Frequency of spontaneous bacterial peritonitis in 265 cirrhotics with ascites

Dario Conte, Paola Bolzoni, Paolo Bodini, Clara Mandelli, Maria L. Ranzi, Lucia Cesarini, Mirella Fraquelli, Roberto Penagini, Paolo A. Bianchi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate, prospectively, the prevalence, outcome and recurrence of spontaneous bacterial peritonitis (SBP) in cirrhotics with ascites. Setting: Gastroenterology unit at a teaching hospital in Milan and four referring hospitals. Patients and methods: Two hundred and sixty-five consecutive cirrhotics with ascites (208 men, 57 women) were studied. Ascitic fluid tap was obtained at entry to determine total protein concentration, absolute polymorphonuclear (PMN) cell count and to allow bedside culture of both aerobic and anaerobic organisms. Statistical analysis: Mann-Whitney and χ2 tests. Results: SBP was diagnosed in 24 patients (9%), with enteric organisms involved in 21 patients, culture-negative neutrocytic ascites (CNNA) in 34 (13%) and bacterascites (BA) in 16 (6%). Ascitic fluid was sterile in 191 patients (72%). In those with SBP, PMN/μl were higher than in those with CNNA (P <0.01) and total protein concentration lower than in those with sterile ascites (SA) (P <0.01). Total protein of 10g/l or less of ascitic fluid were observed in 58% of those with SBP versus 56% of those with BA, 41% in CNNA patients and 28% in those with SA (P <0.01). Inpatient mortality was highest in those with SBP (42% versus 18% of CNNA, 13% of BA and 6% of SA patients; P <0.001). SBP infection by Escherichia coli was more frequent in the 10 patients who died than in the 14 survivors (P <0.01). Five out of these 14 patients (36%) had a recurrence within 6 months and three died (overall mortality 60%). Conclusions: SBP, CNNA and BA are frequent in hospitalized cirrhotics with ascites and early diagnosis is mandatory.

Original languageEnglish
Pages (from-to)41-45
Number of pages5
JournalEuropean Journal of Gastroenterology and Hepatology
Volume5
Issue number1
Publication statusPublished - 1993

Keywords

  • Bacterascites
  • Cirrhosis
  • Culture-negative neutrocytic ascites
  • Spontaneous bacterial peritonitis

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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