Preliminary Study of Bacterial Culture in Mesenteric Lymph Nodes of Patients with Small Bowel Obstruction_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Shikuan , SHANG Wenzhou , LI Yuanbo , PENG Xingang , LU Lianfang , ZHANG Qiuying

Department of Emergency General Surgery， Affiliated Hospital of Qingdao University Medical College， Qingdao 266003， Shandong Province， China;

Corresponding author：

Keywords：

Small bowel obstruction; Mesenteric lymph node; Bacterial culture

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Objective 　To explore the bacterial translocation of mesenteric lymph nodes （MLNs） of the ileum and the spectrum of bacteria in patients with small bowel obstruction.
Methods 　Total 84 patients were divided into study group （with small bowel obstruction） and control group （without small bowel obstruction）. MLNs were obtained under sterile conditions intraoperatively， and which were processed for culture of aerobic and anaerobic organisms. The rate of bacterial translocation and postoperative infection were compared between two groups and the species of bacterial translocation was identified.
Results 　The bacterial translocation rate in the study group was higher than that in the control group 〔57.1% （24/42） versus 16.7% （7/42），χ2=14.775， P＜0.01〕. Escherichia coil was the most commonly bacteria （20）. Emergency surgery and age over 70 years were associated with bacterial translocation （P＜0.05）. Postoperative infection complications rate in the bacterial translocation patients was higher than that in the patients without bacterial translocation 〔29.0% （9/31） versus 3.8% （2/53），χ2=10.965，P＜0.05〕.
Conclusions 　Bacterial translocation to MLNs occurres more frequently in patients with small bowel obstruction，non-elective surgery， and elderly.

Citation： LI Shikuan,SHANG Wenzhou,LI Yuanbo,PENG Xingang,LU Lianfang,ZHANG Qiuying,.. Preliminary Study of Bacterial Culture in Mesenteric Lymph Nodes of Patients with Small Bowel Obstruction. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(8): 842-845. doi: Copy

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12.	Sedman PC， MacFie J， Palmer MD， et al. Preoperative total parenteral nutrition is not associated with mucosal atrophy or bacterial translocation in humans[J]. Br J Surg， 1995， 82(12)：1663-1667.
13.	Berg RD， Wommack E， Deitch EA. Immunosuppression and intestinal bacterial overgrowth synergistically promote bacterial translocation[J]. Arch Surg， 1988， 123(11)：1359-1364.
14.	Tancrède CH， Andremont AO. Bacterial translocation and gram-negative bacteremia in patients with hematological malignancies[J]. J Infect Dis， 1985， 152(1)：99-103.
15.	Reidy JJ， Ramsay G. Clinical trials of selective decontamination of the digestive tract：review[J]. Crit Care Med， 1990， 18(12)：1449-1456.
16.	杨春明. 重视外科感染的防治[J]. 中国普外基础与临床杂志， 2010， 17(11)：1113-1115.

1. 肖菲，康焰. 肠道细菌移位的研究现状[J]. 中国普外基础与临床杂志， 2006， 13(2)：240-243.
2. MacFie J， O’Boyle C， Mitchell C， et al. Gut origin of sepsis：a prospective study investigating associations between bacterial translocation， gastric microflora， and septic morbidity[J]. Gut， 1999， 45(2)：223-228.
3. Wilmore DW， Smith RJ， O’Dwyer ST， et al. The gut：a central organ after surgical stress[J]. Surgery， 1988， 104(5)：917-923.
4. Redan JA， Rush BF Jr， Lysz TW， et al. Organ distribution of gut-derived bacteria caused by bowel manipulation or ischemia[J]. Am J Surg， 1990， 159(1)：85-90.
5. Deitch EA， Winterton J， Berg R. Effect of starvation， malnutrition， and trauma on the gastrointestinal tract flora and bacterial translocation[J]. Arch Surg， 1987， 122(9)：1019-1024.
6. Deitch EA， Bridges WM， Ma JW， et al. Obstructed intestine as a reservoir for systemic infection[J]. Am J Surg， 1990， 159(4)：394-401.
7. Deitch EA. Simple intestinal obstruction causes bacterial translocation in man[J]. Arch Surg， 1989， 124(6)：699-701.
8. Boros M， Takaichi S， Hatanaka K. Ischemia time dependency of reperfusion injury following complete arterial occlusion of the rat small intestine[J]. Transplant Proc， 1995， 27(5)：2789-2790.
9. Steffen EK， Berg RD， Deitch EA. Comparison of translocation rates of various indigenous bacteria from the gastrointestinal tract to the mesenteric lymph node[J]. J Infect Dis， 1988， 157(5)：1032-1038.
10. Hentges DJ. Role of the intestinal microflora in the defence against infection[A]//Hent-Ges DJ ed. Human intestinal microflora in health and disease[M]. New York：Academic Press， 1983：311-331.
11. Guedon C， Schmitz J， Lerebours E， et al. Decreased brush border hydrolase activities without gross morphologic changes in human intestinal mucosa after prolonged total parenteral nutrition of adults[J]. Gastroenterology， 1986， 90(2)：373-378.
12. Sedman PC， MacFie J， Palmer MD， et al. Preoperative total parenteral nutrition is not associated with mucosal atrophy or bacterial translocation in humans[J]. Br J Surg， 1995， 82(12)：1663-1667.
13. Berg RD， Wommack E， Deitch EA. Immunosuppression and intestinal bacterial overgrowth synergistically promote bacterial translocation[J]. Arch Surg， 1988， 123(11)：1359-1364.
14. Tancrède CH， Andremont AO. Bacterial translocation and gram-negative bacteremia in patients with hematological malignancies[J]. J Infect Dis， 1985， 152(1)：99-103.
15. Reidy JJ， Ramsay G. Clinical trials of selective decontamination of the digestive tract：review[J]. Crit Care Med， 1990， 18(12)：1449-1456.
16. 杨春明. 重视外科感染的防治[J]. 中国普外基础与临床杂志， 2010， 17(11)：1113-1115.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Preliminary Study of Bacterial Culture in Mesenteric Lymph Nodes of Patients with Small Bowel Obstruction

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