BACTERIAL TRANSLOCATION TO MESENTERIC LYMPH-NODES IS INCREASED IN CIRRHOTIC RATS WITH ASCITES

Background/Aims: Cirrhotic patients are predisposed to develop spontan eous bacteremias and/or peritonitis, mainly caused by enteric bacteria . The aim of this study was to investigate if bacterial translocation, which is the passage of bacteria from the intestinal lumen to regiona l lymph nodes and/or the systemic circulation, is increased in a rat m odel of cirrhosis. Methods: Rats were studied after 12-16 weeks of CCl 4 inhalation, when samples of mesenteric lymph nodes, blood, liver, an d spleen for standard bacteriologic cultures and a fragment of colon a nd liver for histology were obtained. Immunostaining of the cecum was performed using a polyclonal anti-Escherichia coli antibody. Results: A significantly greater proportion of rats with cirrhosis and ascites (5 of 9; 56%) had positive mesenteric lymph node cultures compared wit h cirrhotics without ascites (6 of 9) and normal controls (0 of 12) (P < 0.01). In one cirrhotic rat, E. coli was isolated from both mesente ric lymph nodes and ascites. Rats with cirrhosis and ascites had signi ficantly greater cecal submucosal edema and inflammation than rats wit h no ascites and controls. Immunoreactivity with E. coli was present i n the cecal wall in 3 of 5 animals with E. cell translocation to mesen teric lymph nodes. Conclusions: In cirrhotic rats, bacterial transloca tion is increased after the development of ascites and may be a major factor in the development of spontaneous infections in cirrhosis.