Use of Probiotics as Prophylaxis for Postoperative Infections 英文参考文献.docVIP

Nutrients 2011, 3, 604-612; doi:10.3390/nu3050604 OPEN ACCESS nutrients ISSN 2072-6643 /journal/nutrients Review Use of Probiotics as Prophylaxis for Postoperative Infections Bengt Jeppsson *, Peter Mangell and Henrik Thorlacius Department of Surgery, Lund University and Skane University Hospital, Malmo, SE 205 02, Sweden; E-Mails: peter.mangell@med.lu.se (P.M.); henrik.thorlacius@med.lu.se (H.T.) * Author to whom correspondence should be addressed; E-Mail: bengt.jeppsson@med.lu.se; Tel.: +46-40-33-37-60; Fax: +46-40-92-78-77. Received: 29 March 2011; in revised form: 26 April 2011 / Accepted: 28 April 2011 / Published: 12 May 2011 Abstract: Postoperative bacterial infections are common despite prophylactic administration of antibiotics. The wide-spread use of antibiotics in patients has contributed to the emergence of multiresistant bacteria. A restricted use of antibiotics must be followed in most clinical situations. In surgical patients there are several reasons for an altered microbial flora in the gut in combination with an altered barrier function leading to an enhanced inflammatory response to surgery. Several experimental and clinical studies have shown that probiotics (mainly lactobacilli) may reduce the number of potentially pathogenia bacteria (PPM) and restore a deranged barrier function. It is therefore of interest to test if these abilities of probiotics can be utilized in preoperative prophylaxis. These factors may be corrected by perioperative administration of probiotics in addition to antibiotics. Fourteen randomized clinical trials have been presented in which the effect of such regimens has been tested. It seems that in patients undergoing liver transplantation or elective surgery in the upper gastrointestinal tract prophylactic administration of different probiotic strains in combination with different fibers results in a three-fold reductio