1997 Fiscal Year Final Research Report Summary
The Mechanism of the Occurrence of Spontaneous Bacterial Peritonitis
| Project/Area Number |
07671428
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Jikei University School of Medicine |
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Principal Investigator |
INAGAKI Yoshinori Jikei University School of Medicine Assistant Professor, 医学部・外科学講座第2, 講師 (40138714)
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| Co-Investigator(Kenkyū-buntansha) |
HOSHINA Sadayori Jikei University School of Medicine Assistant Professor, 医学部・臨床検査医学, 講師 (30119846)
YOKOTA Tokuyasu Jikei University School of Medicine Assistant, 医学部・外科学講座第2, 助手 (80256461)
NAKASATO Yuichi Jikei University School of Medicine Assistant, 医学部・外科学講座第2, 助手 (30266655)
ONDA Keiji Jikei University School of Medicine Assistant, 医学部・外科学講座第2, 助手 (70246388)
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| Project Period (FY) |
1995 – 1997
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| Keywords | spontaneous bacterial peritonitis / liver cirrhosis / ascites / enteric bacteria / Autobacteriography / polymelase chain reaction |
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| Research Abstract |
We studied spontaneous bacterial peritonitis (SBP) to elucidate its infection route, and to develop a quick diagnostic method for it. The following results were obtainted.
(1) SBP occurred in the rats with cirrhosis caused by administration of thioacetamide, but not in the control rats.
(2) SBP was more likely to occur if enterobacteria proliferate in the lower small intestine rather than in the in the large intestine.
(3) Transportation of bacteria was observed to the lymph nodes associated with the area of intestine where enterobacteria proliferate at the occurrence of SBP but not in the portal and peripheral blood.
(4) the route to the abdominal cavity via the intestinal wall was suggested as an invasion route of enterobacteria for the occurrence of SBP.
(5) Even from the ascites inn which the bacteria were not detected by incubation, a very small amount of E.coli or dead bacteria could be detected by PCR using the nucleotide sequence characteristics of prokaryotes as the primers.
As the invasion route of bacteria from the intestine to the abdominal cavity, (i) blood circulation, (ii) lymph circulation, and (iii) direct invasion from the intestinal wall to the abdominal cavity have been considered. The present study suggested that (iii) is the most likely route. The occurrence of SBP is not necessarily mediated by viable bacteria from the intestine, but may be caused by immunoreaction by dead bacteria or bacterial components in the ascites. On the other hand, bacteria are only rarely detected in cultures of the ascites in patients with SBP.Detection of bacterial DNA in the asites by PCR is considered useful for diagnosis of SBP because it is a high sensitivity and rapid method. However, it is clinically difficult to distinguish between secondary bacterial peritonitis by intestinal perforation and SBP,and further studies are required.
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