Amplification of bacterial DNA does not distinguish patients with ascitic fluid infection from those colonized by bacteria.
OBJECTIVE
To evaluate 16S ribosomal RNA (rRNA) gene amplification to diagnose spontaneous bacterial peritonitis (SBP).


METHODS
According to a retrospective protocol, 31 patients with portal hypertensive ascites (serum to ascites albumin gradient > or = 1.1 g/dL) were studied. Ascitic fluid was analyzed as follows: Gram stain, aerobic and anaerobic cultures, polymorphonuclear cell count, and biochemical tests. Bacterial DNA was detected by polymerase chain reaction.


RESULTS
There were 8 episodes of SBP and 4 episodes of bacterascites (BA). Culture was positive in 4 of 8 cases of SBP and bacterial DNA was positive in 7 of 8 cases of SBP. Bacterial DNA was positive in 3 of 4 cases of BA and in 8 of 28 cases of culture-negative non-neutrocytic ascites (CNNNA). The PELD score, serum to albumin ascites gradient, and mortality showed no statistical difference between patients with CNNNA and the result of the bacterial DNA analysis.


CONCLUSIONS
Although the 16S rRNA gene amplification was better than culture to diagnose SBP, bacterial DNA does not seem to allow a distinction between ascites infection and ascites colonization.
Vieira
Sandra M G
SM
Unit of Pediatric Gastroenterology, Hospital de Clínicas de Porto Alegre, Brazil. smvieira@hcpa.ufrgs.br
da Silveira
Themis R
TR
Matte
Ursula
U
Kieling
Carlos O
CO
Ferreira
Cristina T
CT
Taniguchi
Adriano
A
Oliveira
Fernanda dos Santos
Fdos S
Barth
Afonso L
AL
D001201:Ascites / Q000209:etiology / Q000382:microbiology*; D001202:Ascitic Fluid / Q000382:microbiology; D001424:Bacterial Infections / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000302:isolation & purification*; D005260:Female; D005784:Gene Amplification; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D007223:Infant; D008297:Male; D010538:Peritonitis / Q000175:diagnosis* / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies
D004269:DNA, Bacterial