Bacterial translocation in an experimental intestinal obstruction model: C-reactive protein reliability?

Abstract

Background: Bacterial translocation occurs in preseptic conditions such as intestinal obstruction through unclear mechanism. The C-reactive protein is an acute phase reactant and a marker of ischemia. Methods: 45 albino male rats were divided into 3 groups each 15 rats. GI control, GII simple intestinal-obstruction and GIII strangulated obstruction. Outcome measures were: (1) Bacteriologic count and typing for intestinal contents, intestinal wall, liver, mesenteric lymph nodes and blood (cardiac and portal) (2) Histopathologic: mucosal injury score, inflammatory cell infiltrate in the wall, MLN, liver, (3) Biochemical: serum CRP, IL-10, mucosal stress pattern (glutathione peroxidase-malonyldialdhyde tissue levels). Results: (1) Intestinal obstruction associates with BT precursors (Bact-overgrowth, mucosal-acidosis, immuno-incomptence), (2) Bacterial translocation (frequency and density) was found higher in strangulated I.O, that was mainly enteric (aerobic and anaerobic) and mostly E.coli, (3) The pathogen commonality supports the gut origin hypothesis but the systemic inflammatory response goes with the cytokine generating one. (4) The CRP median values for GI, II, III were 0.5, 6.9, 8.5 mg/L, for BT +ve 8 mg/L and 0.75 mg/L for BT -ve rats. Conclusion: Bacterial translocation occurs bi-directional (systemic-portal) in intestinal obstruction and the resultant inflammatory response pathogenesis is mostly 3 hit model. The CRP is a non selective marker of suspected I.O cases. However, it is a reliable marker of BT, BT density and vascular compromise during I.O. Key words: Intestinal Obstruction. Ischemia. Bacterial Translocation. Rats. RESUMO Objetivo:Translocação bacteriana ocorre em condições pré-sépticas como na obstrução intestinal por mecanismo não esclarecido. A proteína C-reativa é um marcador de ischemia em fase aguda. A proposição é investigar os possíveis efeitos da obstrução intestinal no equilíbrio ecológico microbiano. Métodos: 45 ratos machos albinos foram distribuídos em três grupos de 15 ratos. GI controle, GII obstrução intestinal simples e GIII obstrução estrangulada. As medidas adotadas foram: (1) Contagem bacteriológica do conteúdo intestinal, parede intestinal, fígado, linfonodos mesentéricos e sangue (coração e portal) (2) Avaliação histopatológica da lesão da mucosa, infiltrado celular inflamatório da parede, linfonodos mesentéricos, fígado, (3) Avaliação bioquímica. Resultados: (1) Obstrução intestinal está associada a precursora translocação bacteriana (crescimento bacteriano, acidose da mucosa, imuno-incompetência), (2) Translocação bacteriana (freqüência e densidade) foi maior na obstrução intestinal estrangulada, principalmente entérica (aeróbios e anaeróbios), sobretudo E.coli, (3) A ocorrência comum é de origem intestinal. Conclusão: A translocação bacteriana na obstrução intestinal é bi-direcional (sistêmica e portal) A proteina C-reativa não é um marcador seletivo na suspeita de obstrução intestinal. Contudo é marcador confiável da translocação bacteriana, na densidade e com...

The Effects of Erythropoietin on Bacterial Translocation and Inflammatory Response in an Experimental Intestinal Obstruction Model in Rats / Uticaj Eritropoetina Na Bakterijsku Translokaciju I Inflamatorni Odgovor U Eksperimentalnom Modelu Intestinalne Opstrukcije Kod Pacova

“…IO increased oxidative stress in a manner si milar with the one in the study reported by El-Awady et al (3). There were significant inflammatory changes in the liver and ileal mucosal tissues after small bowel obstruction in the IO group when compared with the S group.…”

“…Under normal conditions, the small bowel contains very few bacteria, however the microbiological ecological balance is disrupted after IO (1). Bacterial growth as a result of disrupted ecological balance, immune dysfunction induced by deterioration of the balance of pro-and antiinflammatory cytokines and release of oxidants after mucosal barrier dysfunction accelerate the development of bacterial translocation (3). Increased intestinal permeability leads to the development of systemic inflammatory response, infection, sepsis and multiple organ failure (MOF) (2) by increasing the translocation of bacteria and their pro ducts to the peritoneal space, mesenteric lymph nodes (MLNs), liver, spleen and systemic circulation which are normally sterile (4).…”

Stimulation of the sacral nerve reduces gut bacterial translocation and endotoxemia caused by acute spinal cord injury in rabbits

“…2 These mechanisms may synergistically promote the systemic spread of indigenous translocated bacteria to cause lethal sepsis. 8,9 Bacteria or endotoxin crossing the mucosal barrier can trigger an augmented immune response, so that the gut becomes a proinflammatory organ, releasing chemokines, cytokines and other proinflammatory intermediates. These intermediates may affect the local and systemic immune systems, and even result in systemic inflammatory response syndrome and multiple organ dysfunction syndromes.…”

Procalcitonin, C-Reactive Protein, and Fibrinogen Levels in Cases With Mechanic Bowel Obstruction and Their Changing in Relation With the Duration of Obstruction: An Experimental Study

“…The timing of operation is crucial, and it is difficult to distinguish simple obstruction from strangulation (1,2). Bacterial translocation occurs in preseptic conditions such as intestinal obstruction, and procalsitonin (PCT) may be a marker of this condition (3). C-reactive protein (CRP) is an acute phase reactant and a marker of ischemia and bacterial translocation (3,4).…”

“…Bacterial translocation occurs in preseptic conditions such as intestinal obstruction, and procalsitonin (PCT) may be a marker of this condition (3). C-reactive protein (CRP) is an acute phase reactant and a marker of ischemia and bacterial translocation (3,4). On the other hand, blood fibrinogen level elevates in many ischemic events of the body including intestinal ischemia (5).…”