Endoscopic jejunal biopsy culture: a simple and effective method to study jejunal microflora.
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Date
2010-11
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Abstract
Background Jejunal fluid culture is the gold standard for assessing jejunal microflora. Aspiration of jejunal fluid is sometime difficult. As the microorganisms rests on the
mucosal surface, culture of the mucosal biopsy may be a
possible alternative method.
Aim To study the role of jejunal mucosal biopsy culture to
assess jejunal microflora and to compare it with jejunal
fluid culture.
Methods Thirty adult subjects with gastroesophageal reflux
disease requiring endoscopy underwent enteroscopy.
Jejunal fluid aspirate and mucosal biopsy were cultured.
The procedure was repeated after omeprazole therapy in 18
patients.
Results Forty-eight pairs (30 preomeprazole therapy and 18
postomeprazole therapy) of fluid and mucosal biopsies
were cultured. In 45 of the 48 pairs (94%), both the culture
of jejunal biopsy and jejunal fluid yielded similar results
with respect to the presence (n=27) or absence of growth
(n=18). In the remaining 3 pairs, the growth was present
either in the biopsy culture (n=2) or in the fluid culture
(n=1) only. Among those pairs in which growth was
present, microorganisms isolated were identical in 53%,
differed by ≤2 organism in 37% and different by >2
organisms in 10%. Ten of the 12 patients who were
detected to have small intestinal bacterial overgrowth
(SIBO) on fluid culture were also detected to have SIBO
on biopsy culture. Sensitivity, specificity, positive and
negative predictive value of biopsy culture in diagnosing
SIBO was 83.5%, 97.2%, 94.7%, and 91.6%, respectively.
Conclusion Culture of unwashed endoscopic jejunal mucosal
biopsy is an effective and simple alternative to jejunal fluid culture for assessing jejunal microflora.
Description
Keywords
Bacterial overgrowth, Enteroscopy, Jejunal microflora, Mucosal biopsy culture
Citation
Chandra Sharad, Dutta Usha, Noor Mohd Talha, Taneja Neelam, Kochhar Rakesh, Sharma Meera, Singh Kartar. Endoscopic jejunal biopsy culture: a simple and effective method to study jejunal microflora. Indian Journal of Gastroenterology. 2010 Nov-Dec; 29(6): 226-230.