The categories are diagnosed based on the how the bacteria reacts to the Gram stain. There are two main categories of bacterial infections: Gram-positive and Gram-negative. Gram stains may also be used to check for bacteria in certain body fluids, such as blood or urine. 10.1189/jlb.A Gram stain is a test that checks for bacteria at the site of a suspected infection such as the throat, lungs, genitals, or in skin wounds. 10.1016/j.cell.2006.01.034īianchi ME: DAMPs, PAMPs and alarmins: all we need to know about danger. EMBO Rep 2006, 7: 774-778.įinlay BB, McFadden G: Anti-immunology: evasion of the host immune system by bacterial and viral pathogens. Harris HE, Raucci A: Alarmin(g) news about danger: workshop on innate danger signals and HMGB1. Oppenheim JJ, Yang D: Alarmins: chemotactic activators of immune responses. 10.1378/chest.1Ĭastelli GP, Pognani C, Meisner M, Stuani A, Bellomi D, Sgarbi L: Procalcitonin and C-reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction. Lobo SM, Lobo FR, Bota DP, Lopes-Ferreira F, Soliman HM, Melot C, Vincent JL: C-reactive protein levels correlate with mortality and organ failure in critically ill patients. Povoa P, Almeida E, Moreira P, Fernandes A, Mealha R, Aragao A, Sabino H: C-reactive protein as an indicator of sepsis. Matson A, Soni N, Sheldon J: C-reactive protein as a diagnostic test of sepsis in the critically ill. 10.1023/A:1009878726176ĭinarello CA: Proinflammatory and anti-inflammatory cytokines as mediators in the pathogenesis of septic shock. Panacek EA, Kaul M: IL-6 as a marker of excessive TNF-α activity in sepsis. Plasma IL-1 beta and IL-6 levels are consistent and efficient predictors of outcome over time. Meduri GU, Headley S, Kohler G, Stentz F, Tolley E, Umberger R, Leeper K: Persistent elevation of inflammatory cytokines predicts a poor outcome in ARDS. 10.1146/annurev.pathol.1.110304.100200ĭamas P, Canivet JL, de Groote D, Vrindts Y, Albert A, Franchimont P, Lamy M: Sepsis and serum cytokine concentrations. Munford RS: Severe sepsis and septic shock: the role of gram-negative bacteremia. Future research exploring new biomarkers and danger signals and further characterizing differences in the virulence mechanisms between Gram-negative and Gram-positive bacteria appears promising and could lead to new therapeutics and to improved clinical outcomes.Ībe R, Oda S, Sadahiro T, Nakamura M, Hirayama Y, Tateishi Y, Shinozaki K, Hirasawa H: Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia. These observations suggest a distinct immunopathophysiologic behavior of sepsis in patients with Gram-negative bacteremia that may influence clinical outcomes. In this study, C-reactive protein and IL-6 levels were significantly higher in Gram-negative bacteremia than in Gram-positive bacteremia. In the previous issue of Critical Care, Abe and colleagues report results of a retrospective study that show a significantly higher incidence of Gram-negative bacteremia among adult intensive care unit patients with septic shock than in those with sepsis or severe sepsis. Gram-negative bacteremia has been associated with severe sepsis, although the exact mechanism and pathophysiological differences among bacterial species are not well understood.
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