Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
letter
. 1988 Jul;80(7):765–768.

Contribution of Intestinal Flora to Surgical Infections

Ashis K Mandal, Haragopal Thadepalli
PMCID: PMC2625787  PMID: 3404556

Abstract

Postoperative septic complications related to intestinal injury are regulated by a complex group of factors, including intestinal microflora, site of injury, surgical procedures used, and the type of antimicrobial therapy; however, a large number of yet-to-be understood factors also exist that influence septic morbidity associated with intestinal surgery. The authors present an overview of this serious complication of surgery.

Full text

PDF
765

Selected References

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

  1. Axelsson C. K., Justesen T. Studies of the duodenal and fecal flora in gastrointestinal disorders during treatment with an elemental diet. Gastroenterology. 1977 Mar;72(3):397–401. [PubMed] [Google Scholar]
  2. Brooks J. R., Smith H. F., Pease F. B., Jr Bacteriology of the stomach immediately following vagotomy: the growth of Candida albicans. Ann Surg. 1974 Jun;179(6):859–862. doi: 10.1097/00000658-197406000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Carboni M., Guadagni S., Pistoia M. A., Amicucci G., Tuscano D., Negro P., Smith P. L., Walters C. L. The microflora of the gastric juice after Billroth I and Billroth II partial gastrectomy. Scand J Gastroenterol. 1986 May;21(4):461–470. doi: 10.3109/00365528609015163. [DOI] [PubMed] [Google Scholar]
  4. Chan R. C., Reid G., Bruce A. W., Costerton J. W. Microbial colonization of human ileal conduits. Appl Environ Microbiol. 1984 Dec;48(6):1159–1165. doi: 10.1128/aem.48.6.1159-1165.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Corrodi P., Wideman P. A., Sutter V. L., Drenick E. J., Passaro E., Jr, Finegold S. M. Bacterial flora of the small bowel before and after bypass procedure for morbid obesity. J Infect Dis. 1978 Jan;137(1):1–6. doi: 10.1093/infdis/137.1.1. [DOI] [PubMed] [Google Scholar]
  6. Cummings J. H., James W. P., Wiggins H. S. Role of the colon in ileal-resection diarrhoea. Lancet. 1973 Feb 17;1(7799):344–347. doi: 10.1016/s0140-6736(73)90131-1. [DOI] [PubMed] [Google Scholar]
  7. Edmiston C. E., Jr, Hulsey T. K., Scott H. W., Jr, Hoyumpa A. M., Jr, Wilson F. A. Microbial colonization and hepatic abnormalities in jejunoileal bypass with resection, ileal mucous fistula, and ileocolostomy. J Infect Dis. 1979 Sep;140(3):358–369. doi: 10.1093/infdis/140.3.358. [DOI] [PubMed] [Google Scholar]
  8. 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]
  9. Giuliano M., Barza M., Jacobus N. V., Gorbach S. L. Effect of broad-spectrum parenteral antibiotics on composition of intestinal microflora of humans. Antimicrob Agents Chemother. 1987 Feb;31(2):202–206. doi: 10.1128/aac.31.2.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Goldberg M. J., Smith J. W., Nichols R. L. Comparison of the fecal microflora of Seventh-Day Adventists with individuals consuming a general diet. Implications concerning colonic carcinoma. Ann Surg. 1977 Jul;186(1):97–100. doi: 10.1097/00000658-197707000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gorbach S. L., Plaut A. G., Nahas L., Weinstein L., Spanknebel G., Levitan R. Studies of intestinal microflora. II. Microorganisms of the small intestine and their relations to oral and fecal flora. Gastroenterology. 1967 Dec;53(6):856–867. [PubMed] [Google Scholar]
  12. Greenlee H. B., Vivit R., Paez J., Dietz A. Bacterial flora of the jejunum following peptic ulcer surgery. Arch Surg. 1971 Apr;102(4):260–265. doi: 10.1001/archsurg.1971.01350040022005. [DOI] [PubMed] [Google Scholar]
  13. Gupta S., Reddy K. R., Sanyal S. C. Bacterial flora in acute small bowel obstruction. Chemotherapy. 1980;26(6):446–451. doi: 10.1159/000237941. [DOI] [PubMed] [Google Scholar]
  14. Kraeft H., Roos R., Mrozik E. Influence of gastrostomy on the colonization of the stomach: impact on neonatal septicaemia. Infection. 1985 Sep-Oct;13(5):211–215. doi: 10.1007/BF01667213. [DOI] [PubMed] [Google Scholar]
