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Bacterial Translocation: Myth versus Reality

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Sepsis

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 18))

Abstract

Bacterial translocation has been defined as the passage of viable bacteria through the epithelial mucosa and lamina propria of the gastrointestinal (GI) tract to extraintestinal sites such as the mesenteric lymph nodes (MLN), spleen, liver, peritoneum, and blood [1]. More recently, however, Alexander et al. [2] have suggested a refinement of this definition to include all microbial translocation (viable and nonviable) as well as microbial products, e.g., endotoxin, across an anatomically intact intestinal barrier. It should be noted that neither definition describes the host or bacterial mechanisms responsible for such movement. Currently, it is felt that indigenous bacteria translocate continuously from the GI tract. The numbers of bacteria that translocate are low and the host immune system is able to destroy them prior to systemic spread. This process may very well be a major mechanism of immune sampling to maintain “natural immunity” to a variety of pathogens. Thus, in the presence of normal GI ecology and a well-functioning immune system, the relative impermeability of the GI mucosa, “gut barrier function”, prevents invasion of bacteria into extraintestinal sites [3].

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References

  1. Berg RD, Garlington AN (1979) Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other organs in a gnotobioic mouse model. Infect Immun 23:403.

    PubMed  CAS  Google Scholar 

  2. Alexander JW, Boyce ST, Babcock GF et al (1990) The process of microbial translocation. Ann Surg 212:496.

    Article  PubMed  CAS  Google Scholar 

  3. Berg RD: Conspectus: bacterial translocation from the gastrointestinal tract.

    Google Scholar 

  4. Madera JL (1990) Pathobiology of the intestinal epithelial barrier. Am J Pathol 137:1273.

    Google Scholar 

  5. Dobbins WO (1982) Gut immunophysiology: a gastroenterologist’s view with emphasis on pathophysiology. Am J Physiol 242:G1.

    PubMed  CAS  Google Scholar 

  6. Fine J (1965) Current status of the problem of traumatic shock. Surg Gynecol Obstet 120:537.

    PubMed  CAS  Google Scholar 

  7. Schimpff SC (1980) Infection prevention during profound granulocytopenia. Ann Intern Med 93:358.

    PubMed  CAS  Google Scholar 

  8. Kreger BE, Craven DE, Carling PC et al (1980) Gram negative bacteremia. III. Reassessment of etiology, epidemiology, and ecology in G12 patients. Am J Med 68:332.

    Article  PubMed  CAS  Google Scholar 

  9. Garrison RN, Fry DE, Beberich S et al (1982) Enterococcal bacteremia: clinical implications and determinants of death. Ann Surg 196:43.

    Article  PubMed  CAS  Google Scholar 

  10. Fry DE, Klamer TW, Garrison RN et al (1981) Atypical clostridial bacteremia. Surg Gynecol Obstet 153:28.

    PubMed  CAS  Google Scholar 

  11. Stone HH, Kolb LD, Carrie CA et al (1974) Candida sepsis: pathogenesis and principles of treatment. Ann Surg 179:697.

    Article  PubMed  CAS  Google Scholar 

  12. Wilmore DW, Smith RJ, O’Dwyer ST et al (1988) The gut: a central organ after surgical stress. Surgery 104:917.

    PubMed  CAS  Google Scholar 

  13. Saadia R, Schein M, MacFarlane C et al (1990) Gut barrier function and the surgeon. Br J Surg 77:487.

    Article  PubMed  CAS  Google Scholar 

  14. Fink MP (1993) Adequacy of gut oxygenation in endotoxemia and sepsis. Crit Care Med 21:54.

    Google Scholar 

  15. Haglund U (1993) Systemic mediators released from the gut in critical illness. Crit Care Med 21:515.

    Google Scholar 

  16. Deitch EA, Bridges W, Baker J et al (1988) Hemorrhagic shock-induced bacterial translocation is reduced by xanthine-oxidase inhibition or inactivation. Surgery 104:191.

    PubMed  CAS  Google Scholar 

  17. Deitch EA Morrison J, Berg RD et al (1990) Effect of hemorrhagic shock on permeability in conventional and antibiotic-decontaminated rats. Crit Care Med 18:529.

    Article  PubMed  CAS  Google Scholar 

  18. Hidalgo IJ, Raub TJ, Barchardt RT (1989) Characterization of the human colon carcinoma cell line (Caco-2) as a model system for intestinal epithelial cell permeability. Gastroenterology 96:736.

    PubMed  CAS  Google Scholar 

  19. Chiu CJ, McArdle AH, Brown R et al (1970) Intestinal mucosal lesion in low-flow states. Arch Surg 101:478.

    Article  PubMed  CAS  Google Scholar 

  20. Saydjari R, Beerthuizen GIJM, Townsend CM et al (1991) Bacterial translocation and its relationship to visceral blood flow, gut mucosal ornithine decarboxylase activity, and DNA in pigs. J Trauma 31:639.

    Article  PubMed  CAS  Google Scholar 

  21. Baker JW, Deitch EA, Li M et al (1988) Hemorrhagic shock induced bacterial translocation from the gut. J Trauma 28:896.

    Article  PubMed  CAS  Google Scholar 

  22. Morris SE, Navaratnam N, Herndon DN (1990) A comparison of effects of thermal injury and smoke inhalation on bacterial translocation. J Trauma 30:639.

    PubMed  CAS  Google Scholar 

  23. Navaratnam N, Morris SE, Townsend CM et al (1989) Bacterial translocation and selective mesenteric artery perfusion in an ovine model. Proc Am Burn Assoc 21:240.

    Google Scholar 

  24. Ma L, Ma JW, Deitch EA et al (1989) General susceptibility to mucosal damage leads to bacterial translocation in a murine burn model. J Trauma 29:1245.

    Article  PubMed  CAS  Google Scholar 

  25. Parks DA, Bulkley GB, Granger DN et al (1982) Ischemic injury in the cat small intestine: role of superoxide radicals. Gastroenterology 82:9.

    PubMed  CAS  Google Scholar 

  26. Grisham MB, Hernandez LA, Granger DN (1986) Xanthine oxidase and neutrophil infiltration in intestinal ischemia. Am J Physiol 251:567.

    Google Scholar 

  27. Deitch EA, Berg RD, Specian RD (1987) Endotoxin promotes the translocation of bacteria from the gut. Arch Surg 122:185.

    Article  PubMed  CAS  Google Scholar 

  28. Deitch EA, Taylor M, Grisham MB et al (1989) Endotoxin induces bacterial translocation and increases xanthine oxidase activity. J Trauma 29:1679.

    Article  PubMed  CAS  Google Scholar 

  29. Deitch EA, Specian RD, Berg RD (1991) Endotoxin-induced bacterial translocation and mucosal permeability: role of xanthine oxidase complement activation and macrophage products. Crit Care Med 19:78.

    Article  Google Scholar 

  30. Zimmermann BT, Parks DA, Grisham MB et al (1988) Allopurinol does not enhance antioxidant properties of extracellular fluid. Am J Physiol 255:H202.

    Google Scholar 

  31. Fink MP, Antorrsson JB, Wang H et al (1991) Increased intestinal permeability in endotoxic pigs: mesenteric hypoperfusion as an etiologic factor. Arch Surg 126:211.

    Article  PubMed  CAS  Google Scholar 

  32. Menzies IS (1987) Transmucosal passage of inert molecules in health and disease. In: Skadhauge E, Heintze K (eds) Falk Symposium 36. MTP Press, Lancaster, p 527.

    Google Scholar 

  33. Bulkley GB, Kuietys PR, Parks DA et al (1985) Relationship of blood flow and oxygen consumption to ischemic injury in a canine small intestine. Gastroenterology 89:852.

    PubMed  CAS  Google Scholar 

  34. Deitch EA, Specian RD, Grisham MB et al (1992) Zymosan-induced bacterial translocation: a study of mechanisms, Crit Care Med 20:782.

