Clinical Evidence of Bacterial Translocation from the Gut

  • B. F. RushJr.
  • J. N. McCullough
Conference paper


Physicians have always looked upon the gut with dark suspicion. The colon, that enormous reservoir of potentially pathogenic bacteria, was especially suspect. Purging, sometimes violently, often combined with bleeding was a common remedy of our medical forebears. Wiggers in his classic on shock in 1950 mentions that bacteria might possibly make their way out of the colon as a result of ischemic damage to tissues.


Injury Severity Score Hemorrhagic Shock Positive Blood Culture Bacterial Translocation Indigenous Bacterium 
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  1. Berg R, Savage D (1972) Immunological responses and microrganisms indigenous to the gastrointestinal tract. Am J Clin Nutr 25:1364–71PubMedGoogle Scholar
  2. Berg R, Garlington A (1979) Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesentaric lymph nodes and other organs in a gnotobiotic mouse model. Infec Immune 23:403–411Google Scholar
  3. Berg R (1980a) Inhibition of Escherichia coli translocated from the gastrointestinal tract by normal cecal flora in gnotobiotic or antibiotic decontaminated mice. Infect Immun 29:1073–1081PubMedGoogle Scholar
  4. Berg R (1980b) Mechanisms confining indigenous bacteria to the gastrointestinal tract. Am J Clin Nutr 33:2472–2481PubMedGoogle Scholar
  5. Berg R (1981a) Promotion of the translocation of enteric bacteria from the gastrointestinal tracts of mice by oral treatment with penicillin, clindamycin or metronidazole. Infect Immun 33:854–861PubMedGoogle Scholar
  6. Berg R, (1981b) Factors influencing the translocation of bacteria from the gastrointestinal tract. In: Sasaki S, Ozawa A, Hashimoto K, (ed). Recent advances in germfree research Tokai Univ Press, ToyokoGoogle Scholar
  7. Berg R (1983a) Bacterial translocation from the gastrointestinal tracts of mice receiving immunosupressive chemotherapeutic agents. Curr Microbiol 8:285–292CrossRefGoogle Scholar
  8. Berg, R (1983b) Translocation of indigenous bacteria from the intestinal tract. In Hentges D. (ed) Human intestinal flora in health and disease. Academic Press Orlando, Florida pp 333–352Google Scholar
  9. Cuevas P, Fine J (1971) Demonstration of a lethal endotoxemia in experimental occlusion of the superior mesenteric artery. Surg Gynecol Obstet 133:81–83PubMedGoogle Scholar
  10. Cuevas P, Fine J (1973) Role of intraintestinal endotoxin in death from peritonitis. Surg Gynecol Obstet 134:953–957Google Scholar
  11. Culbertson WR, Elstun W, Cole W, Altemeier WA (1959) Bacterial studies in irreversible hemorrhagic shock. Arch Surg 79:185–189CrossRefGoogle Scholar
  12. Deitch EA, Maejima K, Berg R (1985) Effect of oral antibiotics and bacteria overgrowth on translocation of GI-tract microflora in burned rats. J Trauma 25:385–392PubMedCrossRefGoogle Scholar
  13. Deitch EA, Winterton J, Berg, R (1987a) Effect of starvation, malnutrition, and trauma on the gastrointestinal tract flora and bacterial translocation. Arch Surg 122:1019–1024PubMedCrossRefGoogle Scholar
  14. Deitch EA, Berg RD (1987b) Endotoxin but not malnutrition promotes bacterial translocation of the gut flora in burned mice. J Trauma 27:161–166PubMedCrossRefGoogle Scholar
  15. Deitch EA, Berg R, Specian R (1987c) Endotoxin promotes the translocation of bacteria from the gut. Arch Surg 122:185–190PubMedCrossRefGoogle Scholar
  16. Dietch EA, Bridges RM (1987d) Effect of stress and trauma on bacterial translocation from the gut. J Surg Res 42:536–542CrossRefGoogle Scholar
