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V Soltesz

Publications and source records attributed to V Soltesz.

31 records · Page 2Linked to original sources

The effect of biliary decompression on bacterial translocation in jaundiced rats.

Patients with obstructive jaundice are prone to septic complications after biliary tract operations. Restoring bile flow to the intestine may help to decrease the complication rate. The present study is aimed at evaluating the effect of biliary decompression on bacterial translocation in jaundiced rats. Sixty-six male Sprague-Dawley rats were randomly allocated to six groups subjected to common bile duct ligation (CBDL) and transection (groups 2-6) or sham operation (group 1). In groups 1 and 2 the incidence of enteric bacterial translocation was determined 2 weeks after sham operation or CBDL. In groups 3-6, biliary decompression was achieved by performing a choledochoduodenostomy after 2 weeks of biliary decompression. Bacterial translocation was then studied 1, 2, 3 and 5 weeks following biliary decompression. The rate of bacterial translocation to mesenteric lymph nodes in obstructive jaundice was significantly higher as compared with controls and decreased with time to nil three weeks following biliary decompression. The incidence of bacterial translocation was closely correlated (r = 0.844; p = 0.034) with serum alkaline phosphatase activity and seemed to fit with the morphological changes noted in the small intestine. The decrease in bacterial translocation, however, lags behind the recovery of liver function as measured by routine liver function tests and antipyrine clearance. Obstructive jaundice thus promotes bacterial translocation in the rat. Biliary decompression gradually decreases the rate of bacterial translocation.

Animals↗

The influence of surgically induced acute liver failure on the intestine in the rat.

The influence of acute liver failure induced by 90% hepatectomy on the intestine was evaluated in the rat. Small-intestinal mucosal mass decreased 2 h after hepatectomy. Microvillous height decreased significantly from 1 h and on, and villous height and area in the distal small intestine from 2 h after operation. Ninety per cent hepatectomy resulted in a decrease in systemic arterial blood pressure and an increase in portal venous pressure. Subserosal microcirculation and small-arterial circulation in the proximal and distal small intestine and colon decreased significantly after 90% hepatectomy. Overgrowth and colonization of Escherichia coli occurred in the distal small intestine from 1 h and on after hepatectomy. Protein content in enterocytes and bile secretion from the liver remnant were markedly reduced in hepatectomized rats. Thus, the present study shows evidence of alterations in intestinal morphology and function that can contribute to explain the enteric bacterial translocation after surgically induced acute liver failure.

Animals↗

Modification of reticuloendothelial function by muramyl dipeptide-encapsulated liposomes in jaundiced rats treated with biliary decompression.

Rats with 2 weeks of biliary obstruction, with and without 1 week of concomitant biliary decompression relieving the jaundice, were treated with physiologic saline, free muramyl dipeptide (MDP), placebo liposomes, or liposome-encapsulated MDP. Reticuloendothelial system (RES) function was evaluated by blood clearance of intravenously injected 125I-labelled Escherichia coli. The corrected phagocytic index (alpha) after 1 week of biliary decompression returned to normal levels in animals treated with MDP liposomes, whereas RES function was impaired (P < 0.05) in all other jaundiced and biliary-decompressed groups. In the biliary-decompressed, MDP-liposome-treated group, hepatic uptake of radiolabelled bacteria was significantly higher (P < 0.05) and renal entrapment of bacteria was significantly lower (P < 0.05) than in all other jaundiced and biliary-decompressed groups. We conclude that treatment with MDP liposomes improves the otherwise impaired RES function in rats with biliary obstruction and biliary decompression.

Acetylmuramyl-Alanyl-Isoglutamine↗

Pulmonary infections of gut origin after major liver resection in rats.

OBJECTIVE: To assess the incidence of translocation of enteric bacteria to the lungs in the early postoperative period (1, 2, 4, and 6 hours) after sham operation, 70% hepatectomy, and 90% hepatectomy. DESIGN: Randomised laboratory experiment. SETTING: University department. MATERIAL: 96 Adult male Sprague-Dawley rats. INTERVENTIONS: Sham operation (n = 24), 70% hepatectomy (n = 36), and 90% hepatectomy (n = 36). Injection of 1 ml (1.5 x 10(7) cpm/rat) 125I-labelled heat-killed Escherichia coli 15 minutes before the animals were killed. MAIN OUTCOME MEASURES: Arterial blood gas analyses, wet: dry weight ratio of lungs, and measurements of pulmonary isotopic flux (amount of 125I radioactivity in the lungs compared with that in the blood) 1, 2, 4, and 6 hours after operation. Quantitative microbiology of lungs. RESULTS: There was no pulmonary oedema in those rats that underwent sham operation. Pulmonary oedema had developed by 6 hours after 70% hepatectomy and by 2 hours after 90% hepatectomy. The lung:blood ratio of 125I-labelled bacteria increased as the pulmonary oedema developed, but pulmonary oxygen exchange was not influenced during the first 6 hours after hepatectomy. The incidence of bacterial translocation increased with the extent of hepatectomy and with the length of time after operation. CONCLUSION: Bacterial translocation from the gut could lead to pulmonary infection after major liver resection in rats.

