Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bacterial translocation from the gastrointestinal tract is an important pathway initiating late-onset sepsis and necrotizing enterocolitis in very low-birth-weight infants. The emerging intestinal microbiota, nascent intestinal epithelia, naive immunity, and suboptimal nutrition (lack of breast milk) have roles in facilitating bacterial translocation. Feeding lactoferrin, probiotics, or prebiotics has presented exciting possibilities to prevent bacterial translocation in preterm infants, and clinical trials will identify the most safe and efficacious prevention and treatment strategies.
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PMID:New concepts of microbial translocation in the neonatal intestine: mechanisms and prevention. 2081 71

Sepsis-related morbidity and mortality is an increasing concern in all neonatal intensive care units, with reported incidences that are dramatically high regardless of the improvements in the quality of neonatal assistance. Antimicrobial resistance is also becoming a global and regional threat to public health. Neonatal sepsis include bloodstream, urine, cerebrospinal, peritoneal infections, and are classified as early-onset (occurring <3 days of life, EOS) and late-onset sepsis (LOS), i.e., infections arising after the perinatal period. Whereas prevention of EOS relies mainly on maternal-perinatal policies, attempts to reduce LOS incidence are a task merely for neonatologists but are hampered by non-specific clinical features, inadequate sensitivity of diagnostic tests, and late recognition. The frequent occurrence of late neurodevelopmental impairment after LOS challenges neonatologists to seek effective preventative strategies rather than more efficacious antibiotics for treatment. In the area of prevention, consistent evidence is accumulating on fluconazole--for prevention of fungal LOS--and, more recently, on bovine lactoferrin for prevention of both bacterial and fungal LOS: this innate immune system glycoprotein plays an important role in "in vivo" host defenses, and has been shown effective in a multicenter RCT recently published on VLBW neonates. Future studies are warranted to better elucidate the extent of the prevention provided by Ictoferrin and to identify the most suitable dosages to be administered.
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PMID:Clinical use of lactoferrin in preterm neonates: an update. 2108 28

Lactoferrin (LF) is a glycoprotein widely distributed in mammalian organisms. It is synthesized by epithelial cells; hence it is present in secretions of mucous membranes. It is also contained in secondary granules of neutrophils and released to the circulation during trauma, infection or inflammation. LF belongs to the transferrin family--proteins binding iron ions with a high affinity. Upon isolation in 1961 LF was initially called a red, iron-binding protein. LF's ability to bind iron is associated with other functions which the protein fulfils in the body. As described in the part I. of the article, LF participates in acquisition of iron from food and its storage in the body, and to a certain degree also in iron transport to cells. In this part of the article the effect of LF in combating microorganisms by chelating iron is described. The iron-chelating property of LF renders iron inaccessible to the pathogens, thus restricting their growth. Iron, due to its participation in many metabolic processes, is an essential element for almost all microorganisms. Iron is not easily accessible for pathogens within the host. Since iron is crucial for normal function of both pathogens and the host, an ability to acquire iron during infection is regarded as an important virulence factor. Higher vertebrates have evolved a complicated protection system of iron storage and LF is an important element of this system. Low iron-saturated LF effectively combats bacteria and fungi, acting in a bacteriostatic and fungistatic way. The degree of iron saturation also influences antiviral activity of LF. Some pathogens (e.g. Helicobacter pylori, Neisseria sp, Haemophilus influenzae) have evolved a system of siderophores or cellular receptors which can acquire iron from LF and transferrin. The so-called lactoferrin theory of hypoferremia in inflammation assumes, in addition, a protective role of the protein in inflammation, sepsis and trauma. LF, by chelation and storage of plasma iron in the liver and spleen, temporarily restricts its accessibility for microorganisms and processes of formation of toxic, reactive oxygen species, which contributes to the amelioration of inflammatory states.
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PMID:[The role of lactoferrin in the iron metabolism. Part II. Antimicrobial and antiinflammatory effect of lactoferrin by chelation of iron]. 2116 95

