检测急慢性胆囊炎中的细菌 DNA。

Detection of bacterial DNA in acute and chronic cholecystitis.

机构信息

Biomolecular Laboratory, Medical Department, UNIVILLE University, Brazil.

出版信息

Br J Surg. 2010 Apr;97(4):532-6. doi: 10.1002/bjs.6940.

DOI:10.1002/bjs.6940

PMID:20169571

Abstract

BACKGROUND

The incidence of bacterbilia in cholelithiasis remains controversial. The positivity of cultures ranges from 0 to 73 per cent. The aim of this study was to employ the polymerase chain reaction (PCR) to detect bacterial DNA in gallbladder bile extracted during elective laparoscopic cholecystectomy, and to compare PCR findings with those of bile culture.

METHODS

Bile samples from 84 laparoscopic cholecystectomies were collected for culture and PCR analysis.

RESULTS

Positive results for bacterbilia were found in 42 (50 per cent) of 84 patients by PCR but in only 16 patients (19 per cent) by culture (P < 0.001). Agreement between the two methods was seen in 44 samples (52 per cent), which were negative in 35 cases. Pathological examination showed chronic cholecystitis in 69 cases (82 per cent) and acute cholecystitis in 15 (18 per cent). Thirty-three (48 per cent) of the patients with chronic cholecystitis were PCR positive but only ten (14 per cent) were culture positive (P < 0.001). Only culture results correlated with findings on pathological examination (P = 0.033).

CONCLUSION

PCR is more sensitive in detecting bacterial contamination of gallbladder bile in cholecystitis than conventional culture. The clinical relevance of this high sensitivity remains unclear.

摘要

背景

胆石症患者的菌血症发生率仍存在争议。培养物的阳性率从 0 到 73%不等。本研究旨在采用聚合酶链反应（PCR）检测在择期腹腔镜胆囊切除术中提取的胆囊胆汁中的细菌 DNA，并将 PCR 结果与胆汁培养结果进行比较。

方法

对 84 例腹腔镜胆囊切除术的胆汁样本进行培养和 PCR 分析。

结果

PCR 检测到 42 例（50%）84 例患者存在菌血症阳性，但仅 16 例（19%）患者培养阳性（P<0.001）。两种方法的一致性在 44 份样本中（52%）观察到，这 35 份样本均为阴性。病理检查显示 69 例（82%）为慢性胆囊炎，15 例（18%）为急性胆囊炎。33 例（48%）慢性胆囊炎患者 PCR 阳性，但仅 10 例（14%）培养阳性（P<0.001）。只有培养结果与病理检查结果相关（P=0.033）。