title: Factors predicting the recurrence of spontaneous bacterial peritonitis in patients with cirrhosis.
abstract: OBJECTIVE
  To evaluate the frequency of recurrence of spontaneous bacterial peritonitis (SBP) in patients with end stage liver disease and the factors responsible for it.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  The Aga Khan University Hospital, Karachi, from November 2008 till November 2009.
  
  
  METHODS
  Patients with cirrhosis who were admitted at AKUH with diagnosis of SBP during the study period were included. Any episode of SBP after resolution of the first index case of SBP within one year was considered as recurrence.
  
  
  RESULTS
  Out of 238 cirrhotic patients, 157 (66%) had single, while 81 (34%) had recurrent episodes of SBP. History of using proton pump inhibitors (PPI) and diuretics was found in 113 (47.5%) and 139 (58.4%) patients respectively. Only 58 24.4%) patients were on prophylactic antibiotic therapy. Univariate analysis revealed that the female gender (52%), and presence of porto-systemic encephalopathy (PSE, 31%) were statistically significant (p=0.03) among those who had recurrent SBP. On multivariate analysis bilirubin level of > 1.0 mg (OR=7.03; 95%CI=1.55-32), protective factor of hepatitis B (OR 0.31; 95%CI=0.13-0.70) and presence of urinary tract infection (UTI) (OR=2.24; 95%CI=0.99-5.09) were significant in patients with recurrent SBP.
  
  
  CONCLUSIONS
  Recurrent SBP was noticed in 34% patients. Serum bilirubin level of > 1.0 mg, protective factor of HBV and presence of UTI were significant factors present in patients with recurrent SBP.
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi.
authors.forename: Sajjad
authors.initials: S
authors.lastname: Jamil
authors.forename: Shahid
authors.initials: S
authors.lastname: Ahmed
authors.forename: Adil
authors.initials: A
authors.lastname: Memon
authors.forename: Sara
authors.initials: S
authors.lastname: Masood
authors.forename: Syed Hasnain
authors.initials: SH
authors.lastname: Ali Shah
authors.forename: Saeed Sadiq
authors.initials: SS
authors.lastname: Hamid
authors.forename: S M
authors.initials: SM
authors.lastname: Wasim Jafri
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors