Prevention of infectious complications in surgical patients: potential role of probiotics

Area of Science:

• Gastroenterology
• Infectious Diseases
• Critical Care Medicine

Background:

• Infectious complications in surgical patients frequently arise from intestinal microflora.
• Critically ill patients experience disturbed small bowel motility, leading to bacterial overgrowth and translocation due to impaired gut mucosal barrier function.
• Current prophylactic strategies are insufficient to address all contributing factors.

Purpose of the Study:

• To review the current understanding of infectious complications in surgical patients originating from the gut.
• To evaluate the efficacy of various prophylactic strategies, including antibiotics and selective decontamination.
• To highlight the emerging role of probiotics in preventing gut-derived infections.

Main Methods:

• Review of existing literature on antibiotic prophylaxis and selective decontamination of the digestive tract.
• Analysis of recent randomized placebo-controlled trials on probiotic interventions.
• Summary of in vitro and experimental research on probiotic effects on microflora, mucosal barrier, and immune function.

Main Results:

• Antibiotic prophylaxis has yielded conflicting results in preventing bacterial translocation.
• Selective decontamination of the digestive tract shows efficacy but faces challenges due to concerns about bacterial multiresistance.
• Probiotics have demonstrated promising results in recent trials for managing gut-derived infections.

Conclusions:

• There is a need for optimal prophylactic strategies targeting intestinal microflora, motility, and barrier function in surgical patients.
• Probiotics represent a promising therapeutic avenue, with ongoing research focusing on their impact on gut infections, barrier integrity, and host immunity.
• Further research is warranted to fully elucidate the potential of probiotics in clinical practice for preventing infectious complications.