Bacterial translocation: not a clinically relevant phenomenon in colorectal cancer.
The aim of this study was to identify the risk factors for bacterial translocation and to determine the clinical significance of bacterial translocation in patients with colorectal cancer. Mesenteric lymph node sampling was performed to identify the presence of bacterial translocation in 75 patients with colorectal cancer undergoing laparotomy. Bacterial translocation was identified in 29 patients (39%), with the most common organism being Escherichia coli (31%). Three factors for bacterial translocation were identified, including a preoperative low peripheral lymphocyte count, metastasis to lymph nodes, and invasion depth (= T3). Stepwise regression analysis, however, selected only = T3 [odds ratio (OR) 4.0, 95% confidence interval (CI) 1.2-13.5]. Altogether, 35% of patients with bacterial translocation developed septic complications, compared with 20% in patients without bacterial translocation. In the multivariate analysis, bacterial translocation was not an independent risk factor for infection, with an OR of 1.8 (95% CI 0.56-5.96). Systemic inflammatory response syndrome developed on the first day in 62% of patients with bacterial translocation, compared with 50% of patients without bacterial translocation. Adjusting for the other factors, bacterial translocation was not a significant risk factor in the occurrence of systemic inflammatory response syndrome after surgery (OR 1.1, 95% CI 0.37-3.29). We concluded that in patients with colorectal cancers bacterial translocation does occur and is increased in patients with deep invasion. However, it appears to be of no clinical significance.
Takesue
Yoshio
Y
Department of Surgery, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. takesuey@hiroshima-u.ac.jp
Kakehashi
Masayuki
M
Ohge
Hiroki
H
Uemura
Kenichiro
K
Imamura
Yuuji
Y
Murakami
Yoshiaki
Y
Sasaki
Masaru
M
Morifuji
Masahiko
M
Yokoyama
Yujiro
Y
Kouyama
Mohei
M
Okii
Kazuya
K
Sueda
Taijiro
T
D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D018988:Bacterial Translocation; D015179:Colorectal Neoplasms / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000382:microbiology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology / Q000382:microbiology