[Selective intestinal bacterial decontamination in experimental acute pancreatitis]

Area of Science:

• Gastroenterology
• Microbiology
• Surgical Research

Background:

• Bacterial translocation, the movement of gut bacteria to other organs, is a key factor in severe acute pancreatitis (AP) mortality.
• This phenomenon occurs in a significant percentage of necrotizing hemorrhagic AP cases, contributing to up to 80% of deaths.

Purpose of the Study:

• To investigate the impact of gut bacterial decontamination on bacterial translocation in a rat model of severe experimental acute pancreatitis.

Main Methods:

• Severe acute pancreatitis was induced in Sprague-Dawley rats.
• One group received antibiotic treatment (gentamicin, bacitracin, neomycin) prior to AP induction, while the control group did not.
• Bacterial cultures were obtained from various organs, including mesenteric lymphatic ganglia and pancreas, 24 hours post-induction.

Main Results:

• The antibiotic-treated group showed a significantly lower incidence of positive pancreatic cultures (2/17) compared to the control group (9/17).
• Escherichia coli, enterococcus, and proteus were the most frequently isolated bacteria.
• No significant difference was observed in the Gram-positive/Gram-negative bacterial balance between groups.

Conclusions:

• The majority of bacteria in AP tissues originate from the intestinal microflora, primarily E. coli.
• Bacterial translocation occurs early in AP, predominantly via the lymphatic pathway.
• Pre-emptive bacterial decontamination reduces bacterial translocation frequency without altering the microbial balance or increasing fungal infections.