Deficient Serum Bactericidal Activity Against Escherichia Coli in Patients with Cirrhosis of the Liver

Frequency of toxoplasmosis in patients with cirrhosis

“…Toxoplasmosis may rarely cause various liver pathologies due to granulomatose hepatitis in patients with normal immune systems [1,[5][6][7][8] . Patients with cirrhosis of the liver demonstrate various cellular and humoral immunity disorders [9][10][11][12] . For this reason, it may be thought that toxoplasmosis may lead to more frequent and more severe diseases in patients with cirrhosis and change the course of the disease.…”

The Role of Procalcitonin in the Early Diagnosis of Septic and Non-Septic Complications in the Immediate Postoperative Setting After Orthotopic Liver Transplantation

“…The lack of specific early markers of infection might be responsible in part for delaying of a targeted antimicrobial treatment in this patient population. Moreover, the uncontrolled use of wide spectrum antimicrobial agents as "prophylactic therapy" without use of terms of the pre-emptive therapy is leading to bacterial translocation and the presence of multiresistant microorganisms, which further impairs the patients' outcome [13][14][15][16][17][18][19][20].…”

“…Impaired immunologic mechanisms resulting from the hepatic function deficit such as decreased hepatic production of complement, impaired Kupffer cell function, impairment of neutrophil chemotaxis, and of inflammatory cytokines [15][16][17][18][19][20]. Due to the immunological deficit there is also a decreased activity of immunoglobulins as answer to the circulation of gram-negative pathogens [20].…”

Diagnóstico, manejo y prevención de infecciones en pacientes con cirrosis hepática

“…Esta capacidad está deprimida en pacientes con cirrosis, un fenómeno que parece ser explicado por la hipocomplementemia observada en una fracción de los pacientes y por un déficit de anticuerpos específicos, que impide la activación de la lisis por la vía clásica del complemento 1 . Las concentraciones de lisozima en el suero, otro factor involucrado en la ABS, han resultado normales o incluso aumentadas en estos pacientes y no explican esta deficiencia 1 . A pesar de su hipergamaglobulinemia, paradójicamente estos pacientes tienen una carencia de anticuerpos específicos contra bacterias comunes, que impide su destrucción.…”

“…En pacientes inmunocompetentes, 95% de las bacteriemias por bacilos gramnegativos están asociadas a agentes resistentes a la ABS. En contraste en pacientes con cirrosis se observan bacteriemias por bacilos gramnegativos resistentes o susceptibles a la ABS 1 .…”