Comparison of complement component C3 level with bacterial infections in decompensated liver disease patients in a tertiary care hospital

Bacterial infections are more common in decompensated liver disease patients with low level of complement component 3 and causes 30%-50% of deaths. Therefore, this study done to determine the various bacterial agents causing infections in decompensated liver disease patients and to estimate the level of C3 component of complement by Enzyme linked immunosorbent assay. A prospective study was conducted over a period of one year in Madras Medical College. Ascitic fluid, urine, sputum, wound swab blood and serum were collected. All the samples were processed through Gram’s stain and culture. The organisms were identified by standard protocols and antibiotic susceptibility testing and to correlate the bacterial infections with complement C3 level by ELISA. Out of 100 samples, culture positivity seen in 54[54%]. In 54 culture, positive isolates, 41(76%) were Gram Negative bacilli and 13 (24%) were Gram Positive cocci. Among Gram negative bacilli, Escherichia coli and in Gram positive cocci, Staphylococcus aureus was the most common isolates. The most common infections were spontaneous bacterial peritonitis [29.6%] followed by urinary tract infections [26%], pneumonia [20.3%], Spontaneous bacteraemia [16.7%], and skin and soft-tissue infections [7.4%]. Out of 100patients, 66(66%) patients had low complement component C3 level. Of which 42(63.6%) patients were cultures positive and 24(36.4%) were culture negative. 34(34%) patients had normal complement component C3 level, of which 29 (85.3%) were culture negative and 5 (14.7%) were culture positive .