Novel Colorimetric and Light Scatter Methods to Identify and Manage Peritoneal Dialysis-Associated Peritonitis at the Point-of-Care

使用新型比色和光散射方法在护理点识别和管理腹膜透析相关腹膜炎

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作者:Nishal Govindji-Bhatt, Stephnie M Kennedy, Michael G Barker, Darren Kell, Duncan Henderson, Nicholas Goddard, Ana Yepes Garcia, Adam S Milner, Tom Willett, Ryan Griffiths, Peter Foster, William Kilgallon, Rachel Cant, Christopher G Knight, David Lewis, Richard Corbett, Habib Akbani, Graham Woodrow, 

Conclusion

These complementary new approaches provide a simple means to obtain information to assist diagnosis at the POC. The first provides antibiotic sensitivity following 10 hours incubation, whereas the second optical approach (QuickCheck), provides instant accurate total leukocyte count.

Methods

One approach uses a tetrazolium-based chemical reporting system, primarily focused on detecting bacterial contamination and associated vancomycin-sensitivity. The second approach uses a novel forward light-scatter device (QuickCheck) to provide an instant quantitative cell count directly from PD patient effluent.

Results

The tetrazolium approach detected and correctly distinguished laboratory isolates, taking 10 hours to provide non-quantitative results. We compared the technical performance of the light scatter leukocyte counting approach with spectrophotometry, hemocytometer counting and flow cytometry (Sysmex) using patient effluent samples. QuickCheck had high accuracy (94%) and was the most precise (coefficient of variation <4%), showing minimal bias, overall performing similarly to flow cytometry.

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