    Article  PubMed  CAS  Google Scholar 

  35. Schirmer WJ, Schirmer JM, Neff GB et al (1988) Systemic complement activation produces thermodynamic changes characteristic of sepsis. Arch Surg 123:316.

    Article  PubMed  CAS  Google Scholar 

  36. Deitch EA, Ma W, Ma L et al (1990) Protein malnutrition predisposes the inflammatory-induced gut-origin septic states. Ann Surg 211:560.

    Article  PubMed  CAS  Google Scholar 

  37. Walker RI, Porvaznik MJ (1978) Disruption of the permeability barrier (zonula occludens) between intestinal epithelial cells by lethal doses of endotoxin. Infect Immun 21:655.

    PubMed  CAS  Google Scholar 

  38. O’Dwyer ST, Michie HR, Ziegler TR et al (1988) A single dose of endotoxin increases intestinal permeability in humans. Arch Surg 123:1459.

    Article  PubMed  Google Scholar 

  39. Steiner M, Bourges HR, Freedman LS et al (1968) Effect of starvation on the tissue composition of the small intestine in the rat. Am J Physiol 215:75.

    PubMed  CAS  Google Scholar 

  40. Souba WW, Klimberg VS, Plumley DA et al (1990) Current research review: the role of glutamine in maintaining a healthy gut and supporting metabolic response to injury and infection. J Surg Res 48:383.

    Article  PubMed  CAS  Google Scholar 

  41. Barton RG, Cerra FB, Wells CL (1992) Effect of a diet deficient in essential fatty acids on the translocation of intestinal bacteria. JPEN 16:122.

    Article  CAS  Google Scholar 

  42. Wells CL, Maddaus MA, Simmons RL (1987) Role of the macrophage in the translocation of intestinal bacteria. Arch Surg 122:48.

    Article  PubMed  CAS  Google Scholar 

  43. Wells CL, Maddaus MA, Simmons RL (1987) Role of the macrophage in the translocation of intestinal bacteria. Arch Surg 122:48.

    Article  PubMed  CAS  Google Scholar 

  44. Mainous MR, Rso P, Berg RD et al (1991) Studies of the route, magnitude, and time course of bacterial translocation in a model of systemic inflammation. Arch Surg 126:33.

    Article  PubMed  CAS  Google Scholar 

  45. Wells CL, Maddaus MA, Simmons RL (1988) Proposed mechanisms for the translocation of intestinal bacteria. Rev Infect Dis 10:858.

    Article  Google Scholar 

  46. Alexander JW, Boyce ST, Babcock GF et al (1990) The process of microbial translocation. Ann Surg 212:496.

    Article  PubMed  CAS  Google Scholar 

  47. Cole GT, Sesham KR, Pope LM et al (1988) Morphologic aspects of gastrointestinal tract invasion by Candida albicans in the infant mouse. J Med Vet Mycol 26:173.

    Article  PubMed  CAS  Google Scholar 

  48. Wells CL, Jechorek RP, Erlandson SL (1990) Evidence for the translocation of Enter-ococcus faecalis across the mouse intestinal tract. J Infect Dis 162:82.

    Article  PubMed  CAS  Google Scholar 

  49. Papa M, Halperin Z, Rubinstein E et al (1983) The effect of ischemia of the dog’s colon on transmural migration of bacteria and endotoxin. J Surg Res 35:264.

    Article  PubMed  CAS  Google Scholar 

  50. Wells CL, Rotstein OD, Pruett TL et al (1986) Intestinal bacteria translocate into experimental intra-abdominal abscesses. Arch Surg 121:102.

    Article  PubMed  CAS  Google Scholar 

  51. Rosenberg JC, Kaplan MP, Lyse K (1980) Mechanisms of steroid suppression of immune function: effect of methylprednisolone on lymphocyte activation and proliferation. Surgery 88:193.

