Failure of Lactobacillus spp. to prevent bacterial translocation in a rat model of experimental cirrhosis.
OBJECTIVE
Prophylaxis of spontaneous bacterial peritonitis in cirrhotic patients with norfloxacin is associated with emergence of quinolone-resistant Enterobacteriaceae. We investigated whether an alternative strategy with Lactobacillus prevents bacterial translocation and ascitic fluid infection in cirrhotic rats.


METHODS
CCl(4)-induced cirrhotic rats with ascites (n=34) were allocated to treatment with oral Lactobacillus strain GG at 1-2 x 10(9) cfu/day for 8-10 days (group LGG) or milk (group MILK). In addition, 20 cirrhotic rats were given a single dose of 15 mg norfloxacin orally and then allocated to Lactobacillus (group NOR-LGG) or milk (group NOR-MILK). Ten healthy rats served as control. After sacrifice the cecal flora were analyzed and the prevalence of bacterial translocation and ascitic fluid infection assessed.


RESULTS
Cecal colonization with Lactobacillus was achieved in 90% of treated rats. The prevalence of bacterial translocation to mesenteric lymph nodes was 10% in control rats and 93, 84, 70 and 100% in groups MILK, LGG, NOR-MILK and NOR-LGG, respectively (P>0.1 for comparison of treatment groups), the prevalence of ascitic fluid infection was 60, 32, 40 and 40% (P>0.1). Bacterial translocation of Lactobacillus was observed in 24% of rats treated.


CONCLUSIONS
Lactobacilli fail to prevent bacterial translocation and ascitic fluid infection in experimental cirrhosis in spite of successful intestinal colonization.
Bauer
Tilman Martin
TM
Liver Unit, Institut Malalties Digestives, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain. bauert@med1.ukl.uni-freiburg.de
Fernández
Javier
J
Navasa
Miquel
M
Vila
Jordi
J
Rodés
Juan
J
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001202:Ascitic Fluid / Q000382:microbiology; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology; D018988:Bacterial Translocation / Q000187:drug effects / Q000502:physiology*; D002432:Cecum / Q000382:microbiology; D015169:Colony Count, Microbial; D004755:Enterobacteriaceae / Q000502:physiology; D007778:Lactobacillus / Q000502:physiology*; D008103:Liver Cirrhosis / Q000382:microbiology*; D008297:Male; D009643:Norfloxacin / Q000494:pharmacology; D015995:Prevalence; D019936:Probiotics / Q000627:therapeutic use*; D051381:Rats; D017208:Rats, Wistar
D000900:Anti-Bacterial Agents; D009643:Norfloxacin