Clinical Profile, Bacteriological Profile, and Outcomes of Patients with Spontaneous Bacterial Peritonitis with Preexisting Chronic Liver Disease

Introduction: Spontaneous bacterial peritonitis (SBP) is a critical complication in patients with chronic liver disease (CLD).Understanding the clinical features and bacterial profile of SBP is essential for its effective management.To study the clinical and bacteriological profile and the factors influencing the outcome of SBP in patients with CLD. Materials and Methods: We retrospectively analyzed the medical records of 113 patients diagnosed with SBP between January 2018 and December 2022 at a tertiary care hospital.We assessed the clinical features, laboratory parameters, causes of cirrhosis, and bacterial profiles.Statistical analyses were performed to identify associations between these parameters and the clinical outcomes.A p value of <0.05 was considered statistically significant. Results:The mean age of the patients was 54.04 years.The common clinical features were abdominal distension (80.5%) and abdominal pain (54%).Abnormalities were observed in the parameters of the renal function tests (elevated creatinine, bicarbonate, sodium, and potassium levels) and liver function tests (elevated SGPT, alkaline phosphatase, gamma-glutamyl transferase, and globulin levels).Bacterial cultures of the ascitic fluid and blood predominantly grew Escherichia coli and Klebsiella pneumoniae species.Jaundice (p=0.001) and altered mental status (p=0.000)significantly influenced the clinical outcomes.Total leukocyte count (p=0.001) and bicarbonate levels (p=0.008) were significantly associated with the clinical outcomes.Non-alcoholic fatty liver disease and cryptogenic cirrhosis were significantly associated with the clinical outcomes.Child-Pugh scores, duration of hospital stay, and higher Model for End-Stage Liver Disease scores and INR were associated with negative outcomes (p<0.05). Conclusion:This study provides valuable insights regarding the regional differences in clinical features and bacterial profile of SBP in patients with CLD.Understanding these factors can aid in the management and prognosis of SBP.