Bacterial translocation occurs in humans after traumatic injury: Evidence using immunofluorescence

Collin E. Collin, S. E. Ross, R. Nagele, A. J. Mure, K. F. O’malley, F. A. Garcia-Perez

Research output: Contribution to journalArticlepeer-review

103 Scopus citations

Abstract

We evaluated the occurrence of bacterial translocation (BT) in humans after traumatic injury. Twenty trauma patients (18 with blunt trauma) requiring celiotomy and without hollow viscus injury were studied. After surgical hemostasis and repair, portal venous blood (PVB) was sampled for culture. Additionally, a mesenteric lymph node (MLN) was harvested for culture and indirect immunofluorescence analysis using, first, mouse monoclonal antibody to E. coll beta-galactosidase, then goat anti-mouse immunoglobulin G (IgG). Injury Severity Score (ISS), Trauma Score (TS), and period of hemorrhagic shock (HS; systolic BP < 90 mm Hg with blood loss > 500 mL) were recorded before specimens were obtained. Results: Fifteen patients initially had HS (mean period of 60 minutes). Mean TS and ISS were 10 and 29, respectively. Seven patients did not have HS (mean TS and ISS, 10 and 13). Three patients received antibiotics preoperatively. Portal venous blood culture produced positive results in only three patients (two with HS) and culture of the MLN specimen was positive in one. However E. coll beta-galactosidase was detected within the cytoplasm of macrophages in all MLNs. One patient developed multiple organ failure. Conclusion: Bacterial translocation occurs in humans following traumatic injury and may be independent of HS. Culture techniques may not detect BT since organisms may have been phagocytized by macrophages. The clinical significance of BT in trauma patients remains unclear.

Original languageEnglish (US)
Pages (from-to)586-590
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume34
Issue number4
DOIs
StatePublished - Apr 1993
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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