Comparative study of diagnosis of XXXX by quantitative polymerase chain reaction for bacterial DNA vs culture methods.

@entity1 @entity1726 @entity298
INTRODUCTION: @entity298 remains one of the main complications that afflict peritoneal dialysis @entity1 . We conducted a pilot study to determine the feasibility and potential advantages of quantitative PCR (qPCR) assays for the presence of bacterial DNA in this clinical scenario. METHODS: 14 @entity1 attending with 'cloudy bags' had @entity1726 fluid analyzed in accordance with Renal Association Standards. In addition, quantitative bacterial DNA analysis was performed on 50 mL samples of @entity1726 fluid. DNA was extracted using a Qiagen kit. Quantitative PCR assays using primers and probes targeted at 16S rDNA were used to measure the levels of bacterial DNA. Samples from 13 @entity1 attending the department for other reasons served as negative controls. Laboratory staff were blinded to clinical details at the time of analysis. RESULTS: We determined a threshold of bacterial DNA whereby 11 of 13 negative controls were 'negative'. Significant bacterial DNA was found in 6 of 9 culture positive' @entity298 cases (p < 0.05 by chi(2). The 3 cases of 'no growth' @entity298 had 'insignificant' bacterial DNA. Serial DNA analysis was performed in 8 @entity1 . Of the 6 @entity1 who were 'cured' with standard antibiotic therapy, only 1 showed a rise in bacterial DNA from Day 1 to 5. But the 2 @entity1 who relapsed after antibiotics had marked rises in bacterial DNA (p < 0.05 by chi(2). DISCUSSION: We showed that results from quantitative bacterial DNA PCR assays correlate with current microbiological tests despite the small size of this study. We also suggest that this technology might be clinically useful as an adjunct for cases of 'no growth' @entity298 and to identify those @entity1 likely to relapse despite apparent clinical improvement with standard antibiotic therapy.