    PubMed  CAS  Google Scholar 

  52. Berg RD (1983) Bacterial translocation from the gastrointestinal tract of mice receiving immunosuppressive chemotherapeutic agents. Curr Microbiol 8:285.

    Article  CAS  Google Scholar 

  53. Berg RD, Itoh K (1986) Bacterial translocation from the gastrointestinal tract — immunologic aspects. Microecol Ther 16:131.

    Google Scholar 

  54. Christan NV, McLean RPH, Meakins JL (1980) Host defense in blunt trauma: interrelationships of kinetics of energy and depressed neutrophil function, neutrophil status and sepsis. J Trauma 20:833.

    Article  Google Scholar 

  55. O’Mahorrey JB, Palder S, Roderick M et al (1983) Depression of cellular immunity after multiple trauma in the absence of sepsis. J Trauma 23:654 (abstract).

    Article  Google Scholar 

  56. Sab T, Blumernstock FA, Scoville WA (1978) Cryoprecipitate reversal of opsenic alpha-2 surface binding glycoprotein deficiency in septic surgical and traumatic patients. Science 20:622.

    Article  Google Scholar 

  57. Altura BM, Hershey SG (1973) Reticuloendothelial function in experimental injury and tolerance to shock. Adv Exp Med Biol 33:545.

    Google Scholar 

  58. Ravin HA, Fine J (1962) Biological implications of intestinal endotoxins. Fed Proc 21:65.

    PubMed  CAS  Google Scholar 

  59. Fink MP, Gardiner M, Macvittie JJ (1985) Sublethal hemorrhage impairs the acute peritoneal inflammatory response in rats. J Trauma 25:334.

    Article  Google Scholar 

  60. Owens WE, Barg RD (1980) Bacterial translocation from the gastrointestinal tract of athymic (nu/nu) mice. Infect Immun 27:461.

    PubMed  CAS  Google Scholar 

  61. Border JR, Hassett J, LaDuce J et al (1987) The gut origin septic states in blunt multiple trauma (ISS=40) in the ICU. Ann Surg 206:427.

    Article  PubMed  CAS  Google Scholar 

  62. Faist E, Riedel A, Riebu H et al (1986) Prostaglandin E2 dependent suppression of interleukin 2 production in patients with major trauma. Conference Program American Association for the Surgery of Trauma, Honolulu, p 56.

    Google Scholar 

  63. Wilmore DW, Lang JM, Mason AD et al (1974) Catecholamines: mediators of the hypermetabolic response to thermal injury. Ann Surg 180:653.

    Article  PubMed  CAS  Google Scholar 

  64. Bjerson AB, Bjorson HS, Altemeier WA (1981) Serum mediated inhibition of polymorphonuclear leukocyte function following burn injury. Ann Surg 194:568.

    Article  Google Scholar 

  65. Antonacci AC, Good RA, Gupten S (1982) T-cell subpopulations following thermal injury. Surg Gynecol Obstet 155:1.

    PubMed  CAS  Google Scholar 

  66. Alexander JW, Moncrief JA (1986) Alterations of the immune response following severe thermal injury. Arch Surg 93:75.

    Google Scholar 

  67. Wilson RF (1986) Sepsis prophylaxis in the surgical patient at risk. In: Sibbald WJ, Sprung CL (eds) New Horizons, p 301.

    Google Scholar 

  68. Holper K, Olcay I, Kitahama A et al (1974) Effect of ischemia on hepatic parenchymal and reticuloendothelial function in the baboon. Surgery 76:423.

    PubMed  CAS  Google Scholar 

  69. Schirmer WJ, Schirmer JM, Naff GB et al (1987) Alternate pathway complement activation induces reductions in effective hepatic blood flow. Ann Surg 44:304.

    CAS  Google Scholar 

  70. Machiedo GN, Hurd T, Rush BF Jr et al (1988) Temporal relationship of hepatocellular dysfunction and ischemia in sepsis. Arch Surg 123:42.

