Schwarz M, Thomsen J, Meyer H, Büchler M W, Beger H G
Department of General Surgery, University of Ulm, Germany.
Surgery. 2000 Apr;127(4):427-32. doi: 10.1067/msy.2000.104116.
Infectious complications in severe pancreatitis are the main factors determining clinical course and outcome. The taurocholate model for acute necrotizing pancreatitis was evaluated for frequency and time course of pancreatic and extrapancreatic bacterial infection.
Sixty-five male Wistar rats were divided into 5 groups of 13 animals each. Specimens for bacteriologic examination were taken, and pancreatitis was induced by intraductal infusion of 3% taurocholate under sterile conditions. Animals were killed 8, 16, 24, or 32 hours thereafter, and bacteriologic examination was performed. A control group of animals with intraductal infusion of 0.9% saline solution were killed after 32 hours.
There was no significant pancreatic infection in the control group and in the 8-hour group (1 of 13 rats). Sixteen and 24 hours after induction of pancreatitis, infection and inflammation of the pancreas were found in 77% (10 of 13 rats), and after 32 hours pancreatic infection occurred in 69% (9 of 13 rats). Extrapancreatic bacterial infection after 16 hours occurred in the liver (62%), spleen (62%), and mesenteric lymph nodes (46%). Bacteria infecting the pancreas reflected the bacterial spectrum of the large bowel and terminal ileum before induction of pancreatitis (Escherichia coli [77%], Proteus [43%], Enterococcus [37%], and Staphylococcus [23%]).
Pancreatic infection is an early and frequent finding in the taurocholate model of acute necrotizing pancreatitis. Infection occurs between 8 and 16 hours after induction of pancreatitis. The source of infecting bacteria seems to be the large bowel or the terminal ileum. We present a useful model of severe pancreatitis in which to study bacterial translocation, the further route of spread, and therapeutic approaches.
重症胰腺炎的感染性并发症是决定临床病程和预后的主要因素。对急性坏死性胰腺炎的牛磺胆酸盐模型进行评估，以确定胰腺和胰腺外细菌感染的频率和时间进程。
65只雄性Wistar大鼠分为5组，每组13只。采集细菌学检查标本，在无菌条件下通过导管内注入3%牛磺胆酸盐诱导胰腺炎。此后8、16、24或32小时处死动物，并进行细菌学检查。导管内注入0.9%盐水溶液的动物对照组在32小时后处死。
对照组和8小时组（13只大鼠中的1只）未发生明显的胰腺感染。胰腺炎诱导后16小时和24小时，77%（13只大鼠中的10只）出现胰腺感染和炎症，32小时后69%（13只大鼠中的9只）发生胰腺感染。16小时后胰腺外细菌感染发生在肝脏（62%）、脾脏（62%）和肠系膜淋巴结（46%）。感染胰腺的细菌反映了胰腺炎诱导前大肠和回肠末端的细菌谱（大肠杆菌[77%]、变形杆菌[43%]、肠球菌[37%]和葡萄球菌[23%]）。
在急性坏死性胰腺炎的牛磺胆酸盐模型中，胰腺感染是一个早期且常见的发现。感染发生在胰腺炎诱导后8至16小时之间。感染细菌的来源似乎是大肠或回肠末端。我们提出了一个有用的重症胰腺炎模型，可用于研究细菌移位、进一步的传播途径和治疗方法。
