Serum lipopolysaccharide-binding protein prediction of severe bacterial infection in cirrhotic patients with ascites.
Serum lipopolysaccharide-binding protein is increased in a subset of non-infected ascitic cirrhotic patients, a finding previously related to bacterial passage from the gut to the circulation without overt infection. We prospectively analysed the risk factors associated with a first episode of severe bacterial infection in 84 ascitic cirrhotics, followed up for a median of 46 weeks. The cumulative probability of such infection in patients with raised and normal lipopolysaccharide-binding protein was 32.4% and 8.0% (p=0.004), respectively. Increased lipopolysaccharide-binding protein was the only factor independently associated with severe bacterial infection in a multivariate analysis (relative risk 4.49, 95% CI 1.42-14.1). Monitoring of serum lipopolysaccharide-binding protein could, therefore, help to target cirrhotic patients with ascites for antibiotic prophylaxis.
Albillos
Agustín
A
Laboratorio de Enfermedades del Sistema Inmune y Oncología, Unidad I+D Asociada al CSIC, Departamento de Medicina, Universidad de Alcalá, Carretera Madrid-Barcelona, KM 33.600, 28871 Alcalá de Henares, Madrid, Spain. aalbillosm@meditex.es
de-la-Hera
Antonio
A
Alvarez-Mon
Melchor
M
D000209:Acute-Phase Proteins / Q000032:analysis*; D001201:Ascites / Q000150:complications*; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis; D001424:Bacterial Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000097:blood*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000382:microbiology*; D008562:Membrane Glycoproteins; D015233:Models, Statistical; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis; D018410:Pneumonia, Bacterial / Q000150:complications / Q000175:diagnosis; D012307:Risk Factors; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D015415:Biomarkers; D002352:Carrier Proteins; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein