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Usefulness of 23S rRNA Amplification by PCR in the Detection of Bacteria in CAPD Peritonitis

Authors
 Yoo T.-H.  ;  Chang K.H.  ;  Ryu D.-R.  ;  Kim J.S.  ;  Choi H.Y.  ;  Park H.C.  ;  Kang S.-W.  ;  Choi K.H.  ;  Kim J.M.  ;  Ha S.K.  ;  Han D.S.  ;  Lee H.Y. 
Citation
 AMERICAN JOURNAL OF NEPHROLOGY, Vol.26(2) : 115-120, 2006 
Journal Title
AMERICAN JOURNAL OF NEPHROLOGY
ISSN
 0250-8095 
Issue Date
2006
MeSH
Adult ; Aged ; Bacteria/isolation & purification ; Bacterial Infections/diagnosis* ; Bacterial Infections/microbiology ; Female ; Gram-Negative Bacterial Infections/diagnosis ; Gram-Negative Bacterial Infections/microbiology ; Gram-Positive Bacterial Infections/diagnosis ; Gram-Positive Bacterial Infections/microbiology ; Humans ; Male ; Middle Aged ; Nucleic Acid Amplification Techniques/methods* ; Peritoneal Dialysis, Continuous Ambulatory/adverse effects* ; Peritonitis/complications ; Peritonitis/microbiology ; Polymerase Chain Reaction/methods* ; RNA, Ribosomal, 23S/genetics* ; Sensitivity and Specificity
Keywords
Peritoneal dialysis ; Continuous ambulatory peritoneal dialysis peritonitis ; Bacterial cultures ; peritoneal dialysis patients ; Polymerase chain reaction ; infectious disease detection ; Bacterial RNA amplifi cation
Abstract
BACKGROUND: Peritonitis is the most common complication of continuous ambulatory peritoneal dialysis (CAPD), and the spectrum of organisms causing CAPD peritonitis is broad. Polymerase chain reaction (PCR) has recently broadened its diagnostic capabilities in infectious diseases. PCR can provide a sensitive method for identifying causative infectious organisms.

METHODS: To evaluate the usefulness of 23S bacterial ribosomal RNA amplification and direct sequencing for the detection of infectious organisms, we compared PCR with bacteriological culture for the analysis of dialysates from CAPD peritonitis patients. Thirty-two samples from CAPD peritonitis patients with current antibiotic use and control samples from 30 CAPD patients without peritonitis were examined by PCR with sequencing analysis and by conventional bacteriological culture. In addition, 95 culture-positive samples and 39 culture-negative samples from CAPD peritonitis patients before antibiotic treatment were analyzed by PCR assay.

RESULTS: In the control samples from patients without CAPD peritonitis, false-positive rates were relatively rare: 3 of 30 in the PCR study and 2 of 30 in the culture study. Of the 134 CAPD peritonitis samples collected before antibiotic therapy, positive cultures were obtained in 70.9% (95/134) of them. In 75 of the culture-positive samples, the same microorganisms were confirmed by PCR assay, and the others showed discrepant results as compared with culture study. In 30 of the 39 culture-negative samples, microbial organisms were detected by PCR assay. Of the 32 samples from patients who developed CAPD peritonitis during antibiotic treatment, 17 (53.1%) were positive by PCR assay, and 5 (15.6%) were positive by culture.

CONCLUSION: Our study suggests that broad-spectrum PCR with RNA sequencing can complement culture methods in the diagnosis of CAPD peritonitis, especially in patients with previous or current antibiotic use.
Full Text
http://www.karger.com/?DOI=10.1159/000092040
DOI
10.1159/000092040
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Joo Sung(김주성)
Kim, June Myung(김준명)
Ryu, Dong Ryeol(류동열)
Park, Hyeong Cheon(박형천) ORCID logo https://orcid.org/0000-0002-1550-0812
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Ho Yung(이호영)
Chang, Kyung Hee(장경희)
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Choi, Hoon Young(최훈영) ORCID logo https://orcid.org/0000-0002-4245-0339
Ha, Sung Kyu(하성규)
Han, Dae Suk(한대석)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111128
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