The Septic Multiple-Trauma Patient

Stillwell, M. A.; Caplan, Ellis S.

doi:10.1016/s0749-0704(18)30496-2

Cited by 30 publications

(24 citation statements)

References 173 publications

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“…An important molecule involved in the microbial action towards the host is endotoxin, a cell-wall component of gram-negative bacteria which are responsible for approximately 50% of the septic episodes [30,67]. Endotoxin promotes the translocation by splanchnic vasoconstriction [10,43,23].…”

Section: Introduction and Clinical Relevancementioning

confidence: 99%

Molecular mechanisms of sepsis

Woltmann

Hamann

Ulmer

et al. 1998

Langenbeck's Archives of Surgery

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Today a great number of problems in the field of bacterial sepsis remain to be solved. Understanding the molecular mechanisms of one of the most important bacterial products in the pathogenesis of sepsis - endotoxin may contribute to innovative and more effective therapies. Therefore, this review focuses on the structural and functional elements of endotoxin, its interaction with immune cells, and its biological activity. Finally, other bacterial components and their impact on sepsis are discussed.

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Section: Introduction and Clinical Relevancementioning

confidence: 99%

Molecular mechanisms of sepsis

Woltmann

Hamann

Ulmer

et al. 1998

Langenbeck's Archives of Surgery

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“…In the last decade, Gram-positive organisms were identified as frequently as Gram-negative organisms as the cause of sepsis (3). Staphylococcus aureus is the most frequently isolated Gram-positive pathogen that causes infections (4), e.g., in trauma patients (5,6). A further problem, apart from the increase of S. aureus infections, is the development of antibiotic resistance in this species (7,8).…”

mentioning

confidence: 99%

Definition of Structural Prerequisites for Lipoteichoic Acid-Inducible Cytokine Induction by Synthetic Derivatives

Deininger

Stadelmaier

Aulock

et al. 2003

The Journal of Immunology

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The controversy about the immune stimulatory properties of lipoteichoic acid (LTA) from Staphylococcus aureus was solved recently by showing decomposition and inactivation of LTA obtained by conventional purification strategies, as well as pronounced LPS contamination of commercial preparations. By introducing a novel preparation method, the structure of bioactive LTA was elucidated. This structure was confirmed by chemical synthesis. In this work, synthetic LTA derivatives were employed to study the structure-function relationship of cytokine induction in human monocytes. Synthetic LTA induced the same cytokine pattern as highly purified natural LTA. The gentiobiose core could be omitted without affecting bioactivity. The polyglycerophosphate backbone amplified the response to the lipid anchor (∼100-fold) only when substituted with d-alanine, whereas α-d-N-acetylglucosamine substituents could be omitted. Replacing d-alanine substituents with l-alanine reduced the activity of the molecule at least 10-fold, indicating stereoselectivity. These results define for the first time the crucial patterns required for the immune recognition of LTA.

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“…The overall mortality was 15%, with majority of death due to infections. [15] The Þ nancial implication of infection and sepsis following trauma are also staggering. Resource utilisation is prolonged in traumatised patients with infections, most of which is spent in the ICUs.…”

Section: Infections In Traumatised Patientsmentioning

confidence: 99%

“…[15,27] Necrotising fasciitis of the abdominal wall and diffuse peritonitis are also common in these patients. [28] Other risk factors for abdominal infections include multiple organ injury, pancreatic or duodenal injuries and packing to control haemorrhages.…”

Section: Abdominal Infectionsmentioning

confidence: 99%

Infections in traumatised patients: A growing medico-surgical concern

Mathur¹

2008

Indian J Med Microbiol

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Accidents and trauma are a leading global cause of mortality in young adults. Infections are one of the most important causes of death in traumatized patients. This is because of factors related to host and those due to trauma itself. Trauma jeopardizes the host's tissue integrity and immune effector mechanisms. Severely traumatized patients admitted to the ICUs are prone to get nosocomial infections due to open wounds and indwelling life saving devices. Massive blood loss also impairs the distribution of polymorphs, complement and antibiotics to the damaged tissues. Finally, diagnosis of infections in traumatized patients poses a challenge to clinicians due to various factors.

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The Septic Multiple-Trauma Patient

Cited by 30 publications

References 173 publications

Molecular mechanisms of sepsis

Molecular mechanisms of sepsis

Definition of Structural Prerequisites for Lipoteichoic Acid-Inducible Cytokine Induction by Synthetic Derivatives

Infections in traumatised patients: A growing medico-surgical concern

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