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Simple intestinal obstruction causes bacterial translocation in man
1Department of Surgery, Louisiana State University (LSU) Medical Center, Shreveport 71130-3932.
Abstract:
Indirect clinical evidence has accumulated indicating that the gut may be a reservoir for microorganisms causing systemic infection in man. Our experimental results, in a variety of animal models, demonstrate that bacteria can translocate across the mucosal barrier and cause systemic infections. To determine directly whether bacterial translocation occurs in man, we cultured mesenteric lymph nodes (MLNs) obtained at laparotomy from 42 patients, none of whom were clinically infected. Ten (59%) of 17 patients with intestinal obstruction (none of whom had necrotic bowel) had bacteria in their MLNs, in contrast to one (4%) of 25 patients operated on for other reasons. The most common bacteria cultured from the MLNs was Escherichia coli. Thus, it appeared that simple intestinal obstruction of the colon or small bowel in the absence of necrotic bowel was associated with bacterial translocation.
Insights
The gut can harbor bacteria that cause systemic infections. Intestinal obstruction, even without bowel death, allows bacteria to move from the gut into the bloodstream, leading to potential infections.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Research
Background:
- The gut is suspected as a reservoir for systemic infections.
- Animal models show bacteria can cross the gut barrier and cause systemic illness.
Purpose of the Study:
- To directly investigate bacterial translocation in humans.
- To determine if intestinal obstruction is associated with bacterial translocation.
Main Methods:
- Cultured mesenteric lymph nodes (MLNs) from 42 patients undergoing laparotomy.
- Patients were categorized based on intestinal obstruction or other surgical reasons.
- MLNs were cultured for bacterial presence.
Main Results:
- Bacteria were found in MLNs of 59% of patients with intestinal obstruction (10/17).
- Only 4% of patients without intestinal obstruction (1/25) had bacteria in MLNs.
- Escherichia coli was the most frequently identified bacterium.
Conclusions:
- Simple intestinal obstruction is linked to bacterial translocation in humans.
- The gut mucosal barrier may be compromised during intestinal obstruction.
- This translocation may contribute to systemic infections in patients with obstruction.