TRANSLOCATION OF GUT BACTERIA IN RATS WITH CIRRHOSIS TO MESENTERIC LYMPH-NODES PARTIALLY EXPLAINS THE PATHOGENESIS OF SPONTANEOUS BACTERIALPERITONITIS

Spontaneous bacterial peritonitis is a common infection of ascitic flu id that develops in cirrhosis. The offending organisms are predominant ly of enteric origin. However, the mechanism and route by which bacter ia exit from the gut and enter the fluid remain unclear. ''Translocati on'' of bacteria from the gut to extraintestinal sites has been postul ated in the pathogenesis of gram-negative sepsis in intensive care uni t patients, burn-wound sepsis, and sepsis associated with chemotherapy . Translocation is defined by culture-positivity (with enteric flora) of mesenteric lymph nodes. In this study we assessed the frequency of translocation in a carbon tetrachloride-induced rat model of cirrhosis , ascites, and spontaneous bacterial peritonitis. We determined that t ranslocation was more common in rats with cirrhosis (78.1%) than in no rmal controls (4.3%) (p<0.001). Escherichia coli and other gram-negati ve enteric organisms were cultured. Translocation of enteric bacteria in rats with cirrhosis to extraintestinal sites may be an important ea rly step in the pathogenesis of spontaneous bacterial peritonitis. (C) Journal of Hepatology.