BACKGROUND/AIMS: The diagnosis of spontaneous bacterial peritonitis (SBP) is based on a polymorphonuclear leukocytes (PMNs) exceeding 250/μL in ascitic fluid. The aim of the study was to evaluate serum procalcitonin and ascitic fluid calprotectin as accurate diagnostic markers for detecting SBP. METHODS: Seventy-nine patients with cirrhotic ascites were included. They were divided into a SBP group, including 52 patients, and a non-SBP group of 27 patients. Serum procalcitonin, ascitic calprotectin, and serum and ascitic levels of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) were measured using an enzyme-linked immunosorbent assay. RESULTS: Serum procalcitonin and ascitic calprotectin were significantly higher in SBP patients than in non-SBP patients. Significant increases in both serum and ascitic levels of TNF-α and IL-6 were observed in SBP patients versus non-SBP patients. At a cutoff value of 0.94 ng/mL, serum procalcitonin had 94.3% sensitivity and 91.8% specificity for detecting SBP. In addition, at a cutoff value of 445 ng/mL, ascitic calprotectin had 95.4% sensitivity and 85.2% specificity for detecting SBP. Both were positively correlated with ascitic fluid proteins, PMN count, TNF-α, and IL-6. CONCLUSIONS: According to our findings, determination of serum procalcitonin levels and ascitic calprotectin appears to provide satisfactory diagnostic markers for the diagnosis of SBP.
Ascites ; Ascitic Fluid* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6 ; Leukocyte L1 Antigen Complex* ; Neutrophils ; Peritonitis* ; Sensitivity and Specificity ; Tumor Necrosis Factor-alpha

Aims: The aim of this study was to investigate plasmid profiles and antibiotic resistance patterns of multidrug resistant Pseudomonas aeruginosa strains isolated from different clinical specimens in Jordan. Methodology and results: Pseudomonas aeruginosa strains were isolated from different clinical specimens from different hospitals and primary health care centers. The antimicrobial susceptibility of P. aeruginosa isolates was determined using the disc diffusion method against 16 commonly used antimicrobial drugs. Plasmid DNAs were extracted from lysed P. aeruginosa cells using the plasmid alkaline lysis method and visualized using agarose gel electrophoresis followed by ethidium bromide staining. The isolated strains of P. aeruginosa were resistant to cefepime (90%), meropenem (70%), ceftazidime (60%), piperacillin (55%), aztreonam (50%), ciprofloxacin and tobramycin (35%), gentamicin (29%), imipenem and amikacin (20%). All the isolates were sensitive to colistin. Plasmid analysis of the clinical isolates showed the presence of 0 to 3 plasmids with a size range of 1 to 25 kb compared to the standard strain of Escherichia coli (ATCC 25922). Conclusion, significance and impact of study: The results obtained in this study showed some correlation between the patterns of antibiotic resistance and plasmid profiles.