Bleday R, Braidt J, Ruoff K, Shellito P C, Ackroyd F W
Department of Surgery, New England Deaconess Hospital, Boston, Massachusetts 02215.
Dis Colon Rectum. 1993 Sep;36(9):844-9. doi: 10.1007/BF02047381.
Little is known about the mucosal microflora of the colon and rectum at the time of elective surgery. Our objective was to determine the concentrations of anaerobic and aerobic bacteria associated with the mucosa of the mechanically prepared large bowel. Ten patients were studied after a standard polyethylene glycol-electrolyte lavage preparation. No patient had taken antibiotics in the preceding four weeks. Sterile wire brushes passed through the colonoscope during advancement were used to culture the rectal, transverse colon, and cecal mucosa. Total anaerobic, aerobic, Gram-positive, and enteric bacterial counts were determined along with specific cultures for Bacteroides fragilis, Clostridium difficile, Escherichia coli, Pseudomonas aeruginosa, enterococcus, and staphylococcus species. The results showed that there was a significant increase (P < 0.01) in aerobes, anaerobes, enterics, Gram positives, B. fragilis, and E. coli mucosal counts with proximal progression. Aerobes showed a steady gradient, while anaerobes demonstrated an increase from the rectum to the transverse colon but no change between the transverse colon and cecum. We conclude that, in the prepared bowel, there is an increase in the mucosal bacterial counts in the more proximal portions of the bowel. The results may serve as a baseline for future studies on the mucosal-associated bacteria of the large intestine.
关于择期手术时结肠和直肠的黏膜微生物群，人们了解甚少。我们的目的是确定与机械准备的大肠黏膜相关的厌氧和需氧细菌的浓度。在标准的聚乙二醇电解质灌洗准备后，对10名患者进行了研究。在之前四周内，没有患者使用过抗生素。在推进结肠镜时，通过结肠镜插入无菌钢丝刷，用于培养直肠、横结肠和盲肠黏膜。测定了总厌氧菌、需氧菌、革兰氏阳性菌和肠道细菌计数，以及脆弱拟杆菌、艰难梭菌、大肠杆菌、铜绿假单胞菌、肠球菌和葡萄球菌属的特定培养物。结果显示，随着向近端推进，需氧菌、厌氧菌、肠道菌、革兰氏阳性菌、脆弱拟杆菌和大肠杆菌的黏膜计数显著增加（P < 0.01）。需氧菌呈现稳定的梯度变化，而厌氧菌从直肠到横结肠有所增加，但在横结肠和盲肠之间没有变化。我们得出结论，在准备好的肠道中，肠道近端部分的黏膜细菌计数增加。这些结果可作为未来关于大肠黏膜相关细菌研究的基线。
