Document Detail

Detection of ascitic fluid infections in patients with liver cirrhosis and ascites.
MedLine Citation:
PMID:  21429450     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND AND STUDY AIMS: Ascitic fluid infections (AFIs) are the frequent complications of advanced liver disease. Bacterial translocation is considered a key step in the pathogenesis of gut-derived bacterial infections; mainly spontaneous bacterial peritonitis (SBP) in cirrhotic patients. Bacterial DNA (bactDNA) in ascitic fluid and serum has been suggested as a surrogate marker for bacterial translocation. We attempted at the isolation and identification of bacteria in ascitic fluid in cirrhotic patients and the assessment of polymerase chain reaction (PCR) in ascitic fluid and serum.
PATIENTS AND METHODS: Fifty cirrhotic patients having ascites with no signs of infection were included. Ascitic fluid cultures were obtained from patients. Ascitic fluid and serum were subjected to DNA extraction and PCR for the universal amplification of a region of the 16S ribosomal RNA (16S rRNA) gene to detect bactDNA.
RESULTS: Bacteria were isolated from 9 (18%) of the ascitic fluid samples, and were mainly Gram-positive bacteria. BactDNA was detected simultaneously in the ascitic fluid and serum of 17 (34%) patients and in the ascitic fluid of only 2 patients. In a single patient with positive ascitic fluid culture no bactDNA was detected in ascitic fluid or serum. By considering AFIs as a positive ascitic fluid culture and/or the presence of bactDNA in the ascitic fluid and/or serum, ascitic fluid culture could detect 9 out of 20 patients with AFIs (45%), PCR of ascitic fluid could detect 19 out of 20 (95%) while PCR of serum could detect 17 out of 20 (85%). In 10 patients with culture negative non-neutrocytic ascites (CNNNA) bactDNA could be detected in serum and ascitic fluid.
CONCLUSION: AFI can be caused by Gram positive as well as Gram negative organisms. A substantial percentage of cases with CNNNA show bactDNA in serum and ascitic fluid. PCR of ascitic fluid should, therefore, be used in the diagnostic workup of suspected cases of ascitic fluid infections.
Marwa S Mostafa; Eman A El-Seidi; Abdel Meguid Kassem; Mohamed A Shemis; Mohamed Saber; Michael N Michael
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology     Volume:  12     ISSN:  2090-2387     ISO Abbreviation:  Arab J Gastroenterol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101298363     Medline TA:  Arab J Gastroenterol     Country:  Egypt    
Other Details:
Languages:  eng     Pagination:  20-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.
Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
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