title: Diagnosis of bacterial pathogens in the dialysate of peritoneal dialysis patients with peritonitis using surface-enhanced Raman spectroscopy.
abstract: BACKGROUND
  Bacterial peritonitis is the most common cause of peritoneal dialysis (PD) therapy drop-out. A quick and accurate diagnosis of the bacterial pathogen can reduce the PD drop-out rate. Surface-enhanced Raman spectroscopy (SERS) can rapidly identify bacteria using chips coated with nano-sized metal particles.
  
  
  METHODS
  Known bacteria were loaded in the SERS-chips and illuminated with laser light to establish a reference Raman spectra library. Dialysate from PD peritonitis patients was concentrated by centrifuge and examined with the same SERS, and the resulting Raman spectra were compared with library spectra for bacteria identification. Principal component analysis was used for further confirmation. The same batches of dialysate were sent to routine culture as a reference bacteria identification method. The results of the 2 identification methods were compared.
  
  
  RESULTS
  A total of 43 paired-samples were sent for study. There were 37 samples with bacteria identified but 6 were culture-negative by the reference method. 31 bacteria were identified in paired-samples by SERS, among which, 29 bacteria were exactly the same as those identified by the reference method. Bacteria not included in the reference library spectra cannot be identified.
  
  
  CONCLUSIONS
  SERS techniques can rapidly identify bacterial pathogens in the dialysate of PD peritonitis patients.
authors.affiliation: Department of Laboratory Medicine, China Medical Univeristy Hospital, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan; Department of Medical Laboratory Science and Biotechnology, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: Ni
authors.initials: N
authors.lastname: Tien
authors.affiliation: College of Medicine, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan; Division of Nephrology, China Medical University Hospital, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Department of Statistics, Feng Chia University, No 100 Wenhua Rd, Seatwen, Taichung 40724, Taiwan.
authors.forename: Shiow-Lan
authors.initials: SL
authors.lastname: Gau
authors.affiliation: Division of Nephrology, China Medical University Hospital, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: Tzu-Hsien
authors.initials: TH
authors.lastname: Lin
authors.affiliation: Department of Laboratory Medicine, China Medical Univeristy Hospital, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan; Department of Medical Laboratory Science and Biotechnology, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: Hsiu-Shen
authors.initials: HS
authors.lastname: Lin
authors.affiliation: Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: Bang-Jau
authors.initials: BJ
authors.lastname: You
authors.affiliation: Division of Nephrology, China Medical University Hospital, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: Po-Chuan
authors.initials: PC
authors.lastname: Tsai
authors.affiliation: College of Medicine, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan; Division of Nephrology, China Medical University Hospital, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: I-Ru
authors.initials: IR
authors.lastname: Chen
authors.affiliation: College of Medicine, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: Ming-Fan
authors.initials: MF
authors.lastname: Tsai
authors.affiliation: College of Medicine, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan; Division of Nephrology, China Medical University Hospital, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.affiliation: Graduate Institute of Integrated Medicine, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan.
authors.forename: Chao-Jung
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: College of Medicine, China Medical University, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan; Division of Nephrology, China Medical University Hospital, No. 2 Yu-Der Rd, North District, Taichung 40447, Taiwan. Electronic address: d19863@mail.cmuh.org.tw.
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D006801:Humans; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000175:diagnosis* / Q000382:microbiology*; D013059:Spectrum Analysis, Raman; D013499:Surface Properties
keywords: Dialysate; Peritoneal dialysis; Peritonitis; Principal component analysis; Raman spectroscopy; Surface-enhanced Raman spectroscopy