Outcomes in culture positive and culture negative ascitic fluid infection in patients with viral cirrhosis: cohort study

Abstract

Background: Ascitic fluid infection (AFI) in cirrhotic patients has a high morbidity and mortality. It has two variants namely, spontaneous bacterial peritonitis (SBP) and culture negative neutrocytic ascites (CNNA). The aim of this study was to determine the outcome in cirrhotic patients with culture positive (SBP) and culture negative neutrocytic ascites.

A Study on Clinical and Laboratory Features of Spontaneous Bacterial Peritonitis in Chronic Liver Disease

“…The incidence of SBP (including CNNA and BA) was found to be 25% in our cohort. International studies reports an incidence of 8 -30% in CLD patients with ascites, 3,14 which reciprocates that our results are in concordance with these reports. Regarding SBP variants, CNNA was the most common followed by Bacterascites and classical SBP in descending order.…”

“…International literature suggests a culture positivity rate of 31 -71%. 14,22 A study from Lahore showed similar results (47.5%) 16 but some studies have reported less than 25% rates of culture positivity. 14,23 This difference may be due to the different culture techniques as reported by Pawar et al showing varied rate for different technique.…”

“…Similar pattern of the distribution of different SBP variants has been reported by Evans et al 15 But, some studies have a slightly different pattern which show Bacterascites to be the least common entity. 14,16 Recent literature suggests bacterascites is not an uncommon phenomenon. The differences in frequency of different SBP variants within different populations may be due to more severity of disease in the cases as mentioned above apart from host factors like immunity and general health status of patients.…”

Infections in Cirrhotics: Types, Microbiological Spectrum and Risk Factors—5-Year Cohort Study

“…Fernandez J, et al [2] had shown 25% SBP among patients with cirrhosis of liver. Earlier published local studies on AFI showed frequency of SBP to be (23.5%) and (38.23%) respectively with similar microbiological spectrum [35] [36]. The low frequency of SBP in above studies is probably due to smaller sample size.…”

“…69.93% patients among AFI had CNNA in this study. Above mentioned studies had (76.4%) and (57.84%) CNNA [35] [36].…”