Altaf Baqir Naqvi, Anwaar A Khan, Altaf Alam, Mateen Azhar.
Microbial Diagnosis of Spontaneous Bacterial Peritonitis: Comparison of Conventional Culture with Blood Culture Bottles Method.
Pak J Gastroenterol Jan ;13(1-2):0-.

The commercial blood culture bottles are often not available, expensive in the government hospitals and the capability is available in most laboratories of teaching hospitals to prepare their own culture bottles at very low cost. This was the reason to study both methods in spontaneous bacterial peritonitis and to compare them with routine (conventional) culture. Fifty-five patients with liver cirrhosis and ascites were prospectively studied for spontaneous bacterial peritonitis and different culture systems compared. Thirty-seven (67.3%) were male and 18 (32.7%) were female. Mean age was 51 + 14 years. Sixteen (29.1%) ascitic fluid infections were diagnosed, (7 spontaneous bacterial peritonitis, 6 culture negative neutrocytic ascites and 3 bacterascites). Conventional culture was positive in 3(5.5%), commercial bottle culture was positive in 11 (20%) and laboratory prepared blood culture bottle was positive in 10 (18.2%). The diagnostic yield of conventional cultures were lower than the other two methods (p< 0.05). However the difference in the results of commercial and laboratory blood culture bottles was not statistically significant (p> 0.05). E-Coli were isolated in 8 (14.5%) and Klebsiella in 2 (3.6%). All the microorganisms were sensitive to cefotaxime, quinolones, aztreonam, imipenem and amoxicillin/ clavulanic acid combination. We conclude that ascitic fluid should be inoculated at the bedside in blood culture bottles. The results of laboratory prepared blood culture bottles were comparable with the commercial culture bottles and were cost effective.

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