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Prevention of Yeast Translocation across the Gut by a Single Enteral Feeding after Burn Injury

First Department of Surgery, University of Tokyo, Shriners Burns Institute Cincinnati Unit, Department of Surgery, University of Cincinnati, Cincinnati, Ohio

Mark D. Epstein, M.D.

First Department of Surgery, University of Tokyo, Shriners Burns Institute Cincinnati Unit, Department of Surgery, University of Cincinnati, Cincinnati, Ohio

J. Wesley Alexander, M.D., Sc.D.

First Department of Surgery, University of Tokyo, Shriners Burns Institute Cincinnati Unit, Department of Surgery, University of Cincinnati, Cincinnati, Ohio

Orrawin Trocki, M.S., R.D.

First Department of Surgery, University of Tokyo, Shriners Burns Institute Cincinnati Unit, Department of Surgery, University of Cincinnati, Cincinnati, Ohio

Paul Jacobs, B.S.

First Department of Surgery, University of Tokyo, Shriners Burns Institute Cincinnati Unit, Department of Surgery, University of Cincinnati, Cincinnati, Ohio

Patricia Gura, B.S.

First Department of Surgery, University of Tokyo, Shriners Burns Institute Cincinnati Unit, Department of Surgery, University of Cincinnati, Cincinnati, Ohio

Recently, burn injury has been shown to facilitate the ability of enteric Candida albicans (CA) to penetrate the gut epithelium and translocate to the mesenteric lymph nodes (MLN) during the first 24 hr after injury. Guinea pigs were given 3 x 10¹⁰ CA intragastrically before inflicting a 50% burn to determine if a single enteral feeding could affect CA translocation to the MLN. A bolus infusion (20 kcal/kg, 12 ml in volume) of liquid meal, consisting of 68% carbohydrate, 20% protein, and 12% lipid, was administered either at 3-hr or 12-hr postburn. Control groups received no food or a similar amount of saline by bolus infusion. All animals were allowed water ad libitum until 24-hr postburn when their MLN and intestinal segments were harvested for enumeration of viable CA. Blood was also collected for determination of serum IgG, C3, cortisol, and albumin. Compared to nonfeed animals, those with a single enteral feeding at 12-hr postburn had reduced numbers of CA translocating to the MLN (970 ± 220 vs 7,120 ± 2,130 CFU/g, p < 0.02) and colonizing in the ileum (27,000 ± 6,770 vs 104,000 ± 23,550 CFU/g, p < 0.01). Bolus feeding at 12 hr was associated with a lower cortisol level (237 ± 55% of normal controls) than bolus feeding at 3 hr (310 ± 58, p < 0.02) or the nonfed group (326 ± 66, p < 0.01). Regardless of dietary treatment, serum cortisol levels correlated positively with the extent to which CA translocated to the MLN and negatively with C3 levels. (Journal of Parenteral Enteral Nutrition 13:565-571, 1989)

Journal of Parenteral and Enteral Nutrition, Vol. 13, No. 6, 565-571 (1989)
DOI: 10.1177/0148607189013006565


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