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B acterial translocation (BT) is considered a key event in the pathogenesis of bacterial infections in patients with advanced cirrhosis, 1 and spontaneous bacterial peritonitis is probably the most relevant infection in this setting. 2 BT is considered to be present either in patients or in animal models of cirrhosis when the culture of mesenteric lymph nodes (MLN) shows the growth of at least one bacterial species. 3 The genetic identity of bacteria isolated in ileal content, MLNs, and infected ascitic fluid (AF) in rats with experimental cirrhosis 4 has been shown, which supports the contention of a continuum among intestinal lumen, translocation to MLN, and eventual induction of spontaneous bacterial peritonitis. However, the study of BT is logically difficult in patients with cirrhosis.We have shown that roughly 30% of patients with advanced cirrhosis and AF show the simultaneous presence in blood and AF of fragments of bacterial DNA (bactDNA), mostly from the same type of bacteria, 5 and that these fragments may last in blood during variable periods. 6 The identity of the nucleotide sequences detected in a given patient during the study period, together with the fact that bactDNA may disappear and then reAbbreviations: BT, bacterial translocation; MLN, mesenteric lymph nodes; AF, ascitic fluid; PCR, polymerase chain reaction; TNF-␣, tumor necrosis factor alpha; NOx sum of NO metabolites, nitrite and nitrate. From the

Cirrhotic rats, particularly those with ascites and bacterial translocation, show increased malondialdehyde levels in ileal and caecal mucosa. These results suggest that mucosal oxidative damage in ileum and caecum could favour bacterial translocation in cirrhotic rats.

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