BACTERIURIA IN PATIENTS WITH PRIMARY BILIARY-CIRRHOSIS - A PROSPECTIVE-STUDY

Background. Controversies exist about the association between signific ant bacteriuria and primary biliary cirrhosis. There is evidence sugge sting that infections by Gram negative bacteria may be implicated in t he pathogenesis of this liver disease. Aim. To compare the incidence o f bacteriuria in patients with primary biliary cirrhosis and those wit h autoimmune chronic hepatitis. Patients and methods. Twenty women wit h primary biliary cirrhosis and twenty three female patients with auto immune chronic hepatitis were prospectively studied by routine bacteri ological cultures of midstream urine specimens. Samples were obtained at three months intervals or when patients complained of symptoms sugg esting urinary tract infection. Significant bacteriuria was defined as the growth of > 10(5) organisms/ml in pure culture. Results. During 8 +/- 1 months of follow up. 60 urine samples from patients with primar y biliary cirrhosis and 73 from autoimmune hepatitis cases were tested . Twenty one samples of patients with primary biliary cirrhosis (35%) were positive for significant bacteriuria compared with 7 from women w ith autoimmune hepatitis (9%) p < 0. 01. In the follow up, ten patient s with primary biliary cirrhosis (50%) and six with autoimmune hepatit is (26%) developed at least one episode of significant bacteriuria. Co nclusion. These results suggest that female patients with primary bili ary cirrhosis are in higher risk of significant bacteriuria than women with autoimmune hepatitis. Prospective studies evaluating the effects of long-term antibiotic therapy on cholestasis parameters In primary biliary cirrhosis are deserved.