Polyethylene glycol influences microbial interactions with intestinal epithelium

There is emerging evidence that polyethylene glycol (PEG), widely used as a bowel preparation before surgery, may protect the intestinal epithelium from microbial invasion. Experiments were designed to study the effects of both low-molecular-weight (LMW; 3.35 kd) and high-molecular-weight (HMW; 15-20 kd) PEG on interactions of Escherichia coli, Candida albicans, and Candida glabrata with intestinal epithelium (these three intestinal microbes are frequently involved in systemic infection in shock and trauma patients.) In vitro experiments studied the effects of PEG on mature Caco-2 enterocytes. Using the gentamicin protection assay, both HMW and LMW PEG inhibited E. coli internalization by Caco-2 enterocytes. Using an immunosorbent assay, both HMW and LMW PEG inhibited C. albicans and C. glabrata adherence to Caco-2 enterocytes. Scanning electron micrographs of Caco-2 cells incubated in HMW or LMW PEG showed globular material distributed randomly over the epithelial surface, and apical microvilli seemed distorted. As an in vivo correlate to these experiments, separate groups of antibiotic-treated mice were orally associated with either E. coli, C. albicans, or C. glabrata, and cohort groups were given drinking water containing 5% HMW or 5% LMW PEG. Cecal colonization of E. coli was decreased in mice given HMW but not LMW PEG. Cecal colonization with C. albicans or C. glabrata was decreased in mice given either HMW or LMW PEG. These data provide further evidence that PEG may decrease microbial colonization and microbial interactions with intestinal epithelium.