We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Inoculation of Blood Culture Bottles With Ascitic Fluid: Improved Detection of Spontaneous Bacterial Peritonitis-Reply

Bruce A. Runyon, MD
Arch Intern Med. 1987;147(10):1849-1852. doi:10.1001/archinte.1987.00370100163033.
Text Size: A A A
Published online


—Dr Dalmau and coworkers have confirmed my findings (1) that the conventional method of ascitic fluid culture is less than 50% sensitive in detecting bacterial growth in patients with spontaneous bacterial peritonitis (SBP), and (2) that bedside inoculation of blood culture bottles with ascitic fluid essentially doubles the sensitivity. Dr Dalmau has not yet achieved statistical significance; I presume that he will achieve significance after the study of a few more patients.

Other investigators and practicing physicians from around the world have reported similar observations to me— when they change from the conventional culture method to the blood culture bottle method, their culture-positivity increases dramatically. The explanation is, at least in part, related to the low concentration of bacteria present in SBP. The median concentration of bacteria in ascitic fluid specimens that are diagnostic of SBP is two organisms per milliliter, according to my quantitative cultures (B.A.R., unpublished observations, 1987). The conventional


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.