Objective:To determine the prevalent pathogens responsible for spontaneous bacterial peritonitis(SBP) and their sensitivity pattern,to test the efficiency of different culture techniques in microbial isolation,and to ...Objective:To determine the prevalent pathogens responsible for spontaneous bacterial peritonitis(SBP) and their sensitivity pattern,to test the efficiency of different culture techniques in microbial isolation,and to study the diagnostic predictors of such cases.Methods:One hundred eight SBP episodes from 92 adult patients were compared to 88 cirrhotic ascites patients cross - matched with age and sex without SBP.Ascitic fluid was subjected to cytological,biochemical examination and culture on both conventional and blood culture bottles at the bedside for bacterial identification and antimicrobial susceptibility testing.Results:The prevalence of SBP was 25.02%.Logistic regression analysis revealed that;previous SBP episode,low ascitic fluid protein levels, high serum creatinine and low serum albumin levels were the independent significant predictors of SBP.About forty - five per cent of SBP episodes were detected by conventional culture compared to 73.15%by modified technique with a significant difference.Gram - negative bacteria were the cause of SBP in 46(58.23%) culture positive episodes.Escherichia coli and Staphylococcus aureus were the most commonly detected organisms. Resistance to different antibiotics was high.Conclusion:Culture of ascitic fluid in blood culture bottles at bedside increases the sensitivity of SBP detection.There is a recent increase in Gram - positive pathogen with emergence of multidrug resistance.These recent changes may have an impact on guidelines for management and treatment of SBP in our locality.展开更多
文摘Objective:To determine the prevalent pathogens responsible for spontaneous bacterial peritonitis(SBP) and their sensitivity pattern,to test the efficiency of different culture techniques in microbial isolation,and to study the diagnostic predictors of such cases.Methods:One hundred eight SBP episodes from 92 adult patients were compared to 88 cirrhotic ascites patients cross - matched with age and sex without SBP.Ascitic fluid was subjected to cytological,biochemical examination and culture on both conventional and blood culture bottles at the bedside for bacterial identification and antimicrobial susceptibility testing.Results:The prevalence of SBP was 25.02%.Logistic regression analysis revealed that;previous SBP episode,low ascitic fluid protein levels, high serum creatinine and low serum albumin levels were the independent significant predictors of SBP.About forty - five per cent of SBP episodes were detected by conventional culture compared to 73.15%by modified technique with a significant difference.Gram - negative bacteria were the cause of SBP in 46(58.23%) culture positive episodes.Escherichia coli and Staphylococcus aureus were the most commonly detected organisms. Resistance to different antibiotics was high.Conclusion:Culture of ascitic fluid in blood culture bottles at bedside increases the sensitivity of SBP detection.There is a recent increase in Gram - positive pathogen with emergence of multidrug resistance.These recent changes may have an impact on guidelines for management and treatment of SBP in our locality.
