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Study examines whether giving good bacteria reduces infections

Whether giving good bacteria that normally helps keep the intestinal tract and immune system healthy can reduce infections in intensive-care patients is the focus of a new clinical study at the Medical College of Georgia.

"When people are admitted to intensive care on broad-spectrum antibiotics, we know that 25 to 40 percent of them will get an infection with a resistant bacteria during their stay," says Dr. Robert G. Martindale, gastrointestinal surgeon, nutritionist and principal investigator on the new study.

As the name indicates, these antibiotics are designed to protect patients from infection by a broad range of agents. However, they also can wipe out the natural bacterial flora in the intestinal tract, a disruption with widespread consequences including making the intestinal lining more susceptible to bacterial invasion, impacting the health of colon cells and disarming the immune system.

"We kill all the normal bacteria in our GI tracts, allow these abnormal bacteria to grow and we are in trouble, we have upset the balance," says Dr. Martindale who restores the balance in patients who arrive at MCG Medical Center critically ill from sepsis following routine surgery.

He first prescribes more targeted antibiotic therapy, then returns some of the primary healthy bacteria, such as lactobacillus plantarum, that play many important roles including maintaining a healthy intestinal lining, protecting from invaders such as Salmonella and E. coli, encouraging the activity of macrophages, an immune system component that gobbles up invaders and preventing diarrhea.

"We know very well that the source of sepsis in these patients, 50 to 70 percent of the time, is their own intestines," Dr. Martindale says. "The question is, 'Why?' Why do bacteria from our own intestines that normally live with us in a nice, healthy relationship become aggressive and infective? Because we give these broad-spectrum antibiotics, we have big operations, G
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Contact: Toni Baker
tbaker@mcg.edu
706-721-4421
Medical College of Georgia
2-Mar-2004


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