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September 1986

The Kinetics of Peritoneal Clearance of Escherichia coli and Bacteroides fragilis and Participating Defense Mechanisms

Author Affiliations

From the Departments of Surgery (Drs Skau and Nyström) and Medical Microbiology (Drs Öhman and Stendahl), University Hospital, Linköping, Sweden.

Arch Surg. 1986;121(9):1033-1039. doi:10.1001/archsurg.1986.01400090063010

• In a study using pigs, we delineated the dynamic character and the interplay of defense mechanisms that operate in the peritoneal cavity and their effectiveness against Escherichia coli and Bacteroides fragilis. The bacteria were extensively cleared during the first three hours. The concentration of both organisms in the peritoneal fluid decreased by up to 300 000-fold, and the final concentration was a function of the inoculum given. Clearance efficiency did not differ between a bolus dose and prolonged bacterial administration. Peritoneal absorption was a major eliminating mechanism during the first three hours but was limited to bacterial concentrations exceeding approximately 109 colony-forming units per milliliter of peritoneal fluid. Intraperitoneal elimination started immediately and continued for approximately six hours. Thereafter, residual bacteria were not eliminated, even though the defense capacity was intact. Prolonged bacterial administration, however, protracted the period for active bacterial destruction.

(Arch Surg 1986;121:1033-1039)