The primary site of bacterial translocation
R. Fukushima, L. Gianotti and J. W. Alexander
Department of Surgery, University of Cincinnati Medical Center, Ohio.
OBJECTIVE: To establish the primary anatomic site of bacterial
translocation in the intestinal tract. DESIGN: Prospective randomized
experimental trials. SETTING: Laboratory. MATERIALS: Hartley guinea pigs.
INTERVENTIONS: In guinea pigs, 10-cm closed loops of upper jejunum, distal
ileum, or proximal colon were created. The animals then received
intraluminal injections of Escherichia coli labeled with radioactive carbon
(14C) before a 50% full-thickness burn was inflicted. Four hours after the
burn injury, the animals were killed, and the intestinal loops, mesenteric
lymph nodes, spleen, liver, and lung were harvested. Intestinal loops were
irrigated and then treated with ethylenedinitroilotetraacetic acid to
separate the enterocytes and colonocytes from the lamina propria.
Radionuclide counts were determined in the effluents, the enterocytes (or
colonocytes), lamina propria, and other organs. Colony-forming units of E
coli were also determined in mesenteric lymph nodes, spleen, liver, and
lung. MEASUREMENTS AND MAIN RESULTS: No significant differences were noted
in the radionuclide counts in the lamina propria and epithelial cell
fraction related to the type of loop. In addition, no significant
differences were noted in the radionuclide counts in the mesenteric lymph
nodes, liver, spleen, and lung related to the type of loop, but more viable
bacteria were recovered when bacteria were injected into the jejunal loop.
CONCLUSIONS: Translocation of bacteria occurred with similar intensity
throughout the gut, but more bacteria were killed in the process of
translocation across the lower part of the intestinal tract.
