Abstract
The microbial flora of the normal human gastrointestinal (GI) tract is enormously complex. The number of organisms that normally reside along the mucosal surface stretching from the oropharynx to the rectum exceeds the total number of cells in the human body by a factor of ten [1]. Careful studies of the nature of this flora have shown that it consists of upwards of 600 separate microbial species, each tending to associate with a specific anatomical niche in the GI tract, yet the total population is remarkably stable over time [2]. Under normal circumstances, this flora exists in a symbiotic relationship with the adjacent epithelial cells of the GI mucosa, and remains located on the luminal surface where it prevents colonization by potentially pathogenic organisms [3] and even modulates the immunological activity of epithelial cells of the host [4]. However a variety of pathological conditions can disrupt the relationship between the indigenous flora of the GI tract and the gut epithelium, and organisms can gain entrance to deeper tissues; this process has been termed “bacterial (or more appropriately “microbial”) translocation”.
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References
Savage DC (1977) Microbial ecology of the gastrointestinal tract. Annu Rev Med 31: 107–133
Lee A (1985) Neglected niches. The microbial ecology of the gastrointestinal tract. Adv Microbial Ecol 8: 115–162
Van Der Waaij D (1989) The ecology of the human intestine and its consequences for overgrowth by pathogens such as Clostridium difficile. Annu Rev Microbiol 43: 69–87
Neish AS, Gewirtz AT, Zeng H, et al (2000) Prokaryotic regulation of eptihelial responses by inhibition of IkBa ubiquitination. Science; 289: 1560–1563
Adami JG (1914) Chronic intestinal stasis: autointoxication and subinfection. B M J 1: 177–183
Fine J, Frank ED, Ravin HA, et al (1959) The bacterial factor in traumatic shock. N Engl J Med 260: 214–220
Berg RD (1981) Promotion of the translocation of enteric bacteria from the gastrointestinal tracts of mice by oral treatment with penicillin, clindamycin, or metronidazole. Infect Immun 33: 854–861
Deitch EA (1990) The role of intestinal barrier failure and bacterial translocation in the development of systemic infection and multiple organ failure. Arch Surg 125: 403–404
Carrico CJ, Meakins JL, Marshall JC et al (1986) Multiple organ failure syndrome. The gastrointestinal tract: The ‘motor’ of MOF. Arch Surg 121: 196–208
Wells CL, Maddaus MA, Simmons RL (1988) Proposed mechanisms for the translocation of intestinal bacteria. Rev Infect Dis 10: 958–979
Berg RD (1999) Bacterial translocation from the gastrointestinal tract. Adv Exp Med Biol 473: 11–30
Wells CL, Maddaus MA, Erlandsen SL, Simmons RL (1988) Evidence for the phagocytic transport of intestinal particles in dogs and rats. Infect Immun 56: 278–282
Kucharzik T, Lugering N, Rautenberg K, et al (2000) Role of M cells in intestinal barrier function. Ann NY Acad Sci 915: 171–183
Wells CL, Westerlo EM van de, Jechorek RP, Erlandsen SL (1996) Intracellular survival of enteric bacteria in cultured human enterocytes. Shock 6: 27–34
Sansonetti PJ (2001) Microbes and microbial toxins: paradigms for microbial-mucosal interactions III. Shigelosis: from symptoms to molecular pathogenesis. Am J Physiol Gastrointest Liver Physiol 280: G319 - G323
Lecuit M, Vandormael-Pournin S, Lefort J, et al (2001) A transgenic model for listeriosis: role of internalin in crossing the intestinal barrier. Science 292: 1722–1725
Dombrowicz D, Nutten S, Desreumaux P, et al (2001) Role of the high affinity immunoglobulin E recetor in bacterial translocation and intestinal inflammation. J Exp Med 193: 25–34
Marshall JC (1999) The gastrointestinal flora and its alterations in critical illness. Curr Opin Crit Care 5: 119–125
Mattar AF, Drongowski RA, Coran AG, Harmon CM (2001) Effect of probiotics on enterocyte bacterial translocation in vitro. Pediatr Surg Internat 17: 265–268
Van Der Waaij D, Berghuis De Vries JM, Lekkerkerk Van Der Wees JEC (1971) Colonization resistance of the digestive tract in conventional and antibiotic treated mice. J Hyg Camb 69: 405–411
Deitch EA, Sittig K, Li M, et al (1990) Obstructive jaundice promotes bacterial translocation from the gut. Am J Surg 159: 79–84
Kuzu MA, Kale IT, Col C, et al (1999) Obstructive jaundice promotes bacterial translocation in humans. Hepato-gastroenterology 46: 2159–2164
Alverdy JC, Aoys E, Moss GS (1988) Total parenteral nutrition promotes bacterial translocation from the gut. Surgery 104: 185–190
