Bacterial translocation: impact of probiotics (original) (raw)
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40. Probiotics partly reverse increased bacterial translocation...
Material and methods. In total 68 rats were divided into seven groups: five of the groups received standard rat chow and were subjected to either sham-operation, 70% liver resection, colonic anastomosis, or a combination of 30 or 70% liver resection with synchronous colonic anastomosis, respectively. In two additional groups with synchronous operation, a combination of four different lactic acid bacteria and four fibers was administered two times daily pre-and postoperatively. Bacterial concentrations in cecum, mesenteric lymph nodes, liver, and spleen were analyzed and blood cultures were taken 48 h after operation. Furthermore, the following parameters were assessed: histological changes in the intestine, intestinal paracellular permeability (Ussing chamber), bursting pressure of the colonic anastomosis, and mitosis rate of the remnant liver.
International Journal of Food Microbiology, 2001
Septic complications represent frequent causes of morbidity in liver diseases and following hepatic operations. Most infections are caused by the individual own intestinal microflora. The intestinal microflora composition is important in physiological and pathophysiological processes in the human gastrointestinal tract, but their influence on liver in different situations is unclear. We therefore studied the effect of different Lactobacillus strains and a Bifidobacterium strain on the extent of liver injury, bacterial translocation and intestinal microflora in an acute liver injury model.
Clinical Nutrition Supplements, 2010
AIM: Bacterial translocation and septic events is strongly associated. Pro-prebiotics and symbiotics use in the prevention of bacterial translocation has been widely studied. The aim of this study was to investigate the effects of intestinal Bifidobacterium breve A28 as a newer probiotic, inulin as a prebiotic and both as a symbiotic on a rat model of obstructive jaundice induced-bacterial translocation. METHODS: To create a bacterial translocation obstructive jaundice model was used. Four groups, each have 12 rats, designed. Postoperatively 10 days the groups were fed with normal rat food plus pro-pre and symbiotic, and control group was fed only normal rat food. After this period, systemic blood, liver, spleen and mesenteric lymph nodes samples were obtained for microbiological culture. The Pearson's chi-Square test was used for the statistical analysis. RESULTS: Probiotic, prebiotic effectively reduced bacterial translocation, seperately and as a symbiotic. No significant difference was observed between probiotic and prebiotic groups, and between symbiotic and probiotic groups regarding the rate of bacterial translocation. And there were a significant difference between control and prebiotic group. CONCLUSİONS: This new mixture of pro and prebiotic on bacterial translocation is promising.
e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, 2009
Background & aims: Prophylaxis of bacterial infections in cirrhosis is based on the administration of non-absorbable antibiotics to decontaminate the gut and to avoid intestinal bacterial translocation, leading to the appearance of resistances. We assessed the usefulness of the probiotic Lactobacillus fermentum CECT 5716 on the incidence of intestinal bacterial translocation in ascitic cirrhotic rats. Methods: 27 rats with CCL4-induced cirrhosis and 16 healthy rats were treated with L. fermentum CECT 5716 (10 9 UFC/day) or placebo as follows: cirrhosis þ probiotic (A, n ¼ 12), cirrhosis (B, n ¼ 15), healthy þ probiotic (C, n ¼ 9) and healthy (D, n ¼ 7). After 10 days, mesenteric lymph nodes were obtained as well as caecal content for microbiological cultures, plasma to assess endotoxin and biochemistry parameters and liver for histology. Results: Mortality (A: 2/12, B: 5/15) and intestinal bacterial translocation incidence (6/10, 60% in A vs 5/ 10, 50% in B; p ¼ n.s.) were similar in both groups of cirrhotic rats, A and B. No differences on translocated species were observed. Plasmatic endotoxin decreased significantly in A when compared to B (A: 0.0098 AE 0.006 EU vs B: 0.0434 AE 0.031 EU; p < 0.05). Conclusion: Oral administration of L. fermentum CECT 5716 has no effect on preventing neither bacterial translocation nor mortality in ascitic cirrhotic rats.
