Skip to main content
SpringerLink
Log in

Light and Shadow: Perspectives on Host-Microbial Interactions in the Pathogenesis of Intensive Care Unit-Acquired Infection

  • Conference paper
Sepsis and Organ Dysfunction

  • 64 Accesses

Abstract

Conventional wisdom holds that the relationship between humans and the microbial world is intrinsically inimical. Microorganisms have been responsible for some of the greatest scourges that have faced humanity — the plague, tuberculosis, smallpox, and the spectrum of diseases that threaten the majority of people in the developing world, including malaria, bacillary dysentery, and parasitic diseases. Modern infectious epidemics, such as the influenza pandemic of 1918 and AIDS, have had a devastating effect on large numbers of people. In the developed world, an increasing number of illnesses are being found to have an infectious origin, notably peptic ulcers [1] and atherosclerosis [2]. From the perspective of the clinician, the need to administer a definitive blow to the microbial world has never seemed greater, at a time when our arsenals have never been more potent.

It has been said that in the race for supremacy, microbes are sprinting ahead... technological developments are offering new insights and opportunities to deal a decisive blow to microbes, and improve the health and quality of life of mankind. Sir Richard Sykes Hamao Umezawa Memorial Award Lecture, 21st ICC, Japan, 1999

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Veldhuyzen van Zanten SJO, Sherman PM (1994) Helicobacter pylori infection as a cause of gastritis, duodenal ulcer, gastric cancer and nonulcer dyspepsia: a systematic overview. Can Med Assoc J 150: 177–185

    CAS  Google Scholar 

  2. Gupta S, Camm AJ (1997) Chronic infection in the etiology of atherosclerosis — the case for Chlamydia pneumoniae. Clin Cardiol 20: 829–836

    Article  PubMed  CAS  Google Scholar 

  3. Marshall JC (1999) Rethinking sepsis: from concepts to syndromes to diseases. Sepsis 3: 5–10

    Article  Google Scholar 

  4. Slutsky AS, Tremblay LN (1998) Multiple system organ failure. Is mechanical ventilation a contributing factor?. Am J Resp Crit Care Med 157: 1721–1725

    PubMed  CAS  Google Scholar 

  5. Savage DC (1977) Microbial ecology of the gastrointestinal tract. Annu Rev Med 31: 107–133

    CAS  Google Scholar 

  6. Lee A (1985) Neglected niches. The microbial ecology of the gastrointestinal tract. Adv Microbial Ecol 8: 115–162

    Article  Google Scholar 

  7. Van Der Waaij D, Berghuis De Vries JM et al (1971) Colonization resistance of the digestive tract in conventional and antibiotic treated mice. J Hyg Camb 69: 405–411

    Article  PubMed  Google Scholar 

  8. Levison ME (1973) Effect of colon flora and short chain fatty acids on growth in vitro of Pseudomonas aeruginosa and enterobacteriaceae. Infect Immun 8: 30–35

    PubMed  CAS  Google Scholar 

  9. Berg RD (1981) Promotion of the translocation of enteric bacteria from the gastrointestinal tracts of mice by oral treatment with penicillin, clindamycin, or metronidazole. Infect Immun 33: 854–861

    PubMed  CAS  Google Scholar 

  10. Govan JRW (1986) In vivo significance of bacteriocins and bacteriocin receptors. Scand J Infect Dis [Suppl] 49: 31–37

    CAS  Google Scholar 

  11. Shahani KM, Ayebo AD (1980) Role of dietary lactobacilli in gastrointestinal microecology. Am J Clin Nutr 33: 2448–2457

    PubMed  CAS  Google Scholar 

  12. Link-Amster H, Rochat F, Saudan KY et al (1994) Modulation of a specific humoral immune response and changes in intestinal flora mediated through fermented milk intake. FEMS Immunol Med Microbiol 10: 55–63

    Article  PubMed  CAS  Google Scholar 

  13. Marshall JC (1991) The ecology and immunology of the GI tract in health and critical illness. J Hosp Infect 19: 7–17

    Article  PubMed  Google Scholar 

  14. Matricardi PM, Rosmini F, Riondino S et al (2000) Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study. BMJ 320: 412–417

