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Amplification of bacterial DNA does not distinguish patients with ascitic fluid infection from those colonized by

Sandra M G Vieira1, Themis R da Silveira, Ursula Matte

  • 1Unit of Pediatric Gastroenterology, Hospital de Clínicas de Porto Alegre, Brazil. smvieira@hcpa.ufrgs.br

Journal of Pediatric Gastroenterology and Nutrition
|April 27, 2007
PubMed
Abstract

Insights

16S ribosomal RNA (rRNA) gene amplification shows promise for diagnosing spontaneous bacterial peritonitis (SBP) over traditional culture methods. However, it cannot reliably distinguish between infection and colonization in ascites fluid.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with portal hypertension.
  • Accurate and rapid diagnosis of SBP is crucial for timely treatment and improved patient outcomes.
  • Current diagnostic methods, like ascitic fluid culture, have limitations in sensitivity and speed.

Purpose of the Study:

  • To evaluate the diagnostic utility of 16S ribosomal RNA (rRNA) gene amplification for spontaneous bacterial peritonitis (SBP).
  • To compare the performance of 16S rRNA gene amplification with conventional bacterial cultures in diagnosing SBP.

Main Methods:

  • A retrospective study of 31 patients with portal hypertensive ascites.
  • Analysis of ascitic fluid included Gram stain, aerobic/anaerobic cultures, cell counts, biochemical tests, and bacterial DNA detection via polymerase chain reaction (PCR).

Main Results:

  • 16S rRNA gene amplification detected bacterial DNA in 7 of 8 SBP cases, compared to 4 of 8 positive cultures.
  • Bacterial DNA was positive in 3 of 4 bacterascites (BA) cases.
  • 8 of 28 culture-negative non-neutrocytic ascites (CNNNA) cases were positive for bacterial DNA.

Conclusions:

  • 16S rRNA gene amplification demonstrated superior sensitivity compared to culture for diagnosing SBP.
  • Bacterial DNA detection using 16S rRNA gene amplification could not differentiate between true ascites infection and bacterial colonization.

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