Enteric bacteria and ingested inert particles translocate to intraperitoneal prosthetic materials
E. M. Mora, M. A. Cardona and R. L. Simmons
Department of Surgery, University of Pittsburgh, PA 15261.
Sterile and endotoxin-free biomaterials commonly used in prosthetic devices
(Dacron velour, woven Dacron, and Biomer polyurethane) and cotton (control
material) were implanted intraperitoneally in mice with normal enteric
flora. Intraperitoneal Biomer and woven Dacron became contaminated with 100
to 10,000 enteric bacteria, including Escherichia coli, Pseudomonas
aeruginosa, enterococci, and staphylococci species, within 3 days;
intraperitoneal cotton and Dacron velour were contaminated within 24 hours.
Mesenteric lymph nodes showed parallel incidences of translocation. The
peritoneal cavity became contaminated only if the biomaterial itself became
contaminated. No bacterial overgrowth, perforation, or histologic changes
in the bowel were found. Subcutaneous biomaterials remained sterile.
Ingested fluorescent beads appeared in enterocytes, in lamina propria
within macrophages, and in intraperitoneal biomaterials. The data suggest
that intraperitoneal sterile reactive stimuli can induce bacterial
translocation to the dense prosthesis directly through the intact normal
bowel wall. One of the mechanisms seems to involve phagocytosis of
particles and bacteria within the bowel wall that are then chemotactically
attracted to nearby sites of inflammation.
