Bacterial translocation in abdominal trauma and postoperative infections

Autor: Ernesto Nieves, Dora I. Ríos, Diego Garzón-Ospina, Luisa F. Tobón, Manuel A. Patarroyo, Miguel A. Ramirez, Andrés Isaza, Arley Gómez, Johnny A. Beltrán
Rok vydání: 2011
Předmět:
Male
medicine.medical_treatment
Wound infection
Surgical wound infection
Abdominal Injuries
Skin infection
Molecular typing
Critical Care and Intensive Care Medicine
Gastroenterology
Intestinal mucosa
Postoperative infection
Risk Factors
Laparotomy
Mesenteric lymph nodes
Prospective Studies
Middle aged
Lymph nodes
Priority journal
Aged
80 and over

Gastrointestinal tract
Abdominal infection
Middle Aged
medicine.anatomical_structure
Phenotype
Female
Bacterium isolation
Abdominal injury
Human
Abdominal injuries
Adult
medicine.medical_specialty
Respiratory tract infection
Adolescent
Clinical article
Multilocus sequence typing
Trauma
Article
Sepsis
Internal medicine
medicine
Humans
Surgical Wound Infection
Mesentery lymph node
Aged
Chi-Square Distribution
business.industry
Abdominal Infection
medicine.disease
Bacterium culture
Nonhuman
Chi-square distribution
High risk patient
Postoperative infections
Abdominal trauma
Risk factors
Bacterial translocation
Bacterial Translocation
Surgery
business
Prospective studies
Zdroj: Repositorio EdocUR-U. Rosario
Universidad del Rosario
instacron:Universidad del Rosario
ISSN: 1529-8809
Popis: Background: Bacterial translocation (BT) describes the passage of bacteria residing into the gastrointestinal tract, through the intestinal mucosa barrier to sterile tissues such as mesenteric lymph nodes (MLN) and other organs. This phenomenon has not been thoroughly studied in patients with trauma to date, and an association between BT and postoperative infection has not been well established so far. Methods: MLNs from 36 patients with abdominal trauma were removed during laparotomy and cultured to detect BT. Postoperative infectious complications in these patients were registered, and both phenotypical and molecular typings (through multilocus sequencing) were carried out for microorganisms isolated from MLN and postoperative infection sites. Associations between clinical variables, BT presence, and postoperative infection development were established. Results: BT was detected in 33% of the patients (n = 12). Postoperative infections were present in 22.2% of the patients (n = 8). A significant statistical difference was found between postoperative infections in patients with BT evidence (41.6%), when compared with patients without BT (12.5%; p = 0.047). Bacteria isolated from infection sites were the same as those cultured in MLN in 40% of the cases (n = 2 of 5), allowing us to establish causality between BT and postoperative infection. Conclusions: There is higher risk of BT in trauma patients, and it is associated with a significant increase of postoperative infections. An abdominal trauma index ?10 was found to be associated with the development of BT. This is the first study describing BT among patients with abdominal trauma, where causality is confirmed at molecular level. Copyright © 2011 by Lippincott Williams and Wilkins.
Databáze: OpenAIRE