1 Gastrounit, Medical Division, Gastrounit, Amager and Hvidovre Hospital, The Capital Region of Denmark2 Gastrounit, Amager and Hvidovre Hospital, The Capital Region of Denmark3 Gastrounit, Surgical Division, Gastrounit, Amager and Hvidovre Hospital, The Capital Region of Denmark4 Department of Hepatology, Abdominal Centre, Rigshospitalet, The Capital Region of Denmark5 Clinical Research Centre, Amager and Hvidovre Hospital, The Capital Region of Denmark6 Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and research, Amager and Hvidovre Hospital, The Capital Region of Denmark7 unknown8 Molekylærbiologisk Institut
BACKGROUND: Bacterial translocation (BT) may cause infections, in particular, spontaneous bacterial peritonitis (SBP). In the absence of overt infection, BT may further stimulate the immune system and contribute to haemodynamic alterations and complications. Bacterial DNA (bDNA) is claimed to be a promising surrogate marker for BT, although its clinical relevance has been questioned. MATERIALS AND METHODS: In 38 cirrhotic patients with and without SBP, bDNA in blood and ascites were assessed by 16S rDNA quantitative PCR. Levels of lipopolysaccharide-binding protein in plasma and highly sensitive C-reactive protein, tumour necrosis factor-α, soluble urokinase plasminogen activating receptor, interleukin-6, interleukin 8, interferon-γ inducible protein-10 and vascular endothelial growth factor in plasma and ascites were measured by multiplex cytokine and ELISA assays. RESULTS: In patients without signs of SBP or positive cultures, we found a high frequency of bDNA but low concordance of bDNA between blood and ascites. Markers of inflammation were not significantly different between blood bDNA-positive (22%), ascites bDNA-positive (52%), and bDNA-negative patients. The 16S rDNA PCR failed to show bDNA in two out of six samples with SBP. Sequencing of positive samples did not determine the source of bDNA. CONCLUSION: bDNA as assessed by this PCR method was largely unrelated to markers of inflammation and does not seem to be of clinical value in the diagnosis of SBP. According to our results, bDNA is not a reliable marker of BT.
European Journal of Gastroenterology and Hepatology, 2014, Vol 26, Issue 12, p. 1360-6
Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't