Da li vrsta bakterija i poreklo sekundarne sepse kod kritično obolelih određuju tip supresorskih ćelija mijeloidnog porekla?

  • Ivo Udovičić Military Medical Academy , Clinic of Anesthesiology and Intensive Therapy Belgrade, Serbia
  • Maja Šurbatović Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Goran Rondović Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Ivan Stanojević University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Snježana Zeba Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Dragan Djordjević Military Medical Academy, Clinic of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Aneta Perić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Snežana Milosavljević Clinical Hospital Center Kosovska Mitrovica, Department of Anesthesiology, Kosovska Mitrovica, Serbia
  • Nikola Stanković Mother and Child Health Care Institute of Serbia, Department of Anesthesiology and Intensive Therapy, Belgrade, Serbia
  • Dzihan Abazović Emergency Medical Centar of Montenegro, Podgorica, Montenegro
  • Danilo Vojvodić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP181008174U
Ključne reči: gram-negativne bakerije, gram-pozitivne bakterije, kritična stanja, kostna srž, ćelije, supresorske, sepsa

Sažetak


Uvod/Cilj. Gram-pozitivne i Gram-negativne bakterije mogu indukovati različit imunoinflamatorni odgovor. Cilj istraživanja bio je da se utvrdi da li kod kritično obolelih bolesnika sa sekundarnom sepsom postoji povezanost učes­talosti i/ili apsolutnih brojeva supresorskih ćelija mijeloidnog porekla (MDSC) sa vrstom bakterijskog prouzrokovača i poreklom sekundarne sepse. Metode. Prospektivnom studijom bilo je obuhvaćeno ukupno 40 kritično obolelih bolesnika sa sekundarnom sepsom. Dva bolesnika bez dokazanog prisustva bakterija u sistemskoj cirkulaciji bila su isključena iz daljih analiza. Detektovane su i kvantifikovane obe glavne podvrste MDSC: granulocitne (G)-MDSC i monocitne (M)-MDSC) 1. i 5. dana. Istovremeno je uzimana i krv za određivanje hemokultura. Rezultati. Utvrdili smo da su obe glavne podvrste koje odgovaraju MDSCs bile značajno akumulirane u Gram-pozitivnoj sepsi. Univarijantna logistička regresiona analiza ispitivanih varijabli pokazala je da su 5. dana apsolutni broj G-MDSC, kao i učestalost i apsolutni broj M-MDSC bili značajni prediktori Gram-pozitivne sepse. Multivarijantna logistička regresiona analiza pokazala je da je 5. dana apsolutni broj M-MDSC bio nezavisni prediktor Gram-pozitivne sepse [odds ratio (OR) 1,012; p < 0,05]. Odnosi neutrofili (N)/G-MDSC i monociti (M)/M-MDSC bili su značajni prediktori Gram-pozitivne sepse u oba termina [area under curve (AUC) 0,684 i 0,692, odnosno 0,707 i 0,793]. Takođe, N/G-MDSC odnos je u oba termina bio značajan prediktor smrtnog ishoda (AUC 0,694, odnosno 0,678). Posmatrajući bolesnike sa različitim poreklom sekundarne sepse (peritonitis, pankreatitis, trauma) kao zasebne grupe, i poređenjem učestalosti i apsolutnog broja G-MDSC i M-MDSC, nisu utvrđene statistički značajne razlike ni prvog ni petog dana. Zaključak. Gram-pozitivne bakterije su snažni induktori akumulacije MDSC u sepsi. Takođe, izgleda da poreklo sepse ne utiče na akumulaciju MDSC.

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Objavljeno
2021/03/04
Broj časopisa
Vol. 77 Br. 9 (2020): Vojnosanit pregl
Rubrika
Originalni članak