[Spontaneous bacterial peritonitis: clinical, microbiological and clinical course study of 89 episodes]

We have retrospectively studied 89 episodes of spontaneous bacterial peritonitis (SBP) attended at our service with the purpose of analyzing clinical features, microbiologic data and possible etiopathogenic factors, treatment and course. The most frequent symptoms were ascites, abdominal pain and fever. Only 3.3% of episodes were asymptomatic. Twenty-four episodes (26.96%) resulted in death of the patient and only the presence of septic shock and prothrombin time lower than 35% statistically correlated with a higher mortality (100% and 53.8%, respectively, p less than 0.01) of the possible factors analyzed. The culture of ascitic fluid (AF) was positive in 52.8% of the episodes and there were no clinical or time course differences between these cases and those who presented negative culture. The isolated microorganisms were the usual ones in this condition, outstanding 37.5% of gram-positive cocci in monomicrobial SBP. Treatment was initiated within the first 12 hours from admittance in 76.4% of cases, between 12 and 72 hours in 12.3% and after 72 hours in 11.2%. Cefotaxime was given to 47.1% of episodes and 52.9% of patients received ampicillin or cefoxitin plus aminoglycoside; the mortality was lower with the first schedule (11.9% versus 40.4%, p less than 0.01).