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. 1996 Jan;34(1):34–37. doi: 10.1128/jcm.34.1.34-37.1996

Clinical comparison of isolator, Septi-Chek, nonvented tryptic soy broth, and direct agar plating combined with thioglycolate broth for diagnosing spontaneous bacterial peritonitis.

J E Hay 1, F R Cockerill 3rd 1, D Kaese 1, E A Vetter 1, P C Wollan 1, J Rakela 1, M P Wilhelm 1
PMCID: PMC228724  PMID: 8748267

Abstract

Spontaneous bacterial peritonitis is a life-threatening complication of cirrhotic ascites. Optimal patient management depends on the isolation of the causal organism from ascitic fluid. To evaluate culture techniques for the diagnosis of spontaneous bacterial peritonitis, we prospectively compared three blood culture system, the Isolator system, a lysis-centrifugation system, the Septi-Chek system, a biphasic culture system, and a nonvented tryptic soy broth system, all inoculated at the bedside, and our standard method of direct inoculation of specimens after transport to the laboratory onto agar plates and into thioglycolate broth. The results showed that the Septi-Chek and nonvented tryptic soy broth systems each recovered statistically significantly more pathogens than either the Isolator system (P = 0.0084) or the standard method (P = 0.00098). The Isolator system recovered more pathogens than the standard plate method, but this difference was not statistically significant. Both the Isolator system and the standard plate method recovered more contaminating microorganisms than the Septi-Chek or nonvented tryptic soy broth system. The Isolator system required the most processing time compared with the processing times required by any other method.

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Selected References

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  1. Bobadilla M., Sifuentes J., Garcia-Tsao G. Improved method for bacteriological diagnosis of spontaneous bacterial peritonitis. J Clin Microbiol. 1989 Oct;27(10):2145–2147. doi: 10.1128/jcm.27.10.2145-2147.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Castellote J., Xiol X., Verdaguer R., Ribes J., Guardiola J., Gimenez A., Casais L. Comparison of two ascitic fluid culture methods in cirrhotic patients with spontaneous bacterial peritonitis. Am J Gastroenterol. 1990 Dec;85(12):1605–1608. [PubMed] [Google Scholar]
  3. Crossley I. R., Williams R. Spontaneous bacterial peritonitis. Gut. 1985 Apr;26(4):325–331. doi: 10.1136/gut.26.4.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dalmau B., Nogueras A., Mas P., Segura F. Inoculation of blood culture bottles with ascitic fluid: improved detection of spontaneous bacterial peritonitis. Arch Intern Med. 1987 Oct;147(10):1849–1852. doi: 10.1001/archinte.147.10.1849. [DOI] [PubMed] [Google Scholar]
  5. Elston H. R., Wang M., Philip A. Evaluation of isolator system and large-volume centrifugation method for culturing body fluids. J Clin Microbiol. 1990 Jan;28(1):124–125. doi: 10.1128/jcm.28.1.124-125.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Henry N. K., Grewell C. M., Van Grevenhof P. E., Ilstrup D. M., Washington J. A., 2nd Comparison of lysis-centrifugation with a biphasic blood culture medium for the recovery of aerobic and facultatively anaerobic bacteria. J Clin Microbiol. 1984 Sep;20(3):413–416. doi: 10.1128/jcm.20.3.413-416.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Runyon B. A., Antillon M. R., Akriviadis E. A., McHutchison J. G. Bedside inoculation of blood culture bottles with ascitic fluid is superior to delayed inoculation in the detection of spontaneous bacterial peritonitis. J Clin Microbiol. 1990 Dec;28(12):2811–2812. doi: 10.1128/jcm.28.12.2811-2812.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Runyon B. A., Canawati H. N., Akriviadis E. A. Optimization of ascitic fluid culture technique. Gastroenterology. 1988 Nov;95(5):1351–1355. doi: 10.1016/0016-5085(88)90372-1. [DOI] [PubMed] [Google Scholar]
  9. Runyon B. A., Hoefs J. C. Culture-negative neutrocytic ascites: a variant of spontaneous bacterial peritonitis. Hepatology. 1984 Nov-Dec;4(6):1209–1211. doi: 10.1002/hep.1840040619. [DOI] [PubMed] [Google Scholar]
  10. Runyon B. A. Spontaneous bacterial peritonitis: an explosion of information. Hepatology. 1988 Jan-Feb;8(1):171–175. doi: 10.1002/hep.1840080131. [DOI] [PubMed] [Google Scholar]
  11. Runyon B. A., Umland E. T., Merlin T. Inoculation of blood culture bottles with ascitic fluid. Improved detection of spontaneous bacterial peritonitis. Arch Intern Med. 1987 Jan;147(1):73–75. [PubMed] [Google Scholar]
  12. Ryan S., Fessia S. Improved method for recovery of peritonitis-causing microorganisms from peritoneal dialysate. J Clin Microbiol. 1987 Feb;25(2):383–384. doi: 10.1128/jcm.25.2.383-384.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Saubolle M. A., Sewell D. L., Holland M. D., Golper T. A. Comparison of two commercial broth-culture systems for microbial detection in dialysates of patients on continuous ambulatory peritoneal dialysis. Diagn Microbiol Infect Dis. 1989 Nov-Dec;12(6):457–461. doi: 10.1016/0732-8893(89)90077-1. [DOI] [PubMed] [Google Scholar]
  14. Siersema P. D., de Marie S., van Zeijl J. H., Bac D. J., Wilson J. H. Blood culture bottles are superior to lysis-centrifugation tubes for bacteriological diagnosis of spontaneous bacterial peritonitis. J Clin Microbiol. 1992 Mar;30(3):667–669. doi: 10.1128/jcm.30.3.667-669.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Titó L., Rimola A., Ginès P., Llach J., Arroyo V., Rodés J. Recurrence of spontaneous bacterial peritonitis in cirrhosis: frequency and predictive factors. Hepatology. 1988 Jan-Feb;8(1):27–31. doi: 10.1002/hep.1840080107. [DOI] [PubMed] [Google Scholar]
  16. Vas S. I., Law L. Microbiological diagnosis of peritonitis in patients on continuous ambulatory peritoneal dialysis. J Clin Microbiol. 1985 Apr;21(4):522–523. doi: 10.1128/jcm.21.4.522-523.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Woods G. L., Washington J. A., 2nd Comparison of methods for processing dialysate in suspected continuous ambulatory peritoneal dialysis-associated peritonitis. Diagn Microbiol Infect Dis. 1987 Jun;7(2):155–157. doi: 10.1016/0732-8893(87)90034-4. [DOI] [PubMed] [Google Scholar]

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