Significant bacteriuria has prognostic significance in primary biliary cirrhosis

Area of Science:

• Hepatology
• Urology
• Infectious Disease

Background:

• Significant bacteriuria is associated with increased mortality in community settings.
• Primary biliary cirrhosis (PBC) patients, particularly those with advanced disease, exhibit a high prevalence and recurrence of significant bacteriuria.

Purpose of the Study:

• To prospectively investigate the association between significant bacteriuria and mortality in women with primary biliary cirrhosis (PBC).
• To identify prognostic variables for mortality in PBC patients and assess the independent contribution of bacteriuria.

Main Methods:

• Prospective screening for significant bacteriuria in 187 women with PBC over a 5-year period.
• Utilized Cox's proportional hazard models to analyze prognostic variables including age, serum bilirubin, ascites, cirrhosis, and index bacteriuria.
• Examined the interaction between histological stage and bacteriuria to understand their combined effect on mortality.

Main Results:

• Significant bacteriuria was detected in 17% of patients (index bacteriuria).
• Index bacteriuria was associated with a 65% increased relative hazard for death (P = 0.069), independent of other prognostic factors.
• The increased mortality risk from bacteriuria was primarily observed in non-cirrhotic PBC patients.
• Recurrent bacteriuria was significantly higher in patients with index bacteriuria and those who died or underwent liver transplantation.

Conclusions:

• Significant bacteriuria identifies a subgroup of PBC patients with an elevated risk of death.
• Bacteriuria is an independent prognostic marker for mortality in PBC patients.
• Early detection and management of bacteriuria may be crucial for improving outcomes in PBC patients.