Spatiotemporal progression of localized bacterial peritonitis before and after open abdomen lavage monitored by in vivo bioluminescent imaging

Sharma, Prashant K.; Engels, Eefje; Van Oeveren, Wim; Ploeg, Rutger J.; van Henny der Mei, C.; Busscher, Henk J.; Van Dam, Gooitzen M.; Rakhorst, Gerhard

doi:10.1016/j.surg.2009.05.016

« Previous Next »Surgery
Volume 147, Issue 1 , Pages 89-97, January 2010

Spatiotemporal progression of localized bacterial peritonitis before and after open abdomen lavage monitored by in vivo bioluminescent imaging

Prashant K. Sharma, PhD
- Department of Biomedical Engineering, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
- Reprint requests: Prashant K. Sharma, PhD, Department of Biomedical Engineering (Sector F), University Medical Center Groningen and University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands.
Eefje Engels
- Department of Biomedical Engineering, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
Wim Van Oeveren, PhD
- Department of Biomedical Engineering, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
Rutger J. Ploeg, MD, PhD
- Department of Surgery, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
C. van Henny der Mei, PhD
- Department of Biomedical Engineering, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
Henk J. Busscher, PhD
- Department of Biomedical Engineering, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
Gooitzen M. Van Dam, MD, PhD
- Department of Surgery, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
- BioOptical Imaging Center Groningen, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
Gerhard Rakhorst, PhD
- Department of Biomedical Engineering, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands

Accepted 21 May 2009. published online 07 September 2009.

Background

Bacterial peritonitis is a life-threatening abdominal infection associated with high morbidity and mortality. The rat is a popular animal model for studying peritonitis and its treatment, but longitudinal monitoring of the progression of peritonitis in live animals has been impossible until now and thus required a large number of animals. Our objective was to develop a noninvasive in vivo imaging technique to monitor the spatiotemporal spread of bacterial peritonitis.

Methods

Peritonitis was induced in 8 immunocompetent male Wistar rats by placing fibrin clots containing 5 × 10⁸ cells of both Bacteroides fragilis (American Type Tissue Culture [ATCC)] 25285 and bioluminescent Escherichia coli Xen14. After 1 or 2 days, infected clots were removed and open abdomen lavage was performed. In vivo bioluminescent imaging was used to monitor the spread of peritonitis.

Results

Bioluminescent in vivo imaging showed an increase in the area of spread, and the number of E. coli tripled into the rat's abdominal cavity on day 1 after clot insertion; however, on day 2, encapsulation of the clot confined bacterial spread. Bioluminescent E. coli respread over the peritoneal cavity after lavage; within 10 days, however, in vivo imaging showed a decrease of 3–4 orders of magnitude in bacterial load.

Conclusion

Bioluminescent in vivo imaging can be effectively used to monitor the spatiotemporal behavior of the peritonitis during 3 different stages of the disease process: initiation, treatment, and follow-up. Imaging allows researchers to repeatedly image the same animal, thereby reducing variability and providing greater confidence in determining treatment efficacies for therapeutic interventions using a small number of animals.