الفهرس 
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Abstract
The aim of this study is to identify the bacterial infection in all the ascitic fluid samples by the cultivation method, detect the antimicrobial susceptibility of the isolated organisms. The study also aimed to identify of the presence of bactDNA in all the ascitic fluid samples by PCR and sequencing technique, and to evaluate of the sensitivity and specificity of conventional method & molecular method in the diagnosis of SBP.
This study included 200 patients with ascites on top of liver cirrhosis from out-patients and in-patients at tropical medicine department and general medicine department in Minia University Hospital at Minia Governorate during the period from June 2014 to January 2016.
After Bedside paracentesis, AF samples were directly inoculated in blood culture bottles, then subcultured and identified by the conventional method. Antimicrobial sensitivity was done by using Kirby-Bauer disc diffusion method.
All the AF samples were examined for the presence of the BactDNA by detecting the presence of 16s rRNA gene by PCR technique. The AF samples that were culture negative while bactDNA positive, were sequenced to detect the bacterial strain by automated sequencing technique.
Patients were divided into 2 groups according to the AF culture results, group I (culture negative) 161 (80.5%) were culture negative, with 8 were CNNA, and 153 were CNNNA. group II (culture positive) 39 (19.5%) AF samples were culture positive with a single organism, 36 of them were cSBP and the remaining three were MNBA.
There was no significant difference in Demographic characteristics (age, gender and residence) of patients in both groups. Patients in group I had the mean age of 58.2±8.6 years; 64% of them were males and 36%were females. Patients in group II had the mean age of 55.1±10 years; 61.5% of them were males and 38.5% were females.
The organisms isolated from 39 AF samples were Gram negative bacteria in 20 (51.3%) of the AF samples, mainly E coli 12 (30.8%), then Klebiella 5 (12.8%), Enterobacter 2 (5.1%), and Citrobacter 1 (2.6%), while the Gram positive bacteria was found in 19 (48.7%) AF samples, mainly Enterococcus 8 (20.5%), followed by Staph epidermidis 7 (17.9%), then Staph aureus 2 (5.1%), and Strept pneumonia 2 (5.1%).
Antibiotic susceptibility pattern of the isolated bacteria was as the following:
Gram negative bacteria were highly sensitive to Imipenem (90%), Amikacin (85%), and Cefotaxime (80%) and with low sensitivity to Ceftazidime (40%), Cefoxitin (35%), and Ampcillin (35%).
Meanwhile Gram positive bacteria were highly sensitive to Vancomycin (89.5%) Imipenem (78.9%) and were with low sensitivity to Amoxicillin-clavulonic (31.5%), Ampcillin (31.5%), Ciprofloxacin (26.3%), Cefotaxime (21.1%), and Ceftazidime (15.8%).