SELECTIVE INTESTINAL DECONTAMINATION WITH NORFLOXACIN REDUCES BACTERIAL TRANSLOCATION IN ASCITIC CIRRHOTIC RATS EXPOSED TO HEMORRHAGIC-SHOCK

Bacterial translocation (BT) can be involved in the pathogenesis of se vere infections due to bacteria of enteric origin that complicates ble eding cirrhotic patients, To assess the effect of hemorrhagic shock (H S) on the incidence of BT and if selective intestinal decontamination (SID) reduces this incidence, we studied six groups of Sprague-Dawley rats: ascitic rats, ascitic rats exposed to IIS with and without previ ous norfloxacin prophylaxis, healthy rats, and healthy shocked rats wi th and without previous norfloxacin prophylaxis. BT tended to be highe r in ascitic rats with shock than without shock (69% vs. 41%, P =.15) and was significantly higher in healthy rats with than without shock ( 50% vs. 0%, P =.01). Norfloxacin significantly reduced translocation i n ascitic shocked rats in comparison with nondecontaminated ascitic sh ocked rats (31% vs. 69%, P =.038). This effect was due mainly to a red uction of gram-negative BT (0% vs. 37%, P =.008), In addition, norflox acin prevented translocation in healthy shocked rats. Accordingly, aer obic gram-negative bacteria disappeared from fecal flora in all rats a dministered norfloxacin, except for Klebsiella species in one control rat. Cecal severe submucosal edema, chronic inflammatory infiltrate, a nd intestinal lymphangiectasia were significantly more frequent in asc itic rats than in control rats, Intestinal mucosal injury related with HS, particularly subepithelial cecal edema, was observed only in asci tic shocked rats, In conclusion, HS increases the incidence of BT both in ascitic cirrhotic and healthy rats, Norfloxacin reduces significan tly the incidence of translocation after shock, especially in those ca ses caused by aerobic gram-negative bacilli.