Neutrophils dysfunction during the course of intra-abdominal infection.

Twenty-four patients with intra-peritoneal infections were studied sequentially to evaluate neutrophil chemotaxis, spontaneous migration, and chemiluminescence. In six patients, infection was due to spontaneous disease processes and 18 others, infection was a sequel of intra-abdominal operation. In the patients studied prior to drainage, operation chemotaxis, spontaneous migration and chemiluminescence were all significantly depressed. Operation resulted in a further depression of these functions, and recovery of neutrophil migratory responses was delayed for two weeks. During the period of functional depression, 16 patients developed recurrent infections (nine episodes of intra-abdominal abscess, and 12 episodes of extra-abdominal infection). These infection were associated with a fall-off in neutrophil migratory and chemiluminescence responses prior to clinical evidence of infection. This study suggests that the delayed recovery of neutrophil function may be related to the recurrent infection seen in this patient population. Further, monitoring of neutrophil function in patients recovering from intra-abdominal infection may provide early evidence of recurrent infection.