Bacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directions

Abstract Surgical site infections (SSIs) continue to pose a significant healthcare challenge by contributing to longer post-surgical recovery times, greater healthcare costs and higher patient mortality. The traditional understanding of SSIs has focused on the impact of various external origins of c...

Full description

Saved in:
Bibliographic Details
Main Authors: Simone N. Zwicky, Lara Mordasini, Daniel Spari, Bahtiyar Yilmaz, Guido Beldi
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Translational Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12967-025-06462-x
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849343830488252416
author Simone N. Zwicky
Lara Mordasini
Daniel Spari
Bahtiyar Yilmaz
Guido Beldi
author_facet Simone N. Zwicky
Lara Mordasini
Daniel Spari
Bahtiyar Yilmaz
Guido Beldi
author_sort Simone N. Zwicky
collection DOAJ
description Abstract Surgical site infections (SSIs) continue to pose a significant healthcare challenge by contributing to longer post-surgical recovery times, greater healthcare costs and higher patient mortality. The traditional understanding of SSIs has focused on the impact of various external origins of contamination or on the importance of intestinal spillage during surgical procedures. However, recent studies highlight the significant contribution of the patient's intestinal microbiota in the onset of SSIs. One possible pathway of infection is translocation of bacteria from the intestines to organs that are typically sterile, such as the mesenteric lymph nodes (MLNs). These secondary lymphoid organs are then potential reservoirs for SSIs. This review summarizes the current data on the incidence and mechanisms of bacterial translocation (BT) to MLNs in the context of a surgical insult and its association with postoperative infectious complications. Data from animal studies discuss how BT to MLNs is driven by factors such as dysbiosis and surgical interventions and is strongly linked to infectious outcomes. Potential translocation pathways including intracellular transit and carrier-independent mechanisms are explored. Similarly, human studies provide evidence that BT to MLNs is a frequent occurrence during abdominal surgery and significantly increases the risk of infectious complications. We further discuss the limitations of current methodologies for studying BT and SSIs and highlight how advanced techniques can provide novel insights into these processes. This review identifies key areas for future research and potential targets for preventative strategies to increase our understanding of the role of the intestinal microbiota in BT to MLNs and its contribution to SSIs.
format Article
id doaj-art-288d93f941d043ff9681045354b2fbfe
institution Kabale University
issn 1479-5876
language English
publishDate 2025-08-01
publisher BMC
record_format Article
series Journal of Translational Medicine
spelling doaj-art-288d93f941d043ff9681045354b2fbfe2025-08-20T03:42:52ZengBMCJournal of Translational Medicine1479-58762025-08-0123112410.1186/s12967-025-06462-xBacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directionsSimone N. Zwicky0Lara Mordasini1Daniel Spari2Bahtiyar Yilmaz3Guido Beldi4Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of BernAbstract Surgical site infections (SSIs) continue to pose a significant healthcare challenge by contributing to longer post-surgical recovery times, greater healthcare costs and higher patient mortality. The traditional understanding of SSIs has focused on the impact of various external origins of contamination or on the importance of intestinal spillage during surgical procedures. However, recent studies highlight the significant contribution of the patient's intestinal microbiota in the onset of SSIs. One possible pathway of infection is translocation of bacteria from the intestines to organs that are typically sterile, such as the mesenteric lymph nodes (MLNs). These secondary lymphoid organs are then potential reservoirs for SSIs. This review summarizes the current data on the incidence and mechanisms of bacterial translocation (BT) to MLNs in the context of a surgical insult and its association with postoperative infectious complications. Data from animal studies discuss how BT to MLNs is driven by factors such as dysbiosis and surgical interventions and is strongly linked to infectious outcomes. Potential translocation pathways including intracellular transit and carrier-independent mechanisms are explored. Similarly, human studies provide evidence that BT to MLNs is a frequent occurrence during abdominal surgery and significantly increases the risk of infectious complications. We further discuss the limitations of current methodologies for studying BT and SSIs and highlight how advanced techniques can provide novel insights into these processes. This review identifies key areas for future research and potential targets for preventative strategies to increase our understanding of the role of the intestinal microbiota in BT to MLNs and its contribution to SSIs.https://doi.org/10.1186/s12967-025-06462-xSurgical site infectionsBacterial translocationAbdominal surgeryMetagenomic sequencingWhole genome sequencingPCR
spellingShingle Simone N. Zwicky
Lara Mordasini
Daniel Spari
Bahtiyar Yilmaz
Guido Beldi
Bacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directions
Journal of Translational Medicine
Surgical site infections
Bacterial translocation
Abdominal surgery
Metagenomic sequencing
Whole genome sequencing
PCR
title Bacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directions
title_full Bacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directions
title_fullStr Bacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directions
title_full_unstemmed Bacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directions
title_short Bacterial translocation to mesenteric lymph nodes fueling surgical site infections: evidence, technical challenges and future directions
title_sort bacterial translocation to mesenteric lymph nodes fueling surgical site infections evidence technical challenges and future directions
topic Surgical site infections
Bacterial translocation
Abdominal surgery
Metagenomic sequencing
Whole genome sequencing
PCR
url https://doi.org/10.1186/s12967-025-06462-x
work_keys_str_mv AT simonenzwicky bacterialtranslocationtomesentericlymphnodesfuelingsurgicalsiteinfectionsevidencetechnicalchallengesandfuturedirections
AT laramordasini bacterialtranslocationtomesentericlymphnodesfuelingsurgicalsiteinfectionsevidencetechnicalchallengesandfuturedirections
AT danielspari bacterialtranslocationtomesentericlymphnodesfuelingsurgicalsiteinfectionsevidencetechnicalchallengesandfuturedirections
AT bahtiyaryilmaz bacterialtranslocationtomesentericlymphnodesfuelingsurgicalsiteinfectionsevidencetechnicalchallengesandfuturedirections
AT guidobeldi bacterialtranslocationtomesentericlymphnodesfuelingsurgicalsiteinfectionsevidencetechnicalchallengesandfuturedirections