Aamir Husain, Abdul Qayyum, Dilshad Muhammad, Masood Javed, Muhammad Naeem Iqbal.
Bacteriology of spontaneous bacterial peritonitis.
Professional Med J Jan ;14(4):551-5.

Cirrhosis is a major cause of mortality worldwide and is the most common non neoplastic cause of death among hepatobiliary and digestive diseases. Ascites is often among the first signs of de-compensation in patients with chronic liver disease. Spontaneous Bacterial Peritonitis (SBP) (with out any source of infection) occurs in 30% of patients with ascites. Common causative organisms include escherichia coli, pneumococcus, Klebsiella and anaerobes. It has a 25% mortality and recurs in 70% of patients within a year. Objective: To determine the pathological agents causing SBP in patients with liver cirrhosis. Design: Descriptive study. Setting: Medical Ward Allied and K.M. Hospitals Faisalabad. Period: From 17 Nov 2004 to 15 May 2005. Patients & Materials. Fifty patients of either sex having cirrhosis of liver and ascites were included according to the criteria i.e ascitic fluid leukocyte count of >500 cells/L or >250 PMN, while results of bacterial cultures of ascitic fluid were pending. Results: Out of 5 0 patients, 27 (54%) were males and 23 (46%) females. Mean age of whole the population was found to be 51±12.49) yrs. Classical spontaneous bacterial peritonitis was present in 27 patients and Culture Negative Neutrocytic Ascites (CN NA) in 23(46%) patients. Out of 50 patients, 27(54%) samples of ascitic fluid showed positive culture reports. E Coli was isolated in 9(18%) cases. Klebsiella pneumoniae in 6(12%), streptococcus pneumoniae 4(8%), staphylococcus aureus 2(4%), pseudomonas aeruginosa 2(4%). Acinobacter 2(4%) and proteus mirabilis 2(4%). E.Coli is the commonest organism followed by klebsiella pneumoniae.

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