Pinto Francisco Edilson Leite, Brandt Carlos Teixeira, Medeiros Aldo da Cunha, de Oliveira Ariano José Freitas, Jerônimo Selma Maria, de Brito Helena Marques Fonseca
Federal University of Rio Grande do Norte (UFRN), Brazil.
Acta Cir Bras. 2007 May-Jun;22(3):195-201. doi: 10.1590/s0102-86502007000300007.
To investigate whether the alterations of the diverted colon segment mucosa, evidenced in fecal colitis, would be able to alter Bacterial Translocation (BT).
Sixty-two Wistar male rats ranging from 220 to 320 grams of weight, were divided in two groups: A (Colostomy) and B (Control), with 31 animals each one. In group A, all animals underwent end colostomy, one stoma, in ascending colon; and in the 70th POD was injected in five rats, by rectal route diverted segment - 2 ml of a 0.9% saline solution in animals (A1 subgroup); in eight it was inoculated, by rectal route, 2 ml of a solution containing Escherichia coli ATCC 25922 (American Type Culture Collection), in a concentration of 10(8) Colony Forming Unit for milliliters (CFU/ml) - A2 Subgroup; in ten animals the same solution of E. coli was inoculated, in a concentration of 10(11) CFU/ml (A3 Subgroup); and in eight it was collected part of the mucus found in the diverted distal colonic segment for neutral sugars and total proteins dosage (A4 subgroup). The animals from the group B underwent the same procedures of group A, but with differences in the colostomy confection. In rats from subgroups A1, A2, A3, B1, B2, and B3 2 ml of blood were aspirated from the heart, and fragments from mesenteric lymphatic nodule, liver, spleen, lung and kidney taken for microbiological analysis, after their death. This analysis consisted of evidencing the presence of E. coli ATCC 25922 CFU. Mann-Whitney and ANOVA Tests were applied as analytic techniques for association of variables.
The occurrence of BT was evidenced only in those animals in which inoculated concentration of E. coli ATCC 25922, reached levels of 10(11)CFU/ml, i.e. in Subgroups A3 and B3, although, being significantly greater (80%) in those animals without colostomy (subgroup B3) when compared to the ones with colostomy (20%) from the subgroup A3 (P <0.05). Lung, liver and mesenteric lymphatic nodules were the tissues with larger percentile of bacterial recovery, so much in subgroup A3, as in B3. Blood culture was considered positive in 60% of the animals from subgroup B3 and in 10% of those from subgroup A3 (p <0.05). There was greater concentration of neutral sugars, in subgroup A4 - mean 27.3mg/ml -, than in subgroup B4 - mean 8.4 mg/ml - (P <0.05).
The modifications in the architecture of intestinal mucosa in colitis following fecal diversion can cause alterations in the intestinal barrier, but it does not necessarily lead to an increased frequency of BT.
研究粪便性结肠炎中所见的改道结肠段黏膜改变是否会改变细菌移位（BT）。
62只体重在220至320克之间的雄性Wistar大鼠被分为两组：A组（结肠造口术组）和B组（对照组），每组各31只动物。在A组中，所有动物均接受升结肠单口结肠造口术；在术后第70天，5只大鼠经直肠途径向改道段注射2毫升0.9%生理盐水（A1亚组）；8只大鼠经直肠途径接种2毫升含大肠埃希菌ATCC 25922（美国模式培养物集存库）的溶液，浓度为每毫升10⁸菌落形成单位（CFU/ml）（A2亚组）；10只动物接种相同的大肠埃希菌溶液，浓度为每毫升10¹¹CFU/ml（A3亚组）；8只大鼠收集改道远端结肠段发现的部分黏液用于中性糖和总蛋白定量分析（A4亚组）。B组动物接受与A组相同的操作，但结肠造口术的制作有所不同。在A1、A2、A3、B1、B2和B3亚组的大鼠死亡后，从心脏抽取2毫升血液，并取肠系膜淋巴结、肝脏、脾脏、肺和肾脏的组织进行微生物学分析。该分析包括检测大肠埃希菌ATCC 25922 CFU的存在。采用曼-惠特尼检验和方差分析作为变量关联的分析技术。
仅在接种的大肠埃希菌ATCC 25922浓度达到每毫升10¹¹CFU/ml的动物中证实发生了细菌移位，即A3亚组和B3亚组，尽管与A3亚组有结肠造口术的动物（20%）相比，无结肠造口术的动物（B3亚组）中细菌移位的发生率显著更高（80%）（P<0.05）。肺、肝脏和肠系膜淋巴结是细菌回收率较高的组织，A3亚组和B3亚组均如此。B3亚组60%的动物血培养呈阳性，A3亚组为10%（P<0.05）。A4亚组中性糖浓度更高，平均为27.3mg/ml，高于B4亚组，平均为8.4mg/ml（P<0.05）。
粪便改道后结肠炎中肠黏膜结构的改变可导致肠道屏障改变，但不一定导致细菌移位频率增加。
