Bark T, Katouli M, Ljungqvist O, Möllby R, Svenberg T
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Circ Shock. 1993 Sep;41(1):60-5.
Translocation of enteric bacteria has been suggested to compromise patients in severe catabolic stress. Mechanisms for this route of infection are not known. In this study, rats were subjected to hemorrhage without reinfusion during 60 min, total blood loss was 3.28 +/- 0.14 ml/100 g BW. Control groups consisted of sham-operated animals without bleeding, and rats not operated at all. The mean number of viable bacteria found in mesenteric lymph nodes (MLN) of bled animals was 168 +/- 45 colony forming units (c.f.u./MLN), significantly higher compared to sham operated (5 +/- 3 c.f.u./MLN) and not operated (0 +/- 0 c.f.u./MLN) controls (P < 0.01). Cultures from MLN were positive in 7/9 rats after bleeding, in 3/9 of sham operated, and in 0/6 of non-instrumented control animals. No positive blood cultures were isolated. Escherichia coli was the dominant species found in MLN. A biochemical fingerprinting method (the PhP system) was used to identify translocating strains of E. coli among strains found in cecum. The method was also used to compare translocating strains between different animals. Our findings reveal that bacteria translocate to MLN after hemorrhage. Some phenotypes of E. coli strains translocate more frequently than others, suggesting that they have properties facilitating translocation.
已有研究表明,肠道细菌易位会使处于严重分解代谢应激状态的患者病情加重。但这种感染途径的机制尚不清楚。在本研究中,对大鼠进行60分钟的出血且不进行再灌注,总失血量为3.28±0.14 ml/100 g体重。对照组包括未出血的假手术动物和未进行任何手术的大鼠。出血动物肠系膜淋巴结(MLN)中发现的活菌平均数量为168±45菌落形成单位(c.f.u./MLN),与假手术组(5±3 c.f.u./MLN)和未手术组(0±0 c.f.u./MLN)相比显著更高(P<0.01)。出血后9只大鼠中有7只的MLN培养呈阳性,假手术组9只中有3只呈阳性,未进行手术的对照组6只中无阳性。未分离出阳性血培养物。大肠杆菌是在MLN中发现的主要菌种。采用一种生化指纹图谱方法(PhP系统)来鉴定盲肠中发现的大肠杆菌易位菌株。该方法还用于比较不同动物之间的易位菌株。我们的研究结果表明,出血后细菌易位至MLN。某些大肠杆菌菌株的表型比其他菌株更频繁地易位,这表明它们具有促进易位的特性。