Gram-negative bacteria killed by complement are associated with more severe biliary infections and produce more tumor necrosis factor-α in sera
| Autor: | Beverly Aagaard, Lawrence W. Way, Gary A. Jarvis, J. McLeod Griffiss, Adair L. Oesterle, Lygia Stewart |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Gram-negative bacteria Adolescent macromolecular substances In Vitro Techniques Gastroenterology Sepsis Immune system Cholelithiasis Internal medicine Gram-Negative Bacteria medicine Humans Leukocytosis Biliary Tract Complement Activation Aged Aged 80 and over biology Tumor Necrosis Factor-alpha business.industry Complement System Proteins Gallstones Middle Aged medicine.disease biology.organism_classification Complement system Biliary tract Bacteremia Immunology Female Surgery medicine.symptom Gram-Negative Bacterial Infections business |
| Zdroj: | Surgery. 132:408-414 |
| ISSN: | 0039-6060 |
| Popis: | We previously showed that gallstones contain bacteria and that illness severity correlates with bacterial presence. This study examined virulence differences of gram-negative biliary bacteria.Gallstones and bile were cultured, and sera obtained, from 210 patients. Infection severity was staged as: none-no clinical infection; moderate-fever, leukocytosis; or severe-bacteremia, cholangitis, hypotension, abscess, or organ failure. Gram-negative biliary bacteria were tested against patient (and control) serum for complement-mediated bacterial killing and induction of tumor necrosis factor-alpha (TNFalpha) production (using cultured monocytes) with and without sera. These results were correlated with infection severity.A total of 98 (47%) patients had biliary bacteria. Infection severity distribution was none, 29%; moderate, 35%; and severe, 36%. Gram-negative organisms killed by complement were associated with more severe infections as follows: 13%, none; 60%, moderate; and 88%, severe infections (P =.024 and P.0001, respectively vs none, chi-square test). TNFalpha production in sera increased 182 pg/mL with complement resistant bacteria, but increased 546 pg/mL with bacteria killed by complement (P.0001, killed vs not killed, Student's t test). E coli and Klebsiella were the most virulent bacterial species. They were cultured from blood, usually killed by complement, and had the largest increase in TNFalpha production in sera.Gram-negative biliary bacteria killed by complement (as opposed to complement-resistant) were associated with more serious biliary infections including bacteremia and induced more TNFalpha production in sera. This suggests a potential role for complement activation and cytokine production in biliary sepsis. |
| Databáze: | OpenAIRE |
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