CAUSATIVE ORGANISMS AND THEIR DRUG SENSITIVITY PATTERN IN ASCITIC FLUID OF CIRRHOTIC PATIENTS WITH SPONTANEOUS BACTERIAL PERITONITIS

Abstract

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

and ceftriaxone.

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.