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

Annals of Gastroenterology Nov 25, 2021

Manii I, Vrionii G, Hadziyannisi E, et al. - During a spontaneous bacterial peritonitis (SBP) episode, bacterial identification cannot be improved by using bacterial deoxyribonucleic acid (bactDNA). In the subset of patients who have recovered from the infection episode, 30-day mortality can be predicted by bactDNA.

  • This study included consecutive patients with SBP (SBP-group) and those with decompensated cirrhosis without SBP/bacterascites (control-group).

  • Overall, 55 patients [median age 60, model-for-end-stage liver disease (MELD) score 18 (IQR 13-29)] with SBP were prospectively included.

  • Positive ascitic fluid (AF) cultures and bactDNA were detected in 52.7% (17.2% drug-resistant bacteria) and in 29.1% (58.2% combined sensitivity), respectively.

  • The results of bactDNA were 84.6% concordant with AF cultures, and there was positive bactDNA in 3 patients in the culture-negative SBP-group.

  • Multivariate analysis for 7-day survival revealed MELD and C-reactive protein as the factors adversely affecting outcome.

  • Post-exclusion of patients who died during the first week after admission, a poor prognosis was reported in those with positive bactDNA vs those with a negative test.

  • Neutrophil-to-lymphocyte ratio and positive bactDNA were independently linked with 30-day mortality.

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