Identification of Ascitic Fluid Bacterial Pathogens in Spontaneous Bacterial Peritonitis in Nile Delta and Its Impact on Clinical Outcome of These Patients
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Tanta University
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- identification of SBP bacterial pathogens through gram stain or other specific stains
Study Overview
Brief Summary
Several studies have pointed out changes in the epidemiology of the causative bacteria in SBP and bacterascites and in their susceptibility to antibiotics. In particular, the development of beta-lactamase enzymes, which confer resistance to clavulanate, or extended spectrum beta-lactamases in Escherichia coli. The potential emergence of enterococci, methicillin-resistant S. aureus, or fluoroquinolone-resistant bacteria, following norfloxacin prophylaxis, is also a cause of concern since they may be associated with a higher risk of therapeutic failure.
The microbial etiology of SBP remains relatively constant; however, the antibiotic resistance rate especially for third-generation cephalosporins (including cefotaxime and ceftazidime), ciprofloxacin, and ofloxacin increased dramatically
Detailed Description
Spontaneous bacterial peritonitis (SBP), defined as an infection of ascites in the absence of a contiguous source of infection.
Spontaneous bacterial peritonitis (SBP) is a common and potentially fatal bacterial infection in patients with cirrhosis and ascites, occurring in 10 to 30% of patients, with in-hospital mortality rates ranging from 20 to 30% .
It is secondary to impaired humoral and cellular immune responses that result in indirect intestinal bacterial translocation into the ascitic fluid.
SBP is also associated with a poor long-term prognosis for patients, as mortality rates can reach 50 to 70% at 1 year.
Early diagnosis and early optimal treatment of these infections with appropriate antibiotics and the prevention of hepatorenal syndrome with albumin are required .
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Diagnostic
- Masking
- None
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Liver cirrhosis with ascites and suspected to have SBP.
- •ascitic fluid PMNL ≥ 250 cells/mm3
Exclusion Criteria
- •ascitic fluid with polymicrobial infections
- •patients started empirical antibiotics without prior culture.
Arms & Interventions
SBP patients
ascitic fluid culture and microbiological testing for 100 patients with liver cirrhosis and ascites with suspicion of SBP
Intervention: ascitic fluid culture and microbiological testing (Other)
Outcomes
Primary Outcomes
identification of SBP bacterial pathogens through gram stain or other specific stains
Time Frame: 6 months
identification of SBP bacterial pathogens through gram stain or other specific stains
Secondary Outcomes
No secondary outcomes reported
Investigators
Sherief Abd-Elsalam
PI
Tanta University