Antonie van Leeuwenhoek

, Volume 58, Issue 2, pp 87–93 | Cite as

Relationship between intestinal microecology and the translocation of intestinal bacteria

  • C. L. Wells


It is now well known that endogenous bacteria can translocate from the intestinal tract and cause many of the complicating infections seen in severely ill, hospitalized patients. Of the hundreds of bacterial species in the intestinal tract, relatively few aerobic/facultative species appear to translocate with any frequency. Van der Waaij and colleagues (1971, 1972a, 1972b) originally proposed that, by a process termed ‘colonization resistance’, strictly anaerobic bacteria prevented the intestinal overgrowth and subsequent translocation of these potentially pathogenic aerobic/facultative bacteria. Selective antimicrobial decontamination, designed to maintain colonization resistance, has been effective in reducing the incidence of infectious morbidity in high risk patients. However, the mechanisms controlling bacterial translocation remain unclear, but appear to depend on host factors, as well as on factors inherent in the microbe itself. There is both clinical and experimental evidence supporting the concept that strictly anaerobic bacteria do not readily translocate. Bacteria that are able to survive within macrophages (e.g., Salmonella species and Listeria monocytogenes) translocate easier than others, and there is recent experimental evidence that normal intestinal bacteria may translocate to the draining mesenteric lymph node within host phagocytes. There is also evidence that anaerobic bacteria translocate along with facultative species in situations associated with intestinal epithelial damage, i.e., burn trauma, oral ricinoleic acid, and acute mesenteric ischemia. In contrast, recent experimental evidence demonstrates that facultative bacteria can translocate across a histologically intact intestinal epithelium, and that the ileal absorptive cell may be at least one portal of entry prior to transport into deeper tissues. It is anticipated that further clarification of the routes and mechanisms involved in bacterial translocation will provide new insights into the treatment and prevention of a significant proportion of the infectious morbidity seen in severely ill, hospitalized patients.


