The Diagnostic Role of Bacterial DNA in Ascitic Fluid Infection in Patients with Cirrhotic Ascites

Saleh, Mohammed A.; El-Sehsah, Eman M; Beheiry, Ashraf A.

doi:10.12816/0046280

Cited by 3 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…22 A higher rate was recorded by another study conducted in Egypt on 130 cirrhotic patients, SBP was diagnosed in 63.1% patients with neutrophil count ≥ 250/cmm. 33 Our study demonstrated a high statistically significant difference of CRP, total blood leucocytic count, coagulopathy in the form of high INR and low prothrombin concentration in patients with SBP compared with non-SBP group. These findings go in agreement with another study which stated that CRP is a good indicator of SBP with a cut-off point of 10.5 mg/L at which SBP can be diagnosed with sensitivity and specificity of 91% and 97% respectively and that procalcitonin levels provide an early diagnostic accuracy in advanced liver cirrhotic patients with SBP.…”

Section: Discussionmentioning

confidence: 46%

“…Another study conducted in Egypt on 130 cirrhotic patients; 35 (26.9%) ascitic fluid samples were positive for bacterial culture which represented a higher rate than recorded in our study. 33 The lack of culture positivity was described by another study which stated that classical culture techniques fail to grow bacteria in up to 65% of neutrocytic ascites and that bedside inoculation of ascites into blood culture bottles has been shown to increase the sensitivity to nearly 80%. 27 CNNA variant of SBP may be attributed to poor culture technique, prior antibiotics or low opsonic activity in ascitic fluid or low microbial concentration.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous Fungal Peritonitis in Egyptian Patients with Cirrhotic Ascites

Gohar

Sarei

Marzouk

et al. 2019

Egyptian Journal of Medical Microbiology

View full text Add to dashboard Cite

Background: Spontaneous fungal peritonitis in liver cirrhotic patients is considered a serious complication with a grave prognosis. The available data describing this entity are still deficient, however they all stress that early diagnosis and proper management is essential to decrease mortality. Objectives: This study was conducted to assess the incidence, characteristics and predisposing factors of fungal peritonitis in patients with cirrhotic ascites. Methodology: Ascitic fluid samples were collected from 141 Egyptian patients with cirrhotic ascites. Ascetic fluid specimens were subjected to direct microscopic examination, bacterial and fungal culture. Results: Sixty one patients were diagnosed to have spontaneous bacterial peritonitis (SBP), eight of them were culture positive SBP and E. coli was the commonest organism to be isolated. A single case of spontaneous fungal peritonitis (SFP) was detected caused by Candida albicans. Child-Pugh C, high MELD score and high bilirubin level might be among the risk factors of development of SFP.

show abstract

Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Spontaneous Fungal Peritonitis in Egyptian Patients with Cirrhotic Ascites

Gohar

Sarei

Marzouk

et al. 2019

Egyptian Journal of Medical Microbiology

View full text Add to dashboard Cite

show abstract

“…In addition, Saleh et al 1 found that PCR distinguished DNA from bacteria in their studied AF samples from all positive culture cases (100%) and from (56.8%) of culture negative cases with overall sensitivity and accuracy of 80.1% and 83% respectively.…”

mentioning

confidence: 93%

“…Ascitic fluid infection (AFI) is a serious problem in patients suffering from liver cirrhosis and is accompanied with high morbidity and mortality 1 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Ismail

Abbas

Feky

et al. 2020

Egyptian Journal of Medical Microbiology

View full text Add to dashboard Cite

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 .

show abstract

Neutrophil Gelatinase-Associated Lipocalin (NGAL): An Early Dual Biomarker in Diagnosis of Ascitic Fluid Infection and Acute Kidney Injury in Liver Cirrhosis in a Tertiary Centre, Egypt

Nassar

Elkenawy

El-Naggar

et al. 2021

JAMB

View full text Add to dashboard Cite

Background: This study aimed to evaluate the ascitic Neutrophil gelatinase-associated lipocalin (NGAL) as a diagnostic biomarker for bacterial translocation or bactDNA translocation in ascites of cirrhotic patients and to evaluate the urinary NGAL for identifying renal dysfunction in patients with liver cirrhosis. Methods: This study included 44 patients with ascites. Study participants were divided into two groups. Group (1) had 22 patients with neutrocytic ascites and/or positive ascitic fluid (AF) culture while group (2) included 22 patients with culture negative non neutrocytic ascites (CNNNA), recruited as controls. AF and urine samples were collected from all studied participants. ELISA kit was used for measurement of NGAL levels in AF and urine. DNA extraction and PCR were done. Results: Values of NGAL in ascitic fluid were statistically significantly higher in bactDNA positive group. At cutoff 143.9 ng/ml, ascites NGAL had 86.4% sensitivity, 45.5% specificity, 61.3% positive predictive value (PPV) and 76.9% negative predictive value (NPV). When comparing ascites NGAL between bactDNA positive and negative group, NGAL has a sensitivity of 86.2% and a specificity of 46.7%, PPV of 75.8%, NPV of 63.6%. As for urine NGAL, patients with AKI had statistically significant higher levels of NGAL. Urine NGAL achieved sensitivity of 77.3%, specificity of 50%, PPV of 60.7%, NPV of 68.75%. Conclusion: Early and accurate diagnosis of BT or bactDNA translocation can be aided by utilizing NGAL especially in ruling out infection in those reported to have negative culture results, besides, it can help in early detection of complication of cirrhosis and infection especially AKI helping in the improving the prognosis of cirrhotic patients. It is an advantage that a single marker can detect both infection and kidney injury.

show abstract

The Diagnostic Role of Bacterial DNA in Ascitic Fluid Infection in Patients with Cirrhotic Ascites

Cited by 3 publications

References 0 publications

Spontaneous Fungal Peritonitis in Egyptian Patients with Cirrhotic Ascites

Spontaneous Fungal Peritonitis in Egyptian Patients with Cirrhotic Ascites

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

Neutrophil Gelatinase-Associated Lipocalin (NGAL): An Early Dual Biomarker in Diagnosis of Ascitic Fluid Infection and Acute Kidney Injury in Liver Cirrhosis in a Tertiary Centre, Egypt

Contact Info

Product

Resources

About