title: Analysis of occurrence of bacteraemia with pathogens from gastrointestinal tract in patients fed parenterally and enterally in the intensive care unit.
abstract: BACKGROUND
  Bacterial translocation is a migration of microorganisms and their toxins from the intestinal lumen to the mesenteric lymph nodes, blood, and abdominal organs. It can lead to local inflammatory response and a potential increase in intestinal permeability leading to systemic infections and multiple organ failure. Enteral nutrition stimulates gastrointestinal motility, increases blood flow, and improves the integration of the intestinal barrier.
  
  
  OBJECTIVE
  The impact of enteral (EN) and parenteral (PN) nutrition on occurrence of bacteraemia caused by pathogens from the gastrointestinal tract.
  
  
  METHODS
  It was a retrospective analysis of medical documentation of 254 patients. Microbiological tests were analysed, assessing the presence of bacteraemia or sepsis pathogens from the gastrointestinal tract. In 52 patients gastrointestinal pathogens in blood were found: 29 patients were fed enterally (I group - EN and EN + PN) and 23 only parenterally (II group - PN).
  
  
  RESULTS
  The mean length of stay in hospital until the occurrence of bacteraemia in group I was 14, and in group II it was 13 days. Mean time without EN was 4 days (first group) and 12 days (second group). Time of stay in ICU and mortality in the group of patients fed parenterally was observed: group I - 25 days, mortality 34%; group II - 37 days, mortality 56%. In the analysed group the EN and the length of the absence of this kind of feeding did not affect the occurrence of bacteraemia by gastrointestinal pathogens.
  
  
  CONCLUSIONS
  However, patients fed only parenterally who had bacteraemia required a longer stay in the ICU and had a higher rate of mortality than the patients with EN.
authors.affiliation: Department and Clinic of Anaesthesiology and Intensive Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
authors.forename: Marlena
authors.initials: M
authors.lastname: Jakubczyk
authors.affiliation: Department and Clinic of Anaesthesiology and Intensive Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Różowicz
authors.affiliation: Department and Clinic of Anaesthesiology and Intensive Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Spychalska
authors.affiliation: Department and Institution of Microbiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Nakonowska
authors.affiliation: Department and Clinic of Anaesthesiology and Intensive Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
authors.forename: Kinga
authors.initials: K
authors.lastname: Kupczyk
authors.affiliation: Department and Clinic of Anaesthesiology and Intensive Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland; Department of Anaesthesiology and Intensive Care, Poznan University of Medical Science, Poznan, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kusza
keywords: bacteraemia; enteral nutrition; intensive care; parenteral nutrition; translocation