Gram-positive Organisms and Sepsis

Abstract

In recent years, the importance of gram-negative organisms in the genesis of sepsis has been emphasized. However, this emphasis may no longer be correct; recent studies show an increasing incidence of gram-positive sources of sepsis, and its is possible that these cases may predominate in the coming years. This increase results from more than just a greater prevalence of infection--it appears that gram-positive organisms may also be more virulent in fomenting the disease, as can be evidenced by the emergence of streptococcal toxic shock syndrome and the resurgence of acute rheumatic fever. This may result from the ability of gram-positive organisms to produce more inflammation-causing cell wall constituents, as well as unbound exotoxins. Despite the recent emphasis on gram-negative causes, sepsis resulting from gram-positive sources is increasingly common. Research on these causes of sepsis should be encouraged.

In vitrosynergistic antibacterial activities of helvolic acid on multi-drug resistantStaphylococcus aureus

“…Although some semi-synthetic penicillin and -lactamase inhibitor are indicated for -lactamase-producing strains, treatment of S. aureus infection has become more difficult because of the emergence of multidrugresistant strains (Lowy, 1998). Now S. aureus remains one of the most dangerous pathogens in bacteremia (Mylotte, McDermott, & Spooner, 1987), endocarditis (Sanabria, Alpert, Goldberg, Pape, & Cheeseman, 1990;Sandre & Shafran, 1996), sepsis (Bone, 1994), and toxic shock syndrome (Chesney, Davis, Purdy, Wand, & Chesney, 1981).…”

The immunomodulator ginsan induces resistance to experimental sepsis by inhibiting Toll‐like receptor‐mediated inflammatory signals

“…Total RNA from peritoneal macrophages was isolated using TRIzol reagent (Gibco BRL, USA). The RNA (1 lg/tube) was reverse transcribed into cDNA for 1 h at 37 C using 15 U MMLV RT (Promega, USA) in the presence of 1 lL pd(N) 6 random hexamer (Amersham Biotechnology, USA). The cDNA was used as a template for amplifying TLR-2, TLR-4, TLR-9, and MyD88 by PCR (Applied Biosystems, USA).…”

“…Staphylococcus aureus, a Gram-positive bacterium, often causes toxic shock syndrome by producing toxic shock syndrome toxin-1 (TSST-1) [5] or by inducing proinflammatory cytokines, such as TNF-a, IL-1b, and IL-6 in infected animals. Therefore, S. aureus is considered an appropriate Gram-positive bacterium for the study of sepsis [6]. TNF-a is an important indicator of septic shock in animal models.…”

β2 Integrins Are Involved in Cytokine Responses to Whole Gram-Positive Bacteria

“…Gram-Positive Bacteria 1 T he incidence of sepsis caused by Gram-positive bacteria has been steadily increasing in recent years, while the incidence of Gram-negative sepsis has remained fairly constant (1,2). As a result, septic shock caused by Gram-positive bacteria is, in many centers, as frequent as, or more frequent than, shock caused by Gram-negative organisms.…”