Sepsis-related morbidity and mortality are major problems in NICU. Preterm neonates display clinical characteristics that make them prone to infections. Due to the high frequency of severe neurodevelopmental sequelae in survivors, the best possible strategy to manage sepsis in NICU is to prevent them. Hygiene, cohorting, stewardship on use of H2-blockers, steroids and broad-spectrum antibiotic are mandatory, as well as proper management of central venous accesses and surgical devices. In addition, clinical research offers the opportunity of adopting pharmacological preventative strategies such as use of palivizumab to prevent RSV infection, use of fluconazole to prevent fungal sepsis, use of probiotics and lactoferrin to enhance the innate immunity, and use of pagibaximab to prevent staphylococcal sepsis.
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PMID:Recent advances in prevention of sepsis in the premature neonates in NICU. 2125 68

Fungal-related morbidity and mortality is a major concern for most neonatal intensive care units (NICUs) worldwide. Incidence rates are increasing and might be higher than reported due to the challenges associated with diagnosing fungal infections. As preterm neonates display clinical characteristics that make them prone to Candida spp infections, and there is a high frequency of severe neurodevelopmental sequelae in those who survive neonatal fungal infections, specific prevention--rather than empiric or pre-emptive treatment--should be the optimal strategy. Besides stewardship of drug use and efforts to minimize invasive cares, pharmacological prevention with use of fluconazole has proved highly effective in decreasing the rates of fungal sepsis in very low birth weight (VLBW) neonates. Alternative options needing further and more conclusive assessments include use of nystatin, bovine lactoferrin or probiotics.
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PMID:Antifungal prophylaxis in neonates. 2125 70

Escherichia coli (E. coli) are the most common aerobic gram-negative bacilli in a normal intestinal tract. They cause most of the intra-abdominal infections, wound infections associated with abdominal surgery, and septicemia. Most of these infections are of endogenous intestinal origin. Lactoferrin (LF) is an iron-binding glycoprotein found in milk and various external secretions. This protein has been found to have a number of biological functions, including antimicrobial, anti-cancer, antioxidant, and immunomodulatory effects. Partial degradation of LF by pepsin can give rise to peptides termed lactoferricin (LFcin) with more potent antimicrobial activity. LF and LFcin have been shown to inhibit the growth of a number of pathogenic bacteria (including E. coli and antibiotic-resistant strains), fungi, and even viruses in both in vitro and in vivo studies. We previously demonstrated that both recombinant porcine LF (pLF) produced from yeast and a synthetic 20-residue porcine LFcin peptide exhibit antimicrobial activity in vitro. In one of our recent studies, we performed pathogen challenges, including pathogenic E. coli, Staphylococcus aureus and Candida albicans, of the digestive tract of a transgenic milk-fed animal model. The results showed that LF has broad spectrum antimicrobial activity in the digestive tract and protects the mucosa of the small intestine from injury. Our following study also revealed that pLF as a feedstuff additive enhances avian immunity, including antibody formation and cell-mediated immunity. All of these results suggest that LF could be a novel natural protein in the treatment and prevention of infections with E. coli or antibiotic-resistant bacteria strains.
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PMID:Lactoferrin: an iron-binding antimicrobial protein against Escherichia coli infection. 2132 78

An episode of sepsis occurs in 20 to 40% of all preterm patients, and such figures have been reported constantly increasing in Neonatal Intensive Care Units. Neonatal sepsis include bloodstream, urine, cerebrospinal, peritoneal infections, infections starting from burns and wounds, or from any other usually sterile sites. Many specific risk factors account for the increased risk of sepsis, including employment of broad-spectrum antibiotics selecting resistant microflora, parenteral nutrition, acid inhibitors and steroids, as well as the systematic and long-lasting use of invasive management. In preterm neonates, loss of gut commensals such as bifidobacteria and lactobacilli, due to the difficulties in oral feeding, or a slower acquisition of them, translates into an increased susceptibility to pathogenic gut colonization. Prompt diagnosis, effective treatment, and specific prophylaxis with antibacterial and antifungal drugs are the milestones of management of these life-threatening events. This article discusses the recent advances in prevention and shows how fluconazole for prevention of fungal sepsis, probiotics for prevention of necrotizing enterocolitis, and bovine lactoferrin for prevention of bacterial sepsis may be considered as effective preventive strategies.
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PMID:[Recent advances in prevention of sepsis in the preterm neonate]. 2139 86

