ABSTRACT
The purpose of this study was to investigate bacterial translocation and change in intestinal permeability in patients after abdominal surgery. Sixty-three patients undergoing elective abdominal surgery were enrolled in the study. Blood samples were collected prior to operation and 2, 24, 48 h after surgery for bacterial culture, microbial DNA extraction, plasma D-lactate and endotoxin measurement. PCR analysis was performed after DNA extraction, with beta-lactosidase gene of E. coli and 16S rRNA gene as target genes. All patients were observed for a period of 30 days for infectious complications. Our results showed that no bacterial DNA was detected before surgery, but after operation it was found in 12 patients (19.0%). Bacterial DNA was detected in 41.7% (10/24) of SIRS patients and 5.1% (2/39) of non-SIRS patients (P<0.01). About 83.3% of PCR-positive patients developed systemic inflammatory response syndrome (SIRS), but only 27.5% of PCR-negative patients did so (P<0.01). Two thirds of PCR-positive patients developed infectious complications, while none of PCR-negative patients did (P<0.01). The blood culture was positive only in 3 patients (4.8%), who were all PCR-positive. E. coli DNA was found in 66.7% of the PCR-positive patients. The plasma levels of D-lactate and endotoxin were elevated significantly 2, 24 and 48 h after operation in PCR-positive patients, with a significant positive correlation found between them (r=0.91, P<0.01). It is concluded that increased intestinal permeability was closely related with bacterial translocation. Intestinal bacterial translocation (most commonly E. coli) might occur at early stage (2 h) after abdominal surgery. Postoperative SIRS and infection might bear a close relationship with bacterial translocation.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the protective effect and its underlying mechanism of 2,4-diamino-6-hydroxy-pyrimidine (DAHP), an inhibitor of GTP-cyclohydrolase I (GTP-CHI), on postburn Staphylococcus aureus (S. aureus) sepsis in rats.</p><p><b>METHODS</b>Fifty-six Wistar rats were randomly divided into four groups, i.e. normal control, scalding control, postburn sepsis group and DAHP treatment group. Tissue samples from liver, kidneys, lungs and heart were aseptically taken, and in which the GTP-CHI and inducible nitric oxide synthase (iNOS) contents and the mRNA expression of tumor necrosis factor-alpha (TNFalpha) were determined. Furthermore, biopterin (BH(4)) and nitric oxide (NO) levels in these tissue were also measured.</p><p><b>RESULTS</b>After the scalding injury followed by bacterial challenge, the GTP-CHI gene expression and biopterin levels were significantly increased in all tissue sampled, and so were iNOS mRNA expression and NO (P < 0.01), especially in liver and lungs. The expressions of GTP-CHI mRNA and iNOS mRNA and the production of BH(4) and NO in all tissue were evidently inhibited by the pretreatment with DAHP (P < 0.05 approximately 0.01). At the same time, the TNFalpha expression was also obviously decreased. In addition, The mortality at 6 hr in rats of DAHP treatment group was decreased.</p><p><b>CONCLUSION</b>The prognosis of the scalding rats complicated by sepsis caused by G(+) bacteria could be improved by DAHP pretreatment, which might be related to the inhibition of the production of BH(4) and NO by DAHP.</p>
Subject(s)
Animals , Male , Rats , Biopterins , Metabolism , Burns , Genetics , Metabolism , Enzyme Inhibitors , Pharmacology , GTP Cyclohydrolase , Genetics , Gene Expression Regulation , Heart , Hypoxanthines , Pharmacology , Kidney , Metabolism , Liver , Metabolism , Lung , Metabolism , Myocardium , Metabolism , Nitric Oxide , Metabolism , Nitric Oxide Synthase , Genetics , RNA, Messenger , Genetics , Metabolism , Rats, Wistar , Sepsis , Staphylococcal Infections , Staphylococcus aureus , Sugar Acids , Time Factors , Tumor Necrosis Factor-alpha , GeneticsABSTRACT
ObjectiveTo investigate the hemodynamic changes after multiple firearm injuries in a swine model. Methods Twelve pigs were divided into 2 groups randomly, with control group ( n =6) subjected to catheterization only. Multiple trauma group ( n =6) was subjected to tangential fracture of parietal bone and comminuted fractures of bilateral femora (ISS≥16) using 5 8 mm bullets. The hemodynamic changes, including MAP, PAP, PAWP, CO, SVRI and portal vein blood flow, were observed at different time intervals up to 72 h after trauma or catheterization. At the same time, gastric pHi was measured as well. Results Compared with control group pigs in multiple trauma group suffered a hyperdynamic circulation developed at 48～72 hours. The cardiac output rose and vascular resistance declined obviously. The pulmonary artery pressure and pulmonary capillary wedge pressure elevated significantly. Mean artery pressure, portal vein blood flow and gastric pHi declined significantly. Conclusion Without severe blood loss and hemorrhagic shock, the decrease of portal vein blood flow and viscera underperfusion still took place after multiple firearm injuries.
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Objective To observe the changes in gut mucosal barrier and gut-origin bacteria-endotoxin translocation in acute necrotizing pancreatitis (ANP) rats. Methods Wistar rats were divided randomly into normal group (n=6), sham operation group (n=30) and ANP group (n=39). ANP was introduced by infusion of artificial bile into biliopancreatic duct. Morphology of pancreas and intestine were observed and tight junction on ileum epithelia were assessed by cryofracture replicas electroscopy. Plasma levels of D-lactic acid and endotoxin were examined at various time points. The rates of bacterial translocation to abdominal organs were also calculated. Results Mucosal and tight junction damages of the gut were found during early stage of ANP. Simultaneously, plasma D-lactate levels increased and endotoxemia occurred. The rate of bacterial translocation to organs was 59.5% 72h after ANP occurred. Conclusions Gut barrier function can be injured in the early stage of ANP, and resulting in gut origin bacteria-endotoxin translocation, which may be the originator of systemic inflammatory reaction and secondary infection of the pancreas.
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AIM: To investigate the role of staphylococcal enterotoxin B (SEB) in early intestinal injury in scald rats with Staphylococcus aureus sepsis. METHODS: 86 male Wistar rats were randomly divided into four groups as follows: normal controls ( n= 10), scald control group( n= 10), postburn sepsis group( n= 50) and SEB monoclonal antibody (MAb)treatment group ( n= 16). Plasma samples were collected to determine SEB, endotoxin, tumor necrosis factor-? (TNF-?) and interferon-? (IFN-?). RESULTS: After scald injury followed by Staphylococcus aureus challenge, the levels of SEB, TNF-? and IFN-? in plasma were significantly higher than those of normal controls, peaking at 2-6 h ( P