Euroasian Journal of Hepato-Gastroenterology

Register      Login

VOLUME 2 , ISSUE 1 ( January-June, 2012 ) > List of Articles

ORIGINAL ARTICLE

Spontaneous Bacterial Peritonitis in Alcoholic Cirrhosis: An Indian Perspective

Rajesh Mahajan, Prithpal Singh Matreja, Ajitpal Singh Gill, Rajoo Singh Chinna, Deepinder Kaur Chhina

Citation Information : Mahajan R, Matreja PS, Singh Gill A, Singh Chinna R, Kaur Chhina D. Spontaneous Bacterial Peritonitis in Alcoholic Cirrhosis: An Indian Perspective. Euroasian J Hepatogastroenterol 2012; 2 (1):14-19.

DOI: 10.5005/jp-journals-10018-1024

License: CC BY-NC 4.0

Published Online: 01-01-2012


Abstract

Background: Spontaneous bacterial peritonitis (SBP) is commonly associated with cirrhosis of liver, and has been associated with high mortality. Model for end-stage liver disease (MELD) scoring system has been applied as a marker of disease severity and predictor of mortality in patients with alcoholic cirrhosis. Recent studies have estimated a prevalence of 10 to 30% SBP in cirrhotic patients with ascites admitted to hospitals but the data is lacking on Indian population. Hence, the present study was designed to evaluate the profile of SBP in patients with alcoholic cirrhosis in North India according to MELD score. Materials and methods: The prospective study was conducted in patients admitted in the department of medicine. A total of 100 patients suffering from alcoholic cirrhosis with ascites were enrolled in the study. All subjects underwent the following test for biochemical parameters, abdominal ultrasonography, chest X-ray, endoscopic findings and paracentesis was performed and analyzed. MELD score was calculated for all the patients. Results: Out of total patients, 24% reported with SBP. Patients suffering from SBP had statistically significant (p < 0.05) higher MELD score, International normalized ratio (INR) and serum creatinine levels. Also, the patients with SBP had significantly (p < 0.05) lower platelet count as compared to patients without SBP. All the other parameters were comparable in both the groups. Conclusion: SBP is a common complication of alcoholic cirrhosis of Indian patients and measures should be taken for their containment.


PDF Share
  1. Guarner C, Runyon BA. Spontaneous bacterial peritonitis: Prognosis, diagnosis, and management. Gastroenterologist 1995;3:311-28
  2. Spontaneous bacterial peritonitis in cirrhosis: Variation on a theme. Medicine (Baltimore) 1971; 50:161-97
  3. Spontaneous peritonitis in cirrhotic ascites: A decade of experience. Am J Dig Dis 1974; 19:685-92
  4. Prognosis and long-term recurrence of spontaneous bacterial peritonitis in cirrhosis. J Hepatol 1993;19:188-89
  5. Spontaneous bacterial peritonitis: A prospective investigation in predominantly nonalcoholic cirrhotic patients. Hepatology 1983;3:545-49
  6. Recurrence of spontaneous bacterial peritonitis in cirrhosis: Frequency and predictive factors. Hepatology 1988;8:27-32
  7. Translocation of certain indigenous bacteria from the gastrointestinal tract to mesenteric lymph nodes and other organs in a gnotobiotic mouse model. Infection and Immunity 1979;23:403-11
  8. Intestinal permeability is increased in patients with advanced cirrhosis. Hepatogastroentrology 2003;50:1482-86
  9. Spontaneous bacterial peritonitis associated with cardiac ascites. Am J Gastroenterol 1984;79:796-99
  10. Culture negative neutrocytic ascites: A variant of spontaneous bacterial peritonitis. Hepatology 1984;4:1209-11
  11. Ascitic fluid analysis in the differentiation of spontaneous bacterial peritonitis from gastrointestinal tract perforation into asctic fluid. Hepatology 1984;4:447-50
  12. Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis. Gastroenterology 1990;98:127-33
  13. Spontaneous bacterial peritonitis: Recent data on incidence and treatment. Cleveland Clinic Journal of Medicine 2004;71:564-70
  14. Optimization of ascitic fluid culture technique. Gastroenterology 1988;95: 1351-55
  15. Monomicrobial nonneutrocytic bacterascites: A variant of spontaneous bacterial peritonitis. Hepatology 1990; 12:710-15
  16. Opsonic activity of human ascitic fluid: A potentially important protective mechanism against spontaneous bacterial peritonitis. Hepatology 1985;5:634-37
  17. Spontaneous bacterial peritonitis. Gastroenterology Clinics of North America 1992;21:257-75
  18. MELD score as a predictor of liver failure and death in patients with acetaminophen-induced liver injury. Hepatology 2007;45:789-96
  19. Utility of the model end-stage liver disease (MELD) score in assessing prognosis of patients with alcoholic hepatitis. BMC Gastroenterology 2002,2:2 available from: http://www.biomedcentral.com/1471-230X/2/2
  20. A prospective study of bacterial infections in patients with cirrhosis. J Hepatol 1993;18:353-58
  21. unos.org/resources/MELD calculator 22. Evans LT, Kim WR, Poterucha JJ, Kamath PS. Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites. Hepatology 2003;37:897-901. Spontaneous Bacterial Peritonitis in Alcoholic Cirrhosis: An Indian Perspective Euroasian Journal of Hepato-Gastroenterology, January-June 2012;2(1):14-19 19 EJOHG 23. Filik L, Unal S. Clinical and laboratory features of spontaneous bacterial peritonitis. East Afr Med J 2004;81:474-79
  22. Spontaneous bacterial peritonitis. Hepatology 1982;2:399S-407S
  23. Spontaneous bacterial peritonitis in cirrhosis: Endemic or epidemic? Med Clin North Am 1975; 59:963-81
  24. Spontaneous bacterial peritonitis in hepatic cirrhosis: Prevalence, predictive factors and prognosis. Rev Assoc Med Bras 1999;45:128-36
  25. Low C3 in cirrhotic ascites predisposes to spontaneous bacterial peritonitis. J Hepatol 1988;6:80-84
  26. Incidence of SBP in liver cirrhosis, the causative organism and antibiotic sensitivity. J Postgrad Med Inst 2004;18:614-19
  27. A model to predict survival in patients with end-stage liver disease. Hepatology 2001;33:464-70
  28. The model for endstage liver disease (MELD) score predicts survival in patients with spontaneous bacterial peritonitis, and with ascites. Gastroenterology 2001;120:A378
  29. Improved method for bacteriological diagnosis of spontaneous bacterial peritonitis. J Clin Microbiol 1989;27:2145-47
  30. Evaluation of culture techniques for detection of spontaneous bacterial peritonitis in cirrhotic ascites. Indian J Gastroenterol 1994;13:139-40.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.