Prevalence and Microbial spectrum among cirrhotic patients with ascites in Northeast Nigeria- A preliminary report.

Abstract

Introduction: Spontaneous bacterial peritonitis (SBP) is the most characteristic infectious complication of cirrhosis requiring prompt recognition and treatment. Being a primary infection of the ascetic fluid and it is a recognized cause of death in cirrhotic patients. Normal ascitic fluid is sterile.

Objective: This study aimed to determine the prevalence of primary ascitic fluid infection and the microbes involved, among patients with cirrhosis and ascites seen at our facilities.

Method: Fourty nine (49) patients with liver cirrhosis and ascites who were admitted into the Medical ward of FMC Azare, FTH Gombe, and ATBUTH Bauchi were recruited after informed consent. All the recruited patients had abdominal paracentesis done within 48 hours of admission under aseptic condition and were subjected to culture using the BACT Alert automated method.

Results: Of the fourty nine (49) cirrhotic patients that were studied, nineteen 34.7% (19/49) were culture positive and were all monomicrobial while culture-negative ascites were found in 65.3% (32/49) of the studied population. Gram-negative bacilli being responsible in (12/17)70.6% of the cases with E.coli 7/12 (58.3%) being the predominant organism followed by Klebsiella species 3/12 (25%), the least isolate being Pseudomonas aeroginosa 16.7%. Gram-positive organisms accounted for (5/17) 29.4% with Staphylococci species (3/5) 60% being the predominant organism followed by Streptococcus spp and Candida spp (20%) respectively.

Conclusion: It is, therefore, important to do diagnostic abdominal paracentesis for cell count and culture in any patient with onset of ascites or cirrhotic patients with ascites and suggestive symptoms compatible or suggestive of SBP.