{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:52:13Z","timestamp":1788306733207,"version":"build-2803163510"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2011,8,26]],"date-time":"2011-08-26T00:00:00Z","timestamp":1314316800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Primary Biliary Cirrhosis is known to be associated with Urinary Tract Infections (UTIs), but whether these precede or follow the liver disease is unclear. We have therefore attempted to determine whether UTIs are more common in people with Primary Biliary Cirrhosis (PBC) prior to their diagnosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a case control study in the General Practice Research Database. All cases of PBC first recorded at least one year after entry to the dataset were selected along with up to 10 controls matched for age, sex. A second unmatched control group who had Chronic Liver Diseases but not PBC were chosen. The main exposures studied were the occurrence of Urinary tract infections and pyelonephritis at least one or at least five years before diagnosis. We also performed an analysis restricted to those younger than 55 at diagnosis, as we hypothesized the relationship to be stronger in the younger age group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>PBC is associated with UTI prior to diagnosis, OR 1.50 (CI 1.26-1.78), which was similar 5 years prior to diagnosis and after adjusting for smoking. The strongest relationships were observed in pyelonephritis exposures five years before diagnosis in cases under 55 years: adjusted odds ratios were 2.60 (1.02-6.63) in comparison with matched general population controls and adjusted odds ratios were OR 2.45 (1.02-5.59) in the comparison with chronic liver disease controls.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>We found that the association between urosepsis and PBC is specific to this disease and precedes the diagnosis of PBC in a manner not previously observed in human data. This is consistent with a causal relationship.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-230x-11-95","type":"journal-article","created":{"date-parts":[[2011,8,26]],"date-time":"2011-08-26T18:18:49Z","timestamp":1314382729000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["An increased risk of urinary tract infection precedes development of primary biliary cirrhosis"],"prefix":"10.1186","volume":"11","author":[{"given":"Fumi K","family":"Varyani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"West","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R","family":"Card","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,8,26]]},"reference":[{"issue":"1","key":"628_CR1","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/0300-2977(94)00115-P","volume":"47","author":"PC van de Meeberg","year":"1995","unstructured":"van de Meeberg PC, Wolfhagen FH, van Erpecum KJ, van Berge Henegouwen GP: Cholestatic liver diseases: new strategies for prevention and treatment of hepatobiliary and cholestatic diseases. Neth J Med. 1995, 47 (1): 30-35. 10.1016\/0300-2977(94)00115-P.","journal-title":"Neth J Med"},{"issue":"24","key":"628_CR2","doi-asserted-by":"publisher","first-page":"2544","DOI":"10.1056\/NEJMoa0810440","volume":"360","author":"GM Hirschfield","year":"2009","unstructured":"Hirschfield GM, Liu X, Xu C, Lu Y, Xie G, Lu Y, Gu X, Walker EJ, Jing K, Juran BD, et al: Primary biliary cirrhosis associated with HLA, IL12A, and IL12RB2 variants. N Engl J Med. 2009, 360 (24): 2544-2555. 10.1056\/NEJMoa0810440.","journal-title":"N Engl J Med"},{"issue":"6243","key":"628_CR3","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1136\/bmj.281.6243.772","volume":"281","author":"DR Triger","year":"1980","unstructured":"Triger DR: Primary biliary cirrhosis: an epidemiological study. Br Med J. 1980, 281 (6243): 772-775. 10.1136\/bmj.281.6243.772.","journal-title":"Br Med J"},{"issue":"3","key":"628_CR4","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1002\/hep.21076","volume":"43","author":"A Ala","year":"2006","unstructured":"Ala A, Stanca CM, Bu-Ghanim M, Ahmado I, Branch AD, Schiano TD, Odin JA, Bach N: Increased prevalence of primary biliary cirrhosis near Superfund toxic waste sites. Hepatology. 