    Article  Google Scholar 

  71. Jones WF II, Minei JP, Barber AE et al (1990) Bacterial translocation and intestinal atrophy after thermal injury and burn wound sepsis. Ann Surg 211:399.

    Article  PubMed  Google Scholar 

  72. Marano MA, Moldawer LL, Fong Y et al (1988) Cachectin/TNF production in experi mental burns and Pseudomonas infection. Arch Surg 123:1383.

    Article  PubMed  CAS  Google Scholar 

  73. Chandra RK (1983) Nutrition, infection and immunity: present knowledge and future directions. Lancet i:688.

    Google Scholar 

  74. Meyer J, Yurt RN, Dubancy R et al (1988) Differential neutrophil activation before and after endotoxin infusion in enterally versus parenterally fed volunteers. Surg Gynecol Obstet 167:501.

    PubMed  CAS  Google Scholar 

  75. Berg RD, Owens WE (1979) Inhibition of translocation of viable E. coli from the gastrointestinal tract of mice by bacterial antagonism. Infect Immun 25:820.

    PubMed  CAS  Google Scholar 

  76. Deitch EA, Sittig K, Li M, Berg R (1990) Obstructive jaundice promotes bacterial translocation from the gut. Am J Surg 159:79.

    Article  PubMed  CAS  Google Scholar 

  77. Slocum MM, Sittig KM, Specian RD et al (1992) Absence of intestinal bile promotes bacterial translocation. Am Surg 58:305.

    PubMed  CAS  Google Scholar 

  78. Alverdy JC, Aoys E, Moss GS (1988) Total parenteral nutrition promotes bacterial translocation from the gut. Surgery 104:185.

    PubMed  CAS  Google Scholar 

  79. Spaeth G, Specian RD, Berg RD et al (1990) Bulk prevents bacterial translocation induced by the oral administration of total parenteral nutrition solution. JPEN 14:442.

    Article  CAS  Google Scholar 

  80. Carrico CY, Meakins JL, Marchall JC et al (1986) Multiple-organ failure syndrome. Arch Surg 121:196.

    Article  PubMed  CAS  Google Scholar 

  81. Billiar TR, Maddaus MA, West MA et al (1988) Intestinal gram negative bacterial overgrowth in vivo augments in the in vitro response of Kupffer cells to endotoxin. Ann Surg 208:532.

    Article  PubMed  CAS  Google Scholar 

  82. Cerra FB (1987) Hypermetabolism, organ failure, and metabolic support. Surgery 101:1.

    PubMed  CAS  Google Scholar 

  83. Keller GA, West MA, Cerra FB et al (1985) Multiple systems organ failure: modulation of hepatocyte protein synthesis by endotoxin activated Kupffer cells. Ann Surg 201:87.

    PubMed  CAS  Google Scholar 

  84. Pardy BJ, Spencer RC, Dudley HAF (1977) Hepatic reticuloendothelial protection against bacteremia in experimental hemorrhagic shock. Surgery 81:193.

    PubMed  CAS  Google Scholar 

  85. Katz S, Grosfield JL, Gross K et al (1984) Impaired bacterial clearance and trapping in obstructive jaundice. Ann Surg 199:14.

    Article  PubMed  CAS  Google Scholar 

  86. Sabe TM, Jaffe E (1980) Plasma fibronectin (opsonic glyceprotein): its synthesis by vascular endothelial cells and role in cardiopulmonary integrity following trauma as related to reticuloendothelial function. Am J Med 68:577.

    Article  Google Scholar 

  87. Cerra FB, Holman RT, Bankey PE et al (1990) Nutritional pharmacology: its role in the hypermetabolism-organ failure syndrome. Crit Care Med 18:S154.

    Article  PubMed  CAS  Google Scholar 

  88. Marshall JC, Lee C, Meakins JV et al (1987) Kupffer cell modulation of the systemic immune response. Arch Surg 122:191.

    Article  PubMed  CAS  Google Scholar 

  89. Kahky MP, Daniel CO, Cricz AB et al (1990) Portal infusion of tumor necrosis factor increases mortality in rats. J Surg Res 49:138.

