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Gram-negative bacillary colonization and bacteremia in the compromised host

Kolonisation mit gramnegativen Bakterien und Bakteriämie bei Patienten mit gestörter Immunabwehr

  • The Fifth Sils Maria Symposium
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Summary

A complex interaction of host and microbial factors is unquestionably related to the pathogenesis of gram-negative rod bacteremia in neutropenic, immunocompromised patients. In this paper we summarize evidence that colonization of the gastrointestinal tract often precedes systemic invasion by klebsiellae andPseudomonas aeruginosa, but that the factors directly responsible for the weakening of barriers to colonization remain poorly understood. Additionally, bacteremic isolates ofEscherichia coli appear to segregate into commonly occurring groups by O and K antigens. A broadened investigation ofE. coli surface (fimbrial) antigens indicates several common hemagglutination patterns of bloodstream isolates with various mammalian erythrocytes, but these patterns may also be strongly associated with commonly encountered O and K types. This epidemiologic and microbiologic information may be useful both in clinical management and in following measures to prevent infection in high risk immunocompromised patients.

Zusammenfassung

Die komplexe Wechselwirkung zwischen Wirt und mikrobiellen Faktoren steht zweifellos in enger Beziehung zur Pathogenese der Bakteriämie durch gramnegative Stäbchen bei neutropenischen Patienten mit gestörter Immunabwehr. Die zusammengefaßt dargestellten Untersuchungsergebnisse zeigen, daß der systemischen Invasion von Klebsiellen undPseudomonas aeruginosa häufig die Kolonisation des Gastrointestinaltraktes vorausgeht. Doch bleibt weitgehend unklar, durch welche Faktoren die Schranken für diese Kolonisation geöffnet werden. Aus Blut isolierteEscherichia coli-Stämme gehören offensichtlich weitgehend den üblichen O- und K-Antigengruppen an. Auf breiter Basis durchgeführte Studien anE. coli Oberflächen-(Fimbrien-)Antigenen deckten mehrere häufig vorkommende Hämagglutinationsmuster zwischen Blutisolaten und Erythrozyten verschiedener Mammalier auf. Diese Muster können jedoch ebenfalls mit den üblichen O- und K-Typen assoziiert sein. Diese epidemiologischen und mikrobiologischen Erkenntnisse können für die klinische Behandlung und Prävention von Infektionen bei abwehrgeschwächten Patienten mit hohem Risiko von Nutzen sein.

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  1. Division of Infectious Diseases, Department of Medicine, University of California, 90024, Los Angeles, California, USA

    L. S. Young M. D.

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Young, L.S. Gram-negative bacillary colonization and bacteremia in the compromised host. Infection 10, 319–323 (1982). https://doi.org/10.1007/BF01640888

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