TY - JOUR
TI - Lipid peroxidation in Gram-negative bacteremia modulates the risk for septic shock and infections by resistant Klebsiella pneumoniae
AU - Christodoulou, S.
AU - Kyriazopoulou, E.
AU - Chrysanthakopoulou, M.
AU - Karlis, G.
AU - Karampela, I.
AU - Gkizeli, K.
AU - Veliki, N.
AU - Safarika, A.
AU - Giamarellos-Bourboulis, E.J.
AU - Adamis, G.
AU - on behalf of the Hellenic Sepsis Study Group
JO - European Journal of Clinical Microbiology and Infectious Diseases
PY - 2017
VL - 36
TODO - 11
SP - 2171-2177
PB - Springer-Verlag
SN - null
TODO - 10.1007/s10096-017-3041-5
TODO - carbapenem derivative;  malonaldehyde;  thiobarbituric acid;  antiinfective agent;  antioxidant;  bacterial protein;  beta lactamase;  carbapenem derivative;  carbapenemase;  malonaldehyde, Acinetobacter baumannii;  aged;  antibiotic resistance;  Article;  carbapenem resistant Enterobacteriaceae;  cell function;  controlled study;  death;  female;  Gram negative bacterium;  Gram negative sepsis;  high performance liquid chromatography;  human;  infection risk;  Klebsiella pneumoniae;  Klebsiella pneumoniae infection;  lipid peroxidation;  major clinical study;  male;  neutrophil count;  outcome assessment;  priority journal;  Pseudomonas aeruginosa;  septic shock;  antibiotic resistance;  bacteremia;  blood;  drug effect;  immunology;  Klebsiella infection;  Klebsiella pneumoniae;  lipid peroxidation;  metabolism;  microbiology;  neutrophil;  pathology;  physiology;  prospective study;  risk factor;  septic shock, Aged;  Anti-Bacterial Agents;  Antioxidants;  Bacteremia;  Bacterial Proteins;  beta-Lactamases;  Carbapenems;  Drug Resistance, Bacterial;  Female;  Humans;  Klebsiella Infections;  Klebsiella pneumoniae;  Lipid Peroxidation;  Male;  Malondialdehyde;  Neutrophils;  Prospective Studies;  Risk Factors;  Shock, Septic
TODO - Controversies in outcomes with the parenteral administration of antioxidants as adjuvant therapies led to the measurement of malondialdehyde (MDA), a product of lipid peroxidation, in serum collected from 120 patients with primary Gram-negative bacteremia during the first 24 h from sepsis onset. MDA was measured by the thiobarbiturate assay, followed by high-performance liquid chromatography (HPLC) analysis. After receiver operator characteristic (ROC) curve analysis, patients were divided into those with high levels of MDA and low levels of MDA. The primary endpoint was the association of the level of MDA with septic shock. The level of MDA as an index of neutrophil function and associations with outcome and with infections by carbapenem-resistant Klebsiella pneumoniae were the secondary endpoints. In total, 63 patients had high and 57 had low MDA levels; 27% and 49.1%, respectively, had septic shock (p = 0.015). The rate of the concentration of MDA to the total neutrophil count was used as an expression of neutrophil function; this was lower among patients with septic shock. The odds ratio (OR) for death among patients without septic shock and low level of MDA was 4.00; this was 0.48 for patients with septic shock (p = 0.020 between the two ORs). The OR for resistance to carbapenems among patients with bacteremia by K. pneumoniae and low level of MDA was 7.50 (p = 0.011 compared to patients with bacteremia by other pathogens). Low level of circulating MDA is associated with susceptibility to septic shock and infections by carbapenem-resistant K. pneumoniae. © 2017, Springer-Verlag GmbH Germany.
ER -