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Inflammation. 2019 Nov 22. doi: 10.1007/s10753-019-01108-9. [Epub ahead of print]

Initial Immune Response in Escherichia coli, Staphylococcus aureus, and Candida albicans Bacteremia.

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Medical Supervision S.A. Private Medical Center, Athens, Greece.
Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece.
Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
Department of Anesthesiology, University Hospital of Larisa, C' Wing, 2nd Floor, PC 41110, Mezourlo, Larisa, Greece.
Department of Surgery, 1st Propaedeutic Surgical Clinic, National and Kapodistrian University of Athens, Athens, Greece.
Experimental-Research Center "ELPEN" Pharmaceutical Co, Athens, Greece.
Department of Biopathology - Microbiology and Biochemistry, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
School of Medicine, European University Cyprus, Nicosia, Cyprus.


Sepsis remains a leading cause of mortality worldwide and is characterized by sustained inflammatory responses, reflected as changes in the expression profile of cytokines with time. The aim of the present study was to investigate the dynamic changes in complete blood count, serum chemistry, procalcitonin (PCT), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in Escherichia coli, Staphylococcus aureus, and Candida albicans bacteremia. Study subjects were 32 healthy male Landrace-Large White pigs, aged 10-15 weeks and of average weight 19 ± 2 kg. Bacteremia was induced by continuous intravenous infusion of microbial suspensions during a period of 8 h. E. coli and S. aureus bacteremia were associated with a significant gradual decrease in white blood cells and platelets, respectively (p = 0.002 and p = 0.004), while candidemia was characterized by a significant gradual decrease in lymphocytes (p = 0.009). Serum PCT levels were either undetectable or very low, with no significant changes with time in all groups. E. coli bacteremia elicited a strong pro-inflammatory response, characterized by a significant increase in TNF-α expression from the onset of bacteremia (p = 0.042). C. albicans exhibited a different profile with an early, moderate increase in TNF-α followed by a subsequent marked increase in IL-6 levels (p = 0.03). The differential regulation of inflammatory and hematological responses depending on the pathogenic agent can reveal differences in the underlying inflammatory mechanisms, which may assist in the ongoing quest for the identification of a panel of circulating biomarkers during bacteremia.


bacteremia; inflammation; interleukin-6; procalcitonin; tumor necrosis factor-α


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