Surgical manipulation of the large intestine increases bacterial translocation in patients undergoing elective colorectal surgery

Abstract

Surgical manipulation of the bowel does increase the prevalence of BT and therefore is associated with changes in gut barrier function in elective surgical patients.

Morphological abnormalities and apoptosis in lamellar tissue of equines after intestinal obstruction and treatment with hydrocortisone

“…So, it can must state that hydrocortisone aggravated the morphological abnormalities in the animals subjected to surgical procedures (Tg), because there was no difference with the untreated group. This corroborates the findings of Rio Tinto et al (2004).…”

“…The tissue lesions that were found among these equines were more severe than those reported by Rio Tinto et al (2004), who analyzed horse lamellar tissue after intestinal lesion. This may have occurred because those authors used intestinal reperfusion of 12 hours, i.e.…”

“…Enterotomy, with manipulation of the intestinal loops, causes the release of prostacyclins (Gottlieb et al, 1989) and predisposition towards translocation of intestinal bacteria (Reddy et al, 2006). This would be related to the development of the systemic inflammatory response, and would explain the lamellar abnormalities found among the animals that underwent enterotomy.…”

Detectable serum flagellin and lipopolysaccharide and upregulated anti-flagellin and lipopolysaccharide immunoglobulins in human short bowel syndrome

“…In mice, nonintestinal surgical stress alone (30% partial hepatectomy) shifted the cecal E. coli population to a more adherent phenotype that disrupted gut barrier function and was reversed by antibiotics (27). Also, surgical manipulation of the colon was recently associated with a very high incidence (80%) of positive bacterial cultures in mesenteric lymph nodes of adult patients undergoing colorectal surgery compared with surgical controls (11%) (26). In our study, the average time since the last intestinal operation averaged 36 Ϯ 9 mo (Table 1), and anti-flagellin IgM (a more acute-phase immunoglobulin) was increased compared with control subjects.…”

Current Definitions of Central Line–Associated Bloodstream Infection Is the Emperor Wearing Clothes?

“…Gut-associated BSIs can also arise from gastrointestinal procedures that have or do not have associated localized suppuration. Specifically, bacterial translocation is known to occur after abdominal surgery [5][6][7][8] (at higher rates if there is colon manipulation) 9 in patients with underlying bowel disease 10 and in critically ill patients, even if there is no bowel manipulation or preexisting bowel disease. 11,12 Hospital epidemiologists and infection preventionists now face an unnecessary dilemma when adjudicating whether a patient with bacteremia has a CLABSI or a secondary BSI.…”