烧伤后免疫抑制引起肠道细菌迁移和内源性感染的实验研究

Bacterial translocation from GI tract and endogenous infection induced by immunosuppression after burn

我们报告了25%烧伤后腹腔内注射地塞米松大鼠肠道细菌迁移及其引起的内源性感染。烧伤后注射地塞米松组(n=31)肠道细菌迁移发生率为67.4%,内脏脓肿发生率为65.5%,显著高于仅注射地塞米松组(n=15)。烧伤对照组(n=15)和空白对照组也出现了肠道细菌迁移(前者为3/15,后者为1/23),但未出现内源性感染。感染的细菌为肠遭中的肠杆菌(大肠杆菌占优势)和棒状杆菌。从微生态学上讨论了烧伤后肠道细菌迁移引起的内源性感染的机理。

This study described the endogenous infections and bacterial translocation from GI tract caused by immunosuppression after burn. In the group of burned plus injected dexamethasone (DXM) (BIS, n=31), the rate of enteric bacteria translocation was 67.4%, the rate of visceral abscess was 65.5%, much more higher than in the group of only DXM (IS, n=15). The translocation of intestinal bacteria also was found in the group of only burned (BU 3/15) and control (ck, 1/23), but endogenous infection did not occur in both group. The bacteria cultured from the rat organs are mainly enteric bacilli and corynebacterium. It was assumed that the endogenous infection was originated from the conditions in which the micro-ecologic system of indigenous intestinal flora was disturbed, immunologic function was suppressed by the overlapped effect of burn and injection of DXM, the biological antogonism among the intestinal flora was attenuated, and the intestinal bacilli overgrew, passed through the epithelia of intestine into lymphatic vessel and mesenteric lymph nodes, then colonized and multiplied in other organs, resulting in endogenous infection.