Preventing organ failure in sepsis — the search continues

Graetz, Thomas J.; Hotchkiss, Richard S.

doi:10.1038/nrneph.2016.171

Cited by 24 publications

(17 citation statements)

References 12 publications

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“…Sepsis can occur in patients with serious trauma, burns, multiple injuries, shock, or after major surgery, and it progresses rapidly from bacteremia to vital organ failure and even death. At present, sepsis is a major issue in the field of critical care medicine [ 1 ]. Currently, blood culture is the gold standard for the microbiological diagnosis of sepsis, but this method has drawbacks, including a lack of sensitivity owing to small sample volumes and the long time required for a confirmed diagnosis, resulting in delayed treatment and high mortality rates [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of the lncRNA NEAT1 in Peripheral Blood Mononuclear Cells of Patients with Sepsis

Huang

Qian

Zhu³

et al. 2017

Disease Markers

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Background This study aims to evaluate the diagnostic value of nuclear-enriched abundant transcript 1 (NEAT1) expression in peripheral blood mononuclear cells (PBMCs) for the early diagnosis of sepsis. Methods A total of 59 patients with sepsis, 52 noninfectious SIRS patients, and 56 healthy controls were recruited fort this study. The levels of NEAT1 expression in PBMCs were measured using quantitative real-time polymerase chain reaction (qRT-PCR). Results Compared with healthy controls, NEAT1 expression of PBMCs in sepsis and SIRS groups were significantly increased (3.76 ± 0.71- and 1.64 ± 0.43-fold, resp.) (P < 0.01), but NEAT1 levels are significantly lower in the SIRS group than in the sepsis group, and there was no statistical significant relevance between survivors and nonsurvivors in patients with sepsis. NEAT1 with an area under the curve (AUC) of 0.851 (95% CI: 0.812–0.935) indicated sensitivity (67.85%) and specificity (87.27%) for the diagnosis for sepsis, the positive predictive value (PPV) was 83.3%, and the negative predictive value (NPV) was 71.6%. The AUC for NEAT1 in the diagnosis of SIRS versus healthy controls was 0.755 (95% CI: 0.664–0.847), with 69.23% sensitivity and 70.91% specificity, the PPV was 72.3%, and the NPV was 72.49%. Conclusion Measurement of NEAT1 expression in PBMCs could be considered as a good additive marker for the diagnosis of sepsis.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Value of the lncRNA NEAT1 in Peripheral Blood Mononuclear Cells of Patients with Sepsis

Huang

Qian

Zhu³

et al. 2017

Disease Markers

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“…Infections of mild to moderate severity can be cured with timely and proper treatment. In case of severe medical conditions, especially those accompanied by sepsis, every hour of delay in starting therapy brings the patient closer to death, due to an increasing number of organ dysfunctions [1,2]. Therefore, a number of studies demonstrate that antibiotic therapy should be started as early as possible [3,4].…”

Section: Use Of Antibiotic Drugs In Treatment Of Bacterial Infectionsmentioning

confidence: 99%

“…Sepsis is one of the main causes of death in patients after ineffective and untimely antibiotic therapy, fulminant infections, superinfection, inadequate diagnosis of the patient's condition, risky surgeries performed in violation of asepsis standards, or the appearance and spreading of a wound infection [2]. The generalization of the process, resulting in the disruption of the biochemical functions of vital organs and the appearance of local foci of inflammation, leads ultimately to the inability of the organism to fight bacterial infection, leading to severe septicemia, intoxication of the organism with the decay products of pathogens and its own tissues, septic shock and multi-organ failure [38].…”

Section: Markers Of Inflammatory Processes and Choice Of Bacterial Inmentioning

confidence: 99%

Monitoring Antibiotics and Inflammatory Markers in Human Blood: Impact in Choice of Antibiotic Therapy and Used Methods

Berlina¹,

Zherdev²,

Dzantiev³

2019

Preprint

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In the modern world, the problem of antibiotic therapy is acute. Despite the diversity of existing antibiotic drugs, their efficacy decreases as new, resistant forms of pathogenic microorganisms emerge. It is extremely difficult to control such processes and even more difficult to treat severe bacterial infections. In such situations, an individual approach to each patient is required and physicians need parameters to estimate the efficacy of antibiotic therapy. This review discusses the significance of monitoring the content of antibiotics in the blood for this purpose, in combination with the content of inflammatory markers, such as C-reactive protein and procalcitonin. The basic principles of antibiotic therapy, and factors in the resistance of microorganisms to antibiotics, are examined. Approaches to assess the efficacy of antibiotic therapy, as well as methods to detect antibiotics and inflammatory markers in the blood of patients, and comparative assessment of their capabilities and limitations, are described.

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“…It is very obvious that today patients usually arrive at the Intensive Care Unit (ICU) too late when all the "horses have already left the stable" allowing the immune system to induce organ failure [37,38]. Novel means of detecting early markers of sepsis should be available to every family physicians office and indeed to first responders to recognize the severity of the illness.…”

Section: In Conclusion a Cautionary Commentmentioning

confidence: 99%

Tissue damage in post infectious sequelae is caused by a synergism between microbial and neutrophils-derived agonists: a concern for a disregard for already published data

Ginsburg¹,

Koren²,

Heerden³

2018

J Emerg Rare Dis

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Post infectious sequelae such as sepsis and septic shock are poorly understood and annually take the lives of millions over the world. Severe microbial infections caused by Gram Positive and Gram Negative bacteria and by fungi are the main causes, which are aggravated by the rapid development of antibiotic resistance. It is unfortunate that today all the clinical trials of sepsis which tested the efficacy of single antagonists failed. Sepsis was recently redefined as a synergistic multifactorial episode where no unique alarmin had been identified, which if inhibited could control the deleterious biochemical and immune immunological events characteristic of sepsis.

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Preventing organ failure in sepsis — the search continues

Cited by 24 publications

References 12 publications

Diagnostic Value of the lncRNA NEAT1 in Peripheral Blood Mononuclear Cells of Patients with Sepsis

Diagnostic Value of the lncRNA NEAT1 in Peripheral Blood Mononuclear Cells of Patients with Sepsis

Monitoring Antibiotics and Inflammatory Markers in Human Blood: Impact in Choice of Antibiotic Therapy and Used Methods

Tissue damage in post infectious sequelae is caused by a synergism between microbial and neutrophils-derived agonists: a concern for a disregard for already published data

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