Cited by 393Sepsis Diagnosis and TreatmentAbdominal Surgery and ComplicationsAbdominal vascular conditions and treatments

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Microbiology of bacterial translocation in humans

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O’Boyle, C J, MacFie, J, Mitchell, C J, Johnstone, D, Sagar, P M, Sedman, P C·1998·Gut

DOI 10.1136/gut.42.1.29PMC PMC1726947

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Abstract

BACKGROUND: Gut translocation of bacteria has been shown in both animal and human studies. Evidence from animal studies that links bacteria translocation to the development of postoperative sepsis and multiple organ failure has yet to be confirmed in humans. AIMS: To examine the spectrum of bacteria involved in translocation in surgical patients undergoing laparotomy and to determine the relation between nodal migration of bacteria and the development of postoperative septic complications. METHODS: Mesenteric lymph nodes (MLN), serosal scrapings, and peripheral blood from 448 surgical patients undergoing laparotomy were analysed using standard microbiological techniques. RESULTS: Bacterial translocation was identified in 69 patients (15.4%). The most common organism identified was Escherichia coli (54%). Both enteric bacteria, typical of indigenous intestinal flora, and non-enteric bacteria were isolated. Postoperative septic complications developed in 104 patients (23%). Enteric organisms were responsible in 74% of patients. Forty one per cent of patients who had evidence of bacterial translocation developed sepsis compared with 14% in whom no organisms were cultured (p < 0.001). Septic morbidity was more frequent when a greater diversity of bacteria resided within the MLN, but this was not statistically significant. CONCLUSION: Bacterial translocation is associated with a significant increase in the development of postoperative sepsis in surgical patients. The organisms responsible for septic morbidity are similar in spectrum to those observed in the mesenteric lymph nodes. These data strongly support the gut origin hypothesis of sepsis in humans.

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Authors: O’Boyle, C. J., MacFie, J., Mitchell, C. J., Johnstone, D., Sagar, P. M., & Sedman, P. C.
Affiliations: Combined Gastroenterology Service, Scarborough Hospital, Scalby Road, Scarborough, North Yorkshire, UK
Scarborough General Hospital (GB)
Corresponding author: MacFie, J
ORCID: Mitchell, C J
Sagar, P M
Venue: Gut
Publisher: BMJ
Published: 1998-01-01
Volume: 42
Issue: 1
Pages: 29-35
ISSN: 0017-5749 (ISSN-L)
1468-3288
DOI: 10.1136/gut.42.1.29
PMC: PMC1726947
OpenAlex: W2116727622
Cited by: 393
References: 37
Citations by year: 2026: 3 · 2025: 6 · 2024: 18 · 2023: 6 · 2022: 12 · 2021: 21 · 2020: 12 · 2019: 14 · 2018: 11 · 2017: 11 · 2016: 15 · 2015: 13 · 2014: 17 · 2013: 16 · 2012: 9
FWCI: 13.31
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Gut (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Surgery › Abdominal Surgery and Complications
Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
Keywords: bacterial translocation, postoperative sepsis, mesenteric lymph nodes, Escherichia coli, laparotomy, surgical patients, bacterial diversity, enteric bacteria, multiple organ failure
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Bacterial Infections, Bacteriological Techniques, Escherichia coli, Female, Humans, Laparotomy, Lymph Nodes, Male, Middle Aged, Postoperative Complications, Prevalence, Bacterial Translocation

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