Identification of Ascitic Fluid Bacterial Pathogens in Spontaneous Bacterial Peritonitis in Nile Delta and Its Impact on Clinical Outcome of these Patients
Journal Title: Microbiology Research Journal International - Year 2016, Vol 17, Issue 4
Abstract
Aims: This study aimed to identify ascetic fluid bacterial pathogens and their antibiotic resistance profile in Spontaneous Bacterial Peritonitis (SBP) patients in Nile delta and its impact on the clinical outcome of these patients. Study Design: Retrospective observational study. Place and Duration of Study: Patients enrolled in this study were admitted to Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Egypt. Further laboratory work was carried out at Microbiology and Immunology Department, Faculty of Medicine, Tanta University, Egypt, from July 2015 to June 2016. Methodology: 247 patients with liver cirrhosis and ascites who met the clinical criteria for suspicion of SBP including: fever, encephalopathy, refractory ascites and abdominal pain were enrolled in the study. Patients were subjected to thorough history and clinical examination. Ascetic fluid sampling was done for every patient and ascetic fluid analysis was done including cell counts and differential counts. Also, ascitic fluid culture, microbiological testing and antimicrobial sensitivity tests were done. Results: Out of 247 patients enrolled in this study with liver cirrhosis, ascites and clinical suspicion of SBP, 138 patients were excluded. These excluded patients included: 91 patients had ascetic fluid neutrophils below 250 cells/mm3, 4 patients were cases of secondary peritonitis with polymicrobial culture and 43 patients were found to started empirical antibiotics within 5 days of admission. Out of 109 patients who had SBP, 28 only were culture positive. Among culture positive SBP, 16 (57.1%) were Gram positive and 12 (42.9%) were Gram negative. The most common organism isolated was Gram positive Enterococci followed by E. coli and Staph aureus. Conclusion: While Gram negative bacteria were the main infectious agents causing SBP a few decades ago, and are still reported to be so in the most recent recommendations and reviews, Gram positive bacteria are now predominant and there is a rising prevalence of bacteria with reduced susceptibility to cephalosporins and fluoroquinolones as regarding this study only and not including previous data or speculations. Current international guidelines recommend the use of a third-generation cephalosporin for empirical treatment of SBP which raise the questions about these guidelines and if they are still valid.
Authors and Affiliations
Haidy S. Khalil, Walaa Elkhalawany, Mohamed Elhendawy, Rehab Badawi, Marwa Ahmed Abdelwahab, Sherief Abd-Elsalam
Keywords
Related Articles
- EP ID EP350715
- DOI 10.9734/BMRJ/2016/29869
- Views 85
- Downloads 0
Antimicrobial Resistance of Pathogenic Bacteria Isolated from Mastitis Cows in Khartoum State, Sudan
Aims: The problem of antimicrobial resistance (AMR) is now recognized as a major threat to the health and development in all countries. This study was conducted to determine pathogenic bacteria asso...
Antibiotics Susceptibility Pattern of Methicillin Resistant Staphylococcus aureus (MRSA) In Enugu State, South-East Region of Nigeria
Development of antimicrobial resistance by bacteria is now a worldwide health issue, as infection is one of the leading causes of death in the world today. The aim of this study was to evaluate the prevalence and antimic...
Detection and Molecular Identification of Persistent Water Vessel Colonizing Bacteria in a Table Water Factory in Nigeria
Aims: To establish organisms persistent in a table water production facility and to determine the points they entered in order to eliminate any risk of having pathogens in a water production system. Study Design: Analyti...
Hygienic Status of Cow Milk and Wara from Local Fulani Herdsmen in two Western States of Nigeria
Aims: Microorganisms in milk and milk products are considered to pose certain hygienic risks for human health. The study aim was to assess the microbial load of cows’ milk from free-grazing cattle and local cheeses (wara...
Strain Development of Aspergillus brasiliensis Using Physical and Chemicals Mutagenesis for Possible Overproduction of Xylanase, Amylase, Protease and Cellulase under Submerged Fermentation (SmF)
Aims: Xylanase is commonly involved in the complete hydrolysis of xylan which consisted of hemicelluloses and celluloses as important components of plant cell wall. This enzyme is essential in wide range of applications...