Identification of Causative Organisms and Role of Ceftriaxone in Spontaneous Bacterial Peritonitis (SBP) Secondary to Decompensated Liver Disease

Background There is increasing trend of gram positive organism present in ascetic fluid culture as a result of selective gut decontamination of gram negative organisms by prophylactic antibiotics for SBP and due to different invasive procedures. Objectives to identify causative organisms in ascetic fluid culture of patients with spontaneous bacterial peritonitis secondary to decompensated liver disease and their sensitivities to ceftriaxone as an empiric therapy. Methods A Cross sectional study was conducted at Department of Gastroenterology, Shifa International Hospital, Islamabad. Aseptic technique was adopted to aspirate ascetic fluid. At least 10 ml of ascetic fluid was inoculated in blood culture bottle at bed side before starting ceftriaxone. Result Total 97 patients were included in this study. Among them 57 (58.8%) were male and 40 40(41.2 %) were female. The most common organism was E. coli with a frequency of 42(43.2 %) almost half were ESBL strains 20(20.6%) followed by Klebsiella 15(15.4%) among which 5(5.2%) were ESBL strains while Pseudomonas aeruginosa was 12(12.3%). Conclusion No increasing trend of gram positive pathogens was observed, however ESBL strains are emerging pathogens. Gram negative organisms are still the common pathogens of SBP.