THE DIAGNOSIS OF SMALL-BOWEL BACTERIAL OVERGROWTH - RELIABILITY OF JEJUNAL CULTURE AND INADEQUACY OF BREATH HYDROGEN TESTING
THE DIAGNOSIS OF SMALL-BOWEL BACTERIAL OVERGROWTH - RELIABILITY OF JEJUNAL CULTURE AND INADEQUACY OF BREATH HYDROGEN TESTING
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DOI：
10.1016/0016-5085(90)90818-l
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发表时间：
1990-02-01
期刊：
影响因子：
29.4
通讯作者：
GASBARRINI, G
中科院分区：
文献类型：
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作者：
CORAZZA, GR;MENOZZI, MG;GASBARRINI, G
单个空肠培养在诊断小肠细菌过度生长方面的可靠性最近受到了质疑。77名被认为有细菌过度生长的患者参加了这项研究，细菌过度生长的定义是每毫升吸入物至少产生106个细菌的空肠培养物。在有诱因的患者中有74%的患者发现细菌过度生长，在没有明确的细菌定植原因的患者中有32%的患者发现细菌过度生长。一些患者的肠液是在近端空肠的两个不同水平上使用闭管和开管系统采集的。2个空肠水平的每毫升空肠抽吸液细菌数与每毫升空肠抽吸液的空肠抽吸液细菌数之间呈高度显著相关(rS=0.9，p<；0.001)，相关系数为0.001。与空肠培养相比较，空肠抽吸物中挥发性脂肪酸的气相色谱和葡萄糖和乳果糖-氢呼气试验的敏感性分别为56%、62%和68%，特异性分别为100%、83%和44%。这项工作证明了空肠培养的可靠性和呼气氢试验在预测阳性空肠培养中的不足。当空肠抽吸物中挥发性脂肪酸的检测结果为阳性时，这总是表明细菌过度生长的存在；因此，该程序将避免对空肠样本进行更复杂、耗时和昂贵的细菌学分析。
The reliability of a single jejunal culture in the diagnosis of small bowel bacterial overgrowth has recently been questioned. Seventy-seven patients thought to have bacterial overgrowth, defined as a jejunal culture yielding at least 106 organisms per milliliter of aspirate, took part in the study. Bacterial overgrowth was found in 74% of the patients with predisposing conditions and in 32% of those with no clear causes of bacterial colonization. The intestinal juice of some patients was taken at two different levels of the proximal jejunum, using both the closed-and open-tube systems. Highly significant correlations (rs = 0.90, p < 0.001) were found between the numbers of bacteria per milliliter at the 2 jejunal levels and between the numbers of bacteria per milliliter of jejunal aspirate obtained from the closed and open tubes (rs = 0.84, p < 0.001). Compared with the jejunal culture, the gas chromatography of volatile fatty acids in jejunal aspirate and the glucose- and lactulose-hydrogen breath tests showed sensitivities of 56%, 62%, and 68% and specificities of 100%, 83%, and 44%, respectively. This work demonstrates the reliability of jejunal cultures and the inadequacy of breath hydrogen testing in the prediction of positive jejunal cultures. When results of testing for volatile fatty acids in jejunal aspirates are positive, this always indicates the presence of bacterial overgrowth; thus, this procedure would avoid the more complicated, time-consuming, and costly bacteriological analysis of jejunal samples.