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The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis

Authors: M. S. Zharkova; M. V. Mayevskaya; V. T. Ivashkin;

The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis

Abstract

Aim of investigation. To determine the effect of bacterial overgrowth syndrome and translocation of bacterial DNA in ascitic fluid on morbidity in liver cirrhosis (LC) and long-term life expectancy.Material and methods. Overall 42 LC patients were included to original study (Child-Pugh class A – 15 patients, class B – 10, class C – 17). For diagnostics of bacterial overgrowth syndrome in the bowel hydrogen breath test was carried out. Possible bacterial translocation from intestine to ascitic fluid was assessed by the presence of bacterial DNA by PCR method. For 12 months patients were monitored to assess their life prognosis. Data were processed by «SPSS», version 13.0 software.Results. Bacterial overgrowth syndrome was revealed in 69% (29 of 42) patients with LC (46,7% – class A, 60,0 % – class B and 94,1% – class C, р=0,013). This syndrome was diagnosed mostly in patients with ascites (84,0%) in comparison to those without (47,1%, р=0,017). Correlation between bacterial overgrowth syndrome and stage of varicose dilation of esophageal veins (р=0,001) was revealed. Hypotension and tachycardia, infections were present in patients with positive hydrogen breath test (р<0,036) more often. The survival rate for 12 months in the group of patients with bacterial overgrowth syndrome was lower in comparison to patients without bacterial overgrowth (51,7% vs 84,6% respectively, р<0,042). Among patients with tense ascitis (n=16) bacterial DNA in ascitic fluid was detected in 9 cases (56,3%). Ascitis, resistant to diuretic therapy was more frequent in patients with bacterial translocation (66,7%) in comparison to patients without it (14,3%) [OR 4,667; 95%CI: 0,717–30,353; р=0,036]. All patients with infected ascitis (n=5) had bacterial DNA, though etiological agent was found at culture only in one.Conclusion. In patients with liver cirrhosis bacterial overgrowth syndrome is associated with portal hypertension, hemodynamic disorders, infections. It acts as one of prognostic factors of low survival rate in such patients. The course of disease in LC patients with tense ascitis and bacterial translocation is complicated by development of diuretic-resistant ascitis and ascitic fluid infection most often.

Keywords

survival rate, bacterial overgrowth syndrome, liver cirrhosis, portal hypertension, bacterial translocation, infections, RC799-869, Diseases of the digestive system. Gastroenterology, hemodynamic disorders

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citations
The total number of citations received by all articles of the researcher of interest.
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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