Research Advances in the Subtype of Sepsis-Associated Thrombocytopenia

The incidence and mortality of sepsis in the intensive care unit (ICU) are extremely high. Thrombocytopenia, one of the most common laboratory abnormalities, is correlated with prognosis in sepsis. The pathophysiology of sepsis-associated thrombocytopenia (SAT) remains unclear and may be associated with several factors such as platelet activation due to vascular injury and pathogen, suppression of bone marrow, platelet-targeted antibodies and desialylation. This review summarized all these possible mechanisms in the 3 subtypes of SAT: increased platelet consumption, reduced platelet production and increased platelet destruction. Based on the clinically available platelet parameters, the evidence for identifying SAT subtypes and the recent progress in treatments according to these subtypes are proposed to provide new prospects for the management of SAT.

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The epidemiology, risk factors and outcomes of Carbapenem-resistant Klebsiella pneumoniae infections in the intensive care unit from 2012 to 2018

10.21203/rs.3.rs-17412/v1 ◽

2020 ◽

Author(s):

Ping Wang ◽

Xiaocui Zou ◽

Boting Zhou ◽

Tao Yin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Klebsiella Pneumoniae ◽

Control Measures ◽

Icu Patients ◽

Infection Control Measures ◽

Carbapenem Resistant ◽

Incidence And Mortality ◽

Changing Trend ◽

Different Sources

Abstract Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an increasing globally threat for human health, but the trends and clinical characteristics of CRKP infections in the intensive care unit(ICU) remain uninvestigated.Methods: A retrospective study was conducted among ICU patients infected with KP isolates from January 2012 to December 2018. Carbapenem resistant to Klebsiella pneumoniae was defined according to Clinical and Laboratory Standards Institute (CLSI) criteria. The incidence and changing trend of CRKP were determined. CRKP patient sources, specimen types, infection sources and outcomes were investigated. Results: There were 256(40.13%) patients with CRKP and 382(59.87%) patients with CSKP. The incidence of CRKP increased from 2012(11.11%) to 2017(63.48%) and decreased in 2018(51.52%). The proportion of isolates not susceptible to three carbapenems increased from 0 to 98.04%. The rates of CRKP isolated from blood, wound, urine and pleural fluid were higher than that of CSKP. CRKP infections were mainly ICU acquired, rather than input acquired. Conclusion: The incidence of CRKP was high in ICU, but showed a downward trend. Implementation of different infection control measures to different sources of patients, specimen types, and KP infections are necessary. Surveillance data will be needed for ICU patients to decrease the incidence and mortality of CRKP.

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Effect of clinical outcomes data on intensive care unit utilization by bone marrow transplant patients

Critical Care Medicine ◽

10.1097/00003246-199801000-00018 ◽

1998 ◽

Vol 26 (1) ◽

pp. 66-70 ◽

Cited By ~ 36

Author(s):

Harold L. Paz ◽

Allan Garland ◽

Martha Weinar ◽

Pamela Crilley ◽

Isadore Brodsky

Keyword(s):

Intensive Care Unit ◽

Bone Marrow ◽

Intensive Care ◽

Clinical Outcomes ◽

Bone Marrow Transplant ◽

Marrow Transplant ◽

Transplant Patients

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Respiratory Failure Associated with Ascariasis in a Patient with Immunodeficiency

Case Reports in Infectious Diseases ◽

10.1155/2016/4070561 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Lanocha Aleksandra ◽

Zdziarska Barbara ◽

Lanocha-Arendarczyk Natalia ◽

Kosik-Bogacka Danuta ◽

Guzicka-Kazimierczak Renata ◽

...

Keyword(s):

Intensive Care Unit ◽

Bone Marrow ◽

Intensive Care ◽

Respiratory Failure ◽

General Condition ◽

Risk Groups ◽

Parasitic Diseases ◽

Industrialized Countries ◽

Recent Immigrants ◽

Good General Condition

In industrialized countries, risk groups for parasitic diseases include travelers, recent immigrants, and patients with immunodeficiency following chemotherapy and radiotherapy and AIDS. A 66-year-old Polish male was admitted in December 2012 to the Department of Haematology in a fairly good general condition. On the basis of cytological, cytochemical, immunophenotypic, and cytogenetic analysis of bone marrow, the patient was diagnosed with acute myeloblastic leukemia. On the 7th day of hospitalization in the Department of Haematology, patient was moved to the Intensive Care Unit (ICU) due to acute respiratory and circulatory failure. In March 2013, 3 months after the onset of respiratory failures, a mature form ofAscarisspp. appeared in the patient’s mouth. This report highlights the importance of considering anAscarisinfection in patients with low immunity presenting no eosinophilia but pulmonary failure in the central countries of Europe.

