El cultivo del sedimento de 50 mL no mejora sustancialmente el diagnóstico de peritonitis asociada a diálisis. (Spanish)

Culturing the centrifuged pellet of 50 mL does not improve significantly the diagnosis of dialysis-associated peritonitis. Background: To improve the diagnosis of dialysis-associated peritonitis, culturing the centrifuged pellet of 50 mL has been proposed. Methods: Study of 144 specimens from 144 patients with peritonitis associated to dialysis, without antibiotic treatment. The specimens were processed by three methods: 1) direct plating; 2) culturing the pellet of 50 mL; and 3) inoculating 10 mL in blood-culture bottle (gold standard). The result of the cultures and the identification of the germs were blinded. Results: Culture is blood-culture bottles rendered 92 isolates (63.9%). Of the centrifuged specimens, 73 isolations were obtained (50.7%), with sensitivity of 0.76, and specificity of 0.95. The technique of direct culture in agar plate found 54 isolations (37.5%) with sensitivity of 0.57, and specificity of 0.95. Conclusions: When compared against the gold standard, culturing the sediment of 50 mL is cumbersome and it does not significantly improve the efficiency of culturing the dialysis fluid. [ABSTRACT FROM AUTHOR]

Antecedentes: Para mejorar el diagnóstico de peritonitis asociada a diálisis, se ha propuesto cultivar el sedimento del centrifugado de 50 mL. Métodos: Se incluyeron 144 muestras de 144 pacientes con peritonitis asociada a diálisis sin tratamiento antibiótico previo. La siembra en frasco de hemocultivo fue el estándar de oro. Las muestras se procesaron por tres métodos: 1) siembra de sedimento; 2) siembra directa; 3) siembra en frasco de hemocultivo. El resultado del cultivo y la identificación de los gérmenes fueron cegados. Resultados: La siembra en frasco de hemocultivo produjo 92 aislamientos (63.9%). Del cultivo de sedimento se obtuvieron 73 aislamientos (50.7%), con sensibilidad de 0.76 y especificidad de 0.95. El cultivo directo encontró 54 aislamientos (37.5%), con sensibilidad de 0.57 y especificidad de 0.95. Conclusiones: Cuando se compara con el estándar de oro, el cultivo del sedimento es laborioso y no mejora sustancialmente la eficacia del diagnóstico. [ABSTRACT FROM AUTHOR]

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