MICROBIOLOGICAL ANALYSIS AND ANTIBIOTIC SUSCEPTIBILITY FOR SPONTANEOUS BACTERIAL PERITONITIS IN HOSPITALIZED PATIENTS WITH AND WITHOUT HEPATITIS C

Abstract

In individuals with cirrhosis, spontaneous bacterial peritonitis (SBP) is a common and often fatal bacterial infection with ascites. The Pathological accumulation and collection of fluid in the peritoneal cavity is known as ascites. Ascites can be a challenging diagnosis. Individuals with or without underlying hepatitis C may have varying SBP. Antimicrobials are used to treat SBP, however because MDR organisms are present, initial empirical treatment may not be effective. The aim of the present study was to investigate the causative agents of ascites in SBP and to check antibiotic susceptibility of bacterial isolates. In recent study twenty-five SBP patients were prospectively studied. The ascitic fluid was inoculated in to conventional bacterial broth, agar culture and blood culture media. Among all tested bacterial species E. coli was the most isolated bacteria present in 23 samples out of 25. The presence of E.coli was 92% followed by Shigella spp (72%), Salmonella spp (68%), Enterobacter spp (60%), K. aerogenes (52%), S. aureus (32%), S. epidermidis (30%), A. israelii (28%), P. aeruginosa (24%), C. freundii (20%) and S. marcescens (08%). A total of six antibiotics were used to check antibiotic susceptibility pattern of bacterial isolates through disc diffusion method. The used antibiotics were Meropenem, Moxifloxacin, Ciprofloxacin, Ceftriaxone, Cefixime and vancomycin. Our results showed that most of isolated bacterial species were MDR (Multi drug resistant) except E.coli and A.israelii that were sensitive to used antibiotics. Meropenem was the most effective antibiotic against all tested bacterial species. Meropenem showed maximum zone of inhibition against S.auresus (34mm), followed by A. israelii (33mm), P.aeruginosa (32mm), C.freundii (31mm), S.marcescens (28mm), S.epidermidis (27mm), E.coli (26mm), Salmonella spp (23mm), K.aerogenes (21mm), Enterobacter spp (21mm) and Shigella spp (15mm). It is concluded that gram-positive and gram-negative multi-drug resistant bacteria were the most common cause of SBP in patients with and without hepatitis C and meropenem was the most effective antibiotic against all tested isolate