Association Between Small Intestinal Bacterial Overgrowth and Peripheral Bacterial DNA in Cirrhotic Patients - Digestive Diseases and Sciences

Background

Small intestinal bacterial overgrowth (SIBO) is regarded as the major risk factor of bacterial translocation. Few studies have investigated the direct relation between SIBO and translocation in cirrhotic patients. The purpose of this study is to examine the correlation between SIBO and bacterial DNA in the peripheral blood of patients with cirrhosis.

Aims

The purpose of this study is to examine the correlation between SIBO and bacterial DNA in the peripheral blood of patients with cirrhosis.

Methods

Fifty-three cirrhosis cases and 42 controls underwent a lactulose breath test (LBT) every 15 min for 180 min. To detect and identify the presence of bacterial DNA fragments in peripheral blood, multiplex polymerase chain reaction (PCR) was performed.

Results

The positive rate of LBT was significantly different between the two groups: 60.4% in the patient group and 28.6% in the controls. The SIBO positive rate was 81.3% in the cirrhosis patients with ascites, which was significantly higher than 51.4% in the cirrhosis patients with no ascites (P = 0.03). Eight of the nine patients (88.9%) who had a history of one or more hepatic encephalopathy was SIBO-positive, which was higher than the patients who had had no hepatic encephalopathy. In the cirrhosis group, 32 patients (60.4%) were SIBO-positive, and ten of them (31.3%) were bacterial DNA-positive. Only one case (4.8%) was bacterial DNA-positive in the absence of SIBO-positive. In a multivariate analysis, only the existence of SIBO was the independent risk factor for bacterial DNA (P = 0.026).

Conclusions

SIBO in cirrhosis patients was observed at a very high frequency, and SIBO showed a high correlation with bacterial translocation, suggesting that SIBO could be a major risk factor of bacterial translocation, especially in ascitic patients.

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Authors and Affiliations

1. Department of Internal Medicine, Eulji University, Eulji Hospital, Seoul, Korea

   Dae Won Jun, Byoung Kwan Son, Seong Hwan Kim, Yun Ju Jo & Young Sook Park

2. Department of Biomedical Science and Technology, Konkuk University, Seoul, Korea

   Kyung Tae Kim

3. Department of Internal Medicine, Hanyang University College of Medicine, 17, Haengdang-dong, Seongdong-gu, Seoul, 133-792, Korea

   Oh Young Lee

4. Laboratory Medicine, Eulji University, Eulji Hospital, Seoul, Korea

   Jeong Don Chae

Corresponding author

Correspondence to Oh Young Lee.

Cite this article

Jun, D.W., Kim, K.T., Lee, O.Y. et al. Association Between Small Intestinal Bacterial Overgrowth and Peripheral Bacterial DNA in Cirrhotic Patients. Dig Dis Sci 55, 1465–1471 (2010). https://doi.org/10.1007/s10620-009-0870-9

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• Received: 29 November 2008

• Accepted: 22 May 2009

• Published: 11 June 2009

• Issue Date: May 2010

• DOI: https://doi.org/10.1007/s10620-009-0870-9

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