Mora E M, Cardona M A, Simmons R L
Department of Surgery, University of Pittsburgh, PA 15261.
Arch Surg. 1991 Feb;126(2):157-63. doi: 10.1001/archsurg.1991.01410260041006.
Sterile and endotoxin-free biomaterials commonly used in prosthetic devices (Dacron velour, woven Dacron, and Biomer polyurethane) and cotton (control material) were implanted intraperitoneally in mice with normal enteric flora. Intraperitoneal Biomer and woven Dacron became contaminated with 100 to 10,000 enteric bacteria, including Escherichia coli, Pseudomonas aeruginosa, enterococci, and staphylococci species, within 3 days; intraperitoneal cotton and Dacron velour were contaminated within 24 hours. Mesenteric lymph nodes showed parallel incidences of translocation. The peritoneal cavity became contaminated only if the biomaterial itself became contaminated. No bacterial overgrowth, perforation, or histologic changes in the bowel were found. Subcutaneous biomaterials remained sterile. Ingested fluorescent beads appeared in enterocytes, in lamina propria within macrophages, and in intraperitoneal biomaterials. The data suggest that intraperitoneal sterile reactive stimuli can induce bacterial translocation to the dense prosthesis directly through the intact normal bowel wall. One of the mechanisms seems to involve phagocytosis of particles and bacteria within the bowel wall that are then chemotactically attracted to nearby sites of inflammation.
将常用于假体装置的无菌且无内毒素的生物材料（涤纶绒、编织涤纶和生物聚酯聚氨酯）以及棉花（对照材料）腹腔内植入具有正常肠道菌群的小鼠体内。腹腔内的生物聚酯和编织涤纶在3天内被100至10000种肠道细菌污染，包括大肠杆菌、铜绿假单胞菌、肠球菌和葡萄球菌属；腹腔内的棉花和涤纶绒在24小时内被污染。肠系膜淋巴结显示出平行的移位发生率。只有当生物材料本身被污染时，腹腔才会被污染。未发现肠道细菌过度生长、穿孔或组织学变化。皮下生物材料保持无菌。摄入的荧光珠出现在肠上皮细胞、巨噬细胞内的固有层以及腹腔内的生物材料中。数据表明，腹腔内无菌反应性刺激可直接通过完整的正常肠壁诱导细菌移位至致密假体。其中一种机制似乎涉及肠壁内颗粒和细菌的吞噬作用，然后这些颗粒和细菌被趋化吸引至附近的炎症部位。
