Giris ve amaç: Sirozda spontan assit enfeksiyonu gelismesini ve prevalansi ni etkileyen bir takim faktörler ileri sürülmektedir. Bu prospektif çalismanin amaci, sirotik hasta grubumuzda spontan assit enfeksiyonu prevalansini ve risk faktörlerini belirlemekti. Gereç ve yöntem: Farkli nedenlere bagli (30 HBV, 14 HCV, 16 alkol, 8 kriptojenik) sirozu olan assitli 68 hasta (20 kadin ve 48 erkek, ortalama yas 48.76 ± 7.49) hastaneye yatirilarak incelendi. Serum ve assit sivisinda bir takim biyokimyasal parametreler incelenirken, assit sivisi örneklerinin hemokültür siselerine konmasi ve gram boyamasi için lama yayilmasi hasta basinda gerçeklestirildi. Bulgular: 14 hastada (% 20.58) spontan assit enfeksiyonu saptandi. Bu vakalarin 7’si kültür negatif nötrositik assit, 6’si spontan bakteriyel peritonit ve 1’i monobakteriyel nonnötrositik assit idi. Child- Pugh siniflamasina göre 8 hasta (% 57.14) C evresinde, 6 hasta (% 42.85) B evresinde idi. 8 hastada (% 57.14) HBV, 2 hastada (% 14.28) HCV ve 4’ünde (% 28.57) alkol etyolojik faktördü. Spontan assit enfeksiyonu gelisiminde, Child-Pugh siniflamasi ve etyolojik gruplara göre fark yoktu. Steril assiti olan hastalara göre assit sivisi total protein düzeyi 1 g/dL’nin altinda olmasi, geçirilmis spontan assit enfeksiyonu ve geçirilmis gastrointestinal kanama görülme orani anlamli olarak daha yüksekti (p<0.05). Sonuç: Assiti olan sirotik hastalarda SAI görülme orani % 20.58 olarak tespit edildi. Assit sivisindaki total protein düzeyinin düsüklügü, geçirilmis spontan assit enfeksiyonu ve geçirilmis gastrointestinal kanama varligi spontan assit enfeksiyonu riskini arttiriyordu.
Background and aim: It has been suggested that several factors influence the development and prevalence of spontaneous ascites infection in cirrhosis. The aim of this prospective study was to define the prevalence of spontaneous ascites infection (SAI) and its risk factors in our cirrhotic patient population. Material and methods: 68 patients (20 female and 48 male, mean age 48.76 ± 7.49) with cirrhosis and ascites due to various etiologies (30 HBV, 14 HCV, 16 alcohol, 8 cryptogenic) were evaluated after hospitalization. Inoculation of samples from ascites fluid into the hemoculture bottles and spreading onto lames for Gram staining was done at the bedside, as well as measurement of several biochemical parameters in serum and ascitic fluid. Results: SAI was defined in 14 (20.58 %) of the patients. Out of these cases, 7 were culture negative neutrocytic ascites, 6 spontaneous bacterial peritonitis and 1 monobacterial non-neutrocytic ascites. Out of these patients, 8 (57.14 %) were in C stage, and 6 (42.85 %) in B stage according to Child-Pugh classification. HBV was the etiologic factor in 8 (57.14 %), HCV in 2 (14.28 %) and alcohol in 4 (28.57 %) patients. We found on difference among the etiologic groups and Child-Pugh groups in view of the development of SAI. The rates of patients with ascitic fluid total protein lower than 1 g/dl, previous spontaneous ascites infection and previous gastrointestinal hemorrhage were significantly higher than those of patients with sterile ascites (p<0.05). Conclusion: SAI was seen in 20.58 % of the cirrhotic patients with ascites. The lower rates of total protein in ascitic fluid, previous SAI and previous gastrointestinal hemorrhage increase the risk of SAI.