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. 2025 Jun;59(2):52-59.
doi: 10.4314/gmj.v59i2.2.

Characterising spontaneous bacterial peritonitis in liver cirrhosis and hepatocellular carcinoma in southwestern Nigeria

Abosede G Adeyeye  1 , Adeyemi T Adeyemo  2 , Victor O Adeyeye  3 , Temitope O Ojo  4 , Olusegun Adekanle  5 , Anthony C Anuforo  2 , Aaron O Aboderin  6 , Dennis A Ndububa  5
Affiliations

Characterising spontaneous bacterial peritonitis in liver cirrhosis and hepatocellular carcinoma in southwestern Nigeria

Abosede G Adeyeye et al. Ghana Med J. 2025 Jun.

Abstract

Objectives: This study determined the profile of spontaneous bacterial peritonitis (SBP) and its variants in patients with decompensated liver cirrhosis and hepatocellular carcinoma (HCC).

Design: A descriptive cross-sectional study.

Setting: The study was conducted in a tertiary hospital.

Participants: Patients with decompensated liver cirrhosis and HCC above 18 years.

Interventions: Ascitic fluid (AF) samples were taken for cell count and culture using a BACTEC culture bottle. Sensitivity patterns and ascitic fluid total protein and albumin levels were also assessed.

Main outcome measures: Clinical profile of SBP, organisms isolated from the ascitic fluid and sensitivity of isolated organisms to antibiotics.

Results: One hundred and six (106) participants were recruited. Seventy (66%) had liver cirrhosis, and 36 (34%) had HCC. The mean age was 50.08±12.66 years. Eighty-nine (84%) were males and 17(16%) were females. The overall prevalence of SBP was 29.2% (n = 31). Classical SBP was 5(4.7%), CNNA 20(18.9%) and monobacterial ascites 6(5.7%). The Gram-positive isolates were Staphylococcus aureus 5(45.5%) - [2(18.2%) MRSA, 3(27.3%) MSSA] while the Gram-negative organisms were E. coli 3(27.3%), Acinectobacter 2(18.2%) and Bulkholderia cepacia 1 (9.1%). Gram-negative bacteria showed absolute resistance to cephalosporins but were all susceptible to meropenem. Gram-positive bacteria showed 100% susceptibility to linezolid, vancomycin and daptomycin. Gram-positive bacteria also showed low resistance to fluoroquinolones (20%). Multi-drug resistance pattern was reported for MRSA, Acinetobacter baumannii and Bulkholderia cepacia.

Conclusion: SBP is a common complication in patients with decompensated CLD. Guided antibiotic treatment should be encouraged, particularly in light of the emergence of multidrug resistance patterns.

Funding: None declared.

Keywords: Ile-Ife; Nigeria; Prevalence; liver cirrhosis and HCC; spontaneous bacterial peritonitis.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Causative organisms for SBP
See this image and copyright information in PMC

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