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Mani I, Vrioni G, Hadziyannis E, et al. Bacterial DNA is a prognostic factor for mortality in patients who recover from spontaneous bacterial peritonitis. Ann Gastroenterol. 2021;34(6):852-861doi: 10.20524/aog.2021.0665.
Mani, I., Vrioni, G., Hadziyannis, E., Alexopoulos, T., Vasilieva, L., Tsiriga, A., Tsiamis, C., Tsakris, A., Dourakis, S. P., & Alexopoulou, A. (2021). Bacterial DNA is a prognostic factor for mortality in patients who recover from spontaneous bacterial peritonitis. Annals of gastroenterology, 34(6), 852-861. https://doi.org/10.20524/aog.2021.0665
Mani, Iliana, et al. "Bacterial DNA is a prognostic factor for mortality in patients who recover from spontaneous bacterial peritonitis." Annals of gastroenterology vol. 34,6 (2021): 852-861. doi: https://doi.org/10.20524/aog.2021.0665
Mani I, Vrioni G, Hadziyannis E, Alexopoulos T, Vasilieva L, Tsiriga A, Tsiamis C, Tsakris A, Dourakis SP, Alexopoulou A. Bacterial DNA is a prognostic factor for mortality in patients who recover from spontaneous bacterial peritonitis. Ann Gastroenterol. 2021 Nov-Dec;34(6):852-861. doi: 10.20524/aog.2021.0665. Epub 2021 Sep 14. PMID: 34815652; PMCID: PMC8596224.
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Ann Gastroenterol. 2021 Nov-Dec;34(6):852-861. doi: 10.20524/aog.2021.0665. Epub 2021 Sep 14.

Bacterial DNA is a prognostic factor for mortality in patients who recover from spontaneous bacterial peritonitis.

Annals of gastroenterology

Iliana Mani, Georgia Vrioni, Emilia Hadziyannis, Theodoros Alexopoulos, Larisa Vasilieva, Athanasia Tsiriga, Constantinos Tsiamis, Athanasios Tsakris, Spyros P Dourakis, Alexandra Alexopoulou

Affiliations

  1. 2 Department of Internal Medicine and Research Laboratory, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece (Iliana Mani, Emilia Hadziyannis, Theodoros Alexopoulos, Larisa Vasilieva, Athanasia Tsiriga, Spyros P. Dourakis, Alexandra Alexopoulou).
  2. Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Georgia Vrioni, Constantinos Tsiamis, Athanasios Tsakris).

PMID: 34815652 PMCID: PMC8596224 DOI: 10.20524/aog.2021.0665

Abstract

BACKGROUND: Spontaneous bacterial peritonitis (SBP) is associated with a high mortality. The aim was to investigate whether bacterial deoxyribonucleic acid (bactDNA) could offer an accurate identification of pathogens and to explore its prognostic role during and early after an SBP episode.

METHODS: Consecutive patients with SBP (SBP-group) and patients with decompensated cirrhosis without SBP/bacterascites (control-group) were enrolled. Standard culture methodology was used to isolate and identify pathogens from blood and ascitic fluid (AF). The SeptiFast test was used to identify bactDNA directly from AF.

RESULTS: Fifty-five patients, median age 60 (interquartile range [IQR] 53-74), model-for-end-stage liver disease (MELD) score 18 (IQR 13-29), with SBP were prospectively included. AF cultures were positive in 52.7% (17.2% drug-resistant bacteria) and bactDNA in 29.1% (58.2% combined sensitivity). BactDNA results were 84.6% concordant with AF cultures. Three patients had positive bactDNA in the culture-negative SBP-group. BactDNA was negative in all 36 of the control group (100% specificity). In multivariate analysis for 7-day survival, factors adversely affecting outcome were MELD (P=0.049) and C-reactive protein (P=0.012). After patients who died during the first week post-admission were excluded, patients with positive bactDNA had a poor prognosis compared to those with a negative test (log-rank P=0.005). Variables independently associated with 30-day mortality were neutrophil-to-lymphocyte ratio (P=0.011) and positive bactDNA (P=0.020).

CONCLUSIONS: No evidence was found for the usefulness of bactDNA to improve bacterial identification during an SBP episode. However, bactDNA was a predictor of 30-day mortality in the subset of patients who recovered from the infection episode.

Copyright: © Hellenic Society of Gastroenterology.

Keywords: Spontaneous bacterial peritonitis; bacterial DNA; culture-positive SBP; neutrophil-to-lymphocyte ratio; survival

Conflict of interest statement

Conflict of Interest: None

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