scholarly journals Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia

Critical Care ◽  
2010 ◽  
Vol 14 (2) ◽  
pp. R27 ◽  
Author(s):  
Ryuzo Abe ◽  
Shigeto Oda ◽  
Tomohito Sadahiro ◽  
Masataka Nakamura ◽  
Yo Hirayama ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Negative Bacteremia

scholarly journals Procalcitonin levels in patients with suspected sepsis

2021 ◽  
Vol 12 (11) ◽  
pp. 108-112
Author(s):  
Tribeni Goswami ◽  
Renu Mathew ◽  
Marina Thomas ◽  
Reena Anie Jose ◽  
Anjali Jacob ◽  
...  
Keyword(s):  
Early Recognition ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Care Hospital ◽  
Gram Positive ◽  
Suspected Sepsis ◽  
Gram Negative ◽  
Culture Positivity ◽  
Blood Culture Positivity ◽  
Gram Negative Bacteremia

Background: Procalcitonin (PCT) was found to be a valuable and reliable biomarker for sepsis, especially in critical care patients for whom early recognition and prompt treatment could reduce mortality. Aims and Objectives: This study was aimed at correlating the levels of PCT as diagnostic marker for sepsis in relation to the culture positivity of various samples from blood, respiratory, urine, and exudates from patients admitted in a tertiary care hospital. Materials and Methods: Results of PCT level along with bacterial culture results of blood, respiratory, urine, and exudates were analyzed from 780 patients for a period of 1 year. Results: High PCT values ranging from 0.52 to 200 ng/ml were found in 331 patients admitted with suspected sepsis. Out of 135 cases of sepsis, 85 had blood culture positivity alone and 50 had culture positivity in blood and in other sites with the same organism. Among the 85 cases of bloodstream infections, in which no localized infections were identified, the median PCT was 33 for Gram-negative bacteremia, which was significantly higher as compared with a median of 16 for Gram-positive cocci. In UTI with bacteremia, the median PCT was 45.34 and in UTI without bacteremia, it was 5. Conclusion: From this study, we concluded that PCT values may be useful to distinguish Gram-negative and Gram-positive bacteremia, and furthermore, a high PCT value for patients with UTI may be helpful in predicting bacteremia.

scholarly journals Molecules from Staphylococcus aureus that bind CD14 and stimulate innate immune responses.

1995 ◽  
Vol 182 (6) ◽  
pp. 1673-1682 ◽  
Author(s):  
T Kusunoki ◽  
E Hailman ◽  
T S Juan ◽  
H S Lichenstein ◽  
S D Wright
Keyword(s):  
Staphylococcus Aureus ◽  
Inflammatory Response ◽  
Minor Component ◽  
Lipoteichoic Acid ◽  
Cell Types ◽  
Abundant Species ◽  
Gram Positive ◽  
Gram Negative ◽  
Free Phenol ◽  
Gram Positive Bacteria

Mammals mount a rapid inflammatory response to gram-negative bacteria by recognizing lipopolysaccharide (LPS, endotoxin). LPS binds to CD14, and the resulting LPS-CD14 complex induces synthesis of cytokines and up-regulation of adhesion molecules in a variety of cell types. Gram-positive bacteria provoke a very similar inflammatory response, but the molecules that provoke innate responses to these bacteria have not been defined. Here we show that protein-free, phenol extracts of Staphylococcus aureus contain a minor component that stimulates adhesion of neutrophils and cytokine production in monocytes and in the astrocytoma cell line, U373. Responses to this component do not absolutely require CD14, but addition of soluble CD14 enhances sensitivity of U373 cells by up to 100-fold, and blocking CD14 on monocytes decreases sensitivity nearly 1,000-fold. Deletion of residues 57-64 of CD14, which are required for responses to LPS, also eliminates CD14-dependent responses to S. aureus molecules. The stimulatory component of S. aureus binds CD14 and blocks binding of radioactive LPS. Unlike LPS, the activity of S. aureus molecules was neither enhanced by LPS binding protein nor inhibited by bactericidal/permeability increasing protein. The active factor in extracts of S. aureus is also structurally and functionally distinct from the abundant species known as lipoteichoic acid (LTA). Cell-stimulating activity fractionates differently from LTA on a reverse-phase column, pure LTA fails to stimulate cells, and LTA antagonizes the action of LPS in assays of IL-6 production. These studies suggest that mammals may use CD14 in innate responses to both gram-negative and gram-positive bacteria, and that gram-positive bacteria may contain an apparently unique, CD14-binding species that initiates cellular responses.

