CLINICAL STUDY: BACTERIAL DNA IN DIAGNOSIS OF SPONTANEOUS BACTERIAL PERITONITIS

Germán Soriano (1, 2) , Óscar Esparzia (3) , Michel Montemayor (3) , Carlos Guarner-Argente (1) , Roser Pericas (3) , Xavier Torras (1, 2) , Núria Calvo (4) , E Roman (1, 2) , Ferran Navarro (3) , Carlos Guarner (1, 2) , Pere Coll (3)

1 Department of Gastroenterology
2 CIBERehd
3 Department of Microbiology
4 Department of Oncology

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 PCR and sequencing increases the efficacy of culture in microbiological diagnosis of SBP. Methods We prospectively included 55 consecutive SBP 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 respect to culture positive SBP), 12/20 (60%) sterile ascites (p=0.01 respect to culture positive SBP) and 0/27 neoplasic ascites (p<0.001 respect to other groups). Sequencing identified to genus or species level 12 culture positive SBP, 6 culture negative SBP and 6 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 SBP episodes. Methodology used in the present study did not always allow identification of amplified bacterial DNA.

Mots clés: Medicine

Germán Soriano, Óscar Esparzia, Michel Montemayor, Carlos Guarner-Argente, Roser Pericas, et al.. CLINICAL STUDY: BACTERIAL DNA IN DIAGNOSIS OF SPONTANEOUS BACTERIAL PERITONITIS. Alimentary Pharmacology and Therapeutics, 2010, 33 (2), pp.275. ⟨10.1111/j.1365-2036.2010.04506.x⟩. ⟨hal-00613795⟩