ALTERED GUT BARRIER FUNCTION TO CANDIDA DURING PARENTERAL-NUTRITION

We hypothesize that catheter-related sepsis with Candida during total parenteral nutrition (TPN) is caused by Candida translocation from the gut. Fifty male Sabra rats weighing 330 +/- 40 g were randomized into four groups and put into metabolic cages: group 1 (n = 16), nonoperat ed free-feeding controls; group 2 (n = 10); infused with normal saline and free feeding; group 3 (n = 14), infused with TPN solution for a t otal of 36 kcal and 1.5 g protein 100 g(-1) body wt day(-1); group 4 ( n =10), same TPN regimen as group 3 but also receiving oral and intrav enous antibiotics. On day 7, all animals received 1.5 x 10(10) viable Candida albicans CBS 562 cells by gavage, and 24 h later, the number o f Candida colony-forming units in blood, mesenteric lymph nodes, and k idneys was determined. No growth of Candida was detected in group 1 or group 2. Positive Candida cultures were found in the blood, mesenteri c lymph nodes, and kidneys of groups 3 and 4, although levels reached statistical significance only for mesenteric lymph nodes in group 3. B ecause Candida growth occurred exclusively in groups receiving TPN and bowel rest, we conclude that altered gut-barrier function-to Candida occurs during TPN and speculate that Candida sepsis during TPN might b e the result of Candida translocation from the gut due to the combinat ion of high-density Candida colonization and favorable local condition s in the gut induced by TPN and bowel rest.