TOLGA KATMER1, YEŞİM ERBİL3, HÜSNÜ ÖNDER1, NEZAHAT GÜRLER4, DİLEK YAVUZER2, ÜMİT İNCE2

1Haydarpaşa Numune Hastanesi, Genel Cerrahi Kliniği, İSTANBUL
2Haydarpaşa Numune Hastanesi, Patoloji Laboratuarı, İSTANBUL
3İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Çapa/İSTANBUL
4İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Mikrobiyoloji ABD, İSTANBUL

Abstract

Bacterial translocation which is observed arter trauma, shock, major burns, intestinal obstruction, cholestazis, radiotherapy, total parenteral nutrition is a result of intestinal mucosal disruption and immunological response modification lately, methods preventing bacterial translocation are frequently studied. In this paper the effects of glutamine which is the major fuel of enterocyts, on bacterial translocation are investigated.

Three experimental groups (n:10) of male Wistar-Albino rats are formed Group I, II, III received respectively standard laboratory food and water ad libidum, standard total parenteral nutrition and total parenteral nutrition with extra glutamine. All three groups are compared in respect with mesentary tymph node translocation, colonic intraluminal bacterial counts and histologic mocosal integrity. Bacterial translocation rate was observed to be 80% and 70% in Group II and III respectively. No bacterial growth was found in the control mesentary lymph nodes. Colonic intraluminal bacterial counts were found to be significantly increased in Group II and III when compared to control, but the difference within these two was not significant. Histopathologicaly the mucosal integrity was well kept in Group III, while clear disruption was observed in Group II. The beneficial effect of glutamine during total parenteral nutrition on decreasing bacterial translocation rate was attributed to the preservation of mucosal integrity.

Finally it can be concluded a clinical study investigating glutamine effect on bacterial translocation in the patients receiving total parenteral nutrition is worth consideration.

Keywords: TOTAL PARENTERAL NUTRITION, TRANSLOCATION, GLUTAMINE