scholarly journals The number of circulating endothelial progenitor cells from septic patients are associated with different infectious organisms

2020 ◽  
Author(s):  
Yingying Zhu ◽  
Nana Yang ◽  
Jing Zhu ◽  
Chao Fu ◽  
Xinghan Tian ◽  
...  
Keyword(s):  
Blood Culture ◽  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Healthy Controls ◽  
Negative Blood Culture ◽  
Endothelial Progenitor ◽  
Gram Positive ◽  
Survival Group ◽  
Gram Negative ◽  
Gram Negative Bacteremia

Abstract Background Endothelial progenitor cells (EPCs) can affect the repairment of endothelial injury by improving the process of re-endothelialization and angiogenesis in sepsis patients. However, the markers of EPCs have not been standardized nowadays, and the changes of EPCs are still unclear in patients with different infectious organisms. This study explored the relationship between the number of EPCs and different infectious organisms in patients with sepsis. Materials and Methods 39 septic patients and 20 healthy controls were enrolled in this study. The number of CD34+/KDR+, CD133+/KDR+, CD34+/CD133+/KDR+, CD34+, CD133+, and KDR+ cells were all analyzed through flow cytometry. Analysis of adhesion function of EPCs were also performed by counting the number of adherent cells in different cultured time points (4 days, 14 days, and 21 days). Results The number of EPCs in peripheral blood of septic patients were higher than that of healthy controls, but there were no significant differences between sepsis group and septic shock group, also between the survival group and the non-survival group. Additionally, the percentages of CD34+/CD133+/KDR+ cells in Gram-positive bacteremia group was significantly higher than the Gram-negative bacteremia group and negative blood culture group; the percentage of KDR+ cells in both Gram-positive bacteremia group and Gram-negative bacteremia group were significantly higher than the negative blood culture group. Furthermore, the adhesion function of EPCs in healthy controls was significantly higher than in septic patients. Conclusions The number of circulating EPCs and the adhesion function of EPCs in patients with sepsis are associated with different infectious organisms.

scholarly journals Diagnostic values of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and procalcitonin in early diagnosis of bacteremia

2019 ◽  
Vol 45 (1) ◽  
pp. 57-64
Author(s):  
Ayfer Colak ◽  
Merve Zeytinli Aksit ◽  
Burak Toprak ◽  
Nisel Yılmaz
Keyword(s):  
Complete Blood Count ◽  
Gram Positive ◽  
Distribution Width ◽  
Gram Negative ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Hematological Analysis ◽  
Gram Negative Bacteremia ◽  
Diagnostic Values

Abstract Objective The aim of this study is to investigate the diagnostic accuracy of complete blood count (CBC), C-reactive protein (CRP), and procalcitonin (PCT) levels, which can be used as a cultural alternative for the diagnosis of infection faster. Methods The patients were divided into two groups as bacteremia (n = 220) and nonbacteremia group (n = 812). The bacteremia group was divided into two subgroups as Gram-positive bacteria (n = 167) and Gram-negative bacteria (n = 53). Results PCT, CRP, red blood cell distribution width (RDW), platelet distribution width (PDW), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV) levels were significantly higher in patients with positive blood culture than non-patients. The serum PCT levels were 3.80 (0.83–37.68) and 0.43 (0.16–2.61) ng/mL, respectively (p < 0.001) in the patients with Gram-negative and Gram-positive bacterium. PCT at a cut-off value of 0.45 ng/mL for Gram-negative bacterium; sensitivity of 90% and specificity of 64%. Conclusions It is important that RDW, PDW, NLR, PLR, MPV values can be measured quickly, easily and cheaply by automatic hematological analysis. However, among the markers tested, PCT has the best diagnostic performance for Gram-negative bacteremia.

