title: Bacterial translocation of enteric organisms in patients with cirrhosis.
abstract: 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.
authors.affiliation: Liver Unit, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Cirera
authors.forename: T M
authors.initials: TM
authors.lastname: Bauer
authors.forename: M
authors.initials: M
authors.lastname: Navasa
authors.forename: J
authors.initials: J
authors.lastname: Vila
authors.forename: L
authors.initials: L
authors.lastname: Grande
authors.forename: P
authors.initials: P
authors.lastname: Taurá
authors.forename: J
authors.initials: J
authors.lastname: Fuster
authors.forename: J C
authors.initials: JC
authors.lastname: García-Valdecasas
authors.forename: A
authors.initials: A
authors.lastname: Lacy
authors.forename: M J
authors.initials: MJ
authors.lastname: Suárez
authors.forename: A
authors.initials: A
authors.lastname: Rimola
authors.forename: J
authors.initials: J
authors.lastname: Rodés
mesh_terms: 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