2006, 43 (3): 525-531. 10.1002\/hep.21076.","journal-title":"Hepatology"},{"issue":"4","key":"628_CR5","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1002\/hep.23139","volume":"50","author":"RJ McNally","year":"2009","unstructured":"McNally RJ, Ducker S, James OF: Are transient environmental agents involved in the cause of primary biliary cirrhosis? Evidence from space-time clustering analysis. Hepatology. 2009, 50 (4): 1169-1174. 10.1002\/hep.23139.","journal-title":"Hepatology"},{"issue":"1","key":"628_CR6","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1007\/s12016-008-8087-9","volume":"36","author":"DP Bogdanos","year":"2009","unstructured":"Bogdanos DP, Vergani D: Bacteria and primary biliary cirrhosis. Clin Rev Allergy Immunol. 2009, 36 (1): 30-39. 10.1007\/s12016-008-8087-9.","journal-title":"Clin Rev Allergy Immunol"},{"issue":"6","key":"628_CR7","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1111\/j.1478-3231.2008.01942.x","volume":"29","author":"CP Berg","year":"2009","unstructured":"Berg CP, Kannan TR, Klein R, Gregor M, Baseman JB, Wesselborg S, Lauber K, Stein GM: Mycoplasma antigens as a possible trigger for the induction of antimitochondrial antibodies in primary biliary cirrhosis. Liver Int. 2009, 29 (6): 797-809. 10.1111\/j.1478-3231.2008.01942.x.","journal-title":"Liver Int"},{"issue":"5","key":"628_CR8","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1053\/jhep.2003.50446","volume":"38","author":"C Selmi","year":"2003","unstructured":"Selmi C, Balkwill DL, Invernizzi P, Ansari AA, Coppel RL, Podda M, Leung PS, Kenny TP, Van De Water J, Nantz MH, et al: Patients with primary biliary cirrhosis react against a ubiquitous xenobiotic-metabolizing bacterium. Hepatology. 2003, 38 (5): 1250-1257. 10.1053\/jhep.2003.50446.","journal-title":"Hepatology"},{"key":"628_CR9","volume-title":"Clin Rev Allergy Immunol","author":"D Smyk","year":"2011","unstructured":"Smyk D, Rigopoulou EI, Baum H, Burroughs AK, Vergani D, Bogdanos DP: Autoimmunity and Environment: Am I at risk?. Clin Rev Allergy Immunol. 2011"},{"issue":"11","key":"628_CR10","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/S1590-8658(03)00466-3","volume":"35","author":"DP Bogdanos","year":"2003","unstructured":"Bogdanos DP, Baum H, Butler P, Rigopoulou EI, Davies ET, Ma Y, Burroughs AK, Vergani D: Association between the primary biliary cirrhosis specific anti-sp100 antibodies and recurrent urinary tract infection. Dig Liver Dis. 2003, 35 (11): 801-805. 10.1016\/S1590-8658(03)00466-3.","journal-title":"Dig Liver Dis"},{"issue":"6","key":"628_CR11","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1155\/2010\/595078","volume":"29","author":"DP Bogdanos","year":"2010","unstructured":"Bogdanos DP, Baum H, Vergani D, Burroughs AK: The role of E. coli infection in the pathogenesis of primary biliary cirrhosis. Dis Markers. 2010, 29 (6): 301-311.","journal-title":"Dis Markers"},{"issue":"4","key":"628_CR12","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1093\/jac\/40.4.591","volume":"40","author":"TG Winstanley","year":"1997","unstructured":"Winstanley TG, Limb DI, Eggington R, Hancock F: A 10 year survey of the antimicrobial susceptibility of urinary tract isolates in the UK: the Microbe Base project. J Antimicrob Chemother. 1997, 40 (4): 591-594. 10.1093\/jac\/40.4.591.","journal-title":"J Antimicrob Chemother"},{"issue":"1","key":"628_CR13","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/S0168-8278(03)00501-4","volume":"40","author":"DP Bogdanos","year":"2004","unstructured":"Bogdanos DP, Baum H, Grasso A, Okamoto M, Butler P, Ma Y, Rigopoulou E, Montalto P, Davies ET, Burroughs AK, et al: Microbial mimics are major targets of crossreactivity with human pyruvate dehydrogenase in primary biliary cirrhosis. Journal of hepatology. 2004, 40 (1): 31-39. 