The bacterial flora of the nares, throat, skin, and feces of three men was studied after they were accidentally exposed to total-body irradiation. The three exposure victims were housed in a room equipped with laminar-flow clean benches. Patient A (100-200 R) had an episode of pharyngitis that corresponded with the appearance of Escherichia coli in throat cultures; Klebsiella-Enterobacter was the predominant microorganism isolated from his nares. Patient B (550 R), between 19 and 23 days after exposure, had increased populations of Streptococcus salivarius and a pleomorphic Clostridium sp. in fecal specimens. Patient C (550 R) had a predominance of Klebsiella-Enterobacter in his nares. During oral antibiotic therapy Candida albicans was isolated from both B and C. Victim B had C. albicans on the gums and in the throat during an episode of pharyngitis and gingivitis. The most noticeable changes in the fecal microbial profile appeared to be associated with the anaerobic bacteria. Only patient C, who received a marrow graft from his identical twin, consistently had viable bacteria in his urine. Plasma from the three men was assayed for immunoglobulins (IgG, IgA, IgM), complement (C′3), transferrin, agglutinins, and bacteriocidins. Patient A (100 to 200 R) and patient B (550 R) had good agglutination titers against bacteria isolated from their nares and stool, but no bactericidal effect was evident against the same bacteria. Plasma from patient C (550 R), who received a marrow graft from his twin brother about 8 days after exposure, had the lowest agglutinin titers; but his plasma lost and then regained bactericidal activity. Immunoglobulins (IgG, IgA, IgM), complement (C′3) and transferrin levels were also altered, sometimes dramatically, during a 560 day period after the accidental irradiation.

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