Risk factors of development of gut-derived bacterial translocation in thermally injured rats.
OBJECTIVE
Studies have demonstrated that gut-derived bacterial translocation (BT) might play a role in the occurrence of sepsis and multiple organ dysfunction syndrome (MODS). Yet, no convincing overall analysis of risk factors for BT has been reported. The purpose of this study was to evaluate the related factors for the development of BT in burned rats.


METHODS
Wistar rats were subjected to 30% third-degree burns. Then samples were taken on postburn d 1, 3, and 5. Incidence of BT and counts of mucosal bifidobacteria, fungi and E. coli, mucus sIgA, degree of injury to ileal mucosa, and plasma interleukin-6 were observed. Univariate analysis and multivariate logistic regression analysis were performed.


RESULTS
The overall BT rate was 53.9% (69 in 128). The result of univariate analysis showed that the levels of plasma endotoxin and interleukin-6, the counts of mucosal fungi and E. coli, and the scores of ileum lesion were markedly increased in animals with BT compared with those without (P=0.000-0.005), while the levels of mucus sIgA and the counts of mucosal bifidobacteria were significantly reduced in animals with translocation compared with those without (P=0.000). There was a significant positive correlation between mucus sIgA and the counts of mucosal bifidobacteria (r=0.74, P=0.001). Moreover, there were strong negative correlations between scores of ileum-lesion and counts of bifidobacteria (r=-0.67, P=0.001). Multivariate logistic regression revealed that ileum lesion score (odds ratio [OR] 45.52, 95% confidence interval [CI] 5.25-394.80), and counts of mucosal bifidobacteria (OR 0.039, 95% CI 0.0032-0.48) were independent predictors of BT secondary to severe burns.


CONCLUSIONS
Ileal lesion score and counts of mucosal bifidobacteria can be chosen as independent prognosis factors of the development of BT. Specific interventions targeting these high-risk factors might be implemented to attenuate BT, including strategies for repair of damaged intestinal mucosae and restoration of the balance of gastrointestinal flora.
Wang
Zhong-Tang
ZT
Department of Microbiology and Immunology, Burns Institute, 304th Hospital of PLA, Beijing 100037, China.
Yao
Yong-Ming
YM
Xiao
Guang-Xia
GX
Sheng
Zhi-Yong
ZY
D000818:Animals; D018988:Bacterial Translocation; D039941:Bifidobacteriales Infections / Q000453:epidemiology / Q000276:immunology; D002056:Burns / Q000453:epidemiology*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000276:immunology; D005260:Female; D007070:Immunoglobulin A / Q000276:immunology; D015994:Incidence; D007422:Intestines / Q000276:immunology / Q000382:microbiology; D008297:Male; D015999:Multivariate Analysis; D051381:Rats; D017208:Rats, Wistar; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology
D007070:Immunoglobulin A