    Article  PubMed  CAS  Google Scholar 

  15. Bone RC, Balk RA, Cerra FB et al (1992) ACCP/SCCM Consensus Conference. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101: 1644–1655

    Article  PubMed  CAS  Google Scholar 

  16. Danner RL, Elin RJ, Hosseini JM et al (1991) Endotoxemia in human septic shock. Chest 99: 169–175

    Article  PubMed  CAS  Google Scholar 

  17. van Deventer SJ, Buller HR, Ten Cate JW et al (1988) Endotoxemia: an early predictor of septicaemia in febrile patients. Lancet 1: 605–609

    Article  PubMed  Google Scholar 

  18. Bates DW, Parsonnet J, Ketchum PA et al (1998) Limulus amebocyte lysate assay for detection of endotoxin in paients with sepsis sydrome. Clin Infect Dis 27: 582–591

    Article  PubMed  CAS  Google Scholar 

  19. Marshall JC, Christou NV, Horn R et al (1988) The microbiology of multiple organ failure. The proximal GI tract as an occult reservoir of pathogens. Arch Surg 123: 309–315

    Article  PubMed  CAS  Google Scholar 

  20. Marshall JC, Christou NV, Meakins JL (1993) The gastrointestinal tract. The “undrained abscess” of multiple organ failure. Ann Surg 218: 111–119

    Article  PubMed  CAS  Google Scholar 

  21. Krause W, Matheis H, Wulf K (1969) Fungaemia and funguria after oral administration of Candida albicans. Lancet 1: 598–599

    Article  PubMed  CAS  Google Scholar 

  22. Patrick CC, Plaunt MR, Hetherington SV et al (1992) Role of the Staphylococcus epidermidis slime layer in experimental tunnel tract infections. Infect Immun 60: 1363–1367

    PubMed  CAS  Google Scholar 

  23. Yu L, Lee KK, Hodges RS et al (1994) Adherence of Pseudomonas aeruginosa and Candida albicans to glycosphingolipid (asialo-GMl) receptors is achieved by a conserved receptorbinding domain present on their adhesins. Infect Immun 62: 5213–5219

    PubMed  CAS  Google Scholar 

  24. Reinholdt J, Krogh P, Holmstrup P (1987) Degradation of IgAl, IgA2, and S-IgA by Candida and Torulopsis species. Acta Path Microbiol Immunol Scand 95: 265–274

    CAS  Google Scholar 

  25. Garvey BM, McCambley JA, Tuxen DV (1989) Effects of gastric alkalization on bacterial colonization in critically ill patients. Crit Care Med 17: 211–216

    Article  PubMed  CAS  Google Scholar 

  26. Johanson WG, Pierce AK, Sanford JP (1969) Changing pharyngeal bacterial flora of hospitalized patients. N Engl J Med 281: 1137–1140

    Article  PubMed  CAS  Google Scholar 

  27. Bohnen JMA, Solomkin JS, Dellinger EP et al (1992) Guidelines for clinical care: anti-infective agents for intra-abdominal infection. A Surgical Infection Society policy statement. Arch Surg 127: 83–89

    Article  PubMed  CAS  Google Scholar 

  28. Solomkin JS, Reinhart HH, Dellinger EP et al (1996) Results of a randomized trial comparing sequential intravenous oral treatment with ciprofloxacin plus metronidazole to imipenem cilastatin for intra-abdominal infections. Ann Surg 223: 303–315

    Article  PubMed  CAS  Google Scholar 

  29. Wunderink RG (1998) Attributable mortality of ventilator-associated pneumonia. Sepsis 1: 211–221

    Article  Google Scholar 

  30. Nathens AB, Chu PTY, Marshall JC (1992) Nosocomial infection in the surgical intensive care unit. Infect Dis Clin North Am 6: 657

    PubMed  CAS  Google Scholar 

  31. D’Amico, Pifferi S, Leonetti C et al (1998) Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomized controlled trials. BMJ 316: 1275–1285

