BACTERIAL SPECTRUM AND ANTIBIOTIC SENSITIVITY IN SPONTANEOUS BACTERIAL PERITONITIS ASSOCIATED WITH LIVER CIRRHOSIS

Background: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication of liver cirrhosis, often leading to severe morbidity and mortality. The increasing prevalence of multidrug-resistant (MDR) organisms has complicated empirical treatment protocols, particularly in regions with limited microbiological surveillance. This study aims to address the local gap in data on bacterial spectrum and antimicrobial sensitivity in cirrhotic patients with SBP. Objective: To determine the bacterial spectrum and antibiotic sensitivity patterns in spontaneous bacterial peritonitis among patients with liver cirrhosis. Methods: A cross-sectional study was conducted over six months at the Department of Medicine, Khyber Teaching Hospital, Peshawar. A total of 139 patients aged 30–65 years, diagnosed with SBP secondary to liver cirrhosis, were included through non-probability consecutive sampling. Ascitic fluid was analyzed for culture and sensitivity against commonly used antibiotics. Data on demographics and resistance patterns were recorded and analyzed using SPSS v27. Chi-square tests were applied post-stratification to examine associations. Results: Escherichia coli was the most frequently isolated organism (64.0%), followed by Klebsiella spp. (40.3%) and Staphylococcus spp. (27.3%). High resistance rates were observed for ciprofloxacin and ceftriaxone among E. coli isolates (43.9% and 35.9%, respectively). Klebsiella showed equal resistance and sensitivity to ceftriaxone and piperacillin (50%), while Staphylococcus spp. remained fully sensitive to vancomycin but demonstrated significant resistance to clindamycin (52.6%) and cefazolin (57.9%). Conclusion: The predominance of resistant E. coli and rising MDR patterns underline the need for continuous microbiological surveillance and revised empirical treatment guidelines. Local resistance profiles should guide antibiotic choices in SBP management to improve outcomes.