BACTERIAL TRANSLOCATION IN AN EXPERIMENTAL INTESTINAL OBSTRUCTION MODEL. C-REACTIVE PROTEIN RELIABILITY?

Document Type : Original Article

Authors

1 Departments of Surgery, Mansoura Faculty of Medicine, Egypt

2 Microbiology, Mansoura Faculty of Medicine, Egypt

3 Histology, Mansoura Faculty of Medicine, Egypt

Abstract

Aim: Bacterial translocation occurs in preseptic conditions such as intestinal obstruction. CRP is a marker of ischaemia. 
Methods: 45 albino male rats were divided into 3 groups (15 each). GI control, GII simple intestinal-obstruction and GIII 
strangulated obstruction. Outcome measures were: (1) Bacteriologic count & typing for intestinal contents, intestinal wall, liver, mesenteric lymph nodes and blood (cardiac & portal) (2) Histopathologic: mucosal injury score, inflammatory cell 
infiltrate in the wall, MLN, liver, (3) Biochemical: serum CRP, IL-10, mucosal stress pattern (glutathione peroxidasemalonyldialdhyde tissue levels). 
Results: (1) Intestinal obstruction associates with BT precursors (Bact-overgrowth, mucosal-acidosis, immuno-incomptence), (2) Bacterial translocation (frequency & density) was found higher in strangulated I.O, that was mainly enteric (aerobic & anaerobic) and mostly E.coli, (3) The pathogen commonality supports the gut origin hypothesis but the systemic inflammatory response goes with the cytokine generating one. (4) The CRP median values for GI, II, III were 0.5, 6.9, 8.5 mg/L, for BT +ve 8 mg/L and 0.75 mg/L for BT –ve rats. 
Conclusion: Bacterial translocation occurrs bi-directional (systemic-portal) in intestinal obstruction and the resultant 
inflammatory response pathogenesis is mostly 3 hit model. CRP is a reliable marker of BT, BT density and vascular 
compromise during I.O.

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