S CHISTOSOMA MANSONI is a widespread para- sitic disease with a high prevalence in cer- tain regions of Brazil. In about 7% of infected individuals, a clinical presentation takes place with enlargement of the spleen and liver, as- sociated with portal hypertension. This is the hepatosplenic form of the disease, in which gastrointestinal (GI) bleeding from gastro- esophageal varices occurs in over 20% of cases [1–4]. Several treatment options have been pro- posed to control bleeding from esophagogas- tric varices in schistosomiasis. In addition to medical and endoscopic approaches [5,6], a SURGICAL INFECTIONS Volume 6, Number 2, 2005 © Mary Ann Liebert, Inc. Gut Bacterial Translocation and Postoperative Infections: A Prospective Study in Schistosomotic Patients ALVARO ANTÔNIO BANDEIRA FERRAZ, JOSEMBERG MARINS CAMPOS, JOSÉ GUIDO CORRÊA DE ARAÚJO JÚNIOR, ANTÔNIO CAVALCANTI DE ALBUQUERQUE, and EDMUNDO MACHADO FERRAZ ABSTRACT Background: Bacterial translocation (BT) across the intact intestinal mucosal barrier has been postulated as a source of sepsis in susceptible patients, including those with cirrhosis and portal hypertension. This condition has not been studied in hepatosplenic schistosomiasis, wherein portal hypertension and the presence of an immune deficiency state associated with the parasitic disease could predispose to BT into mesenteric lymph nodes (MLN). A study was conducted to determine the prevalence of aerobic bacteria in MLN (bacterial transloca- tion) of patients with hepatosplenic schistosomiasis, and establish a possible association with postoperative infections. Methods: In a series of 51 patients submitted to surgical treatment of schistosomotic portal hypertension with splenectomy and gastric devascularization, MLN were obtained from each patient at the beginning (MLN 1 ) and at the end (MLN 2 ) of the surgical procedure, and sent for bacteriological analysis. Prospective patient evaluation during the postoperative period correlated positive MLN cultures with infectious complications. Results: The prevalence of aerobic bacteria was 17.6% at MLN 1 and 27.5% at MLN 2 , how- ever, this difference was non-significant (p  0.24). Bacterial translocation to all MLN was 22.5%. Escherichia coli was the most frequent organism (26.1%, 6/23). The overall incidence of postoperative infections was 19.6% (10/51), with a significant association with the presence of positive cultures of MLN (p  0.043). Conclusions: The findings of this study suggest that the presence of aerobic bacteria on MLN as a consequence of BT may play a role in the development of postoperative infectious complications, particularly in schistosomotic patients. General Surgery Service, University Hospital of the Federal University of Pernambuco, Recife, Brazil. Presented at the 5 th World Congress on Trauma, Shock, Inflammation and Sepsis, Munich Germany, February 2000. 197