scholarly journals Morphological and cytokine profiles as key parameters to distinguish between Gram-negative and Gram-positive bacterial keratitis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Aris Konstantopoulos ◽  
Maria del Mar Cendra ◽  
Michael Tsatsos ◽  
Mariam Elabiary ◽  
Myron Christodoulides ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Treatment Options ◽  
Corneal Thickness ◽  
Diagnostic Value ◽  
Bacterial Keratitis ◽  
Gram Positive ◽  
Gram Negative ◽  
Cytokine Analysis ◽  
Tnf Α ◽  
Diagnostic Indicator

AbstractBacterial keratitis (BK) is an ocular disorder associated with poor visual prognosis. Quantification of the associated inflammatory response may provide insight into the pathogenesis of BK and guide treatment options. In this exploratory study, we evaluated 45 BK patients and 20 healthy controls by optical coherence tomography and pro-inflammatory tear cytokine analysis. The aim was to quantify the differential morphological and cytokine inflammatory response between Gram-negative and Gram-positive BK and to determine the diagnostic value of corneal thickness (CT) and infiltrate thickness (IT) in distinguishing Gram−ve BK in a clinical cohort. Greater CT and IT, at clinical presentation, were indicative of Gram−ve infection with values detected of ≥ 950 μm and ≥ 450 μm, respectively. Combination of these CT and IT values had a 100% sensitivity and 83.3% specificity as a diagnostic indicator of Gram−ve infection. Similarly, there were higher levels of IL-1β, IL-6 and IL-8 cytokines were quantified in keratitis caused by Gram-negative bacteria. Among the different tear cytokines analysed, a significant reduction after three days of treatment was detected for pro-inflammatory cytokines IL-1β, IL-2, IL-6, IL-8 and TNF-α, prior to starting with the administration of steroid drops. Overall, this study shows the potential value of serial OCT and tear cytokine measurements in the management of BK.

scholarly journals Different characteristics of bloodstream infection during venoarterial and venovenous extracorporeal membrane oxygenation in adult patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hyoung Soo Kim ◽  
Sunghoon Park ◽  
Ho Hyun Ko ◽  
Sang Ook Ha ◽  
Sun Hee Lee ◽  
...  
Keyword(s):  
Blood Culture ◽  
Extracorporeal Membrane Oxygenation ◽  
Bloodstream Infection ◽  
Clinical Characteristics ◽  
Gram Positive ◽  
Gram Negative ◽  
Membrane Oxygenation ◽  
Gram Negative Bacteremia ◽  
Va Ecmo ◽  
Vv Ecmo

AbstractCurrently, there is scarcity of data on whether differences exist in clinical characteristics and outcomes of bloodstream infection (BSI) between venoarterial (VA) and venovenous (VV) extracorporeal membrane oxygenation (ECMO) and whether they differ between Candida BSI and bacteremia in adult ECMO patients. We retrospectively reviewed data of patients who required ECMO for > 48 h and had BSIs while receiving ECMO between January 2015 and June 2020. Cases with a positive blood culture result within 24 h of ECMO implantation were excluded. We identified 94 (from 64 of 194 patients) and 38 (from 17 of 56 patients) BSI episodes under VA and VV ECMO, respectively. Fifty nine BSIs of VA ECMO (59/94, 62.8%) occurred in the first 2 weeks after ECMO implantation, whereas 24 BSIs of VV ECMO (24/38, 63.2%) occurred after 3 weeks of ECMO implantation. Gram-negative bacteremia (39/59, 66.1%) and gram-positive bacteremia (10/24, 41.7%) were the most commonly identified BSI types in the first 2 weeks after VA ECMO implantation and after 3 weeks of VV implantation, respectively. Timing of Candida BSI was early (6/11, 54.5% during the first 2 weeks) in VA ECMO and late (6/9, 66.7% after 3 weeks of initiation) in VV ECMO. Compared with bacteremia, Candida BSI showed no differences in clinical characteristics and outcomes during VA and VV ECMO, except the significant association with prior exposure to carbapenem in VA ECMO (vs. gram-negative bacteremia [P = 0.006], vs. gram-positive bacteremia [P = 0.03]). Our results suggest that ECMO modes may affect BSI clinical features and timing. In particular, Candida BSI occurrence during the early course of VA ECMO is not uncommon, especially in patients with prior carbapenem exposure; however, it usually occurs during the prolonged course of VV ECMO. Consequently, routine blood culture surveillance and empiric antifungal therapy might be warranted in targeted populations of adult ECMO patients, regardless of levels of inflammatory markers and severity scores.

