Bacterial translocation and change in intestinal permeability in patients after abdominal surgery

  • Zhi Qiao (乔 治)
  • Zhanliang Li (黎沾良)
  • Jiye Li (李基业)
  • Lianrong Lu (陆连荣)
  • Yi Lv (吕 艺)
  • Junyou Li (黎君友)
Article

DOI: 10.1007/s11596-009-0419-3

Cite this article as:
Qiao, Z., Li, Z., Li, J. et al. J. Huazhong Univ. Sci. Technol. [Med. Sci.] (2009) 29: 486. doi:10.1007/s11596-009-0419-3

Summary

The purpose of this study was to investigate bacterial translocation and change in intestinal permeability in patients after abdominal surgery. Sixty-three patients undergoing elective abdominal surgery were enrolled in the study. Blood samples were collected prior to operation and 2, 24, 48 h after surgery for bacterial culture, microbial DNA extraction, plasma D-lactate and endotoxin measurement. PCR analysis was performed after DNA extraction, with β-lactosidase gene of E. coli and 16S rRNA gene as target genes. All patients were observed for a period of 30 days for infectious complications. Our results showed that no bacterial DNA was detected before surgery, but after operation it was found in 12 patients (19.0%). Bacterial DNA was detected in 41.7% (10/24) of SIRS patients and 5.1% (2/39) of non-SIRS patients (P<0.01). About 83.3% of PCR-positive patients developed systemic inflammatory response syndrome (SIRS), but only 27.5% of PCR-negative patients did so (P<0.01). Two thirds of PCR-positive patients developed infectious complications, while none of PCR-negative patients did (P<0.01). The blood culture was positive only in 3 patients (4.8%), who were all PCR-positive. E. coli DNA was found in 66.7% of the PCR-positive patients. The plasma levels of D-lactate and endotoxin were elevated significantly 2, 24 and 48 h after operation in PCR-positive patients, with a significant positive correlation found between them (r=0.91, P<0.01). It is concluded that increased intestinal permeability was closely related with bacterial translocation. Intestinal bacterial translocation (most commonly E. coli) might occur at early stage (2 h) after abdominal surgery. Postoperative SIRS and infection might bear a close relationship with bacterial translocation.

Key words

bacterial translocationintestinal permeabilityabdominal surgerypolymerase chain reaction (PCR)

Copyright information

© Huazhong University of Science and Technology and Springer-Verlag GmbH 2009

Authors and Affiliations

  • Zhi Qiao (乔 治)
    • 1
  • Zhanliang Li (黎沾良)
    • 1
  • Jiye Li (李基业)
    • 1
  • Lianrong Lu (陆连荣)
    • 1
  • Yi Lv (吕 艺)
    • 2
  • Junyou Li (黎君友)
    • 2
  1. 1.Department of General Surgerythe First Affiliated Hospital of Chinese PLA General HospitalBeijingChina
  2. 2.Research Department of Burn Institutethe First Affiliated Hospital of Chinese PLA General HospitalBeijingChina