Abstract

Authors:

Dr. Swapna U S Medicine 3^rd year PG

Background

Spontaneous ascitic fluid infection (SAI) is common in cirrhotic patients. Third-generation cephalosporins are currently recommended as first-line therapy. We conducted a study to determine bacterial etiology, susceptibility patterns.

Objective

To estimate the prevalence of spontaneous ascitic fluid infection in cirrhotic decompensated liver disease patients,and to analyse microbiological profile in cirhhotic ascites

Method

We prospectively collected clinical , laboratory characteristics. Diagnosis paracentesis was performed in all patients with diagnosis of cirrhosis with ascites to investigate the presence of SAI

Result

Among total 45 patients the leading cause of cirrhosis was alcohol consumption. SAI was diagnosed in 27 patients (60%). Of these, 19 patients (70 %) had culture negative neutrocytic ascites(CNNA), 5 (18.5%) had Spontaneous bacterial peritonitis(SBP), and 3 (11.1%)had mono microbial non neutrocytic bacterascites(MNB).CNNAand SBP did not differ in terms of clinical characteristics.Organisms found are – two had Streptococci ,and two had coagulase negative staphylococci , two had E.coli, 1 had klebsiella pneumonia , 1 had candida growth. Gram positive cocci were predominant among culture positive SAI(50%) ,gram negative bacilli (37.5%), fungus(12.5%). only 37.5% are sensitive to 3rdgeneration cephalosporin .Among culture positive patients most sensitive antibiotics found to be carbapenems,linezolid,vancomycin .

Conclusion

Change in the trend of growth of organism from gram negative to gram positive is seen and response rate of SAI to third generation cephalosporin was low. This helps to choose suitable antimicrobial agents in cirrhotic decompensated liver disease patients , both for empirical and therapeutic use.

Keywords

SAI, Acitic fluid culture , Antibiotic sensitivity.