Bacterial translocation from the gastrointestinal tracts of mice receiving immunosuppressive chemotherapeutic agents

Specific pathogen-free (SPF) mice were treated with certain classes of immunosuppressive chemotherapeutic agents to determine if they would promote bacterial translocation from the gastrointestinal tract to the mesenteric lymph node, spleen, or liver. The antimetabolites methotrexate, 5-fluorouracil, and cytosine arabinoside were injected once intraperitoneally into SPF mice, and the mice were tested for bacterial translocation from the gastrointestinal tract. When total organs from the treated mice were compared with the total organs from the control mice, the alkylating agent cyclophosphamide promoted bacterial translocation when injected once intraperitoneally at doses of 100–400 mg/kg. Increasing the number of injections of cyclophosphamide did not increase the incidence of bacterial translocation. The steroid prednisone also promoted bacterial translocation after one intraperitoneal injection of 10–150 mg/kg. Prednisone and cyclophosphamide at various doses appeared to be more effective in promoting bacterial translocation from the gastrointestinal tract than the antimetabolites. The aerobic and facultatively anaerobic bacteria translocating to the various organs were identified asLactobacillus acidophilus, Escherichia coli, Klebsiella pneumoniae, Streptococcus faecalis, Staphylococcus aureus, andProteus mirabilis. Groups of SPF mice also were injected once intraperitoneally with the minimal dose of each chemotherapeutic drug that induced bacterial translocation, and then tested for immune responsiveness toE. coli vaccination. Each of the chemotherapeutic agents at the minimal doses promoting bacterial translocation also suppressed the serum antibody responses to antigens of indigenousE. coli. However, other toxic manifestations of these chemotherapeutic agents also may be involved in promoting bacterial translocation. The promotion of bacterial translocation from the gastrointestinal tract by these chemotherapeutic agents has important implications for the pathogenesis of infectious disease in patients receiving these drugs.