Lactobacillus plantarum reduces infection of pancreatic necrosis in experimental acute pancreatitis

Background: Infection is the commonest cause of death in acute pancreatitis . Early reduction of commensal flora (particularly Lactobacillus species) a nd, at the same time, overgrowth of Enterobacteriaceae, especially Escheric hia coli, have recently been described during acute pancreatitis. Lactobaci llus plantarum has been shown to be effective in reducing the egress of end otoxin and microbia[ translocation in several experimental models such as c hemically induced hepatitis and ulcerative colitis. Aim: The aim of the stu dy was to determine whether L. plantarum 299v (Lp 299v) is capable of effec tively reducing microbial translocation in experimental pancreatitis. Metho ds: Acute pancreatitis was induced by isolation and ligation of the biliopa ncreatic duct in Lewis rats weighing 250-350 g. The animals were divided in to 3 groups: group A, sham operation; group B, induction of pancreatitis an d no further treatment, and group C, induction of pancreatitis + daily admi nistration by gavage of a 5-ml/day suspension of Lp 299v at 0.5-1.0 x 10(9) bacteria/ml for 8 days, 4 days before and 4 days after induction of pancre atitis. All animals were sacrificed after 96 h. Histological studies and mi crobiological analyses were performed. Results: At sacrifice, 40/55 animals showed signs of severe pancreatitis. Since acute pancreatitis was the spec ific disease investigated, only these animals were subjected to further stu dy. In group B, we found pathogenic micro-organisms in the mesenteric lymph nodes in 14/20 animals and in the pancreatic tissue in 10/20. The bacteria l flora consisted predominantly of E. coli, Enterococcus faecalis, Pseudomo nas and Proteus species. In contrast, when the animals were kept under an ' umbrella' of Lp 299v, growth of E. faecalis or E. coli were detected only i n 4/20 mesenteric lymph node cultures and in 3/20 pancreatic tissue culture s. Conclusions: Lp 299v is effective in reducing microbial translocation in experimental pancreatitis. Treatment with probiotic bacteria seems to be a promising alternative to antibiotic therapy. Copyright (C) 2001 S. Karger AG, Basel.