Naaber P, Mikelsaar R H, Salminen S, Mikelsaar M
Department of Microbiology, University of Tartu, Finland.
J Med Microbiol. 1998 Jul;47(7):591-8. doi: 10.1099/00222615-47-7-591.
Bacteraemia and subsequent sepsis is one possible complication of Clostridium difficile infection. The aim of this study was to examine a correlation between bacterial translocation with morphological changes of intestinal mucosa and shifts of intestinal microflora in experimental models of C. difficile infection. A mouse model was used to study post-antibiotic shifts and mild C. difficile infection, and hamsters were used to study fatal enterocolitis. The influence of pro- and pre-biotics (lactobacilli and xylitol) were also studied in the hamster model. The quantitative composition of luminal and mucosal microflora was evaluated in different intestinal loci, inflammatory changes of mucosa were estimated in histological sections and bacterial translocation was detected in samples from blood, liver, spleen and mesenteric lymph nodes. In cases of mild C. difficile infection, the extent of disturbance of intestinal microflora appeared to be a more important promoting factor in translocation than inflammatory activity in the mucosa. Translocation was frequent in fatal enterocolitis, with facultative species predominating in the intestinal mucosa and also C. difficile in some cases. The combination of lactobacilli and xylitol had some protective effect against C. difficile infection in these models.
菌血症及随后的脓毒症是艰难梭菌感染的一种可能并发症。本研究的目的是在艰难梭菌感染的实验模型中，研究细菌易位与肠黏膜形态变化及肠道微生物群变化之间的相关性。使用小鼠模型研究抗生素使用后的变化及轻度艰难梭菌感染，使用仓鼠模型研究致死性小肠结肠炎。还在仓鼠模型中研究了益生元和益生菌（乳酸杆菌和木糖醇）的影响。评估了不同肠道部位管腔和黏膜微生物群的定量组成，在组织学切片中估计黏膜的炎症变化，并在血液、肝脏、脾脏和肠系膜淋巴结样本中检测细菌易位。在轻度艰难梭菌感染的情况下，肠道微生物群的紊乱程度似乎比黏膜中的炎症活动更重要，是促进细菌易位的因素。在致死性小肠结肠炎中细菌易位很常见，兼性菌在肠黏膜中占主导地位，在某些情况下艰难梭菌也占主导地位。在这些模型中，乳酸杆菌和木糖醇的组合对艰难梭菌感染有一定的保护作用。
