Bacterial translocation is favored by the preservation of the ileocecal valve in experimental short bowel with total parenteral nutrition.
Sepsis in short-bowel syndrome (SBS) is in part due to bacterial translocation (BT). Parenteral nutrition (PN) is often necessary in SBS and promotes BT. The aim of this study was to asses the effect of the presence or absence of ileocecal valve (ICV) on BT in parenterally-fed rats with massive intestinal resection. Sixty-five adult Wistar rats underwent central venous cannulations and were randomly assigned to one of five groups receiving for ten days five treatment regimes: Sham (n = 17) standard rat chow + i.v. saline. PN (n = 17) fasting + PN. Res-Sham (n = 10) standard rat chow + i.v. saline + 80% gut resection. Res-PN (n = 11) fasting, PN + 80% gut resection. Res-ICV-PN (n = 10) fasting, PN + 80% gut resection including ICV. At the end of the experiment they were euthanized and mesenteric lymph nodes (MLN), spleen and peripheral and portal blood specimens were recovered and cultured. BT was found in 47% of PN animals, 91% of Res-PN rats, 100% of Res-Sham group and 60% of Res-ICV-PN animals, but not in Sham ones. 97% of BT+ animals had positive cultures in MLN and/or portal blood, whereas germs beyond liver were detected in 30% of Res-Sham, 37% of PN, 50% of Res-PN and 0% of Res-ICV-PN rats. The present study confirms that both massive intestinal resection and PN promote BT. In addition, it shows that animals deprived of ICV have lower incidence of BT in this setting than those with it and that the germs do not reach in them peripheral blood in the same proportions as in ICV-intact animals. These results suggest that the presence of an intact ICV favor BT in parenterally-fed rats with massive intestinal resection.
Eizaguirre
I
I
Department of Pediatric Surgery, Hospital Aranzazu, San Sebastian, Spain.
Aldazabal
P
P
Barrena
M J
MJ
Garcia-Arenzana
J M
JM
Alcorta
M
M
Ariz
C
C
Candelas
S
S
Tovar
J A
JA
D000818:Animals; D018988:Bacterial Translocation; D005069:Evaluation Studies as Topic; D007080:Ileocecal Valve; D008297:Male; D010289:Parenteral Nutrition, Total; D051381:Rats; D017208:Rats, Wistar; D018805:Sepsis / Q000209:etiology; D012778:Short Bowel Syndrome / Q000150:complications / Q000382:microbiology* / Q000503:physiopathology*