Use of D-Lactic Acid Measurements in the Diagnosis of Bacterial Infections

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Abstract
This study explored the use of d-lactic acid as a marker for bacterial infections. d-Lactic acid was produced by frequently encountered human bacterial pathogens under anaerobic growth conditions; Bacteroides fragilis produced the largest amount. Orally administered d-lactic acid was absorbed from the intestines of rats and later found in measurable quantities in the blood and urine. Eunephric and anephric rats that received d-Iactic acid intravenously showed similar quantities of this metabolite in the blood. These quantities are consistent with the distribution of d-lactic acid to total body water. Isolated liver and lung tissues from rats did not metabolize or produce d-lactic acid. Rats with experimentally induced, sublethal klebsiella peritonitis had d-lactic acidemia of 0.2 mM and 25.6 mM at 0 and 6 hr of infection, respectively. In a normal human, d-lactic acid was detected in the urine and blood after a subcutaneous injection of d-Iactic acid, and pharmacokinetics of elimination similar to those of rats were found.