Spontaneous peritonitis in cirrhotic hospital in-patients: retrospective analysis of 101 cases

One hundred and one patients with cirrhosis resulting from alcohol abuse, admitted to Broussais University Hospital, Paris, between January, 1986 and December, 1989 were assessed for infection of the ascitic fluid using clinical and cytobacteriological criteria. All of 46 patients (45.5%) with clinical signs and symptoms of peritonitis had an ascitic fluid polymorphonuclear (PMN) count > 250 cells/mm3. Bacteria could be isolated from the ascitic fluid of 23 patients (50%). Twenty-six bacterial strains were isolated (there was more than one strain in two samples). Escherichia coli was found in 14 cases. It is noteworthy that no anaerobes were grown. Mortality, biochemical parameters and clinical features correlated significantly with an ascitic fluid PMN count > 250 cells/mm3. High mortality correlated with a PMN count > 1000 cells/mm3 (70% vs. 33%).