title: D-lactic acid measurements in the diagnosis of bacterial infections.
abstract: Body fluids suspected of bacterial infection were cultured and examined for the presence of D-lactic acid, a specific bacterial metabolite. We examined 206 patients and 264 specimens. D-Lactic acid was found in concentrations of greater than or equal to 0.15 mM in 11 of 11 infected and 6 of 40 noninfected ascitic fluids, 6 of 6 infected and 4 of 33 noninfected pleural fluids, 4 of 4 infected and 0 of 13 noninfected synovial fluids, and 26 of 27 infected and 2 of 130 noninfected cerebrospinal fluids. The overall sensitivity was 79.7%, and the specificity was 99.5% when the D-lactic acid concentration was at least 0.15 mM. The most important clinical utility of the D-lactic acid measurement appears to be for patients with bacterial infection in various body compartments and in patients who have already received antimicrobial therapy. An elevation in D-lactic acid may indicate the presence of bacterial infection even when cultures are negative.
authors.affiliation: Medical Service, Veterans Administration Medical Center, East Orange, New Jersey 07019.
authors.forename: S M
authors.initials: SM
authors.lastname: Smith
authors.forename: R H
authors.initials: RH
authors.lastname: Eng
authors.forename: J M
authors.initials: JM
authors.lastname: Campos
authors.forename: H
authors.initials: H
authors.lastname: Chmel
mesh_terms: D001202:Ascitic Fluid / Q000032:analysis; D001424:Bacterial Infections / Q000175:diagnosis*; D006801:Humans; D007773:Lactates / Q000032:analysis* / Q000134:cerebrospinal fluid; D019344:Lactic Acid; D010994:Pleura / Q000032:analysis; D011237:Predictive Value of Tests; D013582:Synovial Fluid / Q000032:analysis
chemical_list: D007773:Lactates; D019344:Lactic Acid