Bacterial Infections in Patients with Liver Cirrhosis and Ascites

Introduction Bacterial infections are common complications and the cause of death in patients with cirrhosis and ascites. There is no standard method for a rapid and low-cost diagnosis, and its prognosis is poor. Objective The aim of this study was to determine the etiology and frequency of bacterial infections in patients with liver cirrhosis of different etiology, and the influence of bacterial infections on the prognosis in patients with liver cirrhosis and ascites. Methods Sixty-four patients with cirrhosis and ascites were included in the study. The diagnosis of spontaneous bacterial peritonitis was established based on the diagnostic abdominal paracentesis and the results of biochemical, cytological and microbiologic analysis of ascitic fluid. The diagnosis of urinary infection and pneumonia were made according to the standard criteria. Results Spontaneous bacterial peritonitis was diagnosed in 23 (35.9%) patients, urinary infections in 16(25%) and pneumonia in 11 (17.2%). Gram positive and gram negative bacteria in spontaneous bacterial peritonitis were etiologically almost equally represented (52%; 48%). The most frequent causes were Escherichia coli and Staphylococcus aureus. In 81% of patients urinary infections were caused by gram negative bacteria (Escherichia coli in 44%). The most frequent cause of pneumonia was Streptococcus pneumoniae (46%). Conclusion Spontaneous bacterial peritonitis, urinary infections and bronchopneumonia are the most frequent bacterial infections in patients with liver cirrhosis and ascites. A timely recognition of bacterial infections and the initiation of treatment have a positive effect on the prognosis of such patients.