scholarly journals Practice Patterns of Infectious Diseases Physicians in Transitioning From Intravenous to Oral Therapy in Patients With Bacteremia

2019 ◽  
Vol 7 (12) ◽  
Author(s):  
Duane R Hospenthal ◽  
C Dustin Waters ◽  
Susan E Beekmann ◽  
Philip M Polgreen
Keyword(s):  
Infectious Diseases ◽  
Oral Therapy ◽  
Source Control ◽  
Oral Antibiotics ◽  
Emerging Infections ◽  
Gram Positive ◽  
Gram Negative ◽  
Oral Agents ◽  
Gram Negative Bacteremia ◽  
Rapid Transition

Abstract Background Bacteremia in adult patients has traditionally been treated with extended courses of intravenous antibiotics. Data on the use of (or rapid transition to) oral therapy are limited. Methods Adult infectious disease physicians participating in the Infectious Diseases Society of America Emerging Infections Network (EIN) were surveyed regarding their use of oral antibiotics in patients with bacteremia. Respondents were asked to assume that patients were hemodynamically stable, recovered bacteria were susceptible to potential antibiotics, adequate source control had been achieved, and patients had adequate gastrointestinal absorption. Variables of specific bacteria, oral agent, and associated infection were included. Results A total of 655 (50%) of 1321 EIN participants responded. Under certain conditions, 88% would transition patients with Gram-negative bacteremia to complete a course of therapy with oral antibiotics; 71% would transition patients with Gram-positive bacteremia to oral agents. Only 78 (12%) respondents would not treat any bacteremic patient with oral agents. Most respondents (≥75%) were comfortable treating infections secondary to Enterobacteriaceae, Salmonella, Pseudomonas, Stenotrophomonas, Streptococcus pneumoniae, and β-hemolytic streptococci with oral agents. Fewer than 20% endorsed use of oral antibiotics for Staphylococcus aureus or in cases of endocarditis. Fluoroquinolones and trimethoprim-sulfamethoxazole were the preferred agents in Gram-negative bacteremia; linezolid and β-lactams were the preferred agents in Gram-positive bacteremia. Conclusions In select circumstances, the majority of respondents would transition patients to oral antibiotics, in both Gram-negative and Gram-positive bacteremia. Most agreed with the use of oral agents in Gram-negative bacteremia caused by Enterobacteriaceae, but they would not use oral agents for Gram-positive bacteremia caused by S aureus or in endocarditis.

DYNAMICS OF C-REACTIVE PROTEIN IN CRITICALLY ILL PATIENTS WITH NOSOCOMIAL GRAM-POSITIVE VERSUS GRAM-NEGATIVE BACTEREMIA.

2006 ◽  
Vol 34 ◽  
pp. A127 ◽  
Author(s):  
Dominique M Vandijck ◽  
Eric A Hoste ◽  
Stijn I Blot ◽  
Pieter O Depuydt ◽  
Johan M Decruyenaere ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
C Reactive Protein ◽  
Gram Positive ◽  
Gram Negative ◽  
Reactive Protein ◽  
Gram Negative Bacteremia

scholarly journals Neither Single nor a Combination of Routine Laboratory Parameters can Discriminate between Gram-positive and Gram-negative Bacteremia

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Franz Ratzinger ◽  
Michel Dedeyan ◽  
Matthias Rammerstorfer ◽  
Thomas Perkmann ◽  
Heinz Burgmann ◽  
...  
Keyword(s):  
Routine Laboratory ◽  
Gram Positive ◽  
Gram Negative ◽  
Laboratory Parameters ◽  
Gram Negative Bacteremia
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