Does ascitic fluid filtration improve the microbiological diagnosis of spontaneous bacterial peritonitis? An experimental laboratory study
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2022.180658Keywords:
Cirrose hepática, Peritonite Bacteriana Espontânea, Diagnóstico Microbiológico, Filtragem do líquido ascíticoAbstract
Background: Spontaneous Bacterial Peritonitis (SBP) is a serious and frequent complication among cirrhotic patients with ascites and can be diagnosed by cytological analysis of the ascitic fluid. The microbiological culture of ascitic fluid, however, is positive in less than 40% of SBP cases, which often results in inappropriate antimicrobial therapy. Empirical therapy may be suboptimal, increasing patient's risk of aggravation, or overestimated, unnecessarily boosting bacterial resistance. Objective: This experimental laboratory study aimed to standardize and verify the technical feasibility of ascitic fluid vacuum filtration, as a way to optimize the etiological diagnosis of SBP, compared to the automated method. Method: The method evaluated and standardized in this study was ascitic fluid vacuum filtration. Its principle is the concentration of bacteria on a filter membrane. Results: This study included 36 cirrhotic patients treated at a public university hospital between 11.13.2017 and 06.30.2019. Among them, 47.2% (17/36) presented cytology test results compatible with SBP. For these patients, culture sensitivity using the automated method was 35.3% (6/17), against 11.8% (2/17) with the vacuum filtration method. Conclusion: In conclusion, vacuum filtration does not improve the microbiological diagnosis of SBP in this population compared to the automated method.
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Copyright (c) 2022 Lucas Chaves, Francisco Barbosa Junior, Fernanda Fernandes de Souza, Rodrigo de Carvalho Santana, Roberto Martinez, Fernando Bellissimo-Rodrigues
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