Bacteriologic Analysis of Mucosal Biopsy Specimens for Detecting Small-Intestinal Bacterial Overgrowth

Authors:
  • CMC. J. McIver
    C. J. McIver
  • VDV. M. Duncombe
    V. M. Duncombe
  • TBT. D. Bolin
    T. D. Bolin
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Abstract
Although culture of luminal secretions is regarded as the most accurate diagnostic test for small-intestinal bacterial overgrowth, obtaining an aspirate is often difficult owing to the sparseness of luminal secretions present at the time of aspiration. Obtaining a mucosal biopsy specimen for bacteriologic analysis would overcome this problem. Culture of small-intestinal and gastric aspirates and unwashed small-intestinal mucosal specimens was performed in 51 adult subjects investigated for small-intestinal overgrowth. Highly significant (r = 0.85-0.90; p < 0.0005) correlations were found between viable bacterial counts in small-intestinal luminal secretions and biopsy specimens. Small-intestinal bacterial overgrowth was present in 60.8% of subjects. When specimens weighing 4.0-84.0 mg were suspended in diluent, total aerobic and/or anaerobic bacterial counts > or = 10(2) CFU/ml were found to have 90.3% sensitivity and 100% specificity for small-intestinal bacterial overgrowth. Culture of an unwashed small-intestinal mucosal biopsy specimen is a useful alternative to culture of a small-intestinal aspirate for detecting subjects with small-intestinal bacterial overgrowth, especially when luminal secretions are scanty at the time of aspiration.

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