Conclusions

Bacterial DNA has been detected in the hemodialyzer of hemoculture-negative CKD patients using molecular methods which were found to be far more sensitive than standard methods. The correlation of bacterial DNA presence and inflammatory parameters has shown an increase in CRP, IL-6 and AOPP and a decrease in MFI DR+ cells, an index of the presence of inflammation probably induced by bacterial DNA or bacteria, and decreased immunity. Apart from the number of limitations and problems encountered, the molecular method seems to be useful as a diagnostic tool for screening subclinical infection and diagnosing sepsis when hemoculture is negative. Bacterial identification, however, must be done with species-specific primers. More investigations need to be performed to confirm these results.

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