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

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...

Full description

Saved in:
Bibliographic Details
Main Authors: M. S. Zharkova, M. V. Mayevskaya, V. T. Ivashkin
Format: Article
Language:Russian
Published: Gastro LLC 2012-09-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
Subjects:
Online Access:https://www.gastro-j.ru/jour/article/view/1323
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1823860228547936256
author M. S. Zharkova
M. V. Mayevskaya
V. T. Ivashkin
author_facet M. S. Zharkova
M. V. Mayevskaya
V. T. Ivashkin
author_sort M. S. Zharkova
collection DOAJ
description 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.
format Article
id doaj-art-be13e4ee100b427497d5b10f93c18f64
institution Kabale University
issn 1382-4376
2658-6673
language Russian
publishDate 2012-09-01
publisher Gastro LLC
record_format Article
series Российский журнал гастроэнтерологии, гепатологии, колопроктологии
spelling doaj-art-be13e4ee100b427497d5b10f93c18f642025-02-10T16:14:32ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732012-09-012255663895The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosisM. S. Zharkova0M. V. Mayevskaya1V. T. Ivashkin2State educational government-financed institution of higher professional education first Moscow state medical university named after I.M. Sechenov of the Russian federation Ministry of Health and Social DevelopmentState educational government-financed institution of higher professional education first Moscow state medical university named after I.M. Sechenov of the Russian federation Ministry of Health and Social DevelopmentState educational government-financed institution of higher professional education first Moscow state medical university named after I.M. Sechenov of the Russian federation Ministry of Health and Social DevelopmentAim 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.https://www.gastro-j.ru/jour/article/view/1323liver cirrhosisbacterial overgrowth syndromebacterial translocationportal hypertensionhemodynamic disordersinfectionssurvival rate
spellingShingle M. S. Zharkova
M. V. Mayevskaya
V. T. Ivashkin
The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis
Российский журнал гастроэнтерологии, гепатологии, колопроктологии
liver cirrhosis
bacterial overgrowth syndrome
bacterial translocation
portal hypertension
hemodynamic disorders
infections
survival rate
title The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis
title_full The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis
title_fullStr The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis
title_full_unstemmed The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis
title_short The effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis
title_sort effect of bacterial overgrowth syndrome and bacterial translocation on the course of liver cirrhosis
topic liver cirrhosis
bacterial overgrowth syndrome
bacterial translocation
portal hypertension
hemodynamic disorders
infections
survival rate
url https://www.gastro-j.ru/jour/article/view/1323
work_keys_str_mv AT mszharkova theeffectofbacterialovergrowthsyndromeandbacterialtranslocationonthecourseoflivercirrhosis
AT mvmayevskaya theeffectofbacterialovergrowthsyndromeandbacterialtranslocationonthecourseoflivercirrhosis
AT vtivashkin theeffectofbacterialovergrowthsyndromeandbacterialtranslocationonthecourseoflivercirrhosis
AT mszharkova effectofbacterialovergrowthsyndromeandbacterialtranslocationonthecourseoflivercirrhosis
AT mvmayevskaya effectofbacterialovergrowthsyndromeandbacterialtranslocationonthecourseoflivercirrhosis
AT vtivashkin effectofbacterialovergrowthsyndromeandbacterialtranslocationonthecourseoflivercirrhosis