Abstract
Purpose: Candida Albicans is the most common fungal pathogen that cause infection. Septic complications and renal failure are the most common causes of death in patients with obstructive jaundice. We investigated the translocation of oral administration of Candida albicans in rats with obstructive jaundice.
Materials and Methods: Forty male wistar-albino rats were divided into 4 Groups. In Group I, laparatomi was performed and without any intervention the abdomen was closed with 3/0 prolene suture. In group II, laparatomy was done and abdomen was closed. On first postoperative day, candida inoculation was administered intragastrically. In group III, following laparotomy, common bile duct was ligated and cut than the abdomen was closed. In group IV, common bile duct was ligated and cut and then on 3rd postoperative day oral candida inoculation was administered. On 7th day, blood from vena cava inferior and tissue samples from liver, mesenteric lymph nodes, and cecum were collected for pathological, microbiological and biochemical investigations from all rats.
Results: Microbiological lymph node positivity was statistically higher in group IV (p:0.020). When compared with Group II, candida colonization in cecum was higher in Group IV. Lymph node and cecum positivity were statistically higher in Group II and IV than Groups I and III (p<0.001). Histopathological changes in liver were statistically higher in group IV than in Groups I and III (p<0.05). Histopathological changes in the lymph nodes were statistically higher in group IV when compared with other Groups (p<0.01 and p<0.001). Histopathological changes in the cecum were statistically higher in Group IV when compared with Groups I and III (p<0.001 and p<0.05). Also, histopathological changes in the cecum were statistically higher in Group II than Group I (P<0.01).
Conclusion: Obstructive jaundice results in increase of colonisation and translocation of orally administrated Candida albicans.
Keywords:
Candida albicans, obstructive jaundice, translocation.
References
1Pfaller MA. Nosocomial candidiasis: emerging species, reservoirs, and modes of transmission. Clin Infect Dis, 1996; 22 Suppl 2:89-94.
2Baley JE, Kliegman RM, Fanaroff AA. Disseminated fungal infections in very low-birthweight infants: clinical manifestations and epidemiology. Pediatrics, 1984; 73:144-52.
3Butler KM, Baker CJ. Candida: an increasingly important pathogen in the nursery. Pediatr Clin North Am, 1988; 35:543-63.
4Blinzler L, Fischer K, Just HM, et al.[Importance of mycoses in intra-abdominal infections] Langenbecks Arch Chir 1997; 382:5-8.
5Cole GT, Halawa AA, Anaissie EJ. The role of the gastrointestinal tract in hematogenous candidiasis: from the laboratory to the bedside. Clin Infect Dis, 1996; 22:73-88.
6Clements WD, Halliday MI, McCaigue MD, et al. Effects of extrahepatic obstructive jaundice on Kupffer cell clearance capacity. Arch Surg, 1993; 128:200-4.
7Parks RW, Clements WD, Pope C, et al. Bacterial translocation and gut microflora in obstructive jaundice. J Anat, 1996; 189:561-5.
8Deitch EA, Sittig K, Li M, et al. Obstructive jaundice promotes bacterial translocation from the gut. Am J Surg, 1990; 159:79-84.
9Yılmazlar T, Korun N, Karagöz C, ve ark. Deneysel Obstrüktif Sarılıkta Bakteriyel Translokasyon Sonucu Bakterilerin Multiorgan Yayılımı. Cerrahi Tıp Bülteni, 1995; 4:218-24.
10Gürsel C, Güçlü ME, Tuncer Ü, ve ark. Ekstrahepatik Kolestazda Oluşan Mikrobiyal Translokasyonun Düzeltilmesinde İnternal Bilier Drenaj Girişiminin Etkileri. Ankem Dergisi, 1992; 6:186.
11Berg RD. Inhibition of Escherichia coli translocation from the gastrointestinal tract by normal cecal flora in gnotobiotic or antibiotic-decontaminated mice. Infect Immun, 1980; 29:1073-81.
12Deitch EA. Simple intestinal obstruction causes bacterial translocation in man. Arch Surg, 1989; 124:699-701.
13Chuang JH, Shieh CS, Chang NK, et al. Role of parenteral nutrition in preventing malnutrition and decreasing bacterial translocation to liver in obstructive jaundice. World J Surg, 1993; 17:580-5.
14Katmer T, Erbil Y, Önder H, ve ark. Total Parenteral Beslenmede Bakteriyel Translokasyon ve Glutamin Kullanımı. Ulusal Cerrahi Dergisi, 1994; 10:193-9.
15Bendel CM, Wiesner SM, Garni RM, et al. Cecal colonization and systemic spread of Candida albicans in mice treated with antibiotics and dexamethasone. Pediatr Res, 2002; 51:290-5.
16Pierro A, van Saene HK, Donnell SC, et al. Microbial translocation in neonates and infants receiving long-term parenteral nutrition. Arch Surg, 1996; 131:176-9.
17Inoue S, Peck MD, Alexander JW. Fungal translocation is associated with increased mortality after thermal injury in guinea pigs. J Burn Care Rehabil, 1991; 12:19-22.
18Wiesner SM, Jechorek RP, Garni RM, et al. Gastrointestinal colonization by Candida albicans mutant strains in antibiotic-treated mice. Clin Diagn Lab Immunol, 2001; 8:192-5.
