Clinical and laboratorial features of spontaneous bacterial peritonitis in southern Brazil

Abstract

CONTEXT AND OBJECTIVE: Spontaneous bacterial peritonitis (SBP) is a severe complication that occurs in 8-27% of hospitalized patients with liver cirrhosis and ascites, with high mortality rates. This study aimed to identify the clinical characteristics associated with SBP. DESIGN AND SETTING: Cross-sectional study, conducted in a public university. The subjects were divided into two groups: SBP and controls. RESULTS:Comparison between individuals with SBP and controls showed that those with SBP had lower mean prothrombin activity time (36.1 ± 16.0% versus 47.1 ± 17.2%; P = 0.044) and lower median serum-ascites albumin gradient (SAAG) (1.2 versus 1.7, P = 0.045). There was a tendency towards higher mean MELD in the SBP group, not significant (22.2 ± 7.6 versus 17.9 ± 6.7; P = 0.067). There was a strong positive correlation between the neutrophil count in ascitic fluid and serum leukocyte count (r = 0.501; P = 0.001) and a negative correlation between the neutrophil count in ascitic fluid with prothrombin activity time (r = -0.385; P = 0.011).CONCLUSION: A few characteristics are associated with the presence of SBP, especially liver dysfunction, SAAG and peripheral leukocytosis. RESULTADOS: Quando se compararam os indivíduos com PBE aos controles, observou-se menor média de tempo de atividade da protrombina (TAP; 36,1 ± 16,0% versus 47,1 ± 17,2%; P = 0,044) e menor mediana de gradiente albumina soro-ascite (GASA; 1,2 versus 1,7; P = 0,045). Houve tendência do grupo com PBE de apresentar maior média de MELD, sem significância estatística (22,2 ± 7,6 versus 17,9 ± 6,7; P = 0,067). Foi observada forte correlação positiva entre neutrófilos do líquido ascítico e contagem sérica de leucócitos (r = 0,501; P = 0,001) e correlação negativa de neutrófilos do líquido ascítico com TAP (r = -0,385; P = 0,011). CONCLUSÃO: Poucas características estão associadas à presença de PBE, em especial a disfunção hepáti-ca, o GASA e a leucocitose periférica. RESUMO

Spontaneous Bacterial Peritonitis in the Medical Intensive Care Unit of a University Hospital in Egypt: Frequency, Bacteriological Profile, Risk Factors and Outcomes

“…Risk factors of mortality among SBP patients were analyzed using multivariate regression model. Age and MELD score were the only independent risk factors for such events, and this finding is much similar to other reports [29] Conclusions Spontaneous bacterial peritonitis is occurring at high frequency among cirrhotic patients admitted to the Medical ICU of Zagazig University hospital. This serious complication should be detected without delay, since prompt diagnosis and treatment result in decreased morbidity and mortality among infected patients.…”

Ascitic Fluid Calprotectin Level as a Diagnostic Marker of Spontaneous Bacterial Peritonitis in Cirrhotic Patients

“…SBP patients in this study had lower mean SAAG value (1.80±0.33 g/dl) as compared to non-SBP patients (1.94±0.25 g/dl), but without significant difference. Similar results were reported by Thiele et al (27) as mean value of SAAG in SBP group was (1.3 g/dl) and in non SBP group was (1.7 g/dl) and this can be explained by Tarn and Lapworth (28) who stated that SBP is advanced liver disease associated with low serum albumin concentration and so on lower SAAG than cirrhotic patients without SBP.…”

Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study

“…Albumin is the second component of NPAR and is linked to the development and severity of bacterial infections. It can also predict infectious complications in non-infective diseases [ 36 ]. Low serum albumin levels are a marker for infection because they can directly affect the body’s ability to fight infections.…”