Abstract: Objective The purpose of this study was to analyze pathogen distribution and factors impacting subsidence of ascites in patients with hepatitis B-induced liver cirrhosis (LC) complicated with spontaneous bacterial peritonitis (SBP). Methods 62 patients with hepatitis B-induced LC complicated by SBP were encountered in our hospital between March 2020 and December 2023, ascites pathogens were routinely separated and characterized, and all patients were carefully managed with antibiotics at base of supporting treatment. Multivariate Logistic regression analysis was applied to identify risk factors impacting subsidence of ascites. Results Of the 62 patients with SBP, 77 pathogenic strains were isolated, including 27 Gram-positive bacteria, e.g., Streptococcus pneumonia in 11, Staphylococcus epidermidis in 9, and Enterococcus faecium in 7, and 50 Gram-negative bacteria, e.g., Escherichia coli in 27, Pseudomonas aeruginosa in 14, Klebsiella pneumonia in 7, and Enterobacter cloacae in 2; the resistance of Staphylococcus epidermidis and Enterococcus faecium to cefotaxime reached to 55.6% and 100.0%, and that of Pseudomonas aeruginosa and Klebsiella pneumonia to ceftriaxone reached to 100.0% and 71.4%, respectively; by end of six-month follow-up, ascites subsided in 37 cases(59.7%), and didn’t in 25 cases (40.3%); percentage of concomitant diabetes, albumin-bilirubin scores (ALBI), Child-Pugh score, ascites polymorphonuclear cell (PMN) count and serum procalcitonin (PCT) level in patients without ascites subsidence were 28.0%, (-1.1±0.5), (11.4±2.9), (502.5±162.3)×10⁶/L and (4.2±0.4)ng/ml, all significantly higher than [5.4%, (-1.5±0.5), (8.0±2.4), (282.9±53.7)×10⁶/L and (0.7±0.3)ng/ml, respectively, P<0.05] in those with ascites subsided; multivariate Logistic regression analysis showed that concomitant diabetes, ALBI, Child-Pugh score and ascites PMN counts were all the independent risk factors impacting ascites subsidence(P<0.05). Conclusion Gram-negative bacteria are the predominant microbes in patients with hepatitis B-induced LC and complicated SBP. Effective prevention and treatment for SBP should be based on precise microbiological identification and individualized strategies.

Key words: Liver cirrhosis, Spontaneous bacterial peritonitis, Pathogens, Therapy, Impacting factors