Curr Health Sci J, vol. 42, no. 4, 2016

Study of the Etiological Spectrum of Spontaneous Bacterial Peritonitis in a Group of Patients Suffering from Liver Cirrhosis

[Original Paper]

DIANA RODICA TUDORASCU(1), ANDREEA LILI BARBULESCU(2), ELENA TATIANA CARTANA(3), ILEANA OCTAVIA PETRESCU(4), RALUCA NICULINA CIUREA(5), DANIELA CIOBANU(1), M.C. FORTOFOIU(1), V. PADUREANU(1), OANA SORINA TICA(6), STEFANIA TUDORACHE(6), F. PETRESCU(1)


(1)Department of Clinical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova,
(2)Department of Pharmacology, University of Medicine and Pharmacy of Craiova,
(3)Department of Internal Medicine and Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova,
(4)Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy of Craiova,
(5)Department of Pathology, University of Medicine and Pharmacy of Craiova,
(6)Department of Mother and Child, University of Medicine and Pharmacy of Craiova


Abstract:

Introduction. Spontaneous bacterial peritonitis (SBP) represents the most severe and common infectious complication in patients suffering from liver cirrhosis. The objectives of the study were the evaluation of the risk factors responsible for the occurrence of the spontaneous bacterial peritonitis in a group of patients suffering from liver cirrhosis, the identification of the bacterial spectrum and assessing the response to antibiotic therapy. Material and method - The studied group included 64 patients suffering from liver cirrhosis, with an episode of SBP, who were admitted to the IInd Medical Clinic of the County Hospital of Craiova, within a period of 24 months. The control group included 61 patients with liver cirrhosis with an episode of decompensation of liver disease. The diagnosis of liver cirrhosis was established by using clinical, biological and imagistic criteria, and the SBP’s diagnosis was based on cytological and bacteriological analysis of the ascites fluid. Patients suffering from hepatocellular carcinoma, portal vein thrombosis and other infectious conditions were excluded. The anamnesis, the duration of the disease, the alcohol intake, the complete clinical examination, the clinical, biological and imagistic evaluation were monitored. Results and conclusions - The most frequent etiology of SBP is represented in 67% of the cases by Gram negative germs, and thus, the antibiotic therapy will be orientated against this etiological segment. In what antibiotic sensitivity is concerned, most of the germs were sensitive to third generation cephalosporins, quinolones, carbapenems and vancomycin.


Keywords:
liver cirrhosis, spontaneous bacterial peritonitis, antibiotherapy



Corresponding:
Tudoracu Diana Rodica, Department of Clinical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova. Petru Rares St., no2 , Craiova, Romania.; e-mail: petridiana@yahoo.com


DOI 10.12865/CHSJ.42.04.06 - Download PDF