Animals↗

Bacterial translocation after major hepatectomy in patients and rats.

Bacterial infections are frequent complications after liver resection. Of 138 patients who underwent major hepatectomy, 11 patients (8%) developed intra-abdominal sepsis in the postoperative period. Seven bacterial strains of gut origin were isolated from the abdominal cavity. Eight patients had multiple bacteria cultured. In the experimental studies on rat models, positive mesenteric lymph node cultures were seen 2 hours after removal of 70% and 90% of the total weight of the rat liver, and 12 hours after 50% hepatectomy, persisting for 3 and 4 days after 50% and 70% hepatectomy, respectively. The incidences of bacteremia 2 and 4 hours after 90% hepatectomy were 80% and 100%, respectively; 6 hours after 70% liver resection, the incidence of bacteremia was 33%. Blood cultures were positive in only 6% of the rats following 50% hepatectomy, and in none of the controls. Thus, bacterial translocation occurs in the early course after hepatectomy, the incidence being proportional to the amount of liver tissue removed.

Abdomen↗

Optimal survival of Helicobacter pylori under various transport conditions.

The ability of clinical isolates and type strains of Helicobacter pylori to survive in Stuart transport medium, isotonic saline solution, and urea-containing isotonic saline was evaluated. The influences of temperature (4, 10, 15, 20, and 30 degrees C) and holding time (6 to 48 h) and the effect of exposure to air on survival were also studied. The recovery rate of H. pylori was highest from Stuart transport medium in comparison with the recoveries from the other transport media tested. We found that at holding temperatures above 15 degrees C the organisms became noncultivable within 6 h or less, while they survived for 2 days or longer at 10 degrees C. The presence of urea at a concentration of 2% (wt/vol) in isotonic saline resulted in the loss of viability of the organisms tested.

Air↗

Aerobic and anaerobic bacteria in neurosurgical infections. Per-operative culture with flexible contact agar film.

Fourteen of 80 patients (17.5 per cent) who underwent elective craniotomy preceded by a strict pre-operative routine of skin decontamination contracted postoperative wound infection. Most of the infections were probably from endogenous sources and from eight of the wounds low-virulent resident skin bacteria, Propionibacterium acnes and/or Staphylococcus epidermidis, were isolated. Since thorough pre-operative preparation of the skin did not reduce the incidence of infection to an acceptable level, antibiotic prophylaxis might be indicated in this type of surgery.

Bacteria↗

Single-strain regression analysis for quality control of cephalothin-susceptibility testing and determination of interpretive breakpoints.

Histogram analysis of inhibition zone diameters around the 30 micrograms cephalothin disk for E. coli, P. mirabilis, and K. pneumoniae in samples from 1975 to 1982 showed a marked reproducibility of the disk-diffusion antibiotic-susceptibility test in the routine laboratory. A comparison of interpretive breakpoints with histograms for E. coli, P. mirabilis, K. pneumoniae, S. aureus, coagulase-negative staphylococci, and S. faecalis showed a higher proportion of possible misinterpretations using the breakpoints of the Swedish Reference Group, SRG, as compared to international (NCCLS) breakpoints. Further analysis using single-strain regression analysis revealed two major causes of interpretive errors. Firstly, the laboratory-related regression line for a bacterial species can be different from the general regression line of the reference laboratory. This difference has to be corrected by using species-related breakpoints. For E. coli, a species-specific breakpoint was determined to R = greater than 13 mm. Secondly, MIC limits recommended for the susceptibility categories of cephalothin by SRG are lower than the international limits and close to the true MIC values of many bacterial isolates, leading to misinterpretations due to the methodological variation. These studies suggest an adoption of international MIC limits for the susceptibility categories of cephalothin in Scandinavia. The "I" category should denote an indeterminate zone. A multi-laboratory quality control assessment using histogram analysis is recommended with optional single-strain regression analysis to determine breakpoints for problem combinations of bacterial species and antibiotics.

Bacteria↗

Gut origin sepsis, macrophage function, and oxygen extraction associated with acute pancreatitis in the rat.