    Article  PubMed  CAS  Google Scholar 

  90. Marshall JC, Christou NV, Horn R et al (1988) The microbiology of multiple organ failure: the proximal gastrointestinal tract as an occult reservoir of pathogens. Arch Surg 123:309.

    Article  PubMed  CAS  Google Scholar 

  91. Baker JN, Deitch EA, Berg RD et al (1988) Hemorrhagic shock induces bacterial translocation from the gut. J Trauma 28:896.

    Article  PubMed  CAS  Google Scholar 

  92. Sori AJ, Rush BF Jr, Lyse TW et al (1988) The gut as source of sepsis after hemorrhagic shock. Am J Surg 155:187.

    Article  PubMed  CAS  Google Scholar 

  93. Koziol JM, Rush BF Jr, Smith SM et al (1988) Occurrence of bacteremia during and after hemorrhagic shock. J Trauma 28:10.

    Article  PubMed  CAS  Google Scholar 

  94. Rush BF Jr, Sori AJ, Murphy TF et al (1988) Endotoxemia and bacteremia during hemorrhagic shock. Ann Surg 207:549.

    Article  PubMed  Google Scholar 

  95. Goris RJA, Boekholtz WKF, van Bebber IPT et al (1986) Multiple organ failure and sepsis without bacteremia: an experimental model. Arch Surg 121:897.

    Article  PubMed  CAS  Google Scholar 

  96. Deitch EA, Kemper AC, Specian RD et al (1992) A study of the relationship among survival, gut origin sepsis, and bacterial translocation in a model of systemic inflammation. J Trauma 32:141.

    Article  PubMed  CAS  Google Scholar 

  97. Fukushima R, Gianotti L, Alexander JW et al (1992) The degree of bacterial translocation is a determinant factor for mortality after burn injury and is improved by prostaglandin analogs. Ann Surg 216:438.

    Article  PubMed  CAS  Google Scholar 

  98. Morales J, Kibsey P, Thomas PD et al (1992) The effects of ischemia and ischemia-reperfusion on bacterial translocation, lipid peroxidation and gut histology: studies on hemorrhagic shock in pigs. J Trauma 33:221.

    Article  PubMed  CAS  Google Scholar 

  99. Moore FA, Moore EE, Poggetti R et al (1991) Gut bacterial translocation via the portal vein: a clinical perspective with major torso trauma. J Trauma 31:629.

    Article  PubMed  CAS  Google Scholar 

  100. Levine GM, Deren JJ, Steiger E et al (1974) Role of intake in maintenance of gut mass and disaccharide activity. Gastroenterology 67:975.

    PubMed  CAS  Google Scholar 

  101. Mochizuki H, Trocki O, Dominioni L et al (1984) Mechanism of prevention postburn hypermetabolism and catabolism by early enteral feeding. Ann Surg 200:297.

    Article  PubMed  CAS  Google Scholar 

  102. O’Dwyer ST, Scott T, Smith RJ et al (1987) 5-fluorouracil toxicity on small intestinal mucosa but not white blood cells is decreased by glutamine. Clin Res 35:369 (abstract).

    Google Scholar 

  103. Alexander JW (1986) Nutrition and infection: new perspectives for an old problem. Arch Surg 121:966.

    Article  PubMed  CAS  Google Scholar 

  104. Moore FA et al (1989) TEN versus TPN following major abdominal-reduced septic morbidity. J Trauma 29:916.

    Article  PubMed  CAS  Google Scholar 

  105. Cerra FB et al (1991) Nutrient modulation of inflammatory and immune function. Ann J Surg 161:230.

    Article  CAS  Google Scholar 

  106. Daly JM, Lieberman MD, Goldfine J et al. (1992) Enteral nutrition with supplemental arginine, RNA and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome. Surgery 112:56.

    PubMed  CAS  Google Scholar 

  107. Cerra FB et al (1990) Effects of enteral nutrient on in vitro tests of immune function in ICU patients: a preliminary report. Nutrition 56:84.

