Effect of starvation, malnutrition, and trauma on the gastrointestinal tract flora and bacterial translocation.
Effect of starvation, malnutrition, and trauma on the gastrointestinal tract flora and bacterial translocation.
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DOI：
10.1001/archsurg.1987.01400210057008
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发表时间：
1987-09
影响因子：
--
通讯作者：
E. Deitch;J. Winterton;R. Berg
中科院分区：
文献类型：
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作者：
E. Deitch;J. Winterton;R. Berg
我们以前已经在动物模型中证明，如果肠道的正常细菌生态受到足够的破坏，允许细菌过度生长，或者如果动物受到严重的免疫抑制，活的本土细菌将穿过完整的胃肠道(GI)黏膜并系统传播，这个过程被称为细菌移位。饥饿或蛋白质营养不良会扰乱正常的本土胃肠道微生物区系，并损害宿主的抗菌防御能力。因此，我们测试了饥饿或蛋白质营养不良加上烧伤创伤在促进胃肠道细菌移位方面的效果。通过定量培养正常或烧伤(总体表面积的30%)CD1小鼠的肠系膜淋巴结、脾、肝脏、血液和腹膜腔，定量培养细菌移位。通过定量测量盲肠中存在的细菌水平来确定饥饿或蛋白质营养不良对肠道微生物区系的影响。饥饿和蛋白质营养不良都增加了盲肠革兰氏阴性肠杆菌的水平，降低了乳杆菌和严格厌氧菌的水平。令人惊讶的是，饥饿和蛋白质营养不良都没有促进细菌易位，即使这些动物体重减轻了20%以上，肠道微生物区系的生态也受到了破坏。事实上，当两组动物都与大肠杆菌C-25单一相关或单一相关并烧伤时，蛋白质营养不良的动物表现出比正常营养的动物更低的细菌易位发生率。因此，蛋白质营养不良似乎不会促进细菌易位，即使合并烧伤创伤也是如此。
We have previously shown, in an animal model, that viable indigenous bacteria will cross the intact gastrointestinal (GI) mucosa and spread systemically, a process termed bacterial translocation, if the normal bacterial ecology of the gut was sufficiently disrupted to allow bacterial overgrowth or if the animals were severely immunosuppressed. Starvation or protein malnutrition disrupts the normal indigenous GI tract microflora and impairs host antibacterial defenses. Consequently, we tested the effect of the combination of starvation or protein malnutrition plus burn trauma in promoting bacterial translocation from the GI tract. Bacterial translocation was measured by quantitatively culturing the mesenteric lymph nodes, spleens, livers, blood, and peritoneal cavities of normal or burned (30% of total body surface area) CD1 mice deprived of food for three days or fed a low-protein (0.03%) diet. The effect of starvation or protein malnutrition on the gut microflora was determined by quantitatively measuring the levels of bacteria present in the ceca. Both starvation and protein malnutrition increased the cecal levels of gram-negative enteric bacilli and decreased the levels of lactobacilli and strict anaerobes. Surprisingly, neither starvation nor protein malnutrition promoted bacterial translocation, even though these animals lost over 20% of their body weight and the ecology of the gut microflora was disrupted. In fact, the protein-malnourished animals exhibited lower incidences of bacterial translocation than normally nourished animals when both groups were monoassociated with Escherichia coli C-25 or monoassociated and burned. Thus, it appears that protein malnutrition does not promote bacterial translocation, even when combined with burn trauma.