It has been suggested that the gut plays a role in the development of bacterial complications, which are important contributors to morbidity and mortality in patients with acute pancreatitis. The present study evaluated the enteric bacterial translocation, bacterial homeostasis, and reticuloendothelial system function in experimental acute pancreatitis induced by intraductal injection of 5% sodium taurodeoxycholate in the rat. The incidence of bacterial translocation from the gut to mesenteric lymph nodes (MLNs) and lungs significantly increased after 12 hours and to the systemic circulation, ascites, and pancreas at 24 hours. The number of anaerobic bacteria and lactobacilli decreased in the colon and distal ileum from 6 or 12 hours, whereas the number of Escherichia coli increased from 12 hours. The systemic uptake rate of radiolabeled bacteria decreased from 6 hours after induction of acute pancreatitis. The uptake of radiolabeled bacteria by Kupffer cells decreased from 6 hours, whereas the uptake by macrophages from blood, lungs, and the intestine increased. A decrease in macrophage killing capacity was noted, reflected by an increase in the number of cultured viable bacteria from isolated macrophages. The whole-body oxygen extraction rate increased 4 to 24 hours after induction of pancreatitis, whereas the gut oxygen extraction rate decreased at 2 and 4 hours, followed by an increase at 12 to 24 hours. These data show that translocation of enteric bacteria occurs during the early stage of acute pancreatitis and that the MLN-thoracic duct-circulation may be a major route of bacterial dissemination. Compromised gut oxygen metabolism, overexaggerated intestinal macrophages, and impaired host immune function may be involved in the development of infectious complications associated with acute pancreatitis.

Animals↗

The role of bile and bile acids in bacterial translocation in obstructive jaundice in rats.

Male Sprague-Dawley rats were randomly divided into five groups in which group 1 received a sham operation (controls), groups 2-5 underwent common bile duct ligation and transection 14 days before the experiments. Two days prior to the studies, animals in groups 1 and 2 received saline orally, while groups 3-5 received an oral administration of either cholic acid, deoxycholic acid or whole bile. Specimens were taken for bacterial culture, and blood was collected for endotoxin assay. The rate of positive bacterial cultures from mesenteric lymph nodes in jaundiced saline-treated animals was significantly higher (p < 0.05) as compared with both controls and the other jaundiced animals treated with either bile or bile acids. Assays were positive for endotoxin in the jaundiced saline-treated group, whereas they were negative in both controls and bile- or bile-acid-treated animals. We conclude that oral administration of cholic acid, deoxycholic acid or whole bile inhibited bacterial translocation and endotoxin absorption in obstructive jaundice in the rat.

Animals↗

Effects of a water-soluble ethylhydroxyethyl cellulose on gut physiology, bacteriology, and bacterial translocation in acute liver failure.

Bacterial infection and bacteremia are common complications in patients with acute liver failure. Bacterial translocation from the gut has been suggested to be a major cause of bacterial infections in experimental acute liver failure. In the present study, a water-soluble ethylhydroxyethyl cellulose (EHEC) was administered orally 1 and 24 hours prior to 90% hepatectomy in the rat in order to prevent bacterial translocation in experimental acute liver failure induced by subtotal liver resection in the rat. Ninety percent hepatectomy alone resulted in 80 to 100% translocation to mesenteric lymph nodes or blood 2 and 4 hours after operation. There was no translocation in rats undergoing sham operation or 90% hepatectomy with EHEC administration prior to operation (p < .01). Bacterial overgrowth, increased bacterial adherence onto the intestinal surface, and diminished intestinal and mucosal mass were also observed in animals with subtotal liver resection, but not in those administered EHEC. A delayed 2-hour intestinal transit time occurred in both groups receiving subtotal liver resection, with or without oral EHEC. EHEC inhibited bacterial growth and DNA synthesis and altered bacterial surface properties after 1-hour incubation with bacteria in vitro, an interaction that was not further influenced by time. These results imply that EHEC may alter enterobacterial capacities of metabolism, proliferation, and invasion by effects on the bacterial surface. Furthermore, EHEC seems to possess a trophic action on the intestine, though without enhancing the intestinal motility.

Acute Disease↗

Effect of portal hypertension on bacterial translocation induced by major liver resection in rats.

OBJECTIVE: To evaluate the influence of portal hypertension on bacterial translocation from the gut caused by major hepatic resection. DESIGN: Randomised study. SETTING: University of Lund, Sweden. MATERIAL: 228 adult male Sprague-Dawley rats. INTERVENTIONS: Laparotomy and separation of the liver from its attachments (sham operated group), 70% hepatic resection, 90% hepatic resection, or subtotal ligation of the portal vein. For assessment of the degree of bacterial translocation a further laparotomy was done, 0.2 ml of blood taken from the portal vein and the vena cava, and specimens taken of mesenteric lymph nodes, liver, spleen, lungs, proximal jejunum, distal ileum, and transverse colon. Microcirculation of the intestine was measured by laser Doppler flowmetry with the probe held gently against the bowel wall at six points randomly chosen from the distal small intestine and colon. MAIN OUTCOME MEASURES: Alterations in portal venous pressure, arterial pressure, and bacterial translocation to other organs, particularly mesenteric lymph nodes. RESULTS: Bacterial translocation increased significantly after 90% hepatectomy, and there was an increase in portal pressure together with a decrease in systemic arterial pressure after both 90% hepatectomy and subtotal ligation of the portal vein. Subserosal blood flow to the distal small intestine decreased after 70% resection, 90% resection, and subtotal ligation of the portal vein; subserosal blood flow to the colon decreased only after 90% hepatectomy. CONCLUSION: Increased portal venous pressure after major hepatic resection is not the sole cause of the increase in the incidence of bacterial translocation from the gut in rats.

Animals↗