Abstract

During the last 20 years, there has been the recognition of prompt diagnosis and appropriate initiation treatment of Spontaneous Bacterial Peritonitis (SBP). It has been suggested that the profile of the infections has changed, and severe infections caused by resistant bacteria species have started to emerge. In this study, 166 cirrhotic patients, with SBP, were retrospectively evaluated through positive ascitic fluid and blood culture from the period of January 1996 to January 2008. The study period was dichotomized into two 6-year periods; periods A (01/1996 to 01/2002) and B (01/2002 to 01/2008). 166 (23%) of 721 patients with positive ascitic fluid and blood culture were diagnosed during 1996-2008. Gram-positive bacteria were found to be the cause of SBP in patients of period B than A (37/102 or 36.3% vs 12/64 or 18.8%, p = 0.016). Fungi were the cause of SBP in 3 (4.7%) of the 64 patients during period A and in 6 (5.9%) of the 102 patients during period B. Although it seemed that the numbers and species increased, statistical data indicated that there was no significant difference (p = 1.000). Our retrospective review suggested that bacterial isolates from SBP in cirrhotic patients with ascites had shown an increased incidence of SBP caused by Gram-positive bacteria over the last twelve years.

Key words: Spontaneous bacterial peritonitis, gram-positive bacteria and infection.