Role of 16s rRNA Gene in Early Diagnosis of Spontaneous Bacterial Peritonitis in Cirrhotic Ascitic Patients

Abstract

Background: Ascites is a recognized problem in patients with decompensated liver cirrhosis. Spontaneous bacterial peritonitis (SBP) is a massive problem in patients who suffer from cirrhosis with ascites. Early bacterial detection allows great intervention to stop SBP. 16S ribosomal RNA (rRNA) is a universal gene used to detect different bacteria present within a sample. Objectives: This study aimed to evaluate the efficacy of broad range 16S rRNA gene polymerase chain reaction (PCR) in diagnosis of ascitic fluid (AF) infection. Methodology: Fifty cirrhotic ascitic patients were undergone to full history, clinical examination, laboratory tests including, AF specimens analysis for polymorph nuclear leucocytic (PMN) count, culture for bacteria and PCR-for DNA detection of bacteria. Results: Bacteria were separated from 21 (42%) of samples of ascitic fluid, and they were mainly Gram-negative bacteria. The sensitivities of culture for bacteria and PCR in diagnosing AF infection were 53% and 86% respectively, while the accuracies were 62% and 74% respectively relation with PMNL. Conclusions: Bacterial DNA in AF samples may be another method for diagnosis AF infection rather than bacterial culture and PMN count for early detection and treatment of AF infection. METHODOLOGY Patients:This cross-sectional study was conducted in Benha University and National Liver Institute, Menoufia University over the duration from April 2018 to October 2018 and included fifty patients with cirrhosis of liver and ascites. The study was confirmed by the Research Ethical Committee Menoufia University and an informed consent was obtained from each participant before enrollment in the research. The patients in that study with cirrhosis as detected by clinical methods and by laboratory investigations. Exclusion criteria included the presence of any clinical sign of infection and antibiotic intake within the preceding 2 weeks.Patients were classified into 2 groups depending on PMN count into:Group 1(SBP group): it included all cases with ascitic PMN ≥ 250 cells/mm 3 with +ve and -ve culture.Group 2 (Non SBP group): it included all cases with ascitic PMN < 250 cells/mm 3 .