This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Lethal Combination

Frederick A. Moore, MD; Ernest E. Moore, MD; Renato S. Poggetti, MD; Robert A. Read, MD

Arch Surg. 1992;127(8):893-898.

Abstract
• Gut bacteria translocation has been invoked as a prime cause of early postinjury death. To examine this hypothesis, we obtained emergency department blood cultures in 132 acutely injured patients requiring urgent laparotomy for trauma. In the latter half of these patients, mesenteric lymph node and liver biopsy cultures were also performed. The incidence of early bacteremia was 11% (10/94) in the patients without shock compared with 32% (12/38) in the group with shock. The majority (73%) were gram-positive bacteremias. Most notably, Staphylococcus was isolated in 13% (5/38) of the patients with shock, but these isolates were of no apparent clinical significance. In contrast, 18% (7/38) of the patients with shock had enteric bacteremias, and all of these patients died. Cultures were positive in 11% of the liver samples and 15% of the mesenteric lymph nodes. With the exception of two patients with concurrent enteric bacteremias, these hepatic and mesenteric lymph node bacteria were of no clinical significance. In conclusion, bacterial translocation occurs infrequently, and virtually all enteric bacteria were found in dying patients; the cause or effect remains to be defined.

(Arch Surg. 1992;127:893-898)

Author Affiliations
From the Department of Surgery (Drs F. Moore, E. Moore, Poggetti, and Read), Denver (Colo) General Hospital; and Department of Surgery, University of Colorado Health Science Center, Denver (Drs F. Moore, E. Moore, and Read).

Footnotes
Accepted for publication March 7, 1992.

Presented at the 99th Scientific Session of the Western Surgical Association, Colorado Springs, Colo, November 18, 1991.

Reprint requests to Surgical Critical Care, Denver General Hospital, 777 Bannock St, Denver, CO 80204-4507 (Dr F. Moore).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Total parenteral nutrition: potion or poison?
Jeejeebhoy
Am. J. Clin. Nutr. 2001;74:160-163.
ABSTRACT | FULL TEXT  

Translocation of Bacteria and Endotoxin in Organ Donors
van Goor et al.
Arch Surg 1994;129:1063-1066.
ABSTRACT