الفهرس 
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Abstract
Spontaneous bacterial peritonitis (SBP) is the most common infection in
cirrhotic patients followed by urinary tract infections, pneumonia, and
bacteremia. The outcome of SBP has been considerably improved due to early
diagnosis and the introduction of effective antibiotics. The aim of this study
was to identify clinical and laboratory parameters that predict SBP in
patients with cirrhotic ascites, allow a rapid accurate diagnosis of SBP
or exclude SBP without the need for instant paracentesis. This study
was carried out in the national liver inistitute hospital inpatient departments.
Patients with liver cirrhosis and ascites admitted to our department for any
reason from March 20 15 to December 20 16 were eligible for the study. Patients
with antibiotic treatment at the time of paracentesis, hemorrhagic ascites,
malignant ascites or evidence for secondary peritonitis were excluded.
Diagnostic paracentesis was performed in all of the study population. These
patients were studied for age, sex, FBS, 2hPPBS, Child-Pugh Classification,
MELD-Score, serum creatinine, bilirubin, albumin, ALT , AST, DR, blood
total leucocytic count, platelet count and CRP.
To identify independent predictors of SBP, variables being significantly
correlated with the risk for SBP in univariate analysis were entered in a
multivariate model using stepwise logistic regression.
The results of our study showed that there were no significant differences
as regards sex (men, 18.9% versus 20.8%, P = 0.678), diabetes mellitus
(diabetics, 23.9% versus 17.1 %, P = 0.152), Child clarification ( Child A, 0%
Child B 18.6% , Child C 20.5%) and mean levels of serum albumin and ALT(P
= 0.198 and P = 0.136, resp.) between SBP positive group and SBP negative
group.
Conversely, there were significant differences in mean levels of age,
bilirubin, DR, creatinine, AST, MELD score, TLC, Platlet count and CRP (P
=O.OO1,P=O.OO1,P=O.OOO,P=O.OO6,P=O.OO6,P=O.OOO, P=0.003, P
= 0.000 and P = 0.000, resp.).
In multivariate analysis, only age, platelet count and CRP (P = 0.004, P
= 0.013 and P = 0.000, resp.) independently correlated with the risk of
developing SBP.
from these results we can conclude that the frequency of SBP in
inpatients with cirrhotic ascites was 20% with higher incidence in old age and
only old age, low platelet count and elevated CRP were independent predictors
of SBP.