Sepsis: mechanisms of bacterial injury to the patient

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine Vol. 27; no. 1; pp. 19 - 22
• Main Author: Minasyan, Hayk
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14-02-2019; Springer Nature B.V; BioMed Central; BMC
• Subjects: Adaptation; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibacterial therapy; Antibiotics; Antigens; Antimicrobial agents; Antioxidants (Nutrients); Bacteremia; Bacteria; Bactericidals; Bacteriostatics; Biofilms; Carbenicillin; Care and treatment; Cell division; Cephalothin; Development and progression; Enzymes; Gram-positive bacteria; Hemolysis; Homeostasis; Humans; Infection; Liver; Methicillin; Mortality; Oxidation-reduction reactions; Pathogens; Review; Sepsis; Sepsis - etiology; Sepsis - therapy; Streptococcus infections; Treatment; Sepsis; Treatment; Antibiotics; Antibacterial therapy; Bactericidals; Bacteriostatics
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/s13049-019-0596-4

In bacteremia the majority of bacterial species are killed by oxidation on the surface of erythrocytes and digested by local phagocytes in the liver and the spleen. Sepsis-causing bacteria overcome this mechanism of human innate immunity by versatile respiration, production of antioxidant enzymes, hemolysins, exo- and endotoxins, exopolymers and other factors that suppress host defense and provide bacterial survival. Entering the bloodstream in different forms (planktonic, encapsulated, L-form, biofilm fragments), they cause different types of sepsis (fulminant, acute, subacute, chronic, etc.). Sepsis treatment includes antibacterial therapy, support of host vital functions and restore of homeostasis. A bacterium killing is only one of numerous aspects of antibacterial therapy. The latter should inhibit the production of bacterial antioxidant enzymes and hemolysins, neutralize bacterial toxins, modulate bacterial respiration, increase host tolerance to bacterial products, facilitate host bactericidal mechanism and disperse bacterial capsule and biofilm.