Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1988 Mar;207(3):341–346. doi: 10.1097/00000658-198803000-00020

Microbial colonization of tumors in relation to the upper gastrointestinal tract in patients with gastric carcinoma.

S Sjöstedt 1, L Kager 1, A Heimdahl 1, C E Nord 1
PMCID: PMC1493406  PMID: 3345120

Abstract

The microbial colonization of the oropharynx, the esophagus, the stomach, and the duodenum was studied in relation to the microbial flora found on tumor and gastric mucosal biopsies in 23 patients with gastric carcinoma. The tumor was colonized in all patients, and the stomach, the esophagus, the duodenum, and the gastric mucosa were colonized in 96%, 87%, 83%, and 78% of the patients, respectively. The most common microorganisms isolated were streptococci, bifidobacteria, lactobacilli, and Bacteroides species, belonging to the normal oropharyngeal flora. Microbial colonization with gram-negative rods, Clostridium species or yeasts, was present in at least one site in 91% of the patients. Clostridium species were isolated from 57% of the patients. The total numbers of microorganisms recovered from the tumor biopsies did not vary with the intraluminal gastric pH. A relation between the gastric pH and the total number of microorganisms in the gastric juice existed. Significant higher numbers of different strains of microorganisms (p less than 0.005) colonized the tumor compared to the gastric mucosa. Anaerobic microorganisms colonized the tumor significantly more often than the mucosa (p less than 0.001). Antibiotic agents used as prophylaxis in gastric cancer surgery should cover both aerobic and anaerobic microorganisms, including B. fragilis.

Full text

PDF
341

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Drasar B. S., Shiner M., McLeod G. M. Studies on the intestinal flora. I. The bacterial flora of the gastrointestinal tract in healthy and achlorhydric persons. Gastroenterology. 1969 Jan;56(1):71–79. [PubMed] [Google Scholar]
  2. Evans C., Pollock A. V. The reduction of surgical wound infections by prophylactic parenteral cephaloridine. A controlled clinical trial. Br J Surg. 1973 Jun;60(6):434–437. doi: 10.1002/bjs.1800600605. [DOI] [PubMed] [Google Scholar]
  3. Gatehouse D., Dimock F., Burdon D. W., Alexander-Williams J., Keighley M. R. Prediction of wound sepsis following gastric operations. Br J Surg. 1978 Aug;65(8):551–554. doi: 10.1002/bjs.1800650808. [DOI] [PubMed] [Google Scholar]
  4. Giannella R. A., Broitman S. A., Zamcheck N. Gastric acid barrier to ingested microorganisms in man: studies in vivo and in vitro. Gut. 1972 Apr;13(4):251–256. doi: 10.1136/gut.13.4.251. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hares M. M., Hegarty M. A., Warlow J., Malins D., Youngs D., Bentley S., Burdon D. W., Keighley M. R. A controlled trial to compare systemic and intra-incisional cefuroxime prophylaxis in high risk gastric surgery. Br J Surg. 1981 Apr;68(4):276–280. doi: 10.1002/bjs.1800680417. [DOI] [PubMed] [Google Scholar]
  6. Heimdahl A., Gahrton G., Groth C. G., Lundgren G., Lönnquist B., Ringden O., Nord C. E. Selective decontamination of alimentary tract microbial flora in patients treated with bone marrow transplantation. A microbiological study. Scand J Infect Dis. 1984;16(1):51–60. doi: 10.3109/00365548409068409. [DOI] [PubMed] [Google Scholar]
  7. Heimdahl A., Nord C. E. Effect of phenoxymethylpenicillin and clindamycin on the oral, throat and faecal microflora of man. Scand J Infect Dis. 1979;11(3):233–242. doi: 10.3109/inf.1979.11.issue-3.11. [DOI] [PubMed] [Google Scholar]
  8. Hill M. J., Drasar B. S., Williams R. E., Meade T. W., Cox A. G., Simpson J. E., Morson B. C. Faecal bile-acids and clostridia in patients with cancer of the large bowel. Lancet. 1975 Mar 8;1(7906):535–539. doi: 10.1016/s0140-6736(75)91556-1. [DOI] [PubMed] [Google Scholar]
  9. Keighley M. R., Burdon D. W., Gatehouse D. Rate of wound sepsis with "selective" short-term antibiotic prophylaxis in gastric surgery. World J Surg. 1982 Jul;6(4):445–449. doi: 10.1007/BF01657678. [DOI] [PubMed] [Google Scholar]
  10. Keighley M. R. Prevention of wound sepsis in gastro-intestinal surgery. Br J Surg. 1977 May;64(5):315–321. doi: 10.1002/bjs.1800640505. [DOI] [PubMed] [Google Scholar]
  11. Kekki M., Villako K., Tamm A., Siurala M. Dynamics of antral and fundal gastritis in an Estonian rural population sample. Scand J Gastroenterol. 1977;12(3):321–324. doi: 10.3109/00365527709180934. [DOI] [PubMed] [Google Scholar]
  12. Lewis R. T., Allan C. M., Goodall R. G., Lloyd-Smith W. C., Marien B., Wiegand F. M. Discriminate use of antibiotic prophylaxis in gastroduodenal surgery. Am J Surg. 1979 Nov;138(5):640–643. doi: 10.1016/0002-9610(79)90336-2. [DOI] [PubMed] [Google Scholar]
  13. Lewis R. T. Wound infection after gastroduodenal operations: a 10-year review. Can J Surg. 1977 Sep;20(5):435–440. [PubMed] [Google Scholar]
  14. LoCicero J., 3rd, Nichols R. L. Sepsis after gastroduodenal operations: relationship to gastric acid, motility, and endogenous microflora. South Med J. 1980 Jul;73(7):878–880. [PubMed] [Google Scholar]
  15. Muscroft T. J., Deane S. A., Youngs D., Burdon D. W., Keighley M. R. The microflora of the postoperative stomach. Br J Surg. 1981 Aug;68(8):560–564. doi: 10.1002/bjs.1800680813. [DOI] [PubMed] [Google Scholar]
  16. Nichols R. L., Smith J. W. Intragastric microbial colonization in common disease states of the stomach and duodenum. Ann Surg. 1975 Nov;182(5):557–561. doi: 10.1097/00000658-197511000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nichols R. L., Webb W. R., Jones J. W., Smith J. W., LoCicero J., 3rd Efficacy of antibiotic prophylaxis in high risk gastroduodenal operations. Am J Surg. 1982 Jan;143(1):94–98. doi: 10.1016/0002-9610(82)90136-2. [DOI] [PubMed] [Google Scholar]
  18. Polk H. C., Jr, Lopez-Mayor J. F. Postoperative wound infection: a prospective study of determinant factors and prevention. Surgery. 1969 Jul;66(1):97–103. [PubMed] [Google Scholar]
  19. Sjöstedt S., Heimdahl A., Kager L., Nord C. E. Microbial colonization of the oropharynx, esophagus and stomach in patients with gastric diseases. Eur J Clin Microbiol. 1985 Feb;4(1):49–51. doi: 10.1007/BF02148660. [DOI] [PubMed] [Google Scholar]
  20. Stone H. H., Hooper C. A., Kolb L. D., Geheber C. E., Dawkins E. J. Antibiotic prophylaxis in gastric, biliary and colonic surgery. Ann Surg. 1976 Oct;184(4):443–452. doi: 10.1097/00000658-197610000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Villako K., Tamm A., Savisaar E., Ruttas M. Prevalence of antral and fundic gastritis in a randomly selected group of an Estonian rural population. Scand J Gastroenterol. 1976;11(8):817–822. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES