Influence of bowel preparation and antimicrobials on colonic microflora

Arabi, Y.; Dimock, F; Burdon, D. W.; Alexander-Williams, J; Keighley, M. R. B.

doi:10.1002/bjs.1800650809

Cited by 82 publications

(37 citation statements)

References 17 publications

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“…Osmotic cathartics, such as mannitol have also been advocated either alone or in combination with WGI. However, although impeccable mechanical cleansing of the gut may be achieved, these procedures have little or no effect on the numbers of bacteria in the residual contents of the lumen or associated with the colonic wall (Arabi et al 1978). This is corroborated by the observation that mechanical cleansing alone scarcely reduces the postoperative sepsis rate (Clarke et al 1977).…”

Section: Introductionmentioning

confidence: 99%

Recolonization and colonization resistance of the large bowel after three methods of preoperative preparation of the gastrointestinal tract for elective colorectal surgery

Bogaard¹,

Weidema

Boven³

et al. 1986

J. Hyg.

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SUMMARYThe impact of three current types of preoperative large bowel preparation on the microbial flora and the colonization resistance (CR) was investigated in 15 volunteers. In the first group a whole gut irrigation was performed without administration of antibiotics (group WGI). In the second group 0 5 g/l metronidazole and 1 g/l neomycin was added to the irrigation fluid (group WGI + AB). A whole gut irrigation with prior oral administration of 11 mannitol 10 % was performed in the third group. The antibiotic prophylaxis in this group consisted of two doses of 80 mg gentamicin i.v. and 500 mg metronidazole orally 24 h after lavage (group Mann + AB). One hour after the mechanical cleansing procedure was finished all volunteers were orally contaminated with one dose of an Escherichia coli test strain. The aerobic faecal reduction due to the cleansing procedure was 2-3 logs, while for the anaerobes it was 4-5 logs. The anaerobic flora in group WGI recovered within 24 h, while the aerobes showed a transient 'overgrowth' for the period of 2 days. The overgrowth of aerobes in group WGI + AB was observed for more than a week and the total numbers of aerobes started gradually to decline after the anaerobic flora had reached pretreatment levels at day three or four. Despite the normal numbers of anaerobes present 24 h after treatment, overgrowth of E. coli was seen in the group Mann + AB, probably due to residual mannitol left in the intestinal tract. The test strain of E. coli was excreted for a period of 1 week by the volunteers in the groups WGI and Mann + AB, but it was isolated for more than 10 weeks in the group WGI+AB. It is thought that all three methods of preoperative large bowel preparation decreased the CR of the gastrointestinal tract because of a disturbance of the interaction between aerobic and anaerobic microorganisms and alterations of the colonic wall. The anaerobic microflora, however, appeared to be primarily responsible for the maintenance of the CR. Antimicrobial prophylaxis should consist of a high dose, short term, systemic antibiotic regimen, not only because an adequate serum level of an appropriate drug at the time of operation substantially decreases the incidence of postoperative septic complications but also because a systemic regimen scarcely influences the A. E. J. M. VAN DEN BOGAARD AND OTHERSCR of the gastrointestinal tract. ,-Aspartylglycine appeared to be a specific but not very sensitive marker for decreased CR.

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Section: Introductionmentioning

confidence: 99%

Recolonization and colonization resistance of the large bowel after three methods of preoperative preparation of the gastrointestinal tract for elective colorectal surgery

Bogaard¹,

Weidema

Boven³

et al. 1986

J. Hyg.

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“…Other studies also demonstrated [27][28][29] that repopulation of the microbiota is approximately five hours after bowel preparation.…”

Section: Microbiota Approachmentioning

confidence: 89%

A novel sampling method for the investigation of gut microbiota

Quintanilha

Zilberstein²,

Santos³

et al. 2007

WJG

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INTRODUCTIONIndigenous microbiota is highly competitive with other microorganisms in multiplication [1] . Experimental studies have shown the importance of this microbiota (anaerobes only) to avoid colonization of transitory microbiota [2] , which is more effective than the protection provided by immunological mechanisms [3] . However, these studies were limited to the analysis of only the anaerobic flora, some segments of the colon utilizing feces samples or luminal content. Additionally, it is difficult to identify and quantify anaerobic and/or yeast microorganisms involved in infectious processes.The social and practical benefit of investigating indigenous microbiota is to enable investigators to improve prophylactic/therapeutic methods when antimicrobials are used to determine biological markers and to establish a normal pattern utilized for the analysis of microbiological behavior in different diseases of the lower digestive tract.The aim of this study was to analyze prospectively the indigenous microbiota (qualitative and quantitatively) at different sites of the lower digestive tract in healthy volunteers with a standardized method of collecting intestinal mucous after bowel preparation for colonoscopy for routine utilization in screening patients. MATERIALS AND METHODS T h i s p r o s p e c t ive s t u d y wa s p e r f o r m e d w i t h t h e participation of the Microbiological Laboratory of the

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“…These antibiotics cause a profound reduction in aerobic and anaerobic colonic microflora [30] and reduce the risk of combustible gas in the large bowel [31], …”

Section: Discussionmentioning

confidence: 99%

Potentially Explosive Colonic Gas Is Not Eliminated by Successful Mechanical Bowel Preparation

Takada¹,

Hioki²,

Ambrose³

et al. 1993

Dig Surg

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The influence of Picolax bowel preparation on the risk of explosive colonic gas was studied in 35 patients. The mean concentration of explosive hydrogen was 1% (0-8%) and methane was 3% (0-17.3%). Three samples contained > 4% potentially combustible hydrogen concentrations whilst 13 samples showed potentially combustible methane levels ( > 5%). Fifteen of 35 patients (43%) had potentially or actually explosive gas mixtures: 12 of 19 (63%) patients with an unsatisfactory bowel preparation compared with 3 of 16 (19%) with a satisfactory preparation (p < 0.01). The risk of explosive colonic gas is determined largely by the quality of bowel preparation. Picolax alone does not eliminate the risk of explosion during colonoscopic polypectomy or surgical diathermy at laparotomy or laparoscopy if the bowel is opened.

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Influence of bowel preparation and antimicrobials on colonic microflora

Cited by 82 publications

References 17 publications

Recolonization and colonization resistance of the large bowel after three methods of preoperative preparation of the gastrointestinal tract for elective colorectal surgery

Recolonization and colonization resistance of the large bowel after three methods of preoperative preparation of the gastrointestinal tract for elective colorectal surgery

A novel sampling method for the investigation of gut microbiota

Potentially Explosive Colonic Gas Is Not Eliminated by Successful Mechanical Bowel Preparation

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