10.1016\/S0168-8278(03)00501-4.","journal-title":"Journal of hepatology"},{"issue":"2","key":"628_CR14","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1136\/gut.25.2.133","volume":"25","author":"AK Burroughs","year":"1984","unstructured":"Burroughs AK, Rosenstein IJ, Epstein O, Hamilton-Miller JM, Brumfitt W, Sherlock S: Bacteriuria and primary biliary cirrhosis. Gut. 1984, 25 (2): 133-137. 10.1136\/gut.25.2.133.","journal-title":"Gut"},{"issue":"5","key":"628_CR15","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1002\/hep.20907","volume":"42","author":"ME Gershwin","year":"2005","unstructured":"Gershwin ME, Selmi C, Worman HJ, Gold EB, Watnik M, Utts J, Lindor KD, Kaplan MM, Vierling JM: Risk factors and comorbidities in primary biliary cirrhosis: a controlled interview-based study of 1032 patients. Hepatology. 2005, 42 (5): 1194-1202. 10.1002\/hep.20907.","journal-title":"Hepatology"},{"issue":"5","key":"628_CR16","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1053\/he.2000.7050","volume":"31","author":"D Howel","year":"2000","unstructured":"Howel D, Fischbacher CM, Bhopal RS, Gray J, Metcalf JV, James OF: An exploratory population-based case-control study of primary biliary cirrhosis. Hepatology. 2000, 31 (5): 1055-1060. 10.1053\/he.2000.7050.","journal-title":"Hepatology"},{"issue":"1","key":"628_CR17","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1053\/jhep.2001.21165","volume":"33","author":"A Parikh-Patel","year":"2001","unstructured":"Parikh-Patel A, Gold EB, Worman H, Krivy KE, Gershwin ME: Risk factors for primary biliary cirrhosis in a cohort of patients from the united states. Hepatology. 2001, 33 (1): 16-21. 10.1053\/jhep.2001.21165.","journal-title":"Hepatology"},{"key":"628_CR18","doi-asserted-by":"crossref","unstructured":"Prince MI, Ducker SJ, James OF: Case-control studies of risk factors for primary biliary cirrhosis in two United Kingdom populations. Gut. 59 (4): 508-512.","DOI":"10.1136\/gut.2009.184218"},{"issue":"9084","key":"628_CR19","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1016\/S0140-6736(97)04248-7","volume":"350","author":"T Walley","year":"1997","unstructured":"Walley T, Mantgani A: The UK General Practice Research Database. Lancet. 1997, 350 (9084): 1097-1099. 10.1016\/S0140-6736(97)04248-7.","journal-title":"Lancet"},{"issue":"5","key":"628_CR20","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1592\/phco.23.5.686.32205","volume":"23","author":"SS Jick","year":"2003","unstructured":"Jick SS, Kaye JA, Vasilakis-Scaramozza C, Garcia Rodriguez LA, Ruigomez A, Meier CR, Schlienger RG, Black C, Jick H: Validity of the general practice research database. Pharmacotherapy. 2003, 23 (5): 686-689. 10.1592\/phco.23.5.686.32205.","journal-title":"Pharmacotherapy"},{"issue":"4","key":"628_CR21","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1093\/ije\/26.4.830","volume":"26","author":"JV Metcalf","year":"1997","unstructured":"Metcalf JV, Bhopal RS, Gray J, Howel D, James OF: Incidence and prevalence of primary biliary cirrhosis in the city of Newcastle upon Tyne, England. Int J Epidemiol. 1997, 26 (4): 830-836. 10.1093\/ije\/26.4.830.","journal-title":"Int J Epidemiol"},{"issue":"Suppl 2","key":"628_CR22","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/S0924-8579(03)00234-6","volume":"22","author":"AI Hoepelman","year":"2003","unstructured":"Hoepelman AI, Meiland R, Geerlings SE: Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. Int J Antimicrob Agents. 2003, 22 (Suppl 2): 35-43.","journal-title":"Int J Antimicrob Agents"},{"issue":"4","key":"628_CR23","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1053\/gast.2002.36027","volume":"123","author":"M Prince","year":"2002","unstructured":"Prince M, Chetwynd A, Newman W, Metcalf JV, James OF: Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis: follow-up for up to 28 years. Gastroenterology. 2002, 123 (4): 1044-1051. 10.1053\/gast.2002.36027.","journal-title":"Gastroenterology"},{"issue":"2","key":"628_CR24","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1002\/hep.510300213","volume":"30","author":"OF James","year":"1999","unstructured":"James OF, Bhopal R, Howel D, Gray J, Burt AD, Metcalf JV: Primary biliary cirrhosis once rare, now common in the United Kingdom?. Hepatology. 