Microbiological profile of ascitic fluid infection at Mohammed VI University Hospital in Oujda: A prospective and descriptive study.

Abstract

Introduction-Aim: Spontaneous bacterial peritonitis (SBP) is a common complication in cirrhotic patients and is associated with a high mortality rate. The aim of this study is to determine the epidemiological and bacteriological profile of spontaneous bacterial peritonitis, as well as antibiotic resistance among hospitalized patients at CHU Mohammed VI, in order to guide empirical antibiotic choices for better management. Methods: This is a prospective study conducted over a period of 12 months, from January to December 2023, focusing on all requests for bacteriological examination of ascitic fluid samples. All samples received at the microbiology laboratory were processed according to the Medical Microbiology Reference Standard (Remic) Results: A total of 137 ascitic fluid samples were included. The main etiologies implicated in ascites were cirrhosis (50.36% of cases), followed by neoplastic pathology (24.1% of cases). The prevalence of spontaneous bacterial peritonitis was 13.87%, of which 63.16% corresponded to neutrocytic ascites with negative culture. The rate of bacterascite was 74.07%. Gram-positive cocci constituted the majority of pathogens (56.67%), with 43.33% corresponding to Gram-negative bacilli. 28.57% of coagulase-negative Staphylococci were methicillin-resistant. Quinolone resistance was observed in 23.53% of Gram-positive cocci, and 69.23% of isolated Enterobacteriaceae were multidrug-resistant. Conclusion: The prevalence of SBP due to Gram-positive and multidrug-resistant bacteria has increased in recent years. The currently recommended empirical antibiotic therapy, based on third-generation cephalosporins, carries a high risk of failure and may need to be reassessed.