Reducing susceptibility to bacteremia after experimental burn injury: a role for selective decontamination of the digestive tract

Horton, Jureta W.; Maass, David L.; White, D. Jean; Minei, Joseph P.

doi:10.1152/japplphysiol.01365.2005

Cited by 10 publications

(3 citation statements)

References 37 publications

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“…The use of selective decontamination of the digestive tract (SDD) is of particular interest for application in patients with major burn injury where the need for intubation and mechanical ventilation likely contributes to oropharyngeal and intestinal colonization with pathogenic microorganisms. Recently, SDD treatment of experimental burn in adult rats resulted in attenuated septic challenge-related inflammatory responses and improved myocardial contractile response [5]. However, our data demonstrate that oral antibiotics treatment after burn is not without a cost: decreasing bacterial killing activity of inflammatory cells.…”

Section: Discussionmentioning

confidence: 71%

“…Major burn in humans and experimental animals is associated with a decrease in immune functions dependent upon T cells, the principal cells involved in initiating adaptive immune responses [3]. It is well accepted that clinical or experimental burn injury disrupts gut barrier function, allows dissemination of bacteria from the intestinal tract and facilitates the bacterial translocation (BT) to MLN, liver, and spleen [4,5]. The magnitude of BT is proportional to the severity of the burn injury [6].…”

Section: Introductionmentioning

confidence: 99%

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Commensal microflora induce host defense and decrease bacterial translocation in burn mice through toll-like receptor 4

et al. 2010

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BackgroundMajor burn is associated with decreased gut barrier function and increased bacterial translocation (BT). This study is to investigate whether commensal microflora induce host defense and decrease BT in burn mice.MethodsFirst, we treated Wild type (WT) mice with antibiotics in drinking water for 4 weeks to deplete gut commensal microflora. At week 3, drinking water was supplemented with lipopolysaccharide (LPS); a ligand for TLR4, to trigger TLRs in gut. The intestinal permeability, glutathione level, NF-κB DNA-binding activity, TLR4 expression of intestinal mucosa, BT to mesenteric lymph nodes (MLNs), and bacterial killing activity of peritoneal cells were measured after thermal injury. Second, lung of animals were harvested for MPO activity and TNFα mRNA expression assay. Third, WT animals were treated with oral antibiotics with or without LPS supplement after burn. At 48 hr after burn, TLR4 expression of intestinal mucosa and bacterial killing activity of cells were examined. Finally, bacterial killing activity and BT to MLNs after thermal injury in C3H/HeJ (TLR4 mutant) mice were measured.ResultsBurn induced BT to MLNs in WT mice. Commensal depletion decreased TLR4 expression as well as NF-κB activation of intestine, myeloperoxidase (MPO) activity as well as TNFα expression of lung, and bacterial killing activity of peritoneal cells. Oral LPS supplement markedly reduced 81% of burn-induced BT and increased TLR4 expression, MPO activity of lung, as well as bacterial killing activity of peritoneal cells. LPS supplement did not change BT or bacterial killing activity in C3H/HeJ mice.ConclusionsCollectively, commensal microflora induce TLR4 expression of intestine and bacterial killing activity of inflammatory cells in burn. TLR4 ligand increases bacterial killing activity and decreases burn-induced BT. Taken together with the abolition of LPS effect in TLR4 mutant mice, we conclude that commensal microflora induce host defense and decrease bacterial translocation in burn mice through toll-like receptor 4.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Commensal microflora induce host defense and decrease bacterial translocation in burn mice through toll-like receptor 4

et al. 2010

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“…Decontamination does not appear to conclusively decrease the rate of VAP, antimicrobial resistance, or mortality [56][57][58][59][60]. However, it may have benefits in attenuating the cardio-suppressive effects of burn injury [61]. Certain concerns that are raised with gut decontamination are the cost and potential spread of pathogens from the frequent bowel movements that are induced.…”

Section: Selective Gut Decontaminationmentioning

confidence: 99%

An Ounce of Prevention Saves Tons of Lives: Infection in Burns

Merchant

Smith

Jeschke

2015

Surgical Infections

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The treatment of infection and sepsis against highly adaptable bacteria is often insurmountable by ill patients. In this process, bioburden needs to be corralled to have any success. Thus, preventing organisms from entering the unit and transferring onto other patients, and eliminating the bacteria dwelling in the unit are all necessary actions in this battle. Ultimately, maintaining a culture that is constantly wary of this risk only can achieve this goal.

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Infections and Antibiotic Therapy in Surgical Newborn Infants

Saene

Taylor

Cai

et al. 2018

Rickham's Neonatal Surgery

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Reducing susceptibility to bacteremia after experimental burn injury: a role for selective decontamination of the digestive tract

Abstract: Horton JW, Maass DL, White J, Minei JP. Reducing susceptibility to bacteremia after experimental burn injury: a role for selective decontamination of the digestive tract.

Cited by 10 publications

References 37 publications

Commensal microflora induce host defense and decrease bacterial translocation in burn mice through toll-like receptor 4

Commensal microflora induce host defense and decrease bacterial translocation in burn mice through toll-like receptor 4

An Ounce of Prevention Saves Tons of Lives: Infection in Burns

Infections and Antibiotic Therapy in Surgical Newborn Infants

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