    Article  PubMed  Google Scholar 

  32. Lorber B, Swenson RM (1975) The bacteriology of intra-abdominal infections. Surg Clin North Am 55: 1349–1354

    PubMed  CAS  Google Scholar 

  33. Rotstein OD, Meakins JL (1990) Diagnostic and therapeutic challenges of intraabdominal infections. World J Surg 14: 159–166

    Article  PubMed  CAS  Google Scholar 

  34. Nathens AB, Rotstein OD, Marshall JC (1998) Tertiary peritonitis: clinical features of a complex nosocomial infection. World J Surg 22: 158–163

    Article  PubMed  CAS  Google Scholar 

  35. Rotstein OD, Pruett TL, Simmons RL (1986) Microbiologic features and treatment of persistent peritonitis in patients in the intensive care unit. Can J Surg 29: 247–250

    PubMed  CAS  Google Scholar 

  36. Bunt TJ (1986) Non-directed relaparotomy for intraabdominal sepsis: a futile procedure. Am Surg 52: 294

    PubMed  CAS  Google Scholar 

  37. Norton LW (1985) Does drainage of intraabdominal pus reverse multiple organ failure? Am J Surg 149: 347–350

    Article  PubMed  CAS  Google Scholar 

  38. Archibald L, Phillips L, Monnet D et al (1997) Antimicrobial resistance in isolates from inpatients and outpatients in the United States: increasing importance of the intensive care unit. Clin Infect Dis 24: 211–215

    Article  PubMed  CAS  Google Scholar 

  39. Centers for Disease Control (1993) Nosocomial enterococci resistant to vancomycin — United States — 1989-1993. MMWR 42: 597–599

    Google Scholar 

  40. Berkelman RL, Hughs JM (1993) The conquest of infectious diseases: Who are we kidding? Ann Intern Med 119: 426–428

    PubMed  CAS  Google Scholar 

  41. Gorbach SL (1999) Antibiotics and Clostridium difficile. N Engl J Med 341: 1690–1691

    Article  PubMed  CAS  Google Scholar 

  42. Bross J, Talbot GH, Maislin G et al (1989) Risk factors for nosocomial candidemia: a case control study in adults without leukemia. Am J Med 87: 614–620

    Article  PubMed  CAS  Google Scholar 

  43. Marshall JC, Evans DC (1998) Antimicrobial therapy for ICU-acquired infection: time for a reappraisal. In: Vincent J-L (ed) Yearbook of Intensive Care and Emergency Medicine. Springer-Verlag, Berlin Heidelberg New York, pp 283–291

    Google Scholar 

  44. Emmerson AM (1990) The epidemiology of infections in intensive care units. Intensive Care Med 16[Suppl31: S197–S200

    Article  Google Scholar 

  45. Weinstein RA (1991) Epidemiology and control of nosocomial infections in adult intensive care units. Am J Med 91[Suppl3B]: 3B–179S–3B–184S

    Google Scholar 

  46. Nathens AB, Marshall JC (1999) Selective decontamination of the digestive tract (SDD) in surgical patients. Arch Surg 134: 170–176

    Article  PubMed  CAS  Google Scholar 

  47. Marshall JC (1999) The gastrointestinal flora and its alterations in critical illness. Curr Opin Crit Care 5: 119–125

    Article  Google Scholar 

Download references

Authors
  1. J. C. Marshall
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Surgery, Health Sciences Center, Saint Louis University, St. Louis, USA

    A. E. Baue M.D.

  2. Department of Clinical Sciences, Section of Anaesthesia, Intensive Care and Pain Clinic, Trieste University Medical School, Trieste, Italy

    G. Berlot M.D.  & A. Gullo M.D.  & 

  3. Department of Intensive Care, Erasme University Hospital Free University of Brussels, Belgium

    J.-L. Vincent M.D.

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer-Verlag Italia, Milano

About this paper

Cite this paper

Marshall, J.C. (2001). Light and Shadow: Perspectives on Host-Microbial Interactions in the Pathogenesis of Intensive Care Unit-Acquired Infection. In: Baue, A.E., Berlot, G., Gullo, A., Vincent, JL. (eds) Sepsis and Organ Dysfunction. Springer, Milano. https://doi.org/10.1007/978-88-470-2229-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2229-4_8

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0137-4

  • Online ISBN: 978-88-470-2229-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation