Survival after multiple traumas is associated with improved outcomes from gram-negative sepsis: Clinical and experimental evidence - 18/04/17
Summary |
Objectives |
We investigated the susceptibility to Gram-negative sepsis after multiple traumas (MT).
Methods |
From a prospective cohort of 5076 Greek patients with sepsis, 16 with Gram-negative bacteremia after MT were compared with 204 patients well-matched for severity, comorbidities and appropriateness of antimicrobials; circulating mononuclear cells were isolated and stimulated for the release of interleukin (IL)-10. Male C57Bl6J mice were subject to MT (right pneumothorax and right femur fracture) followed after 72 h by the intravenous challenge with Pseudomonas aeruginosa. Survival was recorded and splenocytes were isolated for cytokine stimulation.
Results |
28-day mortality after MT was 18.8% compared to 48.0% of comparators (48.0%) (odds ratio 0.25, p: 0.035). This was confirmed after logistic regression analysis taking into consideration comorbidities and age. Stimulation of IL-10 was enhanced from MT patients. Survival of mice challenged by P. aeruginosa 72 h after MT was prolonged compared to mice challenged by P. aeruginosa without prior MT. Cytokine production was decreased 24 h after MT and restored 96 h thereafter. Production of IL-10 was particularly pronounced from splenocytes of mice challenged by P. aeruginosa after MT.
Conclusions |
Survival after MT is accompanied by favorable immune responses allowing survival benefit from Gram-negative sepsis. This is associated with increased IL-10 release.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Prior multiple trauma (MT) provides survival benefit from Gram-negative sepsis. |
• | This is associated with increased IL-10 production by circulating monocytes. |
• | Prior MT provides survival benefit from experimental P. aeruginosa infection. |
• | Increased IL-10 production and lower bacterial outgrowth are potential mechanisms. |
Keywords : Multiple trauma, Sepsis, Cytokines, Interleukin-10, Survival
Plan
Vol 74 - N° 2
P. 163-171 - février 2017 Retour au numéro
Article précédent
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