GLUTAMINE-ENRICHED ENTERAL DIET ENHANCES BACTERIAL CLEARANCE IN PROTRACTED BACTERIAL PERITONITIS, REGARDLESS OF GLUTAMINE FORM

Background: The effects of glutamine (Gln)-enriched enteral diets on b acterial clearance were investigated in a rat protracted peritonitis m odel. The effects of the Gln form, peptide-based vs free amino acid-ba sed, were also compared. Methods: Twenty-three rats underwent gastrost omy. An osmotic pump was implanted in the peritoneal cavity. The rats received a continuous intragastric infusion of one of three diets: Gln -depleted (Gln 0), Gln-enriched with the Gln in free amino acid form ( Gln F), or Gin-enriched with the Gln in oligopeptide form (Gln P); The three formulas were isocaloric and isonitrogenous. The pumps delivere d a continuous infusion of Escherichia coli, starting at 48 hours afte r implantation, for 24 hours. Then, the animals were killed. Results: Bacterial numbers in peritoneal lavaged fluid (PLF) and the liver were significantly lower in the Gln P and Gln F groups than in the Gln 0 g roup. The bacterial number in PLF correlated with that in the liver. N either the number nor the population of peritoneal exudative cells dif fered among groups. Plasma levels of proline, alanine and citrulline w ere significantly higher in the Gln P and Gln F groups than in the Gln 0 group. Both Gln supplemented groups showed significantly greater vi llous height, crypt depth, and numbers of mitoses per crypt in the sma ll intestine than the Gln 0 group. Conclusions: Supplemental Gln enhan ces peritoneal and hepatic bacterial clearance, regardless of Gln form . Gln-enriched may be more beneficial than Gln-depleted enteral diets in peritonitis.