How do viral infections predispose patients to bacterial infections?

被引:132
作者
Beadling, C [1 ]
Slifka, MK [1 ]
机构
[1] Oregon Hlth & Sci Univ, Vaccine & Gene Therapy Inst, Beaverton, OR 97006 USA
关键词
sepsis; influenza; RSV; bacteria; synergism;
D O I
10.1097/00001432-200406000-00003
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Purpose of review Bacterial sepsis is a leading cause of death in the United States, accounting for over 200000 fatalities annually. Approximately half of bacterial sepsis cases occur following acute respiratory infections, and the lungs are the most common organs to fail. Notably, outbreaks of respiratory viral infections are associated with an increased incidence or severity of bacterial co-infections, with normally innocuous infections often becoming fatal. Understanding the 'lethal synergism' associated with concomitant infections may point the way toward improved anti-sepsis treatments. Recent findings Murine models of viral and bacterial co-infection mimic the lethal synergism observed in humans and reveal at least two mechanisms of interaction. First, bacterial infiltration is heightened during acute viral infection. Secondly, the nature of responding cell populations is dramatically altered during concomitant infections. Although natural killer cells and macrophages are predominant cell populations responding to bacterial infection in a naive host, there is also a large T cell component that is activated upon viral infection. Inflammatory cytokines produced by these cells contribute to lethal immunopaithology, and therapeutic strategies need to target the initial causative microbes as well as subsequent inflammatory responses. Current therapies directed only at the host immune response have not been overly successful, owing largely to difficulties in reversing the severe immunopathology associated with sepsis. Summary Respiratory viral infections may facilitate secondary bacterial infections and increase host immunopathology through the overproduction of inflammatory cytokines. Preventive measures, including vaccination and aggressive antimicrobial therapy early in the course of infection, may significantly reduce the morbidity and mortality of sepsis.
引用
收藏
页码:185 / 191
页数:7
相关论文
共 47 条
  • [31] Nguyen KB, 1999, J IMMUNOL, V162, P5238
  • [32] Relation between influenza vaccination and outpatient visits, hospitalization, and mortality in elderly persons with chronic lung disease
    Nichol, KL
    Baken, L
    Nelson, A
    [J]. ANNALS OF INTERNAL MEDICINE, 1999, 130 (05) : 397 - +
  • [33] Influenza vaccine effectiveness in preventing hospitalizations and deaths in persons 65 years or older in Minnesota, New York, and Oregon: Data from 3 health plans
    Nordin, J
    Mullooly, J
    Poblete, S
    Strikas, R
    Petrucci, R
    Wei, FF
    Rush, B
    Safirstein, B
    Wheeler, D
    Nichol, KL
    [J]. JOURNAL OF INFECTIOUS DISEASES, 2001, 184 (06) : 665 - 670
  • [34] Influenza A virus-infected hosts boost an invasive type of Streptococcus pyogenes infection in mice
    Okamoto, S
    Kawabata, S
    Nakagawa, I
    Okuno, Y
    Goto, T
    Sano, K
    Hamada, S
    [J]. JOURNAL OF VIROLOGY, 2003, 77 (07) : 4104 - 4112
  • [35] Passive transfer of serum antibodies induced by BBG2Na, a subunit vaccine, in the elderly protects SCID mouse lungs against respiratory syncytial virus challenge
    Plotnicky-Gilquin, H
    Cyblat-Chanal, D
    Goetsch, L
    Lacheny, C
    Libon, C
    Champion, T
    Beck, A
    Pasche, H
    Nguyen, TN
    Bonnefoy, JY
    Bouveret-le-Cam, N
    Corvaïa, N
    [J]. VIROLOGY, 2002, 303 (01) : 130 - 137
  • [36] Novel strategies for the treatment of sepsis
    Riedemann, NC
    Guo, RF
    Ward, PA
    [J]. NATURE MEDICINE, 2003, 9 (05) : 517 - 524
  • [37] Multicenter, double-blind, placebo-controlled study of the use of filgrastim in patients hospitalized with pneumonia and severe sepsis
    Root, RK
    Lodato, RF
    Patrick, W
    Cade, JF
    Fotheringham, N
    Milwee, S
    Vincent, JL
    Torres, A
    Rello, J
    Nelson, S
    [J]. CRITICAL CARE MEDICINE, 2003, 31 (02) : 367 - 373
  • [38] BACTERIAL PNEUMONIA DURING HONG KONG INFLUENZA EPIDEMIC OF 1968-1969 - EXPERIENCE IN A CITY-COUNTY HOSPITAL
    SCHWARZMANN, SW
    ADLER, JL
    SULLIVAN, RJ
    MARINE, WM
    [J]. ARCHIVES OF INTERNAL MEDICINE, 1971, 127 (06) : 1037 - +
  • [39] Sethi S, 2002, GERIATRICS-US, V57, P56
  • [40] Clinical implications of dysregulated cytokine production
    Slifka, MK
    Whitton, JL
    [J]. JOURNAL OF MOLECULAR MEDICINE-JMM, 2000, 78 (02): : 74 - 80