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 .

Background: Clostridium difficile is a very important cause fo antibiotic-associated diarrhea and pseudomembranous colitis. Diagnosis of C. difficile mainly relies on toxin detection in stool specimens from individuals with suspected disease. Objective: is to introduce to our microbiology laboratory of a simple test that may be rapid, cheap and easily manipulated than conventional methods for effective diagnosis of C. difficile infection. Methodology: Stool samples from sixty eight hospitalized patients developing CDI like symptoms were subjected to culture on CCFA, detection of toxins A and/or B by X/pect test (directly from stool samples and from culture isolates) and Real time PCR for detection of tcdA/ tcdB toxin genes. Results: Toxigenic C. difficile was detected in (22.1%) of suspected cases using tcdA/ tcdB real time PCR which was the gold standard method in our study. The positive rate for the direct X/pect test was 13.2% and for the indirect test was 14.7%. The sensitivity of direct X/pect test was 60%, specificity was 100%, PPV was 100%, and NPV was 89.8% with 91.2% agreement between the direct assay and real time PCR. While, the validity values for the indirect test was 66.7%, 100%, 100% & 91.4% for sensitivity, specificity, PP and NP values respectively, with 92.6% agreement between both assays. Antibiotic intake and recent hospitalization were the most commonly encountered risk factors, followed by number of hospitalization days. Penicillins and cephalosporins were the most frequently associated antibiotics, followed by clindamycin Conclusions: Using X/pect test can combine accurate results with simple procedure that offers results within 20 minutes. Although it is accompanied with low sensitivity and high rate of false-negative results, X/pect test may be of great benefit to practitioners particularly when you need STAT testing or 24 hour/ 7 days coverage. Further, it can be used as a preliminary screening approach allowing patients to be treated early and correctly in order to shorten the duration of symptoms and avoid complications. Fayed and El-Feky / A new method for rapid diagnosis of Clostridium difficile infection, Volume 28 / No.

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