GENERAL CLINICAL RESEARCH CENTER

由多糖包裹的生物体引起的细菌性感染 这是导致婴儿和儿童发病和死亡的主要原因。 几十年前的观察表明，年幼的儿童， 特别是那些不到两年的人，患病的风险更高。 由被包裹的细菌引起的菌血症发作，这些 发作可能会导致严重甚至致命的疾病。最近观察到的 感染艾滋病毒的儿童也强调了这些因素的重要性。 这些免疫功能受损患者体内的病原体。虽然有抗菌作用 药物在治疗这些感染方面是非常有效的，它仍然 在这些患者很难准确诊断的时候 演示文稿。没有改进的诊断工具或预防策略 这大大降低了这些感染的发生率，数千人 的儿童将继续服用抗菌药，甚至是 不必要的住院治疗。不完整的理解 这些感染的免疫学一直是取得进展的主要障碍。 这块地。最近的研究表明，复杂的细胞反应 在网状内皮系统内与细菌血症有关 感染和某些调节细胞的蛋白质(细胞因子) 运动、增殖和激活决定了这种反应。这是一项新的 信息是检验血清相关性的基础 细胞因子水平与婴儿严重感染的关系。在拟议的工作中， 对已知直接或间接起中介作用的因素的衡量 鸡细菌性感染的细胞反应特征 包膜细菌将在儿童和婴儿中进行测量 发热性疾病。水平将在以下过程中进行评估 婴幼儿细菌性和非细菌性疾病 这些水平与感染的严重程度和类型、年龄之间的关系 患者和结果将会被决定。感染艾滋病毒的婴儿和儿童 感染将包括在这项研究中，数据收集在这些 患者将与其他健康的患者进行比较，以确定 反应不足解释了艾滋病毒感染和独特的 对严重细菌性感染的易感性。预计这将是一次 这项工作将提高我们对这些病毒免疫学的理解。 感染。更全面地了解主机对这些设备的防御 感染将提高我们识别和治疗这些疾病的能力 感染。

Bacteremic infection caused by polysaccharide encapsulated organisms is a major cause of morbidity and mortality in infants and children. Observations made over decades ago demonstrated that young children, particularly those less than 2 years, are at increased risk for suffering episodes of bacteremia caused by encapsulated bacteria and that these episodes can lead to serious even fatal illness. Recent observations in children with HIV infection have also underscored the importance of these pathogens in these immunocompromised patients. Although antibacterial agents are highly effective in treating these infections, it remains difficult to accurately diagnose these patients at the time of presentation. Without improved diagnostic tools or prevention strategies that significantly reduce the incidence of these infections, thousands of children will continue to be given antimicrobials or even to be hospitalized unnecessarily. An incomplete understanding of the immunology of these infections has been a major obstacle to advances in this field. Recent work has demonstrated that complex cellular responses within the reticuloendothelial system are associated with bacteremic infection and that certain proteins (cytokines) that mediate cell movement, proliferation and activation determine this response. This new information serves as the basis for examining the association of serum cytokine levels with severe infection in infants. In the proposed work, measurement of factors known to either directly or indirectly mediate cellular responses characteristic of bacteremic infection caused by encapsulated bacteria will be measured in children and infants with febrile illnesses. Levels will be assessed during the course of bacteremic and nonbacteremic illnesses in infants and children and association between these levels and severity and type of infection, age of patient and outcome will be determined. Infants and children with HIV infection will be included in this study and data collected in these patients will be compared to otherwise healthy patients to determine if deficient responses explain the association of HIV infection and unique susceptibility to severe bacteremic infection. It is expected that this work will improve our understanding of the immunology of these infections. A more complete understanding of host defenses to these infections will improve our ability to recognize and treat these infections.