Systemic spreading of intraperitoneal Staphylococcus aureus is increased in experimental liver cirrhosis but unaltered by splanchnic sympathectomy

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In liver cirrhosis, nosocomial spontaneous bacterial peritonitis (SBP) is associated with poor prognosis and most frequently caused by gram-positive bacteria. We previously reported that the well-known hyperactivity of the sympathetic nervous system (SNS) in advanced cirrhosis contributes to the translocation of E. coli from the peritoneum to mesenteric lymph nodes and extraintestinal sites. However, the role of splanchnic SNS-activity for spreading of gram-positive challanges in cirrhosis remains unclear. Methods: Staphylococcus aureus (S. aureus 106 CFU/ml) was given i.p. (3ml) and 6 hours later mesenteric lymphnodes (MLN), liver, spleen, lung and peripheral blood were harvested sterile from ascitic cirrhotic rats (LC) and healthy controls (Con) with and without splanchnic sympathectomy (±SE) being achieved by anti-dopamine-ß-hydroxylase-saporin treatment i.p. Bacterial tissue burden was determined by standard microbiological culture techniques. Results: After S. aureus challenge LC rats presented with marked increases in incidence of S. aureus translocation to MLN and blood as compared to control rats (Table 1). Intraperitoneal application of S.aureus induced endogenous translocation of gram-negative bacteria to MLN, liver, spleen and lung in LC but not in healthy rats (Fig. 1). SE had neither impact on incidence nor severity of translocation of Staph.aureus to MLN, liver, spleen, lung or blood in either control or LC rats. However, SE tended to reduce translocation of endogenous gram-negative bacteria from the gut to liver, spleen and lung (Fig.1). Conclusions: In cirrhosis, i.p. application of S. aureus is associated with enhanced systemic spreading and induction of endogenous gram-negative bacterial translocation as compared to controls. Splanchnic sympathetic hyperactivity in cirrhosis seems not to contribute to the translocation of Staph.aureus but enhances gram-negative translocation.