Spontaneous Bacterial Peritonitis in Alcoholic Cirrhosis: An Indian Perspective

Abstract

Background: Spontaneous bacterial peritonitis (SBP) iscommonly associated with cirrhosis of liver, and has beenassociated with high mortality. Model for end-stage liver disease(MELD) scoring system has been applied as a marker ofdisease severity and predictor of mortality in patients withalcoholic cirrhosis. Recent studies have estimated a prevalenceof 10 to 30% SBP in cirrhotic patients with ascites admitted tohospitals but the data is lacking on Indian population. Hence,the present study was designed to evaluate the profile of SBPin patients with alcoholic cirrhosis in North India according toMELD score.Materials and methods: The prospective study was conductedin patients admitted in the department of medicine. A total of100 patients suffering from alcoholic cirrhosis with ascites wereenrolled in the study. All subjects underwent the following testfor biochemical parameters, abdominal ultrasonography, chestX-ray, endoscopic findings and paracentesis was performedand analyzed. MELD score was calculated for all the patients.Results: Out of total patients, 24% reported with SBP. Patientssuffering from SBP had statistically significant (p < 0.05) higherMELD score, International normalized ratio (INR) and serumcreatinine levels. Also, the patients with SBP had significantly(p < 0.05) lower platelet count as compared to patients withoutSBP. All the other parameters were comparable in both thegroups.Conclusion: SBP is a common complication of alcoholiccirrhosis of Indian patients and measures should be taken fortheir containment.Abbreviations: SBP: Spontaneous bacterial peritonitis; MELD:Model for end-stage liver disease; INR: International normalizedratio; TIPS: Transjugular intrahepatic portosystemic shunt; ICHGCP:International conference on harmonization-good clinicalpractice; AFB: Acid fast bacilli; CNNA: Culture negativeneutrocytic ascites; MNB: Monobacterial bacterascites; AST:Aspartate transaminase; ALT: Alanine transaminase; SAAG:Serum ascites albumin-gradient.