Rapid identification of bacterial species with bacterial DNA microarray in cirrhotic patients with spontaneous bacterial peritonitis.
OBJECTIVE
Early detection and identification of bacteria in ascitic fluid could result in more timely treatment of cirrhotic patients with spontaneous bacterial peritonitis (SBP) or subclinical SBP. The aim of this study was to evaluate the usefulness of a bacterial DNA microarray for the rapid diagnosis of SBP and rapid bacterial identification in cirrhotic patients with ascites.


METHODS
Thirty-seven cirrhotic patients with ascites (25 men and 12 women) participated. Ascitic fluid obtained from patients was tested by the bacterial DNA microarray method and by the conventional culture method.


RESULTS
SBP and bacterascites were diagnosed in 8 (16.7%) of 48 specimens by the conventional method. The bacterial DNA microarray proved the existence of bacteria in 6 (75%) of 8 samples with SBP or bacterascites using the conventional method as a gold standard. A corresponding rate of bacterial species identification between the two methods was found in 5 of 6 samples (83.3%). It took 1.47+/-0.96 and 5.14+/-2.6 days to receive the data by the microarray and conventional method, respectively (p<0.0001). After antibiotic therapy, the cumulative survival rate of recovered cases (n=8) was higher than that of unrecovered cases (n=5) (p=0.0008).


CONCLUSIONS
Although the detection rate of the bacterial DNA microarray was similar to the conventional culture method, the DNA microarray could identify pathogens about 4 times more rapidly than bacterial cultivation, thus rendering it useful for managing cirrhotic patients with ascites.
Sugihara
Takaaki
T
Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago.
Koda
Masahiko
M
Maeda
Yoshiko
Y
Matono
Tomomitsu
T
Nagahara
Takakazu
T
Mandai
Mari
M
Ueki
Masaru
M
Murawaki
Yoshikazu
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000382:microbiology; D001424:Bacterial Infections / Q000175:diagnosis / Q000235:genetics* / Q000382:microbiology; D004269:DNA, Bacterial / Q000235:genetics*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000235:genetics* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis / Q000379:methods*; D010538:Peritonitis / Q000175:diagnosis / Q000235:genetics* / Q000382:microbiology; D013997:Time Factors
D004269:DNA, Bacterial