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[Studies on the relationship between gastric acidity and the development of MRSA. Especially for the prevention of
1Second Department of Surgery, Nippon Medical School, Tokyo, Japan.
Abstract:
Enterocolitis caused by methicillin-resistant Staphylococcus aureus (MRSA) has recently been recognized as one of the severe postoperative complications in surgery on the digestive organs. This disease often occurs in the early days after gastrointestinal operation, especially after gastrectomy. MRSA enterocolitis seems to occur when MRSA has first infected the naso-pharyngeal mucosa preoperatively, and then moved into the stomach, and subsequently proliferated in the higher pH gastric juices. The aim of this experiment was to reveal the relationship between the acidity of gastric juices and bacterial growth in the stomach during the pre and post operative period in an effort to prevent of MRSA enterocolitis. In vitro, MRSA was cultured for various periods at various pH values, and its proliferation was observed. MRSA did not grow in the culture at pH 1 at all, neither did it grow at pH 2 when cultured for more than 8 hours. This data shows the germicidal effect of high acidity in the stomach. Clinically, twenty patients with cancer in the digestive tract had the bacteria in their gastric juices examined in terms of acidity before and after operation. In cases with an increased pH level in the gastric juices after the operation. S. aureus including MRSA, was isolated frequently from the stomach. In vitro, incubation of MRSA with gastric juices collected from those cases showed no development of MRSA when the pH was below 3.98. In order to prevent the onset of MRSA enterocolitis, the remnant stomachs of ten patients with stomach cancer were filled with hydrochloric acid lemonade just after operative reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
High stomach acidity prevents methicillin-resistant Staphylococcus aureus (MRSA) growth. Maintaining a low gastric pH post-surgery is crucial for preventing MRSA enterocolitis, a severe complication after digestive organ operations.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Complications
Context:
- Methicillin-resistant Staphylococcus aureus (MRSA) enterocolitis is a serious postoperative complication following digestive surgeries, particularly gastrectomy.
- This condition often arises early post-operation, linked to MRSA colonization of the nasopharyngeal mucosa and subsequent proliferation in the stomach.
- Elevated gastric pH post-surgery appears to facilitate MRSA growth.
Purpose:
- To investigate the relationship between gastric juice acidity and bacterial growth, specifically MRSA, in the pre- and post-operative periods.
- To identify strategies for preventing MRSA enterocolitis.
Summary:
- In vitro studies demonstrated that MRSA does not grow at pH 1 and has limited growth at pH 2 after 8 hours, indicating a germicidal effect of high acidity.
- Clinical examination of 20 patients showed frequent isolation of S. aureus, including MRSA, from gastric juices with increased pH post-operation.
- MRSA failed to develop in gastric juices with a pH below 3.98.
Impact:
- Findings suggest that maintaining a low gastric pH is critical for preventing MRSA enterocolitis.
- The study trialed post-operative gastric acidification with hydrochloric acid lemonade in 10 patients to prevent MRSA enterocolitis.