Bacterial translocation of enteric organisms in patients with cirrhosis.
OBJECTIVE
The aim of the study was to investigate the prevalence and associated risk factors for bacterial translocation in patients with cirrhosis, a mechanism involved in the pathogenesis of bacterial infections in experimental cirrhosis.


METHODS
Mesenteric lymph nodes were obtained for microbiological culture from 101 patients with cirrhosis and from 35 non-cirrhotic patients.


RESULTS
Enteric organisms were grown from mesenteric lymph nodes in 8.6% of non-cirrhotic patients. In the 79 cirrhotic patients without selective intestinal decontamination, the prevalence of bacterial translocation significantly increased according to the Child-Pugh classification: 3.4% in Child A, 8.1% in Child B and 30.8% in Child C patients (chi2 = 6.106, P < 0.05). However, translocation by Enterobacteriaceae, the organisms commonly responsible for spontaneous bacteremia and peritonitis in cirrhosis, was only observed in 25% of the cases. The prevalence of bacterial translocation in the 22 cirrhotic patients undergoing selective intestinal decontamination, all Child-Pugh class B and C, was 4.5%. The Child-Pugh score was the only independent predictive factor for bacterial translocation (odds ratio 2.22, P = 0.02).


CONCLUSIONS
Translocation of enteric organisms to mesenteric lymph nodes is increased in patients with advanced cirrhosis and is reduced to the level found in non-cirrhotic patients by selective intestinal decontamination.
Cirera
I
I
Liver Unit, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
Bauer
T M
TM
Navasa
M
M
Vila
J
J
Grande
L
L
Taurá
P
P
Fuster
J
J
García-Valdecasas
J C
JC
Lacy
A
A
Suárez
M J
MJ
Rimola
A
A
Rodés
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D018988:Bacterial Translocation; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D008103:Liver Cirrhosis / Q000150:complications / Q000382:microbiology*; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D008875:Middle Aged