Head Injury–Associated Bone Fractures Induce Bacterial Translocation: An Experimental Study

OBJECTIVESTo determine whether long bone fractures cause bacterial translocation and to investigate the effect of concomitant head trauma on this process. DESIGNAn in vivo animal model. SETTINGAnimal Laboratory, University of Mersin School of Medicine, Mersin, Turkey. SUBJECTSMale Sprague-Dawley rats (n = 60). INTERVENTIONSixty male Sprague-Dawley rats were divided into five groups(1) anesthesia only (control group, n = 12); (2) anesthesia and tibia fracture (n = 12); (3) anesthesia, tibia fracture, and femur fracture (n = 12); (4) anesthesia, tibia fracture, femur fracture, and moderate head trauma (n = 12); and (5) moderate head trauma only (n = 12). After 24 hours, mesenteric lymph nodes, liver, spleen, ileum, and systemic blood samples were quantitatively cultured for aerobic organisms. MAIN OUTCOME MEASUREMENTSColony-forming unit per gram for bacteria count. RESULTSThe incidence of bacterial translocation was higher in groups that had fractures (4/12 in group 2; 5/12 in group 3) than in the control group (2/12); however, this did not reach statistical significance. There was a significant increase in the number of subjects with bacterial translocation in group 4 (9/12) compared with the control group and group 5 (3/12) (P = 0.0123, P = 0.0391). CONCLUSIONSMultiple fractures of long bones associated with head injury promote bacterial translocation.