1999, 30 (2): 390-394. 10.1002\/hep.510300213.","journal-title":"Hepatology"},{"issue":"4","key":"628_CR25","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1002\/hep.21795","volume":"46","author":"H Jackson","year":"2007","unstructured":"Jackson H, Solaymani-Dodaran M, Card TR, Aithal GP, Logan R, West J: Influence of ursodeoxycholic acid on the mortality and malignancy associated with primary biliary cirrhosis: a population-based cohort study. Hepatology. 2007, 46 (4): 1131-1137. 10.1002\/hep.21795.","journal-title":"Hepatology"},{"key":"628_CR26","volume-title":"British Association of the Study of the Liver Annual Meeting","author":"J West","year":"2004","unstructured":"West J, Card TR, Solaymani-Dodaran M, Logan RFA, Aithal G: Incidence of Primary Biliary Cirrhosis: a UK population-based study. British Association of the Study of the Liver Annual Meeting. 2004, Cambridge"},{"issue":"5","key":"628_CR27","doi-asserted-by":"publisher","first-page":"405","DOI":"10.3109\/13697137.2010.500748","volume":"13","author":"AA Ewies","year":"2010","unstructured":"Ewies AA, Alfhaily F: Topical vaginal estrogen therapy in managing postmenopausal urinary symptoms: a reality or a gimmick?. Climacteric. 2010, 13 (5): 405-418. 10.3109\/13697137.2010.500748.","journal-title":"Climacteric"},{"issue":"9","key":"628_CR28","doi-asserted-by":"publisher","first-page":"5874","DOI":"10.4049\/jimmunol.174.9.5874","volume":"174","author":"K Amano","year":"2005","unstructured":"Amano K, Leung PS, Rieger R, Quan C, Wang X, Marik J, Suen YF, Kurth MJ, Nantz MH, Ansari AA, et al: Chemical xenobiotics and mitochondrial autoantigens in primary biliary cirrhosis: identification of antibodies against a common environmental, cosmetic, and food additive, 2-octynoic acid. J Immunol. 2005, 174 (9): 5874-5883.","journal-title":"J Immunol"},{"issue":"8621","key":"628_CR29","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1016\/S0140-6736(88)90235-8","volume":"2","author":"R Stemerowicz","year":"1988","unstructured":"Stemerowicz R, Hopf U, Moller B, Wittenbrink C, Rodloff A, Reinhardt R, Freudenberg M, Galanos C: Are antimitochondrial antibodies in primary biliary cirrhosis induced by R(rough)-mutants of enterobacteriaceae?. Lancet. 1988, 2 (8621): 1166-1170.","journal-title":"Lancet"},{"issue":"4, Supplement 1","key":"628_CR30","doi-asserted-by":"publisher","first-page":"A","DOI":"10.1016\/S0016-5085(08)63914-1","volume":"134","author":"JJ Palermo","year":"2008","unstructured":"Palermo JJ: W1846 Recurrent Urinary Tract Infection in Mice Results in Immune-Mediated Cholangiopathy Similar to Human Primary Biliary Cirrhosis. Gastroenterology. 2008, 134 (4, Supplement 1): A-837.","journal-title":"Gastroenterology"},{"issue":"3","key":"628_CR31","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1016\/S0168-8278(05)80225-9","volume":"17","author":"P Butler","year":"1993","unstructured":"Butler P, Valle F, Hamilton-Miller JM, Brumfitt W, Baum H, Burroughs AK: M2 mitochondrial antibodies and urinary rough mutant bacteria in patients with primary biliary cirrhosis and in patients with recurrent bacteriuria. J Hepatol. 1993, 17 (3): 408-414. 10.1016\/S0168-8278(05)80225-9.","journal-title":"J Hepatol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-230X-11-95.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-230X-11-95\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-230X-11-95","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-230X-11-95.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T15:51:42Z","timestamp":1630511502000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/1471-230X-11-95"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,8,26]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011,12]]}},"alternative-id":["628"],"URL":"https:\/\/doi.org\/10.1186\/1471-230x-11-95","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,8,26]]},"assertion":[{"value":"11 February 2011","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2011","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2011","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"95"}}