Severe infections represent the main cause of neonatal mortality and morbidity. Strategies of proven effectiveness in reducing the incidence of infection in neonatal intensive care units (NICUs) include hand hygiene practices and prevention of central venous catheter-related bloodstream infections. In recent years, new strategies have been developed to prevent infections in NICU including prevention of neonatal sepsis with lactoferrin, the use of heparin for the prevention of CRBSIs, the judicious use of antibiotics and chemoprophylaxis, prevention of invasive fungal infections with fluconazole, the use of specific anti-staphylococcal immunoglobulins, and the early identification of infants at higher risk of infection with the use of specific markers (mannose-binding lectin). This review will focus on these new strategies and on their role in clinical practice in order to further reduce the incidence of infection in NICU.
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PMID:New possibilities of prevention of infection in the newborn. 2174 1

Neonates hospitalized in NICU are at risk for healthcare associated infections because of their poor immune defenses, related to gestational age, colonization of mucous membranes and skin with nosocomial microorganisms, exposure to antibiotics, invasive procedures and frequent contacts with healthcare workers (HCWs). Healthcare associated infections are the major source of morbidity and mortality in NICU in the developed world. Most infections are caused by Gram-positive organisms, fulminant sepsis are often associated to Gram-negative organisms, fungal sepsis occurs frequently in ELBW infants. Hand hygiene is the most important preventive procedure, nevertheless hand hygiene compliance among HCWs remains low. Continuous educational strategies can improve hand hygiene and contribute to reducing the incidence of neonatal infections. Other important prevention strategies include early enteral feeding with human milk, minimization and safety in the use of invasive devices, limiting unnecessary empiric broadspectrum antibiotics, eventual use of lactoferrin bifidobacteria and lactobacilli, prophylactic administration of fluconazole in VLBW. Emergence of multi drug resistant organisms (MDRO) is a worrying perspective. Methicillin-resistant Staphylococcus aureus (MRSA) is an important healthcare-associated pathogen. Active surveillance culturing for MRSA carriers, in combination with contact precautions and decolonization in some hyperendemic settings, has been proved to reduce MRSA transmission and infection rates. Multidrug-resistant Gram-negatives are frequently reported. Overuse of antimicrobial drugs and crosstransmission via caregiver hands, contaminated equipment or inanimate objects are the major drivers of selection and dissemination. Strategies to control outbreaks of MDRO colonization/infection in the NICU may include performing hand hygiene, cohorting and isolating patients, screening healthcare workers and performing admission and periodic surveillance cultures.
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PMID:Prevention of nosocomial infections and surveillance of emerging resistances in NICU. 2194 85

Lactoferrin (Lf), an iron-binding glycoprotein expressed in most biological fluids, represents a major component of the mammalian innate immune system. Lf's multiple activities rely not only on its capacity to bind iron, but also to interact with molecular and cellular components of both host and pathogens. Lf can bind and sequester lipopolysaccharide (LPS), thus preventing pro-inflammatory pathway activation, sepsis and tissue damage. However, Lf-bound LPS may retain the capacity to induce cell activation via Toll-like receptor 4-dependent and -independent mechanisms. This review discusses the complex interplay between Lf and LPS and its relevance in the regulation of the immune response.
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PMID:Reciprocal interactions between lactoferrin and bacterial endotoxins and their role in the regulation of the immune response. 2206 46


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