Sind Darmbakterien an der Entstehung der Anastomoseninsuffizienz beteiligt? Eine Übersicht über experimentelle und klinische Arbeiten

Schardey, H. M.; Rogers, S.; Schopf, S. K.; von Ahnen, T. und Wirth, U. (2018): Sind Darmbakterien an der Entstehung der Anastomoseninsuffizienz beteiligt? Eine Übersicht über experimentelle und klinische Arbeiten. In: Coloproctology, Bd. 40, Nr. Suppl. 1: S. 1-8

Abstract

It has been proven in experimental and clinical studies that the combined perioperative systemic antibiotic prophylaxis and prolonged nonresorbable topical antibiotics directed against common intestinal Gram-negative and Gram-positive pathogens in a mechanically cleaned bowel are effective in preventing intestinal anastomotic leaks (AL). For 60 years evidence has accumulated showing that AL are caused by microbial pathogenicity. Examples are E. faecalis and P. aeruginosa, which have developed the ability to breakdown collagen and cleave host matrix metalloproteinase 9 (MMP9). Surgical trauma seems to trigger such complex reactions as genotypical and phenotypical changes in commensal microbiota turning them into tissue-destroying leak-inducing pathogens. Investigations of further molecular mechanisms and clinical studies are ongoing. The use of antibiotics disrupts the endogenous microbiome and causes antibiotic resistance. It is therefore important to find therapies that leave the microbiome intact and target microbial virulence expression, such as phosphate-containing polyethylene glycol polymers to avoid indiscriminately eliminating all potential pathogens while simultaneously damaging protective microbiota.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0174-2442
• Sprache: Deutsch