[Spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis based on bacteriological and...

Spontaneous bacterial peritonitis (SBP) is frequent and insidious complication of liver cirrhosis regardless of its aetiology. The aim of the study was to assess the usefulness of biochemical markers in the blood and ascitic fluid, including the concentration of proinflammatory cytokines in the diagnosis of SBP in the patients with decompensated liver cirrhosis. The material and methods: 117 examinations in 88 patients were performed as following: ascitic fluid and blood cultures, throat and anus smears, biochemical examinations in the serum and ascitic fluid including concentration of procalcitonin, TNF-alpha, IL-6 and neopterin.

25% of patients have died during the hospitalisation, the positive blood cultures were found in 7 cases (5.9%), whereas the positive ascitic culture in 17 (14.5%) cases. The procalcitonin level were increased in 56.6% of the cases, the remaining levels of cytokines were increased considerably in one case with SBP. Biochemical examinations in the blood, performed on the admission, revealed: hyperbilirubineamia, increased level of ALT, AST, GGTP, alkaline phosphatase, creatinine, WBC and gamma-protein and decreased level of haemoglobin and albumin.

We have obtained Gram positive bacteria in 57% of cases in the ascitic fluid and Gram negative in the 43%. THE RESULTS of the cytokines concentration seam do not have significant importance in the SBP diagnosis. However our study was performed on the small amount of the cases and requires further investigations including the control group.