ICU-acquired immunosuppression and the risk for secondary fungal infections
ICU-acquired immunosuppression and the risk for secondary fungal infections
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DOI：
10.3109/13693786.2010.509744
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发表时间：
2011-04-01
期刊：
影响因子：
2.9
通讯作者：
Netea, Mihai G.
中科院分区：
文献类型：
--
作者：
Monneret, Guillaume;Venet, Fabienne;Netea, Mihai G.
败血症和相关的感染综合征，包括医院感染，是全球范围内一个主要但在很大程度上没有得到承认的医疗保健问题，每年导致数千人死亡。在短暂的促炎阶段之后，严重受伤的ICU患者进入长期免疫抑制阶段，表现为休眠病毒或微生物(包括真菌)感染的重新激活，这些微生物通常只在免疫受损的宿主中致病。这篇简短的综述将集中于迄今为止在ICU患者中描述的关于单核细胞和T淋巴细胞的免疫功能障碍(作为先天免疫细胞和获得性免疫细胞的例子)，以及它们作为生物标志物的潜在用途，用于识别有继发性医院感染风险的患者和指导免疫治疗。最后，我们将更具体地关注ICU患者真菌感染的风险，以及辅助治疗的潜在益处，不仅可以预防这些感染，而且一旦诊断出这些感染，还可以增强免疫反应。
Sepsis and related infectious syndromes, including nosocomial infections, represent a major but largely under recognized healthcare problem worldwide, accounting for thousands of deaths every year. After a short pro-inflammatory phase, severely injured ICU patients enter a stage of protracted immunosuppression illustrated by reactivation of dormant viruses or infections due to microorganisms, including fungi, which are normally pathogenic solely in immunocompromised hosts. This brief review will focus on immune dysfunctions described so far in ICU patients regarding monocytes and T lymphocytes (as examples for innate and adaptive immune cells) and on their potential use as biomarkers for identification of patients at risk of secondary nosocomial infections and for guidance of immunotherapy. Finally, we will more specifically focus on the risk for fungal infections in ICU patients, and on the potential beneficial effects of adjunctive therapy not only to prevent these infections, but also to reinforce immune responses once they are already diagnosed.