Clinical Spectrum, Microbiological Profile, and Complications of Spontaneous Bacterial Peritonitis in Ascitic Cirrhosis: An 18-Month Cross-Sectional Study

Abstract

Introduction: Ascites, a common complication of liver cirrhosis, often lead to spontaneous bacterial peritonitis (SBP), a severe infection of ascitic fluid. SBP contributes to high morbidity and mortality in cirrhotic patients. This study aimed to evaluate the prevalence, risk factors, clinical spectrum, and microbiological and biochemical profiles of SBP in patients with ascites. Material and methods: An 18-month cross-sectional observational study included 84 cirrhotic patients with ascites, diagnosed clinically and radiologically. SBP was diagnosed based on ascitic fluid analysis (polymorphonuclear count >250 cells/mm³ or positive ascitic fluid culture). Exclusion criteria included age under 18, prior antibiotics use, and secondary causes of ascites. Data were analyzed using SPSS, with chisquare and t-tests for categorical and continuous variables, respectively. Ethical approval was obtained. Results: SBP patients had significantly higher neutrophil counts (292.3 ± 31.9 vs. 126.5 ± 15.0, p < 0.001). The microbiological culture revealed E. coli (60%) as the predominant pathogen. SBP patients also had higher rates of UGI bleeding (48.0 vs. 10.2%, p = 0.001) and worse severity scores (CTP Class C: 48.0%, p = 0.0017). Hepatorenal syndrome (HRS) was significantly more common in SBP patients (28.0 vs. 5.1%, p = 0.003), and mortality was higher (16.0 vs. 3.4%, p = 0.04). Conclusion: SBP in cirrhotic patients is associated with increased neutrophil counts, complications such as UGI bleeding and HRS, and higher mortality. Early detection and appropriate management are crucial for improving patient outcomes.