Normal Viral and Bacterial Flora of the Human Small and Large Intestine

Kalser, Martin H.; Cohen, R; Arteaga, Ingrid; Yawn, E.; Mayoral, Luis Guillermo; Hoffert, W. R.; Frazier, D.

doi:10.1056/nejm196603102741006

Cited by 62 publications

(17 citation statements)

References 52 publications

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“…Although this approach has yielded useful information, the results presented in this paper demonstrate (Kalser, Cohen, Arteaga, Yawn, Mayoral, Hoffert, and Frazier, 1966), and by a direct surgical approach in man (Anderson and Langford, 1958), and in experimental animals (Gorbach et al, 1967b).…”

Section: Discussionmentioning

confidence: 68%

Bacteria, bile and the small bowel

Gorbach¹,

Tabaqchali²

1969

Gut

172

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SUMMARY Microbial populations of the small bowel and bile salt metabolism were studied in 15 patients with lesions of the stomach and small intestine. These types of microorganism could be correlated with the site and extent of stasis in the small bowel and the presence of a normally functioning stomach. The presence of obligate anaerobes (bacteroides) and free bile acids could be correlated with areas of stagnation. When these abnormalities were detected throughout the small bowel, steatorrhoea was also noted. However, bacteroides and free bile acids in localized regions of either proximal or distal small bowel were generally associated with normal faecal fat excretion. Vitamin B12 malabsorption appeared to be related to the total number of bacteria colonizing the small bowel rather than to any specific type of microorganisms.The effect of antibiotics on intestinal function and bacteriology was studied in three patients. In one patient, the broad-spectrum antibiotic tetracycline was effective in eradicating an abnormal bacterial flora. In the other two, lincomycin, which is specifically effective in eradicating the anaerobic flora, restored intestinal function to normal.Under normal circumstances the lumen of the upper gastrointestinal tract in man contains low concentrations (less than 103 per ml) of predominantly Grampositive microorganisms (Van der Reis, 1925; Gorbach, Plaut, Nahas, Weinstein, Spanknebel, and Levitan, 1967b). Anaerobic lactobacilli (bifidobacterium) and Gram-negative organisms, such as coliform and bacteroides, are usually confined to the large bowel, although the distal ileum may also contain such bacteria, possibly derived by retrograde flow from the caecum. These microorganisms, however, are not normally found in the stomach and upper small intestine of healthy individuals.A luxuriant and abnormal intestinal bacterial flora may develop in association with certain diseases of the stomach and small intestine. Faecal-type microorganisms may colonize the upper small intestine in patients with gastrectomy, jejunal diverticulosis, blind loops, strictures, resections, and fistulae (Goldstein, Wirts, and

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Section: Discussionmentioning

confidence: 68%

Bacteria, bile and the small bowel

Gorbach¹,

Tabaqchali²

1969

Gut

172

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“…This finding applies to all patients regardless of the type of operation. It could be that our definition of normality, though supported by other authors (Kalser et al 1966), is either too strict or that bacterial counts must rise considerably above the normal before steatorrhoea occurs. Relating the stool fat content to counts of 105/ml and over, 106/ml and over, and 107/ml and over, however, does not demonstrate any statistically significant relationship.…”

Section: Faecal Type Flora In Stomach and Small Intestine Of Twenty-omentioning

confidence: 83%

The Significance of Abnormal Bacterial Proliferation in the Gastrointestinal Tract after Gastric Surgery

Dellipiani

Girdwood

1967

Scandinavian Journal of Gastroenterology

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DELLIPIANI, A. W. & GIRDWOOD, R. H. The Significance of Abnormal Bacterial Proliferation in the Gastrointestinal Tract after Gastric Surgery. Scand. J. Gastroent. 2, [161][162][163][164][165][166][167][168]1967. The juices of the stomach or stomach remnant and of the jejunum of twenty-one patients who had undergone gastroenterostomy and twenty-six patients with partial gastrectomy have been studied for the presence of faecal type organisms as represented by Enterobacteriaceae, Streptococcus faecalis and Clostridiurn welchii. In the postgastrectomy cases faecal type organisms were commonly found in abnormal concentrations. After gastroenterostomy with vagotomy the bacteriological findings were very similar. It was not possible to show any relationship between the presence of steatorrhoea, diarrhoea, and impaired absorption of vitamin BIZ and the finding of abnormal numbers of these organisms. The possible effect on the bacteriological findings of the achlorhydria which was commonly found in these patients is discussed. Scand J Gastroenterol Downloaded from informahealthcare.com by University of Otago on 12/26/14 For personal use only. Scand J Gastroenterol Downloaded from informahealthcare.com by University of Otago on 12/26/14 For personal use only. J. I, 1356-1359. 8,25-70. 189-210.Scand J Gastroenterol Downloaded from informahealthcare.com by University of Otago on 12/26/14For personal use only.

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“…Other workers (Kalser et al, 1966) defined an upper numerical limit to the total bacterial count in the duodenum of normal adults of 3 0 log10/ml above which the total count becomes abnormal. We were unable to confirmn this finding in the 6 control infants * from whom duodenal bacteria were isolated, and the total count in these infants ranged from 3e0-6*0 * log1)/ml.…”

Section: Discussionmentioning

confidence: 99%