Gastric colonisation, @entity1944 and septic morbidity in acute XXXX .

@entity1 @entity1944 @entity788 @entity295 @entity11884 @entity20689 @entity356
INTRODUCTION: Bacterial translocation (BT) may represent an important cause of septic morbidity in @entity1 with acute @entity788 . We have previously demonstrated an association between BT, septic morbidity and colonisation of the proximal GI tract. Alterations in @entity1944 ( @entity1944 ) may also predispose to BT. The aim of this study was to assess the extent of @entity356 , measure @entity1944 in @entity1 with acute @entity788 and relate these to both disease severity and septic complications. METHODS: Gastric colonisation was determined by culturing a sample of nasogastric aspirate, and @entity1944 was measured using a dual sugar probe technique ( @entity11884 / @entity20689 test). Disease severity was assessed according to the modified Glasgow (Imrie) criteria. All septic complications were recorded prospectively. RESULTS: A total of 59 @entity1 were studied (M:F ratio 32:27, median age 66 years, range 18-89), 24 (31%) of whom had severe disease. A nasogastric aspirate was obtained in 56 @entity1 . There was a significantly higher incidence of colonisation with potentially pathogenic enteric bacteria in @entity1 with severe disease compared to those with mild disease (57 vs. 6%, p < 0.001). Septic morbidity occurred in 29% of severe @entity1 and 11% mild @entity1 (p = 0.17). 33% of @entity1 colonised with enteric organisms developed @entity295 , compared to 16% with no enteric bacteria in the NG aspirate (p = 0.34). Enteric bacteria caused 77% of the septic complications. Intestinal permeability was neither associated with disease severity nor was it predictive of septic morbidity. CONCLUSIONS: There is significantly higher incidence of @entity356 with enteric bacteria in @entity1 with severe acute @entity788 , but no difference in @entity1944 . Enteric bacteria were implicated in the majority of septic complications. These findings support the gut origin of @entity295 in acute @entity788 .
