Beschreibung:
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<jats:title>Background</jats:title>
<jats:p>The prognostic relevance of bacterial DNA (bactDNA) detection in ascitic fluid of patients with cirrhosis is still under debate. Using quantitative real-time PCR with broad-range primers targeting the V3 and V4 variable region of the <jats:italic toggle="yes">16S rRNA</jats:italic> gene, we measured bactDNA concentrations in patients with and without leukocytic ascites and evaluated the impact on short-term survival.</jats:p>
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<jats:title>Patients and methods</jats:title>
<jats:p>Ascites samples from 173 patients with decompensated cirrhosis were consecutively collected between February 2011 and December 2012. BactDNA-positive ascites samples were sequenced and chromatograms were identified using RipSeq. Clinical data collection and survival analyses were carried out retrospectively and correlated with ascites bactDNA levels.</jats:p>
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<jats:title>Results</jats:title>
<jats:p>BactDNA was detected qualitatively with a similar frequency in both nonleukocytic and leukocytic ascites [40% (57/144) and 43.5% (10/23), respectively; <jats:italic toggle="yes">P</jats:italic>=0.724]. However, the median bactDNA level was significantly higher in leukocytic ascites than in nonleukocytic ascites (1.2×10<jats:sup>4</jats:sup> vs. 5.7×10<jats:sup>2</jats:sup> copies/ml; <jats:italic toggle="yes">P</jats:italic>=0.008). Patients’ survival was associated significantly with bactDNA level. The 30-day and 180-day survival was reduced if bactDNA was above the quantification limit of 520 copies/ml (84 and 63% vs. 72 and 43%, respectively; <jats:italic toggle="yes">P</jats:italic><0.05) and worst if bactDNA was above 5000 copies/ml. The bacterial spectrum was dominated by Gram-positive strains as shown by direct sequencing.</jats:p>
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<jats:title>Conclusion</jats:title>
<jats:p>BactDNA quantification in ascitic fluid samples using culture-independent <jats:italic toggle="yes">16S rRNA</jats:italic> gene-based methods seems to be an interesting approach to identify patients at risk of reduced survival. Our study warrants further evaluation of antibiotic treatment in patients with molecular bacterascites.</jats:p>
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