Tocchioni Francesca, Tani Chiara, Bartolini Laura, Moriondo Maria, Nieddu Francesco, Pecile Patrizia, Azzari Chiara, Messineo Antonio, Ghionzoli Marco
Department of Pediatric Surgery, University of Florence and Children's University Hospital A. Meyer.
Department of Microbiology, Careggi Hospital , Florence.
Pediatr Rep. 2016 Sep 19;8(3):6487. doi: 10.4081/pr.2016.6487.
Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR) and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, (in 7 cases), (3), (3), (2), (1), (1), (1). Bacterial growth was instead observed only in four patients (3 and 1 and ). Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated.
在急性阑尾炎手术过程中获取的腹腔液标本的细菌生长情况，可能有助于优化复杂病例的进一步抗生素治疗。DNA扩增是一种检测微生物序列的快速技术。我们旨在比较DNA扩增与传统细菌生长培养的潜力，突出其在手术环境中的优缺点。在2012年5月至12月期间，对36例行阑尾切除术的儿童在手术过程中采集腹腔液标本。对每个样本进行实时聚合酶链反应（RT-PCR）和培养。RT-PCR显示18/36个样本中有16S扩增，（7例为 ），（3例为 ），（3例为 ），（2例为 ），（1例为 ），（1例为 ），（1例为 ）。相反，仅在4例患者中观察到细菌生长（3例为 ，1例为 ， ）。术前C反应蛋白和炎症程度作为细菌易位最可靠的指标，如预期一样升高。DNA扩增是一种快速且有用的检测病原体的方法，在检测如厌氧菌等难以在生物培养中保存的侵袭性病原体方面更有价值；其缺点是缺乏生物生长和药敏试验结果。在我们的初步研究中，RT-PCR和培养并未影响患者的治疗方式。
