Sewake H
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1992 Jun;93(6):616-25.
Adherence to host tissues and cell surfaces is an early step in infections. However nothing has been reported about bacterial adherence in biliary infections. The following experiment was carried out in rabbits with Escherichia coli isolated from the bile of a patient with acute suppurative cholangitis. Adhesion was observed by scanning electron microscopy. First, with cholecystic mucosa of normal, jaundice, acid (mucosa was injured with 0.1 N hydrochloric acid) and stone groups (stones were inserted into the gallbladder), bacterial adhesion as a virulence factor was examined in vitro. Second, in a cholangitis model the role of bacterial adherence to the bile duct in the development of localized biliary infection was examined in vivo.
(1) As compared to the normal, jaundice and stone groups, the number of adhering bacteria was remarkably increased in the acid group. The mucosa of the former groups was relatively intact, but that of the latter was remarkably destroyed. (2) In the cholangitis model, the number of bacteria adhered to the bile duct was negatively correlated with that of bacteria isolated from blood. These results suggest that bacterial adherence to the biliary tract is an important virulence factor, but not in the development from localized cholangitis to sepsis.
黏附于宿主组织和细胞表面是感染的早期步骤。然而,关于细菌在胆道感染中的黏附情况尚无报道。以下实验在从一名急性化脓性胆管炎患者胆汁中分离出的大肠杆菌的家兔身上进行。通过扫描电子显微镜观察黏附情况。首先,在正常、黄疸、酸(黏膜用0.1 N盐酸损伤)和结石组(将结石插入胆囊)的胆囊黏膜上,体外检测作为毒力因子的细菌黏附情况。其次,在胆管炎模型中,体内检测细菌黏附于胆管在局部胆道感染发展中的作用。
(1)与正常、黄疸和结石组相比,酸组中黏附细菌的数量显著增加。前几组的黏膜相对完整,但后者的黏膜明显受损。(2)在胆管炎模型中,黏附于胆管的细菌数量与从血液中分离出的细菌数量呈负相关。这些结果表明,细菌黏附于胆道是一个重要的毒力因子,但在从局部胆管炎发展为败血症的过程中并非如此。