title: Gut bacterial translocation and postoperative infections: a prospective study in schistosomotic patients.
abstract: BACKGROUND
  Bacterial translocation (BT) across the intact intestinal mucosal barrier has been postulated as a source of sepsis in susceptible patients, including those with cirrhosis and portal hypertension. This condition has not been studied in hepatosplenic schistosomiasis, wherein portal hypertension and the presence of an immune deficiency state associated with the parasitic disease could predispose to BT into mesenteric lymph nodes (MLN). A study was conducted to determine the prevalence of aerobic bacteria in MLN (bacterial translocation) of patients with hepatosplenic schistosomiasis, and establish a possible association with postoperative infections.
  
  
  METHODS
  In a series of 51 patients submitted to surgical treatment of schistosomotic portal hypertension with splenectomy and gastric devascularization, MLN were obtained from each patient at the beginning (MLN1) and at the end (MLN2) of the surgical procedure, and sent for bacteriological analysis. Prospective patient evaluation during the postoperative period correlated positive MLN cultures with infectious complications.
  
  
  RESULTS
  The prevalence of aerobic bacteria was 17.6% at MLN1 and 27.5% at MLN2, however, this difference was non-significant (p = 0.24). Bacterial translocation to all MLN was 22.5%. Escherichia coli was the most frequent organism (26.1%, 6/23). The overall incidence of postoperative infections was 19.6% (10/51), with a significant association with the presence of positive cultures of MLN (p = 0.043).
  
  
  CONCLUSIONS
  The findings of this study suggest that the presence of aerobic bacteria on MLN as a consequence of BT may play a role in the development of postoperative infectious complications, particularly in schistosomotic patients.
authors.affiliation: General Surgery Service, University Hospital of the Federal University of Pernambuco, Recife, Brazil. aabf@truenet.com.br
authors.forename: Alvaro Antônio Bandeira
authors.initials: AA
authors.lastname: Ferraz
authors.forename: Josemberg Marins
authors.initials: JM
authors.lastname: Campos
authors.forename: José Guido Corrêa De Araújo
authors.initials: JG
authors.lastname: Júnior
authors.forename: Antônio Cavalcanti
authors.initials: AC
authors.lastname: De Albuquerque
authors.forename: Edmundo Machado
authors.initials: EM
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D000368:Aged; D018988:Bacterial Translocation / Q000276:immunology*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000276:immunology / Q000601:surgery*; D016867:Immunocompromised Host; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012552:Schistosomiasis / Q000150:complications* / Q000276:immunology; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology / Q000382:microbiology*