Digestive Diseases and Sciences, 2012
Background Probiotics may exert beneficial effects in the gastrointestinal tract. This randomized trial investigated the effect of the probiotic Lactobacillus plantarum 299v on the intestinal load of potentially pathogenic bacteria, bacterial translocation, and cell proliferation in elective colon surgery. Methods Seventy-five patients were randomized to preand postoperative oral intake of Lactobacillus plantarum 299v or placebo. Rectal swabs and mucosal biopsies were taken before the start of intake, after 1 week, at surgery, and after 6 days, weeks, and months. Viable counts were quantified for clostridia, Enterobacteriaceae, Gramnegative anaerobes, and lactobacilli. Bacterial translocation was determined by the analysis of bacterial DNA genes in mesenteric lymph nodes. Ki-67 was used as a marker of cell proliferation in normal mucosa and tumor. Results Lactobacillus plantarum 299v was given without adverse effects. Lactobacillus plantarum 299v as well as Enterobacteriaceae and Gram-negative anaerobes increased in the colon 1 week after the administration of Lactobacillus plantarum 299v. There were no significant differences between patients receiving Lactobacillus plantarum 299v and placebo in the incidence of bacterial translocation (27 vs. 13 %) and postoperative complications (16 vs. 31 %). Conclusions Lactobacillus plantarum 299v was established in the intestine, but no inhibitory effect on enteric bacteria, bacterial translocation, or postoperative complications was found. The mechanism behind the protective effects of probiotics found in animal and some human studies remain elusive and require further explorations. No adverse effects were recorded after the administration of high doses of Lactobacillus plantarum 299v.
Commensal bacteria do translocate across the intestinal barrier in surgical patients
Clinical Nutrition, 2007
Background: The ''gut origin of sepsis'' hypothesis proposes that enteric bacteria may cause sepsis at distant extra-intestinal sites. Whilst there is much circumstantial evidence to support this hypothesis, there is no conclusive proof in humans. The nature of translocating bacteria remains unclear. The aim of this study was to establish the origin of Escherichia coli (E. coli) cultured from mesenteric lymph nodes (MLN) and determine if they belonged to any recognized pathotypes known to cause infections in humans. Methods: MLN and faecal samples were obtained from 98 patients undergoing colonic resection. E. coli were isolated from 9/98 MLN samples. DNA fingerprints of MLN isolates were compared with faecal isolates from the same patient. MLN isolates were tested for adherence and invasion using HEp-2 epithelial cells, and screened for DNA markers indicative of different pathotypes of E. coli. MLN isolates were also tested for internalisation into Caco-2 cells. Results: All the nine E. coli cultured from MLNs were found to have identical DNA fingerprints to at least one and often several E. coli isolates cultured from faecal samples of the same patient. 8/9 (89%) MLN isolates were weakly adherent and 2/9 (22.2%) were invasive. 8/9 (89%) tested negative for DNA markers. All the nine MLN strains were internalised by Caco-2 cells. Conclusion: This study confirms the gut origin of translocating bacteria. Most translocating E. coli do not belong to any recognised pathotype and are therefore normal commensal ARTICLE IN PRESS (J. MacFie).
The Journal of surgical research, 2004
Material and methods. In total 68 rats were divided into seven groups: five of the groups received standard rat chow and were subjected to either sham-operation, 70% liver resection, colonic anastomosis, or a combination of 30 or 70% liver resection with synchronous colonic anastomosis, respectively. In two additional groups with synchronous operation, a combination of four different lactic acid bacteria and four fibers was administered two times daily pre-and postoperatively. Bacterial concentrations in cecum, mesenteric lymph nodes, liver, and spleen were analyzed and blood cultures were taken 48 h after operation. Furthermore, the following parameters were assessed: histological changes in the intestine, intestinal paracellular permeability (Ussing chamber), bursting pressure of the colonic anastomosis, and mitosis rate of the remnant liver.
