OBJECTIVE: To find out the organisms causing Spontaneous Bacterial Peritonitis (SBP)
in cirrhotic patients.
PLACE AND DURATION OF STUDY: Department of Medical Unit-III, Chandka
Medical College Hospital Larkana, from June 2008 to June 2009.
DESIGN : Descriptive Study
PATIENTS AND METHODS: One Hundred patients of either sex having cirrhosis of
liver with ascites, were included according to the criteria i-e ascetic fluid leukocyte count
> 500 cells or >250 polymorphonuclear (PMN) cells. Patients with history of antibiotics
for one week prior to admission, malignant ascites and tuberculous ascites, were excluded
from this study.
RESULTS: Out of 100 patients, 54 (54%) males and 46 (46%) were females. Male to
female ratio was 1.2:1 and mean age was 51+ 12.49 years. Classic SBP was present
in 54(54%) patients while culture negative SBP was present in 46 (46%) patients. E-Coli
was isolated in 31 (57.40%) cases, klebsiella in 10 (18.15%), Streptococcus pneumoniae
in 07 (12.96%), staphylococcus auerus 02 (3.70%), pseudomonas aeruginosa 02 (3.70%)
and proteus mirabilis were present in 02 (3.70%) patients.
CONCLUSION: It is concluded that SBP is the common complication of cirrhosis of
liver and E-Coli is the most common culprit.
KEY WORDS: Cirrhosis, Spontaneous bacterial peritonitis, Portosystemic encephalopathy
Cirrhosis is a general term of end stage liver disease which can have many causes. It
results from necrosis of liver cells followed by fibrosis and nodule formation.(1) WHO
has estimated that cirrhosis is responsible for 1.1 % deaths and comprises the 10th most
common cause of death in USA.(2) Nothing is known about such figures in Pakistan, but
definitely the problem seems much bigger in Pakistan. Usual presentations are upper
gastrointestinal bleeding, Spontaneous bacterial peritonitis (SBP), portosystemic
encephalopathy (PSE), hepatorenal syndrome (HRS), hepatopulmonary syndrome and
hepato cellular carcinoma (HCC).(3) Ascites is frequent complication of cirrhosis and is