    Google Scholar 

  108. Stowtenbeek CP, Seane HFK, Miranda DR et al (1984) The effect of SDD on colonization and infection rate in multiple trauma patients. Intensive Care Med 10:185.

    Article  Google Scholar 

  109. Ledingham IM, Eastaway AT, McKay IC et al (1988) Triple regimen of SDD, systemic cefotaxime, and microbiological surveillance for prevention and acquired infection in ICU. Lancet i:785.

    Article  Google Scholar 

  110. Kerver AIH, Rommes JA, Meuisseu-Verhage EAE et al (1988) Prevention of colonization and infection in critically ill patients: a prospective randomized study. Intensive Care Med 16:1087.

    CAS  Google Scholar 

  111. Brun-Buissen C, Legrande P, Rauss A et al (1989) Intestinal decontamination for control of nosocomial multi-resistant and gram negative bacilli. Study of an outbreak in an intensive care unit. Ann Intern Med 110:873.

    Google Scholar 

  112. Hartenauer U, Muney AE, Williams PS et al (1990) Infection surveillance and selective decontamination of the digestive tract (SDD) in critically ill patients: results of a controlled study. Infection 18:522.

    Article  Google Scholar 

  113. Cerra FB, Maddaus MA, Dunn DL et al (1992) Selective gut decontamination reduces nosocomial infections and length of stay but not mortality or organ failure in surgical intensive care unit patients. Arch Surg 127:163.

    Article  PubMed  CAS  Google Scholar 

  114. Koruda MJ (1993) Gut sterilization to prevent nosocomial infection. In: Solonkin JS (ed) New Horizons, p 1994.

    Google Scholar 

  115. Chin C, Scott W, Gurd F (1970) Intestinal mucosal lesion in low-flow states. II: the protective effect of intraluminal glucose as energy substrate. Arch Surg 101:484.

    Article  Google Scholar 

  116. Shute K (1976) Effect of intraluminal oxygen on experimental ischemia of the intestine. Gut 17:1001.

    Article  PubMed  CAS  Google Scholar 

  117. Oldham K, Guice K, Gore D et al (1987) Treatment of intestinal ischemia with oxygenated intraluminal perfluorocarbons. Am J Surg 153:291.

    Article  PubMed  CAS  Google Scholar 

  118. Salzman A, Wallert S, Warre H et al (1993) Intraluminal oxygenation ameliorates ischemia/reperfusion-induced gut mucosal hypermeability in pigs. Circ Shock 40:37.

    PubMed  CAS  Google Scholar 

  119. Hyuang KF, Chung DH, Herndon DN (1993) Insulinlike growth factor reduces gut atrophy and bacterial translocation after severe burn injury. Arch Surg 128:47.

    Article  Google Scholar 

  120. Gianotti L, Alexander W, Jukushima R, Pyles T (1993) Reduction of bacterial translocation with oral fibroblast growth factor and sucralfate. Am J Surg 165:195.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. M. D. Pasquale
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  2. M. D. Cipolle
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  3. F. B. Cerra
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Editors and Affiliations

  1. Klinik für Anästhesiologie und Intensivtherapie, Klinikum der Friedrich Schiller-Universität Jena, Bachstraße 18, 07740, Jena, Germany

    Konrad Reinhart

  2. Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Steglitz der FU Berlin, Hindenburgdamm 30, 12200, Berlin, Germany

    Klaus Eyrich

  3. Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University, Medical Center, P. O. Box 12000, 91120, Jerusalem, Israel

    Charles Sprung (Direktor) (Direktor)

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Pasquale, M.D., Cipolle, M.D., Cerra, F.B. (1994). Bacterial Translocation: Myth versus Reality. In: Reinhart, K., Eyrich, K., Sprung, C. (eds) Sepsis. Update in Intensive Care and Emergency Medicine, vol 18. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-85036-3_7

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  • DOI: https://doi.org/10.1007/978-3-642-85036-3_7

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