Gram-Negative Bacterial Sepsis and Sepsis Syndrome

Introduction: Procalcitonin is known as a marker of infection and indicator for severity of infections. In sepsis, elevated procalcitonin levels in blood have a significant value that can be used as a sepsis biomarker. The aim of this study was to determine the mean difference of procalcitonin levels in Gram-positive and Gram-negative bacterial sepsis patients.Methods: This study used quantitative method with cross sectional approach. The sample of this study were bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 which were divided into two groups: Gram-positive and Gram-negative bacterial sepsis patients with the number of each group was 30 samples. The data were analyzed by using independent t test.Results: This study showed that mean levels of procalcitonin in Gram-positive bacterial sepsis patients was 6.47 ng/ml and Gram-negative was 66.04 ng/ml. There was a significant difference between mean levels of procalcitonin in Gram-positive and Gram-negative bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 with p value = 0.000 (p < 0.05).Conclusion: The mean difference of procalcitonin levels in Gram-negative bacterial sepsis patients were higher than Gram-positive bacterial sepsis patients, because Gram-negative bacteria have lipopolysaccharide which is a strong immunostimulator and increases TNF-α production higher than Gram-positive bacteria.

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Lipopolysaccharide-Trap-Fc, a Multifunctional Agent To Battle Gram-Negative Bacteria

Infection and Immunity ◽

10.1128/iai.00004-09 ◽

2009 ◽

Vol 77 (7) ◽

pp. 2925-2931 ◽

Cited By ~ 5

Author(s):

Philipp Groß ◽

Katharina Brandl ◽

Christine Dierkes ◽

Jürgen Schölmerich ◽

Bernd Salzberger ◽

...

Keyword(s):

Myeloid Differentiation ◽

Gram Negative Bacteria ◽

Bacterial Sepsis ◽

Tlr Signaling ◽

Monocytic Cells ◽

Gram Negative ◽

The Family ◽

Myeloid Differentiation Factor ◽

Lps Treatment

ABSTRACT The family of Toll-like receptors (TLRs) plays a pivotal role in host defense against pathogens. However, overstimulation of these receptors may lead to uncontrolled general inflammation and eventually to systemic organ dysfunction or failure. With the intent to control overwhelming inflammation during gram-negative bacterial sepsis, we constructed soluble fusion proteins of the lipopolysaccharide (LPS)-receptor complex to modulate TLR signaling in multiple ways. The extracellular domain of mouse TLR4 and mouse myeloid differentiation factor 2 (MD-2) fusions (LPS-Trap) were linked to human immunoglobulin G Fc domains (LPS-Trap-Fc). In addition to the ability to bind LPS or gram-negative bacteria and to inhibit interleukin-6 secretion of monocytic cells after LPS treatment, LPS-Trap-Fc was able to opsonize fluorescent Escherichia coli particles. This led to enhancement of phagocytosis by monocytic cells which was strictly dependent on the presence of the Fc region. Moreover, only LPS-Trap-Fc- and not LPS-Trap-coated bacteria were sensitized to complement killing. Therefore, LPS-Trap-Fc not only neutralizes LPS but also, after binding to bacteria, enhances phagocytosis and complement-mediated killing and could thus act as a multifunctional agent to fight gram-negative bacteria in vivo.

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Review and Critique of the Use of Immunoglobulins in Prevention and Treatment of Infection in Critically Ill Patients

Canadian Journal of Infectious Diseases ◽

10.1155/1992/192064 ◽

1992 ◽

Vol 3 (suppl b) ◽

pp. 3-10

Author(s):

Geogrio Zanetti ◽

Michel P Glauser ◽

Jean-Daniel Baumgartner

Keyword(s):

Clinical Trials ◽

Immunoglobulin G ◽

Sepsis Syndrome ◽

Biologically Active ◽

Gram Negative ◽

Prophylactic Use ◽

Seriously Ill Patients ◽

Conserved Core ◽

Treatment Of Infection ◽

Seriously Ill

The study of standard intravenous immunoglobulin G (IVIG) preparations as adjunctive therapy in seriously ill patients is motivated by the possible need to: restore immunoglobulin G levels depleted after trauma or surgery; and/or to provide patients with specific antibodies directed against various microorganisms. Whereas no therapeutic efficacy has been shown in clinical studies with standard IVIG, some data suggest a benefit in prophylactic use. Antisera or IVIG hyperimmune against the biologically active. highly conserved core portion of the endotoxin of Gram-negative bacteria have demonstrated variable degrees of protection in animal models and clinical trials. Two clinical trials using monoclonal antibodies against core lipopolysaccharide have been completed. Only subsets of patients with the Gram-negative sepsis syndrome were protected, but both studies gave discrepant results concerning the type of patients that were reported to benefit from administration of these antibodies. Further studies will be necessary to establish whether application of this therapy can be recommended.

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Select Gram-negative Aerobic Bacteria

Mayo Clinic Infectious Diseases Board Review ◽

10.1093/med/9780199827626.003.0007 ◽

2012 ◽

pp. 90-101

Author(s):

David R. McNamara ◽

Franklin R. Cockerill

Keyword(s):

Cell Wall ◽

Sepsis Syndrome ◽

Vital Role ◽

Klebsiella Pneumonia ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Neisseria Meningitides ◽

A Cell ◽

Normal Human ◽

Specific Species

Gram-negative bacteria may be rod-shaped (bacilli), spherical (cocci), oval, helical, or filamentous. Cytoplasmic membrane is surrounded by a cell wall consisting of a peptidoglycan layer and an outer cell membrane. Gram-negative bacteria are widely distributed in the natural environment. They are commensals with many animals and play a vital role in normal human physiology as intestinal commensals. Gram-negative bacteria are the cause of various human illnesses. The gram-negative bacterial cell wall contains various lipopolysaccharide endotoxins. Endotoxins trigger intense inflammation and the sepsis syndrome during infection. Specific species of gram-negative bacteria such as Neisseria meningitides, Moraxella catarrhalis, Acinetobacter, Vibrio, Klebsiella pneumonia, Salmonella, Pseudomonas aeruginosa, and Haemophilus influenza are reviewed.

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