Background: Bacterial translocation (BT) across the intact intestinal mucosal barrier has been
postulated as a source of sepsis in susceptible patients, including those with cirrhosis and
portal hypertension. This condition has not been studied in hepatosplenic schistosomiasis,
wherein portal hypertension and the presence of an immune deficiency state associated with
the parasitic disease could predispose to BT into mesenteric lymph nodes (MLN). A study
was conducted to determine the prevalence of aerobic bacteria in MLN (bacterial translocation)
of patients with hepatosplenic schistosomiasis, and establish a possible association with
postoperative infections.
Methods: In a series of 51 patients submitted to surgical treatment of schistosomotic portal hypertension with splenectomy and gastric devascularization, MLN were obtained from each
patient at the beginning (MLN1) and at the end (MLN2) of the surgical procedure, and sent
for bacteriological analysis. Prospective patient evaluation during the postoperative period
correlated positive MLN cultures with infectious complications.
Results: The prevalence of aerobic bacteria was 17.6% at MLN1 and 27.5% at MLN2, however, this difference was non-significant (p = 0.24). Bacterial translocation to all MLN was
22.5%. Escherichia coli was the most frequent organism (26.1%, 6/23). The overall incidence
of postoperative infections was 19.6% (10/51), with a significant association with the presence
of positive cultures of MLN (p = 0.043).
Conclusions: The findings of this study suggest that the presence of aerobic bacteria on
MLN as a consequence of BT may play a role in the development of postoperative infectious
complications, particularly in schistosomotic patients.
