BACKGROUND:
Spontaneous bacterial peritonitis (SBP) is the most common infection, with a significant fatality rate if remains untreated. Weakened immune systems render them more susceptible to infections, necessitating early detection and treatment. Our study was designed to compare the frequency, disease characteristics, and mortality among SBP subtypes and factors associated with mortality.
METHODS:
This cross-sectional study was conducted at the Aga Khan University Hospital, Karachi from 2007-2012. Patients aged ≥ 18 years and admitted with SBP were included. Data were collected about disease characteristics, 1, 6, and 12 months mortality.
RESULTS:
Overall 243 patients were reviewed. CNNA was the most common (68.3%), whereas NB was the least common (11.9%) subtype. The ascitic fluid total leucocyte countwas significantly lower (170-500x103/uL) in NB as compared to classical SBP (1150 - 6526 x103 /ul) and CNNA (800 -3400x103 /ul) (p <0.001) in contrast to polymorphonuclear counts (PMN) which were significantly lower in NB as compared to classical SBP, NNBC respectively (56.0 ± 27.8% vs 85.5 ± 14.0% vs 72.4 ± 21.2%, p<0.001). Although not statistically significant, overall mortality was higher in NB and CNNA, as opposed to 1-, 6-, and 12-month mortality in classical SBP (31.2%, 7.7%, and 30.0%, respectively).
CONCLUSION
High morbidity-mortality associated with SBP, necessitates early identification and treatment. Lower TLC and PMN counts in NB may mislead, therefore clinical correlation can aid in the prompt administration of antibiotics. Although not statistically significant, overall mortality was higher in NB and CNNA, in contrast, classical SBP had higher 1-,6-, and 12-month mortality.