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 10 g/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.

Frequency of spontaneous bacterial peritonitis in 265 cirrhotics with ascites / D. Conte, P. Bolzoni, P. Bodini, C. Mandelli, M.L. Ranzi, L. Cesarini, M. Fraquelli, R. Penagini, P.A. Bianchi. - In: EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY. - ISSN 0954-691X. - 5:1(1993), pp. 41-45.

Frequency of spontaneous bacterial peritonitis in 265 cirrhotics with ascites.

D. Conte
Primo
;
R. Penagini
Penultimo
;
1993

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 10 g/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.
Bacterascites; Cirrhosis; Culture-negative neutrocytic ascites; Spontaneous bacterial peritonitis
Settore MED/12 - Gastroenterologia
1993
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/213113
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