Related Experiment Videos
Influence of bowel preparation and antimicrobials on colonic microflora
Abstract:
The influence of three types of preoperative mechanical bowel preparation on colonic microflora has been studied in 88 patients undergoing elective bowel resection and compared with 21 controls. Neither conventional bowel preparation (CBP) using oral magnesium sulphate, enemas and rectal washouts nor whole bowel irrigation (WBI) via a nasogastric tube influenced the type or number of organisms in the colon at the time of operation. The administration of an elemental diet (ED) was associated with only a small reduction the numbers of Escherichia coli (P less than 0.02). The addition of oral neomycin and metronidazole for 48 h before operation to all three methods of bowel preparation was associated with a highly significant reduction in the counts per ml of E. coli (P less than 0.001) and Bacteroides fragilis (P less than 0.001) in the colon. There was no correlation between the diameter of the lesion being resected with the numbers of bacteria in the colon even when oral neomycin and metronidazole were added to the bowel preparation.
Insights
Preoperative mechanical bowel preparation methods, including conventional bowel preparation (CBP) and whole bowel irrigation (WBI), did not significantly alter colonic microflora. However, adding neomycin and metronidazole drastically reduced key bacteria like E. coli and B. fragilis.
Area of Science:
- Gastroenterology
- Microbiology
- Surgical Preparation
Background:
- Preoperative mechanical bowel preparation is standard for elective bowel surgery.
- Its impact on colonic microflora composition and bacterial load remains an area of investigation.
Purpose of the Study:
- To evaluate the influence of three distinct preoperative mechanical bowel preparation methods on colonic microflora.
- To assess the effect of antibiotic administration in conjunction with bowel preparation.
Main Methods:
- Study involved 88 patients undergoing elective bowel resection and 21 controls.
- Compared conventional bowel preparation (CBP), whole bowel irrigation (WBI), and elemental diet (ED).
- Assessed colonic microflora before operation, with and without oral neomycin and metronidazole.
Main Results:
- CBP and WBI did not alter colonic microflora type or number.
- Elemental diet (ED) showed a minor reduction in Escherichia coli counts.
- Adding oral neomycin and metronidazole significantly reduced E. coli and Bacteroides fragilis counts.
Conclusions:
- Standard mechanical bowel preparation methods have minimal impact on colonic microflora.
- Antibiotic administration (neomycin and metronidazole) is crucial for significantly reducing specific bacterial populations.
- Bacterial load in the colon does not correlate with the size of the resected lesion.