Department of Clinical Microbiology, Odense University Hospital, Denmark.
Research Unit for Surgery, Odense University Hospital, Denmark.
Surgery. 2024 Sep;176(3):798-802. doi: 10.1016/j.surg.2024.04.030. Epub 2024 Jun 11.
Polymerase chain reaction is a method to detect bacterial DNA and is widely used because it delivers results within a few hours with the potential to guide postoperative antibiotic treatment. This study aims to determine if polymerase chain reaction can accurately detect bacteria in the peritoneal fluid compared with conventional culture from patients operated for acute appendicitis.
This prospective cohort study included patients above the age of 18 years who underwent laparoscopic surgery for acute appendicitis. Peritoneal samples were collected before the appendectomy procedure for conventional culture and polymerase chain reaction using the BioFire Blood Culture Identification 2 Panel for comparison. During surgery, the surgeon assessed the appendicitis as either complicated or noncomplicated.
Samples from 102 patients were eligible for analysis. Twelve samples were polymerase chain reaction positive, and 14 samples were culture positive. The concordance of positive results when comparing these 2 methods was 71.4%. The most commonly found bacteria were Escherichia coli and Bacteroides fragilis. Of the 36 patients with complicated appendicitis, no bacteria were detected by either conventional culture or polymerase chain reaction in 21 (58%) of the patients. In patients with uncomplicated appendicitis, bacteria were demonstrated in 1 out of 66 (2%) patients.
This study suggests that polymerase chain reaction can be used to detect bacteria in the peritoneal fluid and has the potential to guide postoperative antibiotic treatment.
聚合酶链反应是一种检测细菌 DNA 的方法，由于它可以在几个小时内提供结果，并有可能指导术后抗生素治疗，因此被广泛应用。本研究旨在确定聚合酶链反应是否能比传统的培养方法更准确地检测急性阑尾炎手术患者的腹腔液中的细菌。
这是一项前瞻性队列研究，纳入了 18 岁以上接受腹腔镜手术治疗急性阑尾炎的患者。在阑尾切除术之前，采集腹腔样本进行传统培养和聚合酶链反应，使用 BioFire 血培养鉴定 2 面板进行比较。手术过程中，外科医生将阑尾炎评估为复杂或非复杂。
102 名患者的样本符合分析条件。12 个样本聚合酶链反应阳性，14 个样本培养阳性。比较这两种方法的阳性结果一致性为 71.4%。最常见的细菌是大肠杆菌和脆弱拟杆菌。在 36 例复杂阑尾炎患者中，21 例（58%）患者的传统培养或聚合酶链反应均未检测到细菌。在单纯性阑尾炎患者中，66 例患者中有 1 例（2%）患者检测到细菌。
本研究表明，聚合酶链反应可用于检测腹腔液中的细菌，并有可能指导术后抗生素治疗。