Listeria Anaerobic Bacterium Listeria Monocytogenes Bacterial Translocation Intestinal Bacterium 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Berg RD & Garlington AW (1979) Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model. Infect. Immun. 23: 403–411Google Scholar
  2. Berg RD, Wommack E & Deitch RA (1988) Immunosuppression and intestinal bacterial overgrowth synergistically promote bacterial translocation. Arch. Surg 123: 1359–1364Google Scholar
  3. Bennion RS, Wilson SE, Serota AI & Williams RA (1974) The role of gastrointestinal microflora in the pathogenesis of complications of mesenteric ischemia. J. Infect. Dis. 6 (Suppl): S132-S138Google Scholar
  4. Brook L, MacVittie TJ & Walker RI (1984) Revovery of aerobic and anaerobic bacteria from irradiated mice. Infect. Immun. 46: 270–271Google Scholar
  5. Clasener HAL, Vollard EJ & Van Saene HKF (1987) Longterm prophylaxis of infection by selective decontamination in leukopenia and in mechanical ventilation. Rev. Infect. Dis. 9: 295–328Google Scholar
  6. Guiot HFL & Van Furth R (1984) Selective antimicrobial modulation of the intestinal flora. Prophylaxis against infection in neutropenic patients. Infection. 12: 1–4Google Scholar
  7. Harmsen AG, Muggenburg BA, Snipes MB & Bice DE (1985) The role of the macrophage in particle translocation from lungs to lymph nodes. Science 230: 1277–1280Google Scholar
  8. Kerver AJH, Rommes JH, Verhage EAE, Hulstaert PF, Vos A, Verhoef J & Wittebol P (1988) Prevention of colonization and infection in critically ill patients: A prospective randomized study. Crit. Care Med. 16: 1087–1093Google Scholar
  9. Maejima K, Deitch EA & Berg RD (1984) Bacterial translocation from the gastrointestinal tracts of rats receiving thermal injury. Infect. Immun. 43: 6–10Google Scholar
  10. McConville JH, Snyder MJ, Calia FM & Hornick RB (1981) Model of intraabdominal abscess in mice. Infect. Immun. 31: 507–509Google Scholar
  11. Moore WEC & Holdeman LV (1975) Discussion of current bacteriological investigations between intestinal flora, diet, and colon cancer. Cancer. Res. 35: 3418–3412Google Scholar
  12. Morehouse JL, Specian RD, Stewart JJ & Berg RD (1986) Translocation of indigenous bacteria from the gastrointestinal tract of mice after oral ricinoleic acid. Gastroenterol. 91: 673–682Google Scholar
  13. Onderdonk AB, Weinstein WM, Sullivan NM, Bartlett JG & Gorbach SL (1974) Experimental intra-abdominal abscesses in rats: Quantitative bacteriology of infected animals. Infect. Immun. 10: 1256–1259Google Scholar
  14. Pingleton SK, Hinthorn DR & Liu C (1986) Enteral nutrition in patients receiving mechanical ventilation. Multiple sources of tracheal colonization include the stomach. Am. J. Med. 80: 827–832Google Scholar
  15. Schweinberg FB, Seligman AM & Fine J (1950) Transmural migration of intestinal bacteria: A study based on the use of radioactive Escherichia coli. N. Engl. J. Med. 242: 747–751Google Scholar
  16. Steffen EK, Berg RD & Deitch EA (1988) Comparison of the translocation rates of various indigenous bacteria from the gastrointestinal tract to the mesenteric lymph node. J. Infect. Dis. 157: 1032–1038Google Scholar
  17. Tancrede CH & Andremont A (1985) Bacterial translocation and gram-negative bacteremia in patients with hematological malignancies. J. Infect. Dis. 152: 99–103Google Scholar
  18. Van der Waaij D, Berghuis-De Vries JM & Lekkerkerk-Van der Wees (1971) Colinization resistance of the digestive tract in conventional and antibiotic-treated mice. J. Hyg. 69: 405–411Google Scholar
  19. Van der Waaij D, Berghuis-de Vries JM & Lekkerkerk-Van der Wees (1972a) Colonization resistance of the digestive tract and the spread of bacteria to the lymphatic organs in mice. J. Hyg. 70: 335–342Google Scholar
  20. Van der Waaij D, Berghuis JM & Lekkerkerk JEC (1972b) Colinization resistance of the digestive tract of mice during systemic antibiotic treatment. J. Hyg. 70: 605–609Google Scholar
  21. Van Uffelen R, Rommes JH & Van Saene HKF (1987) Preventing lower airway colonization and infection in mechanically ventilated patients. Crit. Care Med. 15: 99–102Google Scholar
  22. Wells CL, Rotstein OD, Pruett TL & Simmons RL (1986) Intestinal bacteria translocate into experimental intra-abdominal abscesses. Arch. Surg. 121: 102–107Google Scholar
  23. Wells CL, Maddaus MA & Simmons RL (1987a) Role of the macrophage in the translocation of intestinal bacteria. Arch. Surg. 122: 48–53Google Scholar
  24. Wells CL, Maddaus MA, Reynolds CM, Jechorek RP & Simmons RL (1987b) The role of the anaerobic flora in the translocation of aerobic and facultatively anaerobic intestinal bacteria. Infect. Immun. 55: 2689–2694Google Scholar
  25. Wells CL, Jechorek RP & Maddaus MA (1988a) The translocation of intestinal facultative and anaerobic bacteria in defined flora mice. Microb. Ecol. Health Dis. 1: 227–235Google Scholar
  26. Wells CL, Jechorek RP, Maddaus MA & Simmons RL (1988b) The effects of clindamycin and metronidazole on the intestinal colonization and translocation of enterococcus in mice. Antimicrob. Agents Chemother. 32: 1769–1775Google Scholar
  27. Wells CL, Maddaus MA & Simmons RL (1988c) Proposed mechanisms for the translocation of intestinal bacteria. Rev. Infect. Dis. 10: 958–979Google Scholar
  28. Wells CL, Maddaus MA, Erlandsen SL & Simmons RL (1988d) Evidence for the phagocytic transport of intestinal particles in dogs and rats. Infect. Immun. 56: 278–282Google Scholar
  29. Wells CL, Maddaus MA, Jechorek RP & Simmons RL (1988e) Role of intestinal anaerobic bacteria in colonization resistance. Eur. J. Clin. Microbiol. Infect. Dis. 7: 107–113Google Scholar
  30. Wells CL, Jechorek RP & Erlandsen SL (1990) Evidence for the translocation of Enterococcus faecalis across the mouse intestinal tract. J. Infect. Dis. (in press)Google Scholar

Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • C. L. Wells
    • 1
    • 2
  1. 1.Department of Laboratory MedicineUniversity of MinnesotaMinneapolisUSA
  2. 2.Department of Pathology and SurgeryUniversity of MinnesotaMinneapolisUSA

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