Use of D-lactic acid measurements in the diagnosis of bacterial infections.

This study explored the use of D-lactic acid as a marker for bacterial infections. D-Lactic was produced by frequently encountered human bacterial pathogens under anaerobic growth conditions; Bacteroides fragilis produced the largest amount. Orally administered D-lactic acid was absorbed from the intestines of rats and later found in measurable quantities in the blood and urine. Eunephric and anephric rats that received D-lactic acid intravenously showed similar quantities of this metabolite in the blood. These quantities are consistent with the distribution of D-lactic acid to total body water. Isolated liver and lung tissues from rats did not metabolize or produce D-lactic acid. Rats with experimentally induced, sublethal klebsiella peritonitis had D-lactic acidemia of 0.2 mM and 25.6 mM at 0 and 6 hr of infection, respectively. In a normal human, D-lactic acid was detected in the urine and blood after a subcutaneous injection of D-lactic acid, and pharmacokinetics of elimination similar to those of rats were found.