Effects of H 2 Receptor Blocking Agents on Bacterial Translocation in Burn Injury*

Department of Pediatric Surgery, Ege University Faculty of Medicine, Izmir, Turkey.
European Journal of Pediatric Surgery (Impact Factor: 0.99). 11/1997; 7(5):278-81. DOI: 10.1055/s-2008-1071171
Source: PubMed


We experimentally studied the effects of H2 receptor blockers (ranitidine) on bacterial translocation (BT) in 42 male albino rats. Sham group (Group I, n = 12 rats) were exposed to 21 degrees C water while Burn group (Group II, n = 15 rats) and Ranitidine group (Group III, n = 15 rats) were exposed to 95 degrees C hot water for 10 seconds to produce a full thickness burn in 30% of total body surface area. 300 mg/kg ranitidine was administered to Group III starting immediately after the burn injury. Rats were sacrificed on the fifth postburn day. Sham group gained weight while groups II and III had significant weight loss. Gastric pH increased with the administration of ranitidine. Both gram negative and total number of bacteria were found to be reduced in cecal stool cultures in ranitidine group. Significant increase in BT was observed in Group III, and translocating bacteria were found to be different in burn and ranitidine groups with a final conclusion that administration of ranitidine changes intestinal ecological equilibrium and promotes BT.

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    ABSTRACT: In 1964 it was observed that small microscopic particles could be absorbed from the intestinal canal into the mesenteric circulation and into the lymphatics of the gastrointestinal tract.1 This phenomenon was termed “persorption.” Shortly after these observations, a technique was developed for the quantitative measurement of endotoxin in human plasma using the lysate technique of the horseshoe crab Limulus.2 It was next demonstrated that tissue homogenates obtained postmortem had measurable levels of endotoxin in 20 of 35 patients, particularly following major trauma, gastrointestinal (GI) bleeding, and liver injury. The findings were explained on the basis of failure of the reticuloendothelial system of the liver to detoxify circulating endotoxin of intestinal origin.
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    ABSTRACT: To investigate the effects of antibiotics and the probiotic, Saccharomyces boulardii, on indigenous microflora and bacterial translocation (BT) in burned rats. Twenty-three male albino rats were divided into a sham burn group (group 1, n = 7) exposed to 21 degrees C water, a burn + antibiotic group (group 2, n = 8), and a burn + antibiotic + S. boulardii group (group 3, n = 8) exposed to 95 degrees C water for 10 s, producing a full-thickness burn to 30% of the total body surface area. Ampicillin-sulbactam (1,000 mg/kg per day) was given as two doses via an orogastric feeding tube to groups 2 and 3. Saccharomyces boulardii (1 mg/g body weight per day) was given as two doses via the same route to group 3. All rats were killed on the fifth day postburn and cultures of the mesenteric lymph nodes, liver, spleen, blood, and cecal contents were done. The incidences of BT were 0% (0/7) in group 1, 87.5% (7/8) in group 2, and 37.5% (3/8) in group 3. A significant increase in the BT incidence was found in group 2 (P < 0.01), while a significant decrease was found in group 3 when compared with group 1. The total bacteria count of cecal flora was significantly lower in group 3 than in group 1 (P < 0.01). The decrease in Gram-negative bacteria in the cecal flora was significant in group 3. These results suggest that the incidence of BT in burn injury is enhanced by using an antibiotic, and that S. boulardii decreases the incidence of antibiotic-induced BT. Thus, we conclude that S. boulardii can effectively protect the intestinal ecologic equilibrium and prevent BT in burn injury victims.
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