19Andrutis KA, Riggle PJ, Kumamoto CA, et al. Intestinal lesions associated with disseminated candidiasis in an experimental animal model. J Clin Microbiol, 2000; 38:2317-23.
20Pappo I, Polacheck I, Zmora O, et al. Altered gut barrier function to Candida during parenteral nutrition. Nutrition, 1994; 10:151-4.
21Colombo AL, Branchini ML, Geiger D, et al. Gastrointestinal translocation as a possible source of candidemia in an AIDS patient. Rev Inst Med Trop Sao Paulo, 1996; 38:197-200.
22de Repentigny L, Phaneuf M, Mathieu LG. Gastrointestinal colonization and systemic dissemination by Candida albicans and Candida tropicalis in intact and immunocompromised mice. Infect Immun, 1992; 60:4907-14.
23Richards MJ, Edwards JR, Culver DH, et al. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med, 1999; 27:887-92.
24Pittet D, Wenzel RP. Nosocomial bloodstream infections. Secular trends in rates, mortality, and contribution to total hospital deaths. Arch Intern Med, 1995; 155:1177-84.
25MacFie J. Bacterial translocation in surgical patients. Ann R Coll Surg Engl, 1997; 79:183-9.
26Sedman PC, Macfie J, Sagar P, et al. The prevalence of gut translocation in humans. Gastroenterology, 1994; 107:643-9.
27Reed LL, Martin M, Manglano R, et al. Bacterial translocation following abdominal trauma in humans. Circ Shock, 1994; 42:1-6.
28Fink MP. Effect of critical illness on microbial translocation and gastrointestinal mucosa permeability. Semin Respir Infect, 1994; 9:256-60.
29Oruç M.T, Kulaçoğlu H, Doğan H, ve ark. Oral lactulose prevents bacterial translocation in obstructive jaundice \"An experimental study\". The Turkish Journal of Gastroenterology, 2000; 11:108-12.
30Deitch EA, Berg R. Bacterial translocation from the gut: a mechanism of infection. J Burn Care Rehabil, 1987; 8:475-82.
31Illig KA, Ryan CK, Hardy DJ, et al. Total parenteral nutrition-induced changes in gut mucosal function: atrophy alone is not the issue. Surgery, 1992; 112:631-7.
32Sugiura T, Tashiro T, Yamamori H, et al. Effects of total parenteral nutrition on endotoxin translocation and extent of the stress response in burned rats. Nutrition, 1999; 15:570-5.
33Tosun EA, Küpelioğlu R, Karahan S, ve ark. Total Parenteral Beslenmede Bakteriyel Translokasyona Antibiyotiklerin Etkileri (Deneysel Çalışma) Ankem Dergisi, 1994; 8:137.
34Yalçın O, Soybir G, Er E, ve ark. Yanığa Bağlı Bakteriyel Translokasyona Granülosit Koloni Stimülan Faktörün Etkileri. Ulusal Travma Dergisi, 1995; 1:185-8.
35Ruiz-Sanchez D, Calderon-Romero L, Sanchez- Vega JT, et al. Intestinal candidiasis. A clinical report and comments about this opportunistic pathology. Mycopathologia, 2002; 156:9-11.
36Bodey GP, Mardani M, Hanna HA, et al. The epidemiology of Candida glabrata and Candida albicans fungemia in immunocompromised patients with cancer. Am J Med, 2002; 112:380-5.
37Marina NM, Flynn PM, Rivera GK, et al. Candida tropicalis and Candida albicans fungemia in children with leukemia. Cancer, 1991; 68:594-9.
38Scott-Conner CE, Grogan JB. The pathophysiology of biliary obstruction and its effect on phagocytic and immune function. J Surg Res, 1994; 57:316-36.
39Ding JW, Andersson R, Soltesz V, et al. The role of bile and bile acids in bacterial translocation in obstructive jaundice in rats. Eur Surg Res, 1993; 25:11-9.
40Katz S, Merkel GJ, Folkening WJ, et al. Impaired clearance and organ localization of Candida albicans in obstructive jaundice. J Pediatr Surg, 1991; 26:904-6.
41Kennedy MJ, Volz PA. Ecology of Candida albicans gut colonization: inhibition of Candida adhesion, colonization, and dissemination from the gastrointestinal tract by bacterial antagonism. Infect Immun, 1985; 49:654-63.
42Kennedy MJ, Volz PA, Edwards CA, et al. Mechanisms of association of Candida albicans with intestinal mucosa. J Med Microbiol, 1987; 24:333-41.
43Takahashi K, Kita E, Konishi M, et al. Translocation model of Candida albicans in DBA-2/J mice with protein calorie maltuntrition mimics hematogenous candidiasis in humans. Microbial Pathogenesi,s 2003; 35:179-87.
44Meis JF, Ruhnke M, De Pauw BE, et al. Candida dubliniensis candidemia in patients with chemotherapy-induced neutropenia and bone marrow transplantation. Emerg Infect Dis, 1999; 5:150-3.
45Ishii H, Hiruma K, Morio S, et al.[Multiple liver abscesses due to Candida albicans in a patient with acute promyelocytic leukemia: percutaneous transhepatic intraportal administration of amphotericin B] Rinsho Ketsueki, 1990; 31:330-4
46Adderson EE, Pappin A, Pavia AT. Spontaneous intestinal perforation in premature infants: a distinct clinical entity associated with systemic candidiasis. J Pediatr Surg, 1998; 33:1463-7.