Lactobacilli attenuate bacteremia and endotoxemia associated with severe intra-abdominal infection
2003
Background. Systemic administration of antibiotics or selective decontamination is frequently used in the prophylaxis and treatment of infections originating from the gastrointestinal flora. In this study, we wanted to compare the protective effect of enteral administration of lactobacilli to gentamicin against severe intra-abdominal infection. Methods. Male Sprague-Dawley rats underwent cecal ligation and puncture (CLP). Rats were pretreated with saline, Lactobacillus R2LC, and gentamicin. Bacterial growth and endotoxin levels in the blood, reticuloendothelial system (RES)-function, and intestinal transit were determined up to 24 hours after CLP. Results. CLP-provoked bacteremia was significantly reduced by 48% and 55% in lactobacilli-and gentamicin-treated rats, respectively. Notably, CLP-induced endotoxemia was abolished at 12 hours, and reduced by 47% at 24 hours, in rats pretreated with lactobacilli. Gentamicin reduced endotoxin levels provoked by CLP by 86% at 12 hours, but had no effect at 24 hours. Lactobacilli had no effect on the clearance of Escherichia coli (E coli) from the blood, whereas intestinal transit was increased in lactobacilli-treated animals, suggesting that the beneficial effect of Lactobacillus R2LC is not related to an increase of phagocytic capacity but may rather be partly attributable to an enhanced intestinal motility. Conclusion. Enteral administration of Lactobacillus R2LC attenuates bacteremia and endotoxemia associated with intra-abdominal infection in rats. (Surgery 2003;134:467-73.
Surgery, 2008
Postoperative infectious complications, such as sepsis, are usually caused by the patient's own intestinal microbiota. 1 Despite widespread use of perioperative antibiotic prophylaxis, these infections remain a serious problem, causing substantial morbidity associated with high costs. Antibiotic resistance is now a major issue, threatening safety in many surgical wards throughout the world. Therefore, a new array of safe and effective strategies to prevent infection in surgical patients is warranted. With increasing evidence for the role of the patient's own intestinal microbiota in surgical infection, it seems logical that attention has shifted to prophylactic strategies that act where it matters most: the gut. Prophylactic treatment with probiotics might form such a strategy. Probiotics are non-pathogenic bacteria that, on delivery to the host's intestinal tract, can exert health-promoting effects. In the last decade, numerous papers in various fields of medicine have been published on the use of probiotics. It is apparent that this topic is no longer propagated only by a small number of 'believers.' Extensive research on probiotics ranging from basic science to large, well-designed, randomized, controlled trials (RCTs) is being performed currently worldwide. This review provides a brief overview of the proposed mechanism of action of probiotics and current evidence from RCTs, with focus on prevention of infection in surgical patients. MECHANISM OF ACTION Host-bacterial interactions. It is only in recent years that we have begun to understand the complex and active interaction between the intestinal microbiota and the biology of the host in whom they reside. 2,3 While the microbial ecosystem in the intestine flourishes on the available nutrients, the host benefits from several key functions fulfilled by more than 1000 different species of bacteria that comprise the intestinal flora. These interactions include a wide range of physiologic processes, such as regulation of motility and mucus secretion, prevention of colonization or overgrowth by pathogenic organisms, and regulation of local and systemic immunity. The continuous interaction between bacteria and their host takes place primarily at 3 levels: 1) the intestinal lumen, 2) the intestinal epithelium, and 3) the immune system. 2,3 The suggested levels of host-bacterial interaction are depicted in fig 1. Bacterial translocation. The pathophysiologic mechanism held responsible for infectious complications in surgical and critically ill patients is bacterial translocation: the phenomenon that bacteria cross the gastrointestinal mucosal barrier and invade the systemic compartment. 1 We have reviewed comprehensively the role of bacterial translocation and its potential regulation by probiotics previously. 4 In short, bacterial translocation is believed to depend on a disturbance at the three levels of hostbacterial interactions. These disturbances observed in experimental and clinical studies in critically ill patients and after major abdominal surgery include: 1) the intestinal lumen: impaired motility and bacterial overgrowth, 2) the intestinal epithelium; failure of the structural mucosal barrier leading to increased gut permeability, and: 3) the immune system; a dys