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Incidence and mortality of sepsis, severe sepsis, and septic shock in intensive care unit patients with candidemia

Infectious Diseases ◽

10.3109/23744235.2015.1028100 ◽

2015 ◽

Vol 47 (8) ◽

pp. 584-587 ◽

Cited By ~ 15

Author(s):

Kevin Ng ◽

Christa Schorr ◽

Annette C. Reboli ◽

Sergio Zanotti ◽

Constantine Tsigrelis

Keyword(s):

Intensive Care Unit ◽

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Incidence And Mortality ◽

Sepsis And Septic Shock

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Surveillance on secular trends of incidence and mortality for device–associated infection in the intensive care unit setting at a tertiary medical center in Taiwan, 2000–2008: A retrospective observational study

BMC Infectious Diseases ◽

10.1186/1471-2334-12-209 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 12

Author(s):

Yin-Yin Chen ◽

Liang-Yu Chen ◽

Seng-Yi Lin ◽

Pesus Chou ◽

Shu-Yuan Liao ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Observational Study ◽

Medical Center ◽

Secular Trends ◽

Intensive Care Unit Setting ◽

Retrospective Observational Study ◽

Incidence And Mortality ◽

Device Associated Infection

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Outcome of Recipients of Bone Marrow Transplants Who Require Intensive-Care Unit Support

Mayo Clinic Proceedings ◽

10.1016/s0025-6196(12)61310-x ◽

1992 ◽

Vol 67 (2) ◽

pp. 117-122 ◽

Cited By ~ 122

Author(s):

BEKELE AFESSA ◽

AYALEW TEFFERI ◽

H. CLARK HOAGLAND ◽

LOUIS LETENDRE ◽

STEVE G. PETERS

Keyword(s):

Intensive Care Unit ◽

Bone Marrow ◽

Intensive Care ◽

Bone Marrow Transplants

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Detection of Sepsis in Platelets Using MicroRNAs and Membrane Antigens

Genes ◽

10.3390/genes12121877 ◽

2021 ◽

Vol 12 (12) ◽

pp. 1877

Author(s):

Priscilla Cristina Moura Vieira Corrêa ◽

Débora Monteiro Carneiro ◽

Luciana do Socorro da Silva Valente ◽

Fabíola Marques Diogo ◽

Leticia Martins Lamarão ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Platelet Activation ◽

Inverse Relationship ◽

Diagnostic Parameters ◽

Negative Results ◽

Blood Banks ◽

Membrane Antigens ◽

And Function

The present study proposes to legitimize in sepsis a characteristic found in platelets that suffer storage lesions in blood banks, which is the increased expression of miRNA miR-320a in relation to miR-127. Under physiologically normal conditions, an inverse relationship is observed. The aim of this study was to verify whether the analysis of miR-320a and miR-127 expression in platelets could detect a decrease in their viability and function due to the presence of pathogens in the blood of patients hospitalized in the Intensive Care Unit. We also investigated the expression of membrane antigens sensitive to platelet activation. Of the 200 patients analyzed, only those who developed sepsis (140) were found to have a higher relative quantity of miR-320a than that of miR-127. This characteristic and the increased expression of membrane antigens P2Y12, CD62P, CD41, and CD61 showed a significant association (p < 0.01) with all types of sepsis evaluated in this study. Additionally, 40% of patients hospitalized for sepsis had negative results for the first cultures. We conclude that analysis of miR-127 and miR-320a expression combined with membrane antigens evaluation, in association with the available clinical and diagnostic parameters, are important tools to detect the onset of sepsis.

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Sepsis incidence and mortality are underestimated in Australian intensive care unit administrative data

The Medical Journal of Australia ◽

10.5694/mja2.50017 ◽

2019 ◽

Vol 210 (4) ◽

pp. 188 ◽

Cited By ~ 3

Author(s):

Jake C Valentine ◽

Gabrielle Haeusler ◽

Leon Worth ◽

Karin Thursky

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Administrative Data ◽

Incidence And Mortality

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Thrombopoietin induces rapid resolution of thrombocytopenia after orthotopic liver transplantation through increased platelet production

Blood ◽

10.1182/blood.v95.3.795.003k25_795_801 ◽

2000 ◽

Vol 95 (3) ◽

pp. 795-801 ◽

Cited By ~ 128

Author(s):

Markus Peck-Radosavljevic ◽

Martina Wichlas ◽

Johannes Zacherl ◽

Gabriele Stiegler ◽

Petra Stohlawetz ◽

...

Keyword(s):

Bone Marrow ◽

Liver Transplantation ◽

Platelet Count ◽

Liver Disease ◽

Orthotopic Liver Transplantation ◽

Platelet Activation ◽

Serum Levels ◽

Etiologic Factor ◽

Coagulation Activation ◽

Platelet Production

Thrombopoietin (TPO) deficiency has been proposed as an important etiologic factor for thrombocytopenia in advanced-stage liver disease. To clarify the contributions of platelet production, platelet consumption, coagulation activation, and splenic sequestration to thrombocytopenia in liver disease, we studied TPO serum levels and markers of platelet production, platelet activation, and coagulation activation before and 14 days after orthotopic liver transplantation (OLT) in 18 patients with advanced liver cirrhosis. Thrombocytopenia before transplantation occurred with low-normal serum levels of TPO, normal levels of platelet and coagulation activation markers, and no increase in bone marrow production of platelets. TPO serum levels increased significantly on the first day after OLT, preceding the increase of reticulated platelets by 3 days and peripheral platelets by 5 days. Normalization of the peripheral platelet count occurred in most patients within 14 days of OLT, irrespective of the change in spleen size assessed by computed tomography volumetry. Normalization of platelet counts was not hampered by a certain degree of platelet activation observed during the steepest increase in the peripheral platelet count. Bone marrow production of platelets increased significantly within 2 weeks of transplantation. Low TPO serum levels with low platelet counts and without platelet consumption suggests low TPO production in end-stage liver disease. The rapid increase in TPO serum levels after transplantation induces an increase in the bone marrow production of platelets. Decreased TPO production in the cirrhotic liver is an important etiologic factor for thrombocytopenia in liver disease that is rapidly reversed by transplantation.

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