Professor Hu Zhongjie: Application of New Molecular Diagnosis Technology in Bacteriological Diagnosis of Cirrhosis and Ascites

From November 25th to 26th, 2021, the Beijing You'an Hospital Affiliated to Capital Medical University, hosted by Beijing You'an Hospital, Capital Medical University, was successfully held in Beijing
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This conference brought together a number of well-known domestic experts in the field of liver disease and infectious diseases to exchange and discuss on cutting-edge academic topics
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Yimaitong is fortunate to invite Professor Hu Zhongjie from Beijing You'an Hospital, Capital Medical University, to share the application of new molecular diagnostic technology in the bacteriological diagnosis of liver cirrhosis and ascites
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Bacterial infection is relatively common in patients with liver cirrhosis, and is one of the most important causes of the progression, complications, and death of liver cirrhosis
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Intestinal flora imbalance, increased intestinal mucosal permeability, bacterial translocation, and immune dysfunction play an important role in the pathophysiological mechanism of liver cirrhosis complicated by bacterial infection
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Early diagnosis and timely and reasonable antimicrobial treatment are the keys to the management of bacterial infections in liver cirrhosis.
Delayed treatment and inappropriate treatment can increase the mortality rate
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Yimaitong: What is the current overall status of the clinical diagnosis and treatment of bacterial infections in ascites due to liver cirrhosis? What are the problems? Professor Hu Zhongjie: The most common infection in patients with liver cirrhosis in China is spontaneous bacterial peritonitis (SBP), but there are still some problems that need to be solved urgently in the clinical diagnosis and bacterial identification of SBP, and these problems have been plagued by clinicians
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First of all, from the perspective of diagnosis, the current international diagnostic criteria for SBP is that the count of ascites neutrophils (PMN) is ≥250/μL, but there are many clinically patients with symptoms and signs of peritonitis, whose PMN count in ascites is less than 250 /μL, so more objective indicators are needed to assist in the diagnosis of SBP
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The second is the issue of bacterial identification.
If bacterial identification cannot be carried out, then targeted anti-infective treatment cannot be taken
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If we can quickly identify the bacteria in abdominal cavity infection, we can select appropriate antibacterial drugs for treatment
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Ascites culture is currently used for bacterial identification.
Although bacterial culture technology has been continuously developed over the years, the positive rate of ascites culture has not been significantly improved, so further research work may be needed in this regard
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Yimaitong: What do you think about the development of molecular diagnostic technology and its future clinical application prospects? Professor Hu Zhongjie: In recent years, molecular diagnostic technology has developed very rapidly.
With the development of second-generation sequencing technology, many technologies have gradually been applied to the clinic.
We also conduct bacterial DNA testing and metagenomic testing (mNGS) for ascites bacterial identification.
Some explorations have been made and some preliminary results have been achieved
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Although these technologies have not been widely used in clinical practice, and there are still some problems that need to be solved, they have shown good clinical application prospects
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Professor Hu Zhongjie, Doctor of Medicine, Chief Physician, Member of the Party Committee and Deputy Dean of Beijing You'an Hospital, Capital Medical University , 2014, 30(07):588-591.