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British Medical Bulletin 2004 71(1):1-11; doi:10.1093/bmb/ldh029
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Published online 13 December 2004

British Medical Bulletin, Vol. 71 © The British Council 2004; all rights reserved

Current status of bacterial translocation as a cause of surgical sepsis

John MacFie

Combined Gastroenterology Unit, Scarborough Hospital, Scarborough, UK

Correspondence to: John MacFie, The Combined Gastroenterology Unit, Scarborough Hospital, Woodland Drive, Scarborough, North Yorkshire YO12 6QL, UK. E-mail: Johnmacfie@aol.com

The first 150 words of the full text of this article appear below.


   Background
 
In recent years it has been increasingly recognized that the gastrointestinal tract has functions other than simply the digestion and excretion of foodstuffs. The gut is also a metabolic and immunological organ that serves as a barrier against living organisms and antigens within its lumen. This role is termed ‘gut barrier function’. The fact that luminal contents in the caecum have a bacterial concentration of the order of 1012 organisms per millilitre of faeces,1 whilst portal blood and mesenteric lymph nodes are usually sterile, dramatically illustrates the efficacy of this barrier function.

The idea that the alimentary tract, teeming with its own bacterial flora, could represent a source of sepsis under certain conditions has interested clinicians for many years. This theory, usually referred to as the ‘gut origin of sepsis’ hypothesis, is not new. In the late nineteenth century, the idea developed that peritonitis could result from the passage of . . . [Full Text of this Article]


   Bacterial translocation: human studies
 

   Factors influencing the prevalence of bacterial translocation
 
Host defence: the mucosal barrier and permeability

Gastrointestinal microflora

Immune status

Miscellaneous factors


   Bacterial translocation and nutritional support
 

   Gut-specific nutrients
 

   Bacterial translocation, sepsis and multiple organ failure
 

   Conclusion
 

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