Acute pancreatitis in mice impairs bacterial clearance from the lungs, whereas concurrent pneumonia prolongs the course of pancreatitis.
OBJECTIVE
Nosocomial pneumonia is a feared complication in the critically ill patient. Serious acute pancreatitis is frequently complicated by infections. The objectives of this study were to determine the influence of acute pancreatitis on host defense against Pseudomonas pneumonia and to determine the influence of Pseudomonas pneumonia on the severity of concurrent pancreatitis.


METHODS
A controlled, in vivo laboratory study.


METHODS
Research laboratory of a health sciences university.


METHODS
Female C57Bl/6 mice.


METHODS
Pancreatitis was induced by 12 hourly intraperitoneal injections of cerulein (pancreatitis) or saline (sham) immediately followed by intranasal administration of Pseudomonas aeruginosa (to induce pneumonia) or saline (controls). Mice were killed 24 hrs later. Hence, four groups were studied: sham/control, pancreatitis/control, sham/pneumonia, and pancreatitis/pneumonia mice.


RESULTS
When compared with sham/pneumonia mice, pancreatitis/pneumonia mice demonstrated exaggerated lung inflammation, higher bacterial counts in lungs and pancreas, and enhanced dissemination of the infection. Concurrently, pneumonia prolonged the course of pancreatitis, as reflected by histopathology and higher plasma amylase and relative pancreas weights (all p < .05 for the difference between pancreatitis/pneumonia and pancreatitis/control mice), which was associated with the localization of Pseudomonas in the pancreas.


CONCLUSIONS
Acute pancreatitis impairs host defense against Pseudomonas pneumonia, whereas pneumonia prolongs the course of pancreatitis.
Laboratory of Experimental Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
David J
DJ
van Westerloo
Marcus J
MJ
Schultz
Marco J
MJ
Bruno
Alex F
AF
de Vos
Sandrine
S
Florquin
Tom
T
van der Poll
D000208:Acute Disease; D000818:Animals; D002108:Ceruletide / Q000009:adverse effects; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects; D051379:Mice; D008810:Mice, Inbred C57BL; D023421:Models, Animal; D010195:Pancreatitis / Q000139:chemically induced / Q000150:complications / Q000276:immunology* / Q000473:pathology; D018410:Pneumonia, Bacterial / Q000150:complications / Q000276:immunology* / Q000473:pathology; D011552:Pseudomonas Infections / Q000150:complications / Q000276:immunology* / Q000473:pathology; D012720:Severity of Illness Index
D005765:Gastrointestinal Agents; D002108:Ceruletide