TITLE:
Spontaneous Bacterial Peritonitis and Short-Term Prognosis in a Group of Decompensated Cirrhotic Patients in Yaounde: A Cross-Sectional Study
AUTHORS:
Mathurin Pierre Kowo, Sylvain Raoul Simeni Njonnou, Nelly Karelle Weyou Noubissi, Firmin Ankouane Andoulo, Gabin Ulrich Kenfack, Larissa Pessidjo Djomatcho, Hortense Gonsu Kamga, Bernadette Ngo Nonga
KEYWORDS:
Spontaneous Bacterial Peritonitis, Decompensated Liver Cirrhosis, Sub-Saharan Africa
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.10 No.8,
August
7,
2020
ABSTRACT: Introduction: Spontaneous bacterial
peritonitis (SBP) is among the most common infections in cirrhotic patients. Data on SBP are rare in Cameroon. This prompted us
to carry out this study on patients with decompensated cirrhosis of the liver in
Yaounde University Hospital Centre (YUHC). Methods: We carried out a cross-sectional
study from December 2015 to June 2016 in three units of YUHC. All patients with
decompensated liver cirrhosis were included. Our sampling was consecutive. Diagnosis
of cirrhosis was performed, based on clinical, biological and ultrasound criteria.
A neutrophil count greater than 250 cell/mm3 in ascites fluid defined
an SBP. Data on socio-demography, clinical presentation, and outcomes were collected. Results: We included 34 decompensated cirrhotic patients (15 males). Patients
mean age was 57.5 ± 2 years (SBP positive: 48.7 ± 21.3 versus without SBP: 59.8 ± 19.5, p = 0.22). SBP diagnosis was made in 6 (17.7%) patients. Compared to patients
with decompensated liver cirrhosis and without SBP, positive SBP patients had a
higher pulse rate (p = 0.002) and respiratory rate (p = 0.02). The patients with SBP were more likely to present these other clinical
features: pulse rate >100 (RR: 4.2, [95% CI: 0.7 - 27.7]; p = 0.02), presence of jaundice (RR: 3.4, [95% CI: 0.6 - 21.1]; p = 0.09), being from female gender (RR: 3.2, [95% CI: 0.5 - 19.9]; p = 0.11), advanced liver disease (Child C class) (RR: 2.4, [95% CI: 0.4 - 14.5], p = 0.66), low-plasma albumin (less than 20 g/L) (RR: 1.7, [95% CI: 0.8 - 3.9], p = 0.08), respiratory rate > 30 (RR: 1.6, [95%
CI: 0.6 - 3.3], p = 0.05) and fever/hypothermia (RR: 1.5, [95% CI: 0.6 - 3.4]; p = 0.22). Evolution after a 72-hours antibiotherapy was stationary in four cases
and unfavorable in two patients, resulting in death. Conclusion: SBP prevalence
was 17.7%. SBP patients were younger, from female sex, tachycardia and polypnea,
presenting with fever/hypothermia and signs of advanced liver disease than non-SBP
patients. Improvement of our technical platform will be useful to determine the
cause of cirrhosis and identify the different germs responsible for SBP.