The Role of 16s Ribosomal RNA in Diagnosing Spontaneous Bacterial Peritonitis Sally Abed 1 , Mohamed Egezy 1 , Tarek Sheta 2 and Maysaa El-Sayed Zaki 3* 1 Tropical Medicine Department, Mansoura University of Medicine, Mansoura, Egypt 2 Gastroenterology Medicine Department, Mansoura University of Medicine, Mansoura, Egypt 3 Faculty of Medicine, Department of Clinical Pathology, Mansoura University of Medicine, Mansoura, Egypt * Corresponding author: Maysaa El-Sayed Zaki, Faculty of Medicine, Department of Clinical Pathology, Mansoura University, Egypt, Tel: +0020502258877; E-mail: may_s65@hotmail.com Rec Date: December 28, 2018, Acc Date: February 07, 2019, Pub Date: February 11, 2019 Copyright: © 2019 Abed S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Cancer, the accurate clinical diagnosis of spontaneous bacterial peritonitis (SBP) is challenging due to frequent absence of the symptoms and signs which are non-specific. The laboratory diagnosis of SBP depends mainly on the ascetic fluid neutrophil count. Therefore, it is recommended to inoculate the ascitic fluid into blood culture but cultures are time consuming and have a limited value to urgently direct the initiation of specific effective antibiotic treatment. Aim of study: To evaluate the role of 16s ribosomal RNA in early diagnosis of SBP. Patients and methods: The present study was cross-sectional study that was carried out in Mansoura University hospital from January 2016 till March 2017. The study included 120 patients complaining of chronic hepatitis C. Each patient was subjected to full clinical history including symptoms of spontaneous bacterial peritonitis such as fever, constipation and abdominal pain. The severity of liver affection was classified according to Child score. Complete liver function tests were performed. The peritoneal fluid was divided to three samples, one sample for total leucocytic count by hemocytometer, the other sample was centrifuged and the sediment was cultured on blood agar, MacConkey agar and Sabouraud’s dextrose agar at 37C for 24-48 hours DNA Extraction the sediment pellet of the peritoneal fluid was subjected to DNA extraction by QIAampDNAM; ini kit (QIAGEN, Germany) according to the manufacturer’s instruction. Results: The culture positive cases were 21 patients 20 of them were positive for 16sRNA and only 1 patient was negative for 16sRNA. While 16s RNA was positive in 26 patients in which 6 were negative culture. The WBCS count was >250/mm 3 in 31 patients of which 26 patients were positive for 16s RNA and 21 were culture positive. The 16sRNA had higher sensitivity (81.25%), while the culture the sensitivity was (67.7%). Conclusion: In the current study we assessed the 16s ribosomal RNA detection by PCR and it was more rapid and sensitive than bacterial cultures to confirm bacterial infection of the ascetic fluid even after cultures with bedside inoculation of the ascetic fluid samples. Keywords: Spontaneous bacterial peritonitis; PCR; 16s rRNA Introduction Spontaneous bacterial peritonitis (SBP) is a serious acute and life threatening ascetic fuid infection occurring in about 10-30% of ascetic cirrhotics. It occurs in absence of a defned surgical source of infection [1]. Spontaneous bacterial peritonitis occurs as a result of impaired host immune response in cirrhoticsand bacterial translocation throughout the gut wall. Te enteric organisms represent about 90% of the isolated organisms in SBP. An alternative proposed mechanism for SBP is hematogenous transmission of infection to the ascetic fuid [2-4]. At least 92% of SBP cases are monomicrobial [4]. Te most frequent pathogens responsible for SBP are the Gram negative bacteria specially the E coli [1,5] but recent studies have shown an increased incidence in SBP cases due Gram positive cocci infection which is suggest to be associated with the frequent use of prophylactic antibiotics, the frequent long term hospitalization with exposure to invasive maneuvers and nosocomial infections [5-7]. Te accurate clinical diagnosis of SBP is challenging due to frequent absence of the symptoms and signs which are non-specifc [8]. Te laboratory diagnosis of SBP depends mainly on the ascetic fuid neutrophil count. Spontaneous bacterial peritonitis is defned as a count >250/mm in absence of secondary bacterial peritonitis and the detection of the causative agent for SBP depends routinely on the ascetic fuid cultures [1,8]. Te ascetic fuid neutrophil count may not rise to this threshold in SBP cases due to many factors in cirrhotics including the immune defciency, hypersplenism and SBP caused by Gram positive cocci [9]. J o u r n a l o f M o l e c u l ar B i o m a r k e r s & D i a g n o s i s ISSN: 2155-9929 Journal of Molecular Biomarkers & Diagnosis Abed et al., J Mol Biomark Diagn 2019, 10:1 DOI: 10.4172/2155-9929.1000411 Research Article Open Access J Mol Biomark Diagn, an open access journal ISSN: 2155-9929 Volume 10 • Issue 1 • 1000411