  17. Dietch EA, Winterton J, Berg R (1987e) The gut as a portal of entry for bacteremia. Ann Surg 205:681–692CrossRefGoogle Scholar
  18. Donohoe MK, Rush BF Jr., Koziol JM, Machiedo GW (1986) Role of antiobiotics in late survival from hemorrhagic Shock. Surgical Forum 27:62–64Google Scholar
  19. Fine J, Frank HA, Schneinburg F, Jacob S, Gordon T (1952) The bacterial factor in traumatic shock. Ann NY Acad Sci 55:429–437PubMedCrossRefGoogle Scholar
  20. Fine J, Frank E, Rutenburg S, Schweinberg F, (1959) The bacterial factor in traumatic shock. New England J Med 260:214–220CrossRefGoogle Scholar
  21. Ford WW (1900) The bacteriology of healthy organs. Trans Assoc Am Physicians 15:389–415Google Scholar
  22. Hardy E, Morris G, Yow E, Haynes B, DeBakey M (1954) Studies on the role of bacteria in irrervisible hemorrhagic shock in dogs. Am Surg 139:282–286Google Scholar
  23. Heneghan JB (1968) Hemorrhagic shock in unanesthetized gntobiotic rats. In: Muyakawa M, Luckey TD (eds) Advances in germfree research and gnotobiology. Chemical Rubber Co. Press Cleveland, OH p 165–171Google Scholar
  24. Koziol JM, Rush BF, Jr., Smith SM, Machiedo GW (1986) Occurence of bacteremia during and after hemorrhagic shock. J Trauma 26:678 (Abs)CrossRefGoogle Scholar
  25. Koziol JM, Rush BF, Jr., Smith SM, Machiedo GW (1988) Occurence of bacteremia during and after hemorrhagic shock. J Trauma 28:10–16PubMedCrossRefGoogle Scholar
  26. McCullough JN, Spillert CR, Lazaro EJ (1990) Direct correlation between injury severity and two markers of the functional status of the immune system. (In Press) Circ ShockGoogle Scholar
  27. McNulty WP, Linares R (1960) Hemorrhagic shock in germfree rats. Am J Physiol 198:141–144Google Scholar
  28. Redan JA, Flanagan JJ, Rush BF, Machiedo GW, Lysz TW, Murphy TF (1990) Correlation of anaphylatoxin levels and survival with bacteremia and endotoxiemia in the first 2 hours after trauma. Current Surg 47:30–32Google Scholar
  29. Rush BF, Jr., Sori AJ, Murphy TF, Smith S, Flanaga JJ, Machiedo GW (1988) Endotoxemia and bacteremia during hemorrhagic Shock The link between trauma and sepsis? Ann Surg 207:549–554PubMedCrossRefGoogle Scholar
  30. Rush BF, Jr., Koziol JM (1987) Advances in the treatment of hypovolemic shock. Infect in Surg 369–376Google Scholar
  31. Rush BF, Jr., Redan JA, Flanagan JJ, Heneghan JB, Hsieh J, Murphy TF, Smith S, Machiedo, GW (1989) Does the bacteremia observed in hemorrhagic shock have clinical significance? A study in germfree animals. Ann Surg 210:342–347PubMedCrossRefGoogle Scholar
  32. Rush BF Jr., McCullough JN, Hsieh JT (1990) Evolution of a treated model of hemorrhagic shock (Submitted) Circ ShockGoogle Scholar
  33. Sori AJ, Rush BF, Jr., Lysz, TW, Smith S, Machiedo GW (1988) The gut as a source of sepsis after hemorrhagic shock. Am J of Surg 155:188–192CrossRefGoogle Scholar
  34. Wiggers C (1950) Physiology of shock. Harvard University Press, Cambridge, MAGoogle Scholar
  35. Wolochow H, Hildebranch GJ, Lamanna C (1966) Translocation of microrganisms across the intestinal wall of the rat: Effect of microbral size and concentration. J Infect Dis 116:523–528PubMedCrossRefGoogle Scholar
  36. Zweifach BW (1959) Hemorrhagic shock in germfree rats. Ann NY Acad Sci 78:315–320PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin, Heidelberg 1991

Authors and Affiliations

  • B. F. RushJr.
    • 1
  • J. N. McCullough
    • 1
  1. 1.Department of SurgeryNew Jersey Medical SchoolNewarkUSA

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