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- Bergquist, Maria, et al.
(författare)
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Expression of the glucocorticoid receptor is decreased in experimental Staphylococcus aureus sepsis
- 2013
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Ingår i: Journal of Infection. - : Elsevier BV. - 0163-4453 .- 1532-2742. ; 67:6, s. 574-583
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Glucocorticoid treatment in septic shock remains controversial after recent trials. We hypothesized that failure to respond to steroid therapy may be caused by decreased expression and/or function of glucocorticoid receptors (GR) and studied this in a mouse model of Staphylococcus aureus sepsis. The impact of timing of dexamethasone treatment was also investigated. Methods: Male C57BL/6J mice were intravenously inoculated with S. aureus and GR expression and binding ability in blood, spleen and lymph nodes were analysed by means of flow cytometry. GR translocation was analysed using Image Stream. Septic mice were administered dexamethasone at 22, 26, 48, 72 and 96 h after inoculation and body weight, as a sign of dehydration, was observed. Results: GR expression was decreased in septic animals, but not the ligand binding capacity. GR translocation was decreased in septic mice compared to control animals. Early dexamethasone treatment (22 and 26 h) improved clinical outcome as studied by weight gain compared to when treatment was started at later time points (48, 72 and 96 h). Conclusion: Our data provide evidence that GR expression is progressively decreased in experimental sepsis and that dexamethasone has a decreased ability to translocate into the cell nucleus. This may explain why steroid treatment is only beneficial when administered early in sepsis and septic shock.
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- Bergquist, Maria, et al.
(författare)
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Glucocorticoid receptor function is decreased in neutrophils during endotoxic shock
- 2014
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Ingår i: Journal of Infection. - : Elsevier BV. - 0163-4453 .- 1532-2742. ; 69:2, s. 113-122
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: It remains unclear whether glucocorticoid treatment can improve the outcome of sepsis. The aim of the present study was to investigate if glucocorticoid receptor (GR) expression and function is impaired in lipopolysaccharide (LPS) induced shock, and whether the time point for start of glucocorticoid treatment affects the outcome.METHODS: Male C57BL/6J mice were administered LPS i.p. and GR expression and binding ability in blood and spleen leukocytes were analysed by flow cytometry. GR translocation was analysed using Image Stream technique. The effect of dexamethasone treatment started 2 h before or 2, 12 or 36 h after LPS administration on survival was studied.RESULTS: Despite increased GR expression in neutrophils after LPS administration, the GR binding capacity was reduced. In addition, GR translocation was decreased in neutrophils and T lymphocytes from endotoxic mice at 12 h compared to control animals. Dexamethasone treatment improved survival only when started early (2 h) after LPS administration.CONCLUSION: The decreased glucocorticoid responsiveness displayed by neutrophils, in combination with their increased numbers, may explain why survival is increased only when dexamethasone treatment is given early during LPS induced shock.
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- Ngan, TTD, et al.
(författare)
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First report of human psittacosis in Vietnam
- 2013
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Ingår i: The Journal of infection. - : Elsevier BV. - 1532-2742 .- 0163-4453. ; 66:5, s. 461-464
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Rasmussen, Magnus
(författare)
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Aerococci and aerococcal infections.
- 2013
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Ingår i: Journal of Infection. - : Elsevier BV. - 1532-2742 .- 0163-4453. ; 66:6, s. 467-474
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Forskningsöversikt (refereegranskat)abstract
- Aerococcus is a genus that comprises seven species, of which Aerococcus urinae, and Aerococcus sanguinicola are emerging human pathogens. Aerococci are gram positive cocci that are easily misidentified as streptococci or staphylococci, and thus the incidence of aerococcal infections has been underestimated. With the introduction of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) clinical microbiologists now have access to a rapid and accurate method to identify aerococci. A. urinae and A. sanguinicola are isolated in a small proportion of urinary specimens in many laboratories and many patients with bacteriuria with aerococci have symptoms of urinary tract infection (UTI). A. urinae, and also A. sanguinicola, cause invasive infections including infective endocarditis (IE) with many reported fatalities. Especially older men with urinary tract abnormalities are at risk for bacteraemia with A. urinae but the prognosis of bacteraemia without IE is favourable. Penicillin is appropriate for treatment of invasive infections and in IE, addition of an aminoglycoside should be considered. Treatment of UTI with aerococci is complicated by uncertainty about the effect of trimethoprim-sulphametoxazole and fluoroquinolones on aerococci. This review will discuss identification of Aerococcus spp., antibiotic resistance, the clinical presentation and management of aerococcal infections as well as the virulence mechanisms of these bacteria.
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- Ricard, Jean-Damien, et al.
(författare)
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A European survey of nosocomial infection control and hospital-acquired pneumonia prevention practices
- 2012
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Ingår i: Journal of Infection. - : Elsevier BV. - 0163-4453 .- 1532-2742. ; 65:4, s. 285-291
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to examine organizational, structural and routine infection control measures provided by European ICUs and staff practices in ventilator-associated pneumonia prevention in relation with current recommendations.Methods: European ICU staffs were invited to complete a web-based 20 closed-item questionnaire.Results: 675 nurses and 886 physicians from 13 countries answered the questionnaire. Median number of respondents per country was 118.0 (64.5-155.5). Availability and organizational aspects of infection control revealed wide variations between countries. Among them, single-patient rooms was the aspect with the lowest availability (median availability 38%), but the largest variation ranging from 15 to 84%. Self-reported median adherence rate to recommendations was 72% (34.5-83.0) with a strong correlation between nurses and physicians responses (r(2) = 0.96; p < 0.0001). Sub-glottic drainage (31%), and infrequent ventilatory-circuit change (24%) were the measures with the lowest adherence rate whereas preferential use of oral intubation (90%) and of NIV (84%) and use of HMEs (82%) were the three with the highest rate. Organization of infection control was consistently self-reported. Disparities among countries were more frequent for specific actions regarding airway management, and even moreso for controversial issues (subglottic drainage, closed-suction systems).Conclusion: This European survey shows a 72% overall adherence rate to VAP prevention measures; with strong agreements between physician and nurses but considerable differences among countries for availability and organization aspects of infection control, providing healthcare authorities with figures for future programs.
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