Antibiotic resistance in sepsis patients: Evaluation and recommendation of antibiotic use

Pradipta, Ivan Surya; Sodik, Dian C.; Lestari, Keri; Parwati, Ida; Halimah, Eli; Diantini, Ajeng; Abdulah, Rizky

doi:10.4103/1947-2714.114165

Cited by 62 publications

(64 citation statements)

References 36 publications

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“…More than 70% of sepsis associated mortality occurs in the later course of disease, which is dominated by inability to control the primary infection and development of secondary nosocomial infections [20]. Sepsis still remains a serious threat with high mortality rates [4], the burden of which is compounded by a growing incidence of antibiotic resistant micro-organisms [97, 98]. Therefore, strategies to augment host immunity warrant detailed investigation and hold promise as a therapy in sepsis.…”

Section: Is a Need For Immunotherapy Justified?mentioning

confidence: 99%

Immunotherapy: A promising approach to reverse sepsis-induced immunosuppression

Patil

Bohannon

Sherwood

2016

Pharmacological Research

124

123

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Sepsis is defined as life-threatening organ dysfunction caused by dysregulated host responses to infection (Third International Consensus definition for Sepsis and septic shock). Despite decades of research, sepsis remains the leading cause of death in intensive care units. More than 40 clinical trials, most of which have targeted the sepsis-associated pro-inflammatory response, have failed. Thus, antibiotics and fluid resuscitation remain the mainstays of supportive care and there is intense need to discover and develop novel, targeted therapies to treat sepsis. Both pre-clinical and clinical studies over the past decade demonstrate unequivocally that sepsis not only causes hyper-inflammation, but also leads to simultaneous adaptive immune system dysfunction and impaired antimicrobial immunity. Evidences for immunosuppression include immune cell depletion (T cells most affected), compromised T cell effector functions, T cell exhaustion, impaired antigen presentation, increased susceptibility to opportunistic nosocomial infections, dysregulated cytokine secretion, and reactivation of latent viruses. Therefore, targeting immunosuppression provides a logical approach to treat protracted sepsis. Numerous pre-clinical studies using immunomodulatory agents such as interleukin-7, anti-programmed cell death 1 antibody (anti-PD-1), anti-programmed cell death 1 ligand antibody (anti-PD-L1), and others have demonstrated reversal of T cell dysfunction and improved survival. Therefore, identifying immunosuppressed patients with the help of specific biomarkers and administering specific immunomodulators holds significant potential for sepsis therapy in the future. This review focusses on T cell dysfunction during sepsis and discusses the potential immunotherapeutic agents to boost T cell function during sepsis and improve host resistance to infection.

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Section: Is a Need For Immunotherapy Justified?mentioning

confidence: 99%

Immunotherapy: A promising approach to reverse sepsis-induced immunosuppression

Patil

Bohannon

Sherwood

2016

Pharmacological Research

124

123

View full text Add to dashboard Cite

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“…Although studies have shown that clinical criteria apply as well and in cases that patient condition deteriorates it should be treated promptly after antibiotic susceptibility testing. Oncological patients, immunosuppresed and patients in ICU as well as septic conditions may predispose to the high possibility that this innocent bacterium may cause serious complications [20]. Our patient was diagnosed immediately after tube removal with pleural effusion and high fever without any sign of rashes or other histamine reaction.…”

Section: Discussionmentioning

confidence: 81%

Clinical significance of positive Raoultella Ornithinolytica and Staphylococcus hominis cultures in a post lobectomy patient. A case report

Papakanderaki

Kanakakis

Goule

et al. 2018

Monaldi Arch Chest Dis

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Raoultella ornithinolytica is an encapsulated, Gram-negative, nonmotile aerobic rob which was reclassified from Klebsiella genus belonging to the family of Enterobacteriaceae. It is a rare human infection and few cases have been reported in post thoracotomy patients. Here we present a case of a left lower lobectomy patient that was complicated by pleural effusion, high fever with positive sputum cultures of Raoultella ornithinolytica and positive pleural fluid cultures of Staphylococcus hominis. The disease is related with aquatic life poisoning. There are few cases reported and even fewer postoperatively. The infection is rare in humans therefore the bacteria is still underreported.

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“…This is of great concern as it contributes to failure of therapy leading to poor prognosis, prolonged hospital stay and increased cost of therapy [11]. Therefore, to reduce the development of AM resistance regulation of their use is essential [12,13]. These regulations can be customized to suit the requirements of the institution.…”

Section: Discussionmentioning

confidence: 99%