The Curious Clinicians [Archive] - (Trans)locating the Bacteria
Feb 7, 2024
Debunking the belief of direct bacteria translocation in cirrhosis patients with SBP. Exploring the presence of intestinal bacterial overgrowth and its connection to various factors. Understanding the intricate bacterial pathway in SBP and the role of altered immunity. Emphasizing the relationship between SBP, bacteremia, and gram-negative bacteria in ascitic fluid.
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SBP Bacteria Translocation
- In spontaneous bacterial peritonitis (SBP), bacteria translocate from the gut, but not directly into ascites.
- This translocation involves a more complex process than previously thought.
SBP Risk Factors in Cirrhosis
- Cirrhosis predisposes to SBP through intestinal bacterial overgrowth, increased permeability, and altered immunity.
- Proton pump inhibitors (PPIs) may also contribute to bacterial overgrowth and SBP risk.
SBP's Lymphatic Route
- Bacteria in SBP don't directly enter ascites; they travel via mesenteric lymph nodes.
- Studies using fluorescent E. coli in rats confirm this pathway.