Spontaneous Bacterial Peritonitis and its Common Pathogens in HCV Cirrhotic Patients

  • Gordhan Soothar Assistant Professor, Muhammad Medical College, Mirpur-Khas
  • Nand Lal Seerani Senior Registrar, Gastroenterology Department, LUMHS Jamshoro
  • Rabia Akram Medical Officer, Muhammad Medical College, Mirpur-Khas
Keywords: HCV cirrhosis, Spontaneous bacterial peritonitis,, Micro-organisms


Objective: To determine the spontaneous bacterial peritonitis and its common pathogens in HCV Cirrhotic patients.
Patients and Methods: This cross-sectional descriptive study was conducted at department of Medicine, Liaquat University Hospital Hyderabad/Jamshoro. This study was carried out for period of six months, i.e. from 1st March, 2009 to 31st August, 2009. Patients with liver cirrhosis caused by hepatitis C virus, ranging from 15 to 70 years of age and either gender were included in this study. Ascitic fluid was sent to Diagnostic and Research Laboratory of LUMHS within half hour of collection and ascitic fluid culture was done on blood agar media. TLC count >500-cells/µl or polymorph nuclear leucocyte >250-cells/µl were labelled as SBP positive. Growth positive on different disc was labelled with respect to the positive pathogen. All the data was entered on predesigned proforma.
Results: Total 177 cases were studied and the mean age was 50.06±11.5 years with range of 20 to 70 years. Males were found in majority (78.5%) of cases, with male/female ratio of 2.3:1. Most of the patients 120(67.8%) were found having cirrhosis for 1-5 years’ duration. Most of the cases 77(43.5%) presented with Child Pugh-Class B. Spontaneous bacterial peritonitis was present in 100(56.49%) patients. Among these 100 cases, 85.0% were found with positive culture, which showed Escherichia coli (most common) in 54.11% patients, followed by Klebsiella in 16.47% patients, Pneumococci in 9.41% and Enterococci in 7.0% patients.
Conclusion: It is concluded that spontaneous bacterial peritonitis was 56.49%, which is a major complication of HCV cirrhosis and E. coli is the major culprit micro-organism. Ascitic fluid culture is a sensitive method to detect the microorganism causing spontaneous bacterial peritonitis. 

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