Modern concept of bacterial complications at liver cirrhosis
Abstract
The aim of review. To carry over for consideration the basic mechanisms of bacterial infections at liver cirrhosis (LC), their consequences, methods of diagnostics and prophylaxis.
Original positions. Bacterial infections is a cause of high mortality in liver cirrhosis patients. These patients are more predisposed to infections than others hospital patients due to disorders of immune system along with bacterial translocation from intestine, that, in turn, depends on immune changes of the latter and bacterial overgrowth. Bacterial translocation even without clinical signs of infection results in deterioration of hemodynamic status at patients with liver function decompensation that causes progression of portal hypertension and hepatorenal syndrome. Proinflammatory response related to bacterial complication stimulates progression of liver failure, encephalopathy, disorders in blood coagulation system, thus triggering gastro-intestinal bleeding.
Conclusion. Bacterial infections is the important cause of morbidity and mortality in patients with LC that is caused, first of all, by immune-compromised state. Prophylaxis, early diagnostics and well-timed treatment of infections considerably increase survival rate of these patients. Various methods of prophylaxis, including the use of antibiotics, pre- and probiotics, bile acids can be applied to alter bacterial overgrowth and bacterial translocation. Each of these methods proved its efficacy in scientific studies.
About the Authors
M. S. ZharkovaRussian Federation
M. V. Mayevskaya
Russian Federation
V. T. Ivashkin
Russian Federation
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Review
For citations:
Zharkova M.S., Mayevskaya M.V., Ivashkin V.T. Modern concept of bacterial complications at liver cirrhosis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2010;20(6):61-69. (In Russ.)
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