was done before the rst dose of antibiotic and ascitic uid was examined for cell count, neutrophil count, protein, gram stain, direct microscopy for fungus and bacterial culture and sensitivity. Results: The prevalence of SBP was 24.77%. E-Coli (38.48%) was the most common bacteria isolated followed by Klebsiella Aerogenes (15.38%), MRSA (15.38%), Acinetobacter Lwofi (7.69%), Klebsiella Pneumoniae (7.69%), Enterobacter Cloacae (7.69%) and Staphylococcus Aureus (7.69%). Out of 10 gram negative bacteria which were isolated, 3 (23.07%) isolates were XDR (Extensively drug resistant) bacteria and 2(15.38%) isolates were MDR (Multi drug resistant) bacteria.