  15. Levy S. B., FitzGerald G. B., Macone A. B. Changes in intestinal flora of farm personnel after introduction of a tetracycline-supplemented feed on a farm. N Engl J Med. 1976 Sep 9;295(11):583–588. doi: 10.1056/NEJM197609092951103. [DOI] [PubMed] [Google Scholar]
  16. Lou M. A., Chen D. F., Bansal M., Balasubramaniam S., Thadepalli H. Evaluation of ceftizoxime in acute peritonitis. J Antimicrob Chemother. 1982 Nov;10 (Suppl 100):183–189. doi: 10.1093/jac/10.suppl_c.183. [DOI] [PubMed] [Google Scholar]
  17. Lou M. A., Mandal A. K., Alexander J. L., Thadepalli H. Bacteriology of the human biliary tract and the duodenum. Arch Surg. 1977 Aug;112(8):965–967. doi: 10.1001/archsurg.1977.01370080063010. [DOI] [PubMed] [Google Scholar]
  18. Lou M. A., Thadepalli H., Sims E. H., Mandal A. K. Comparison of cefamandole and carbenicillin in preventing sepsis following penetrating abdominal trauma. Am Surg. 1985 Oct;51(10):580–586. [PubMed] [Google Scholar]
  19. Mandal A. K., Thadepalli H., Matory E., Lou M. A., O'Donnell V. A., Jr Evaluation of antibiotic therapy and surgical techniques in cases of homicidal wounds of the colon. Am Surg. 1984 May;50(5):254–257. [PubMed] [Google Scholar]
  20. Marshall B. J., Armstrong J. A., McGechie D. B., Glancy R. J. Attempt to fulfil Koch's postulates for pyloric Campylobacter. Med J Aust. 1985 Apr 15;142(8):436–439. doi: 10.5694/j.1326-5377.1985.tb113443.x. [DOI] [PubMed] [Google Scholar]
  21. Marshall B. J., Warren J. R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984 Jun 16;1(8390):1311–1315. doi: 10.1016/s0140-6736(84)91816-6. [DOI] [PubMed] [Google Scholar]
  22. Moore W. E., Cato E. P., Holdeman L. V. Anaerobic bacteria of the gastrointestinal flora and their occurrence in clinical infections. J Infect Dis. 1969 Jun;119(6):641–649. doi: 10.1093/infdis/119.6.641. [DOI] [PubMed] [Google Scholar]
  23. Nichols R. L., Broido P., Condon R. E., Gorbach S. L., Nyhus L. M. Effect of preoperative neomycin-erythromycin intestinal preparation on the incidence of infectious complications following colon surgery. Ann Surg. 1973 Oct;178(4):453–462. doi: 10.1097/00000658-197310000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Nichols R. L., Smith J. W., Klein D. B., Trunkey D. D., Cooper R. H., Adinolfi M. F., Mills J. Risk of infection after penetrating abdominal trauma. N Engl J Med. 1984 Oct 25;311(17):1065–1070. doi: 10.1056/NEJM198410253111701. [DOI] [PubMed] [Google Scholar]
  25. O'Donnell V. A., Lou Sister, Alexander J. L., Mandal A. K. Role of antibiotics in penetrating abdominal trauma. Am Surg. 1978 Sep;44(9):574–577. [PubMed] [Google Scholar]
  26. O'Donnell V., Mandal A. K., Lou S. M., Thadepalli H. Evaluation of carbenicillin and a comparison of clindamycin and gentamicin combined therapy in penetrating abdominal trauma. Surg Gynecol Obstet. 1978 Oct;147(4):525–528. [PubMed] [Google Scholar]
  27. Rosseland A. R., Midtvedt T., Aasen A. O. Gallbladder and duodenal bacterial flora after papillotomy in rabbits. Scand J Gastroenterol. 1982 Sep;17(6):785–790. doi: 10.3109/00365528209181094. [DOI] [PubMed] [Google Scholar]
  28. 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]
  29. Sykes P. A., Boulter K. H., Schofield P. F. Alterations in small-bowel microflora in acute intestinal obstruction. J Med Microbiol. 1976 Feb;9(1):13–22. doi: 10.1099/00222615-9-1-13. [DOI] [PubMed] [Google Scholar]
  30. Thadepalli H., Lou M. A., Bach V. T., Matsui T. K., Mandal A. K. Microflora of the human small intestine. Am J Surg. 1979 Dec;138(6):845–850. doi: 10.1016/0002-9610(79)90309-x. [DOI] [PubMed] [Google Scholar]
  31. Thadepalli H., Mandal A. K., Prabhala R. H., Brown J. Antibiotic levels in the small intestine. Surg Gynecol Obstet. 1986 Dec;163(6):561–567. [PubMed] [Google Scholar]
  32. Vince A., O'Grady F., Dawson A. M. The development of ileostomy flora. J Infect Dis. 1973 Nov;128(5):638–641. doi: 10.1093/infdis/128.5.638. [DOI] [PubMed] [Google Scholar]
  33. Wands J. R., LaMont J. T., Mann E., Isselbacher K. J. Arthritis associated with intestinal-bypass procedure for morbid obesity. Complement activation and characterization of circulating cryoproteins. N Engl J Med. 1976 Jan 15;294(3):121–124. doi: 10.1056/NEJM197601152940301. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES