Microbial spectrum and antibiotic sensitivity in cirrhotic patients with spontaneous bacterial peritonitis
Irfan Ahmad, Muhammad Shahbaz Hussain, Muhammad Shoaib Akhtar
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ABSTRACT
Objective: There are reports
of changing microbial profile of ascitic fluid in spontaneous bacterial
peritonitis (SBP) and developing resistance of these bacteria to commonly used
antibiotics. This study was done to determine the micro-organism causing SBP
and their sensitivity to various antibiotics.
Setting and Methods: This
observational study was done in Medical department of Sheikh Zayed Medical
College/Hospital, Rahim Yar Khan from March to November 2019. Thirty five
cirrhotic patients with ascites admitted in ward for various reasons and having
positive ascitic fluid culture were included in the study. Exclusion criteria
was presence of secondary bacterial peritonitis. Ten ml of ascitic fluid was
inoculated in blood culture bottle and sent immediately to hospital laboratory.
Results: The mean age of these
35 patients was 48.94 ± 13.51 years with a range of 19 to 80 years. Twenty
(57.1 %) patients were male and 15 (42.9 %) were female. Bacteria that had
caused SBP were E.coli (62.9 %), staph aureus (11.4 %), klebsiella (8.6 %),
streptococci (8.6 %), gram positive cocci (5.7 %) and pseudomonas aeruginosa
(2.8 %). Imipenem had high sensitivity rate (100 %) along with amikacin (82.9
%) and cefoperazone-sulbactam (68.6 %). Sensitivity of these organisms to other
commonly used antibiotics were: ciprofloxacin 57.1 %, ofloxacin 40 %,
norfloxacin 37.1 %, ceftazidime 34.3 %, ceftriaxone 31.4 % and
piperacillin-tazobactam 25.7 %.
Conclusion: We found that
E.coli was the commonest bacteria causing SBP, and ceftriaxone and ciprofloxacin
have significantly high resistance rate in these patients.
Key words: cirrhosis,
ascitic fluid, spontaneous bacterial peritonitis, antibiotic sensitivity