title: Clinical, laboratory and bacterial profile of Spontaneous Bacterial Peritonitis in Chronic Liver Disease patients.
abstract: OBJECTIVE
  To determine the clinical and laboratory features, bacterial profile and antibiotic sensitivity pattern of Spontaneous Bacterial Peritonitis (SBP) in Chronic Liver Disease (CLD) patients presenting at a tertiary care hospital of Karachi.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  PMRC Centre for Gastroenterology and Hepatology and Jinnah Postgraduate Medical Centre, Karachi, from April 2010 to March 2012.
  
  
  METHODS
  CLD patients with ascites were recruited from PMRC Centre for Gastroenterology and Hepatology and Jinnah Postgraduate Medical Centre, Karachi. Basic demographics, symptoms and clinical signs of patients were recorded. Patients with the history of antibiotic use within last 3 days or any intra-abdominal source of infection were excluded. Diagnostic paracentesis was done for ascitic fluid detailed report (D/R) and culture. Blood sample was collected for total leukocyte count, serum proteins and billirubin levels.
  
  
  RESULTS
  Out of a total 152 CLD patients, 38 (25%) were diagnosed with SBP. Eight (24.2%) patients presented with classical SBP, 20 (52.6%) had culture negative neutrocytic ascites and 10 (26%) had bacterascites. Fever, abdominal tenderness and constipation were common in SBP patients. Ascitic fluid culture was positive in 19 (50%) patients. E. coli (65%) was the predominant pathogen followed by Enterococcus species (15%). Resistance was high against cephalosporins (78%) and fluoroquinolones (69.6%) and least against amikacin (13%) and meropenem (12%).
  
  
  CONCLUSIONS
  Ascitic fluid D/R and culture together can lead to the accurate diagnosis of SBP and can guide for the right antibiotic choice as resistance to commonly prescribed antibiotic is common in such patients.
authors.affiliation: PMRC Specialized Centre of Gastroenterology and Hepatology, Jinnah Postgraduate Medical Centre, Karachi.
authors.forename: Safia
authors.initials: S
authors.lastname: Bibi
authors.affiliation: PMRC Specialized Centre of Gastroenterology and Hepatology, Jinnah Postgraduate Medical Centre, Karachi.
authors.forename: Waquaruddin
authors.initials: W
authors.lastname: Ahmed
authors.affiliation: PMRC Specialized Centre of Gastroenterology and Hepatology, Jinnah Postgraduate Medical Centre, Karachi.
authors.forename: Ambreen
authors.initials: A
authors.lastname: Arif
authors.affiliation: PMRC Specialized Centre of Gastroenterology and Hepatology, Jinnah Postgraduate Medical Centre, Karachi.
authors.forename: Furqan
authors.initials: F
authors.lastname: Khan
authors.affiliation: PMRC Specialized Centre of Gastroenterology and Hepatology, Jinnah Postgraduate Medical Centre, Karachi.
authors.forename: Syed Ejaz
authors.initials: SE
authors.lastname: Alam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001201:Ascites / Q000188:drug therapy; D001202:Ascitic Fluid / Q000382:microbiology*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D001431:Bacteriological Techniques / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000175:diagnosis / Q000382:microbiology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010538:Peritonitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents