Bacterial translocation in patients with Crohn's disease undergoing surgery.
OBJECTIVE
Much evidence, derived from experimental studies, suggests that bacterial translocation indeed occurs, yet its clinical significance is still a matter of controversy in humans. The aims of this study were to determine the prevalence of bacterial translocation in patients with Crohn's disease undergoing laparotomy and to identify any association with postoperative septic complications or systemic inflammatory response syndrome.


METHODS
Mesenteric lymph node and peripheral blood samples from 42 patients with Crohn's disease undergoing laparotomy were collected for bacteriologic assessments.


RESULTS
Bacterial translocation to mesenteric lymph node was identified in 20 patients (48 percent). The most common organism was (27 percent). Blood cultures were positive in 2 of 20 patients in whom translocation to lymph node was identified. Bacterial translocation was associated with a greater than two-fold increase in the incidence of postoperative septic complications (35 14 percent), but this difference was not significant. In the analysis of the occurrence of systemic inflammatory response syndrome, a significantly higher incidence continued until the third postoperative day in patients with those without bacterial translocation. In a logistic regression analysis, bacterial translocation had a significant effect on the occurrence of systemic inflammatory response syndrome, even though septic complications were taken into account.


CONCLUSIONS
Bacterial translocation to mesenteric lymph node predisposed patients with Crohn's disease undergoing laparotomy to systemic inflammatory response syndrome.
Takesue
Yoshio
Y
First Department of Surgery, Faculty of Medicine, Hiroshima University, Japan.
Ohge
Hiroki
H
Uemura
Kennichro
K
Imamura
Yuuji
Y
Murakami
Yoshiaki
Y
Yokoyama
Takashi
T
Kakehashi
Masayuki
M
Sueda
Taijiro
T
D000293:Adolescent; D000328:Adult; D018988:Bacterial Translocation; D003424:Crohn Disease / Q000382:microbiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007813:Laparotomy; D008198:Lymph Nodes; D008297:Male; D008643:Mesentery; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology* / Q000382:microbiology; D013530:Surgical Wound Infection; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology* / Q000382:microbiology