The Interplay between Host Defense, Infection, and Clinical Status in Septic Patients: A Narrative Review

Abstract

Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Despite significant morbidity and mortality throughout the world, its pathogenesis and mechanisms are not clearly understood. In this narrative review, we aimed to summarize the recent developments in our understanding of the hallmarks of sepsis pathogenesis (immune and adaptive immune response, the complement system, the endothelial disfunction, and autophagy) and highlight novel laboratory diagnostic approaches. Clinical management is also discussed with pivotal consideration for antimicrobic therapy management in particular settings, such as intensive care unit, altered renal function, obesity, and burn patients.

Nosocomial Extracardiac Infections After Cardiac Surgery

“…Among the biomarkers to diagnose the sepsis, the only one with a some specificity for the infections and a great accuracy to detect a severe inflammatory state is procalcitonin (PCT). The serum levels of PCT, a peptide, derived from the parafollicular cells of the thyroid and from the neuroendocrine cells of the lung and the bowel, are undetectable in healthy subjects and very high in those with bacterial infections [ 94 ]. This promises to be a valuable biomarker to distinguish between bacterial infection and systemic inflammatory response syndrome [ 95 ].…”

“…The timing of an early and proper antibiotic treatment increases the probabilities of survival and prevents the development of septic shock [ 94 ]; for a correct management and to set up an effective treatment we should be aware of: The source of infection; The prevalence and susceptibility of various pathogens in that hospital; The patient’s clinical conditions. …”

“…A broader antibiotic coverage represents the first choice until the pathogen is isolated and the treatment can be more specific based on the antibiogram [ 94 ]. Due to high resistance rate to methicillin (87% of cases) and fluoroquinolones and clindamycin (66% and 55%, respectively), the administration of vancomycin, linezolid, and daptomycin should be preferred against Gram-positive bacteria [ 47 ].…”

Cervical sympathetic trunk transection alleviates acute lung injury caused by intestinal obstruction via inhibition of phospholipase A2 in rats

“…‘Sepsis’ is currently identified as ‘a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs’ [ 21 ]. Initiated by an invading pathogen, generally represented by bacteria and, less frequently, by viruses or fungi, sepsis results in an inflammatory process in which the body’s own response has a deleterious effect on itself [ 22 ]. Pathogen infection is the condition of ‘sepsis’ and activates sPLA 2 .…”

Anti-Inflammatory Activity of Ferula assafoetida Oleo-Gum-Resin (Asafoetida) against TNF-α-Stimulated Human Umbilical Vein Endothelial Cells (HUVECs)

“…Activation of E.C.s at the inflammatory site leads to the upregulation of endothelial cell adhesion molecules (ECAMs), which include vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and E-selectin (CD62E) [ 4 , 5 ]. Also, leukocyte migration following ECAM expression causes tissue and organ dysfunction by secreting inflammatory cytokines and chemokines, including tumour necrosis factor- α (TNF- α ) and interleukin- (I.L.-) 1 β , 6, and 8 [ 6 , 7 ]. Furthermore, there is considerable evidence that TNF- α can trigger oxidative stress via increasing reactive oxygen species (ROS).…”