Bacterial DNA in the diagnosis of spontaneous bacterial peritonitis
Por:
Soriano, G, Esparcia, O, Montemayor, M, Guarner-Argente, C, Pericas, R, Torras, X, Calvo, N, Roman, E, Navarro, F, Guarner, C, Coll, P
Publicada:
15 ene 2011
Resumen:
P>Background
Despite inoculation into blood culture bottles, ascitic fluid culture is negative in 50% of cases of spontaneous bacterial peritonitis (SBP).
Aim
To determine whether 16S rDNA gene detection by real-time polymerase chain reaction (PCR) and sequencing increases the efficacy of culture in microbiological diagnosis of spontaneous bacterial peritonitis.
Methods
We prospectively included 55 consecutive spontaneous bacterial peritonitis episodes in cirrhotic patients, 20 cirrhotic patients with sterile ascites and 27 patients with neoplasic ascites. Ascitic fluid was inoculated into blood culture bottles at the bedside and tested for bacterial DNA by real-time PCR and sequencing of 16S rDNA gene.
Results
Bacterial DNA was detected in 23/25 (92%) culture-positive SBP, 16/30 (53%) culture-negative SBP (P = 0.002 with respect to culture-positive SBP), 12/20 (60%) sterile ascites (P = 0.01 with respect to culture-positive SBP) and 0/27 neoplasic ascites (P < 0.001 with respect to other groups). Sequencing identified to genus or species level 12 culture-positive SBP, six culture-negative SBP and six sterile ascites. In the remaining cases with positive PCR, sequencing did not yield a definitive bacterial identification.
Conclusions
Bacterial DNA was not detected in almost half the culture-negative spontaneous bacterial peritonitis episodes. Methodology used in the present study did not always allow identification of amplified bacterial DNA.
Filiaciones:
Soriano, G:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Gastroenterol, Inst Invest Biomed St Pau, Barcelona 08041, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Esparcia, O:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Microbiol, Inst Invest Biomed St Pau, Barcelona 08041, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Barcelona 08041, Spain
Montemayor, M:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Microbiol, Inst Invest Biomed St Pau, Barcelona 08041, Spain
Guarner-Argente, C:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Pericas, R:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Microbiol, Inst Invest Biomed St Pau, Barcelona 08041, Spain
Torras, X:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Calvo, N:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Oncol, Inst Invest Biomed St Pau, Barcelona 08041, Spain
Roman, E:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Navarro, F:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Microbiol, Inst Invest Biomed St Pau, Barcelona 08041, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Barcelona 08041, Spain
Guarner, C:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Coll, P:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Microbiol, Inst Invest Biomed St Pau, Barcelona 08041, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Barcelona 08041, Spain
Open Access
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