IMPROVED DETECTION OF SPONTANEOUS BACTERIAL PERITONITIS WITH BACTEC AS COMPARED WITH CONVENTIONAL CULTURE METHODS - A PROSPECTIVE-STUDY

Bacteriologic diagnosis of spontaneous bacterial peritonitis is diffic ult due to the low yield of isolating the bacteria from the ascitic fl uid. We prospectively compared the conventional culture method with th e nonradiometric BACTEC culture system for the detection of bacteria i n 20 episodes of spontaneous bacterial peritonitis. The ascitic fluid culture was positive by the conventional culture method in 25% and by BACTEC in 79% of the episodes of spontaneous bacterial peritonitis (P = 0.004). Of culture-positive episodes, Gram-negative bacteria were de tected by conventional cultures in 20% and by BACTEC in 47%. BACTEC cu lture system was significantly better than the conventional cultures f or the detection of streptococci (viridans streptococci and Enterococc us fecalis), 33% versus 0 (P < 0.05). Conventional cultures did not de tect bacteria that were not also detected by BACTEC cultures. In concl usion, the BACTEC nonradiometric culture method is superior to convent ional cultures for the diagnosis of spontaneous bacterial peritonitis.