1
|
Lange A, Cajander S, Magnuson A, Sundén-Cullberg J, Strålin K, Hultgren O. Plasma concentrations of secretory leukocyte protease inhibitor (SLPI) differ depending on etiology and severity in community-onset bloodstream infection. Eur J Clin Microbiol Infect Dis 2019; 38:1425-1434. [PMID: 31089838 PMCID: PMC6647850 DOI: 10.1007/s10096-019-03567-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 04/17/2019] [Indexed: 11/24/2022]
Abstract
The severity of bloodstream infections (BSI) depends on pathogen, source, and host factors. Secretory leukocyte protease inhibitor (SLPI) counteracts tissue damage, balances inflammation, and is increased in pneumonia and sepsis. We aimed to evaluate whether SLPI production differs depending on etiology, disease severity, and sex in BSI and to correlate SLPI with markers of inflammation and immunosuppression. Of the adult patients with BSI, 109 were included and sampled repeatedly, from hospital admission through day 28. Controls (blood donors) were sampled twice. SLPI in plasma was measured with enzyme-linked immunosorbent assay (ELISA) technique. Streptococcus pneumoniae and Staphylococcus aureus etiology were associated with higher SLPI than Escherichia coli on days 1–2 and 3. On day 1–2, subjects with sepsis had higher SLPI concentrations than those with non-septic BSI. Pneumonia was associated with higher SLPI than a non-pulmonary source of infection. SLPI co-varied with inflammatory markers. SLPI concentrations did not differ with regard to sex in the full cohort, but men with pneumonia had higher SLPI than women on day 1–2. S. pneumoniae and S. aureus BSI were associated with higher SLPI, when compared to E. coli. Severity and pneumonia, as well as male sex in the pneumonia sub-cohort, were factors independently associated with higher SLPI.
Collapse
Affiliation(s)
- Anna Lange
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, SE-70182, Örebro, Sweden.
| | - Sara Cajander
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, SE-70182, Örebro, Sweden
| | - Anders Magnuson
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, SE-70182, Örebro, Sweden
| | - Jonas Sundén-Cullberg
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Kristoffer Strålin
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Olof Hultgren
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Faculty of Medicine and Health, Örebro University, SE-70182, Örebro, Sweden
| |
Collapse
|
2
|
Liu M, Li H, Xue CX, Gu L, Qu JX, Yu XM, Wang YM, Liu YM, Cao B. Differences in inflammatory marker patterns for adult community-acquired pneumonia patients induced by different pathogens. CLINICAL RESPIRATORY JOURNAL 2017; 12:974-985. [PMID: 28139879 DOI: 10.1111/crj.12614] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 01/17/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The inflammatory marker patterns of community-acquired Pneumonia (CAP) induced by different microorganisms in adult patients remained unclear. OBJECTIVES We aim to explore the inflammatory marker patterns of adult CAP patients induced by different pathogens. METHODS Adult CAP patients with definite etiologies were enrolled from September 2010 to June 2012. They were divided into three groups according to the causative pathogens: typical bacteria, Mycoplasma pneumoniae (MP), and viruses. Twenty-seven cytokines and bactericidal/permeability-increasing protein (BPI) levels of serum collected within 7 days onset in these groups were compared. RESULTS One hundred twenty-four cases were enrolled for serum detection and analysis, including 10 typical bacterial pneumonia patients, 56 cases with MP pneumonia and 58 with viral pneumonia. Three kinds (PDGF-BB, IP-10, RANTES) of 27 cytokines and BPI levels were significantly elevated in patients with acute pneumonia than healthy controls. Distinct inflammatory marker patterns were released by different pathogens: typical bacterial pneumonia patients had highest levels of BPI, IL-6, IL-8, IL-1rα; while patients caused by MP presented higher levels of PDGF-BB, IL-17A, G-CSF than those caused by viruses. Rhinovirus owned a higher inflammatory response level than the other viruses. The area under the curve (AUC) of PDGF-BB to differentiate MP and virus infection was biggest, which was 0.708. CONCLUSION Distinct inflammatory marker patterns were released by different pathogens during acute pneumonia. Significantly increased level of PDGF-BB was observed in acute pneumonia for the first time. It showed a better ability to differentiate MP and virus infection.
Collapse
Affiliation(s)
- Meng Liu
- Department of Infectious diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Beijing, 100020, China.,Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, 100010, China
| | - Hui Li
- Department of Respiratory Medicine, Capital Medical University, Beijing, 100069, China
| | - Chun Xue Xue
- Department of Respiratory Medicine, Capital Medical University, Beijing, 100069, China
| | - Li Gu
- Department of Infectious diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Beijing, 100020, China
| | - Jiu Xin Qu
- Department of Infectious diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Beijing, 100020, China
| | - Xiao Min Yu
- Department of Infectious diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Beijing, 100020, China
| | - Yi Min Wang
- National Clinical Research Centre of Respiratory Diseases, Center for Respiratory Diseases, China - Japan Friendship Hospital; Department of Pulmonary and Critical Care Medicine, China - Japan Friendship Hospital, Beijing, 100029, China
| | - Ying Mei Liu
- National Clinical Research Centre of Respiratory Diseases, Center for Respiratory Diseases, China - Japan Friendship Hospital; Department of Pulmonary and Critical Care Medicine, China - Japan Friendship Hospital, Beijing, 100029, China
| | - Bin Cao
- Department of Respiratory Medicine, Capital Medical University, Beijing, 100069, China.,National Clinical Research Centre of Respiratory Diseases, Center for Respiratory Diseases, China - Japan Friendship Hospital; Department of Pulmonary and Critical Care Medicine, China - Japan Friendship Hospital, Beijing, 100029, China
| |
Collapse
|
3
|
Nair GB, Niederman MS. Year in review 2012: Critical Care--respiratory infections. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2013; 17:251. [PMID: 24438847 PMCID: PMC4057239 DOI: 10.1186/cc12773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Over the last two decades, considerable progress has been made in the understanding of disease mechanisms and infection control strategies related to infections, particularly pneumonia, in critically ill patients. Patient-centered and preventative strategies assume paramount importance in this era of limited health-care resources, in which effective targeted therapy is required to achieve the best outcomes. Risk stratification using severity scores and inflammatory biomarkers is a promising strategy for identifying sick patients early during their hospital stay. The emergence of multidrug-resistant pathogens is becoming a major hurdle in intensive care units. Cooperation, education, and interaction between multiple disciplines in the intensive care unit are required to limit the spread of resistant pathogens and to improve care. In this review, we summarize findings from major publications over the last year in the field of respiratory infections in critically ill patients, putting an emphasis on a newer understanding of pathogenesis, use of biomarkers, and antibiotic stewardship and examining new treatment options and preventive strategies.
Collapse
|