Cited by 212Liver Disease and TransplantationGut microbiota and healthGastrointestinal motility and disorders

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Small intestinal bacterial overgrowth in human cirrhosis is associated with systemic endotoxemia

Bauer, Tilman M., Schwacha, Henning, Steinbruckner, Bernhard, Brinkmann, Folke E., Ditzen, Anette K., Aponte, John J., Pelz, Klaus, Berger, Dieter, Kist, Manfred, Blum, Hubert E.·2002·The American Journal of Gastroenterology

DOI 10.1111/j.1572-0241.2002.05791.x

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Abstract

OBJECTIVES: Systemic endotoxemia has been implicated in various pathophysiological sequelae of chronic liver disease. One of its potential causes is increased intestinal absorption of endotoxin. We therefore examined the association of small intestinal bacterial overgrowth with systemic endotoxemia in patients with cirrhosis. METHODS: Fifty-three consecutive patients with cirrhosis (Child-Pugh group A, 23; group B, 18; group C, 12) were included. Jejunal secretions were cultivated quantitatively and systemic endotoxemia determined by the chromogenic Limulus amoebocyte assay. Patients were followed up for 1 yr. RESULTS: Small intestinal bacterial overgrowth, defined as > or = 10(5) total colony forming units per milliliter of jejunal secretions, was present in 59% of patients and strongly associated with acid suppressive therapy. The mean plasma endotoxin level was 0.86 +/- 0.48 endotoxin units/ml (range = 0.03-1.44) and was significantly associated with small intestinal bacterial overgrowth (0.99 vs 0.60 endotoxin units/ml, p = 0.03). During the 1-yr follow-up, seven patients were lost to follow up or underwent liver transplantation and 12 patients died. Multivariate Cox regression showed Child-Pugh group to be the only predictor for survival. CONCLUSIONS: Small intestinal bacterial overgrowth in cirrhotic patients is common and associated with systemic endotoxemia. The clinical relevance of this association remains to be defined.

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Authors: Bauer, T. M., Schwacha, H., Steinbruckner, B., Brinkmann, F. E., Ditzen, A. K., Aponte, J. J., Pelz, K., Berger, D., Kist, M., & Blum, H. E.
Affiliations: University of Freiburg (DE)
University Medical Center Freiburg (DE)
Hospital Clínic de Barcelona (ES)
University Hospital Ulm (DE)
ORCID: Schwacha, Henning
Brinkmann, Folke E.
Aponte, John J.
Venue: The American Journal of Gastroenterology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2002-09
Volume: 97
Issue: 9
Pages: 2364-2370
ISSN: 0002-9270 (ISSN-L)
1572-0241
DOI: 10.1111/j.1572-0241.2002.05791.x
OpenAlex: W1987665619
Cited by: 211
References: 43
Citations by year: 2026: 5 · 2025: 7 · 2024: 7 · 2023: 13 · 2022: 6 · 2021: 18 · 2020: 12 · 2019: 9 · 2018: 14 · 2017: 13 · 2016: 16 · 2015: 14 · 2014: 12 · 2013: 5 · 2012: 8
FWCI: 2.33
Type: journal article
Language: en
Open access: closed
Locations: The American Journal of Gastroenterology (publishedVersion)
PubMed (publishedVersion)
FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
Topics: Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords: small intestinal bacterial overgrowth, liver cirrhosis, endotoxin, acid-suppressive therapy, Child-Pugh score, survival, chronic liver disease
MeSH terms: Adult, Aged, Female, Follow-Up Studies, Humans, Jejunum, Liver Cirrhosis, Male, Middle Aged, Predictive Value of Tests, Severity of Illness Index, Time Factors, Colony Count, Microbial, Survival Rate, Endotoxemia

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Small intestinal bacterial overgrowth in human cirrhosis is associated with systemic endotoxemia

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