RÉSUMÉ
In summary the carbon tetrachloride/phenobarbital of cirrhosis in rats mimics human cirrhosis very closely, with development of ascites and SBP. This model shows us that bacterial overgrowth occurs as cirrhosis progresses and that bacterial translocation from the gut to extra-intestinal sites is part of the early pathogenesis of SBP. SID with norfloxacin dramatically reduced translocation and SBP at the expense of grampositive overgrowth and infection with gram-positives and colonization with strange gram negatives. SID with TMP-SMZ actually delayed development of ascites and prolonged survival.
Sujet(s)
Animaux , Rats , Ascites/microbiologie , Cirrhose expérimentale/complications , Péritonite/microbiologie , Translocation bactérienne/physiologie , Ascites/prévention et contrôle , Cirrhose expérimentale/induit chimiquement , Cirrhose expérimentale/microbiologie , Association triméthoprime-sulfaméthoxazole/usage thérapeutique , Phénomènes physiologiques bactériens , Intoxication au tétrachlorure de carbone , Norfloxacine/usage thérapeutique , Péritonite/prévention et contrôle , Antibioprophylaxie , Translocation bactérienneSujet(s)
Humains , Cirrhose du foie/microbiologie , Infections bactériennes/complications , Péritonite/microbiologie , Péritonite/traitement médicamenteux , Antibactériens/usage thérapeutique , Céfotaxime/usage thérapeutique , Ceftriaxone/usage thérapeutique , Cirrhose du foie/complications , Escherichia coli/pathogénicité , Liquide d'ascite/microbiologie , Norfloxacine/usage thérapeutique , Péritonite/diagnostic , PronosticRÉSUMÉ
Patients with cirrhosis are regularly infected with a plethora of bacteria, fungi and mycobacteria. A high index of suspicion of infection and a low threshold for culturing, ascitic fluid, blood, urine, pleural fluid, spinal fluid, joint fluid, etc will lead to a rapid diagnosis of infection and perhaps prolong survival of these very fragile patients.