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Objectives: To find out the relative frequencies of various etiologic pathogens and their sensitivity pattern
in ascitic fluid of cirrhotic patients with spontaneous backrid patients.
Material and Methods: This prospective observational study was conducted at Lady Reading Hospital
Peshawar from July 2004 to April 2005 on 50 patients with established diagnosis of cirrhosis liver with
possible diagnosis of spontaneous bacterial peritonitis (SBP). A questionnaire was designed comprising
detailed history, general physical examination, history of alcoholism, history of upper GI bleed and
features suggestive of SBP.
Results: Study included 50 patients (30 male and 20 female) ranging in age from 18-72 years with mean
age of 47.02+13.43 years. Ascitic fluid culture was positive by blood culture bottle method (BCBM) in
42(84%) cases. The relative frequencies of classical SBP, bacter-ascites (BA) and culture negative
neutrocytic ascites (CNNA) by the BCBM were 36 (72%), 06 (12%) and 08 (16%) respectively. Gram
negative enterobacteria were detected by BCBM in 30 (60%) cases. E. coli was the commonest organism
isolated in 15 cases (30%) followed by Klebsiella pneumonia in 7 cases (14%). All gram negative
organisms showed good sensitivity for quinolone, cefotaxime and ceftriaxone. Gram positive bacteria were
isolated from 12 (24%) cases by BCBM with Streptococcus pneumonia as the commonest organism from 8
(16%) patients. Gram positive isolates showed good sensitivity to amoxicillin-clavulanic acid, cefotaxime
Conclusion: Bedside inoculation of the ascitic fluid in blood culture bottles results in earlier growth
detection and subsequent start of specific antibiotic therapy which is the main goal of SBP treatment.
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