Fazal N, Shamim M, Khan SS, et al (2000) Neutrophil depletion in rats reduces burn injury-induced intestinal bacterial translocation. Crit Care Med 28: 1550–1555
Eaves-Pyles T, Wong HR, Alexander JW (2000) Sodium arsenite induces the stress response in the gut and decreases bacterial translocation in a burned mouse model with gut-derived sepsis. Shock 13: 314–319
Alexander JW, Boyce ST, Babcock GF, et al (1990) The process of microbial translocation. Ann Surg 212: 496–512
Kane TD, Alexander JW, Johannigman JA (1998) The detection of microbial DNA in the blood: a sensitive method for diagnosing bacteremia and/or bacterial translocation in surgical patients. Ann. Surg 227: 1–11
Sakamoto H, Naito H, Ohta Y, et al (1999) Isolation of bacteria from cervical lymph nodes in patients with oral cancer. Arch Oral Biol 44: 789–793
Krause W, Matheis H, Wulf K (1969) Fungaemia and funguria after oral administration of Candida albicans. Lancet 1: 598–599
O’Boyle CJ, MacFie J, Mitchell CJ, et al (1998) Microbiology of bacterial translocation in humans. Gut 42: 29–35
Woodcock NP, Sudheer V, El-Barghouti N, et al (2000) Bacterial translocation in patients undergoing abdominal aortic aneurysm repair. Br J Surg 87: 439–442
Marshall JC, Christou NV, Meakins JL (1993) The gastrointestinal tract. The “undrained abscess” of multiple organ failure. Ann Surg 218: 111–119
MacFie J, O’Boyle C, Mitchell CJ, et al (1999) Gut origin of sepsis: a prospective study investigating associations between bacterial translocation, gastric microflora, and septic morbidity. Gut 45: 223–228
Andersen LW, Landow L, Baek L, et al (1993) Association between gastric intramucosal pH and splanchnic endotoxin, antibody to endotoxin, and tumor necrosis factor-a concentrations in patients undergoing cardiopulmonary bypass. Crit Care Med 21: 210–217
Soong CV, Blair PHB, Halliday ML, et al (1993) Endotoxemia, the generation of cytokines, and their relationship to intramucosal acidosis of the sigmoid colon in elective abdominal aortic aneurysm repair. Eur J Vasc Surg 7: 534–539
Buttenschoen K, Buttenschoen DC, Berger D, et al (2001) Endotoxemia and acute-phase proteins in major abdominal surgery. Am J Surg 181: 36–43
Winchurch RA, Thupari JN, Munster AM (1987) Endotoxemia in burn patients: Levels of circulating endotoxins are related to burn size. Surgery 102: 808–812
Niebauer J, Volk HD, Kemp M, et al (1999) Endotoxin and immune activation in chronic heart failure: a prospective cohort study. Lancet 353: 1838–1842
Woodcock NP, Robertson J, Morgan DR, et al (2001) Bacterial translocation and immunohistochemical measurement of gut immune function. J Clin Pathol 54: 619–623
Schoeffel U, Pelz K, Haring RU, et al (2000) Inflammatory consequences of the translocation of bacteria and endotoxin to mesenteric lymph nodes. Am J Surg 180: 65–72
Baxby D, van Saene HKF, Stoutenbeek CP, Zandstra DF (1996) Selective decontamination of the digestive tract: 13 years on, what it is and what it is not. Intensive Care Med 22: 699–706
D’Amico R, Pifferi S, Leonett C, et al (1998) Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomized controlled trials. B M J 316: 1275–1285
Nathens AB, Marshall JC (1999) Selective decontamination of the digestive tract ( SDD) in surgical patients. Arch Surg 134: 170–176
Kudsk KA, Croce MA, Fabian TC, et al (1992) Enteral versus parenteral feeding. Effects on septic morbidity after blunt and penetrating abdominal trauma. Ann Surg 215: 503–513
McGregor CS, Marshall JC (2001) Enteral feeding in acute pancreatitis: just do it. Curr Opin Crit Care; 7: 89–91
Demetriades D, Smith JS, Jacobsen LE, et al (1999) Bactericidal/permeability-increasing protein (rBPI21) in patients with hemorrhage due to trauma: results of a multicenter phase II clinical trial. J Trauma Injury Infect Crit Care; 46: 667–677
Lemaire LC, Lanschot JJ van, Stoutenbeek CP, et al (1997) Bacterial translocation in multiple organ failure: cause or epiphenomenon still unproven. Br J Surg 84: 1340–1350
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: 629–638
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Marshall, J.C. (2002). Microbial Translocation: from Myth to Mechanism. In: Baue, A.E., Berlot, G., Gullo, A., Vincent, JL. (eds) Sepsis and Organ Dysfunction. Springer, Milano. https://doi.org/10.1007/978-88-470-2213-3_10
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DOI: https://doi.org/10.1007/978-88-470-2213-3_10
Publisher Name: Springer, Milano
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