Department of Infectious Diseases and Clinical Microbiology, Kayseri City, Education and Research Hospital, Kayseri, Turkey
Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
Turk J Med Sci. 2021 Dec 13;51(6):3108-3114. doi: 10.3906/sag-2001-163.
BACKGROUND/AIM: In the last years, incidence of carbapenem resistant Acinetobacter baumannii sepsis is increasing with high mortality. However, it is not clear whether this is due to inadequate antimicrobial choice or a more severe clinical course. We aimed to evaluate the inflammation and adrenal involvement in the carbapenem resistant A. baumannii by using experimental mouse model sepsis.
Balb/c female mice were randomly put into control and three sepsis groups ( A. baumannii susceptible to carbapenem-CSAB-, A. baumannii resistant to carbapenem-CRAB-, Escherichia coli). A total of sixty mice were included in this study with each group having 15 mice. Mice were sacrificed 72 h after bacterial inoculation, and blood was taken from each mouse for the assessment of cytokines and corticosterone. Both adrenal glands were dissected; one was used for culture and the other was used for histopathological examination. Bacterial loads of organs were calculated as CFU/g. The histopathological changes, bacterial levels in adrenal and cytokine and corticosterone levels were assessed and compared among the groups.
The bacterial level was higher in E. coli (108, 45 ±30, 55 log10 CFU/g) (mean±SD) than other sepsis groups. The lowest level of corticosterone was observed in the E. coli group (p < 0.001). TNF alpha level was highest in the CRAB and E. coli group and this difference was statistically significant than control group (p < 0.05). The IL-6 level in CRAB was significantly higher than the control group (10, 20 pg/mL). The adrenal gland congestion was significantly severe in all the sepsis groups compared to the control. In the group comparison, congestion was significantly more severe in the E. coli group than in CSAB and CRAB groups.
Adrenal involvement and inflammatory reactions are seen in E. coli sepsis and in CRAB sepsis. These findings will be focused on in future clinical trials.
背景/目的：近年来，碳青霉烯耐药鲍曼不动杆菌败血症的发病率不断上升，死亡率居高不下。然而，目前尚不清楚这是由于抗菌药物选择不当还是更严重的临床病程所致。我们旨在通过使用实验性小鼠败血症模型来评估碳青霉烯耐药鲍曼不动杆菌的炎症和肾上腺受累情况。
将雌性 Balb/c 小鼠随机分为对照组和三组败血症组（对碳青霉烯敏感的鲍曼不动杆菌-CSAB、对碳青霉烯耐药的鲍曼不动杆菌-CRAB、大肠杆菌）。本研究共纳入 60 只小鼠，每组 15 只。细菌接种后 72 小时处死小鼠，从每只小鼠取血评估细胞因子和皮质酮。从每只小鼠取双侧肾上腺，一侧用于培养，另一侧用于组织病理学检查。计算器官细菌负荷（CFU/g）。评估并比较各组的组织病理学变化、肾上腺细菌水平以及细胞因子和皮质酮水平。
大肠杆菌组的细菌水平最高（108，45 ±30，55 log10 CFU/g）（平均值±标准差），高于其他败血症组。大肠杆菌组皮质酮水平最低（p < 0.001）。CRAB 和大肠杆菌组 TNF alpha 水平最高，与对照组相比差异有统计学意义（p < 0.05）。CRAB 组的 IL-6 水平明显高于对照组（10，20 pg/mL）。与对照组相比，所有败血症组的肾上腺充血均明显更严重。在组间比较中，大肠杆菌组的充血明显比 CSAB 和 CRAB 组更严重。
大肠杆菌败血症和 CRAB 败血症均存在肾上腺受累和炎症反应。这些发现将在未来的临床试验中得到关注。
