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Microbiomic Analysis of Intra-Abdominal Infections by Using Denaturing High-Performance Liquid Chromatography: A
Christian Koch1, Anca L Amati2, Andreas Hecker2
11 Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg , Giessen, Germany .
Background:
Intra-abdominal infections represent a subgroup of septic syndromes with high death rates and the need for prompt and appropriate antimicrobial therapy. Conventional culture-based microbial identification has notable shortcomings in the diagnostics of polymicrobial infections. Modern culture-independent molecular methods may represent a new diagnostic approach. The current study aimed to compare the results obtained from the denaturing high-performance liquid chromatography WAVE® system as a culture-independent diagnostic tool with those obtained from standard culture-based microbiologic testing in the clinical setting of severe intra-abdominal sepsis.
Patients And Methods:
The study included 42 samples of pathologic intra-abdominal fluids, collected from 37 patients with intra-abdominal sepsis. Micro-organisms grown in culture and detected by the WAVE system were compared. Further, we recorded clinical data including baseline characteristics and the use of antibiotic agents.
Results:
In 38.1% of the analyzed samples, the classic, culture-based methods showed no bacterial growth on agar plates, in comparison with the microbiomic analysis in which the proportion of samples with negative signal was 31%. In about 40% of the patients, both methods detected one microbiologic agent, whereas in approximately one quarter of the samples, two or more agents were identified. The detection rate of certain bacteria such as Enterobacteriacae or Enterococcus faecium was significantly higher using the microbiomic analysis. Bacteria such as Haemophilus, Lactobacillus, Clostridium, Methylobacterium, Collinsella aerofaciens, and Solobacterium moorei were detected exclusively using microbiomic analysis.
Conclusion:
The culture independent molecular WAVE system provided additional information, especially concerning unusual, fastidious bacteria in patients with intra-abdominal infections. Further, it has a higher detection rate for polymicrobial infection and delivers results much sooner than conventional microbiologic methods.
Insights
The molecular WAVE system offers faster and more comprehensive detection of bacteria, including unusual and polymicrobial infections, compared to traditional culture methods for intra-abdominal sepsis.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Intra-abdominal infections are severe sepsis syndromes with high mortality rates.
- Culture-based methods for identifying microbes in polymicrobial infections have limitations.
- Culture-independent molecular methods offer a potential advancement in diagnostics.
Purpose of the Study:
- To compare the diagnostic performance of the denaturing high-performance liquid chromatography WAVE® system against standard culture-based methods.
- To evaluate the utility of a culture-independent diagnostic tool in severe intra-abdominal sepsis.
Main Methods:
- Analysis of 42 intra-abdominal fluid samples from 37 patients with sepsis.
- Comparison of microbial identification between the WAVE system and conventional culture.
- Collection of clinical data, including patient characteristics and antibiotic use.
Main Results:
- Culture methods yielded no bacterial growth in 38.1% of samples, versus 31% for microbiomic analysis.
- The WAVE system demonstrated a higher detection rate for certain bacteria like Enterobacteriacae and Enterococcus faecium.
- Exclusive detection of bacteria such as Haemophilus, Lactobacillus, and Clostridium was achieved with microbiomic analysis.
Conclusions:
- The culture-independent WAVE system provides valuable additional information, particularly for fastidious and unusual bacteria.
- The molecular method offers a higher detection rate for polymicrobial infections.
- The WAVE system delivers diagnostic results significantly faster than conventional microbiologic methods.