Sepsis and septic shock: Pathogenesis and treatment perspectives

Abstract The majority of bacteremias do not develop to sepsis: bacteria are cleared from the bloodstream. Oxygen released from erythrocytes and humoral immunity kill bacteria in the bloodstream. Sepsis develops if bacteria are resistant to oxidation and proliferate in erythrocytes. Bacteria provoke...

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Bibliographic Details
Published in:Journal of critical care 2017-08, Vol.40, p.229-242
Main Author: Minasyan, Hayk
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antibiotics
Bacteremia
Bacteremia - blood
Bacteremia - drug therapy
Bacteremia - microbiology
Bacteremia - physiopathology
Bacteria
Biofilms
Critical Care
E coli
Gram-Negative Bacteria - metabolism
Gram-Positive Bacteria - metabolism
Humans
Immune system
Mortality
Oxidation
Oxidative stress
Oxygen - metabolism
Pathogenesis
Pathogens
Patients
Plasma Exchange
Respiration
Rodents
Sepsis
Septic shock
Shock, Septic - blood
Shock, Septic - drug therapy
Shock, Septic - microbiology
Shock, Septic - physiopathology
Streptococcus infections
Treatment
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Summary:Abstract The majority of bacteremias do not develop to sepsis: bacteria are cleared from the bloodstream. Oxygen released from erythrocytes and humoral immunity kill bacteria in the bloodstream. Sepsis develops if bacteria are resistant to oxidation and proliferate in erythrocytes. Bacteria provoke oxygen release from erythrocytes to arterial blood. Abundant release of oxygen to the plasma triggers a cascade of events that cause: 1. oxygen delivery failure to cells; 2. oxidation of plasma components that impairs humoral regulation and inactivates immune complexes; 3. disseminated intravascular coagulation and multiple organs' failure. Bacterial reservoir inside erythrocytes provides the long-term survival of bacteria and is the cause of ineffectiveness of antibiotics and host immune reactions. Treatment perspectives that include different aspects of sepsis development are discussed.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2017.04.015