Effect of CO(2) insufflation on bacteremia and bacterial translocation in an animal model of peritonitis.

BACKGROUND: The widespread adoption of the laparoscopic approach has created some concern over the potential for increased risk of bacteremia and sepsis due to increased intraabdominal pressure in patients with intraabdominal infection and peritonitis. This study examines the effect of the CO(2) pneumoperitoneum on bacteremia and bacterial translocation. METHODS: New Zealand white rabbits were assigned into three groups of 10 animals. In group 1, 100 ml of sterile saline was infused into the peritoneal cavity under 10 mmHg CO(2) insufflation for 1 h. Group 2 received 100 ml of saline containing 10(9) CFU/ml (colony-forming units) E. coli strain 0163 and 10 mmHg CO(2) insufflation for 1 h. Group 3 received an identical bacterial inoculum, followed by a 10-cm midline laparotomy. Blood samples were taken for culture by cardiac puncture at various intervals during the experiment. At 6 h after being subjected to the experimental procedures, the rabbits were killed and their organs were cultured quantitatively for translocating bacteria. RESULTS: In group 1, neither blood nor organ cultures were positive, whereas in group 2 all blood cultures became positive in 1 h, and intraperitoneally infused bacteria translocated to the lung and kidney in all rabbits. In group 3, blood cultures became positive in 1 h, all but two of the rabbits had translocated bacteria in their lungs, and kidney samples from two of the rabbits were culture-positive. CONCLUSIONS: Our results indicate that both CO(2) pneumoperitoneum and laparotomy increase the incidence of bacterial translocation from the peritoneal cavity into the bloodstream. Thus, the risk of translocation to extraperitoneal organs such as lung and kidney is increased significantly by laparoscopy. Therefore, laparoscopic surgery should be avoided or used cautiously in the setting of acute peritonitis.

Immunochemical characterization of the MPB70/80 and MPB83 proteins of Mycobacterium bovis.

MPB70 and MPB80 (MPB70/80) and MPB83 are closely related antigens which are highly expressed in Mycobacterium bovis. MPB70/80 are soluble secreted antigens, while MPB83 is an exported lipoprotein associated with the bacterial surface. In the present study, these antigens had different mobilities in sodium dodecyl sulfate-polyacrylamide gel electrophoresis under reducing and nonreducing conditions. These differences may be explained by the fact that MPB70 and MPB83 both have two internal cysteine residues which would create ring structures by disulfide bonding. We analyzed the structures of MPB70/80 and MPB83 by using monoclonal antibodies (MAbs) raised against bovine purified protein derivative or whole M. bovis cells. MAb 1-5C reacted specifically with MPB70 and MPB80, and MAb MBS43 reacted specifically with MPB83, while the other antibodies, including several previously described MAbs, bound all three antigens. MAbs and polyclonal antibodies reacted strongly with reduced protein and less well with nonreduced protein, indicating involvement of linear epitopes. Epitopes of MAbs Bov-1, 2-6B, 1-5C, and 1-1D were mapped by using synthetic peptides of MPB70. Sequence comparison showed the peptide with the 1-5C-reactive epitope to have three residues different from those in the homologous region of MPB83. Exchanges of A for S in position 112 or Q for E in position 116 abolished the reactivity of MAb 1-5C. Polyclonal rabbit antibodies to native purified MPB70 reacted strongly with peptides 6, 7, and 8 of the N-terminal half of mature MPB70. Cattle sera of experimentally M. bovis-infected animals recognized a broader spectrum of peptides. These findings indicate that there is diagnostic potential for these proteins and that there is also a possible role for antibodies in elucidation of the host-mycobacterium relationship involving a surface-bound and exposed lipoprotein, MPB83, and its highly homologous soluble secreted MPB70/80 counterparts.

[Detection of Chlamydia trachomatis antigen in cases of cervicitis and patients with vaginal discharge]. / Cesitli servisit olgularinda ve vajinal akintisi bulunan hastalarda Chlamydia trachomatis antijeni arastirilmasi.

This study was carried on 129 women of 16-62 age group, with complaints of vaginal discharge, genital itching and soreness, dysuria and pollakiuria. Endocervical specimens were investigated for Chlamydia trachomatis (C. trachomatis) antigen by ELISA. Risk factors for several gynecologic and obstetric pathologies and the role of C. trachomatis in mucopurulent cervicitis were emphasized. C. trachomatis antigen was found to be positive in 9 (7%) specimens. We concluded that, in cases of cervicitis, especially to prevent complications and social problems, the presence of C. trachomatis should also be investigated in addition to several viral, bacterial and fungal agents.

[In vitro susceptibility to cefoperazone and sulbactam/cefoperazone combination of bacterial strains isolated from various patient materials]. / Cesitli hastalik materyallerinden izole edilen bakteri suslarinin sefoperazon ve sulbaktam/sefoperazon kombinasyonuna karsi duyarliliklarinin in-vitro arastirilmasi.

Susceptibility of 110 bacterial strains isolated from clinical materials to Cefoperazone (CPZ) and Sulbactam/Cefoperazone (SBT/CPZ) combination was investigated and every strain was examined for beta-lactamase activity. Total beta-lactamase positivity rate was 40.9%. Antibacterial activity of SBT/CPZ combination was found to be higher than CPZ alone, especially on beta-lactamase producing bacteria.

[Chlamydia trachomatis antigens in endocervical samples and serum IgG antibodies in sterile-infertile women using ELISA]. / Steril-infertil olgularin endoservikal sürüntü örneklerinde chlamydia trachomatis antijeninin ve serulmarinda IgG antikolarinin ELISA ile arastirilmasi.

In this study, Ch.trachomatis antigen was investigated by ELISA, endocervical swab material of 35 infertile and sterile women, and 4 of them were antigen positive. All of these 4 cases were secondary sterile and 3 of them showed Ch.trachomatis IgG seropositivity. Chlamydia IgG seropositivity was seen in 8 of 35 cases. In this study, 68 patients were investigated for Ch.trachomatis IgG antibodies and 17 patients were found to be seropositive. These findings indicate the importance of Ch.trachomatis infections and the effect of recurrent infections on tubal factor infertility.