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Biomedicines
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Microbial Infections and Sepsis: Pathophysiological Mechanisms and Therapeutic Approaches
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Microbial Infections and Sepsis: Pathophysiological Mechanisms and Therapeutic Approaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Microbiology in Human Health and Disease".

Deadline for manuscript submissions: closed (31 August 2025) | Viewed by 3121

Special Issue Editor

Dr. Nirupam Biswas

E-Mail Website
Guest Editor
New York State Department of Health, Wadsworth Center, Division of Environmental Health Sciences, Empire State Plaza, Albany, NY 12237, USA
Interests: bacteriology; molecular biology; sepsis; microbiology

Special Issue Information

Dear Colleagues,

Sepsis survivors exhibit immune dysfunction, hematological changes, and an increased risk of infection. Clinical and experimental studies indicate that sepsis causes an immunosuppressive state characterized by diminished antimicrobial effector functions that increase susceptibility to infection. Sepsis-induced immunosuppression is multi-factorial and thought to be due to impaired cytokine secretion and diminished phagocytic activity of myeloid cells. However, researchers are still trying to discover whether and how sepsis impacts stem cell location and mobilization long-term, upon recovery from sepsis. In this Special Issue, we aim to accumulate original research articles and review articles related to pathophysiological mechanisms and therapeutic approaches in sepsis.

Dr. Nirupam Biswas
Guest Editor

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Keywords

  • sepsis
  • cytokines
  • inflammation
  • bacteria
  • stem cell
  • molecular biology
  • flow cytometry
  • multiplex
  • MALDI-TOF-MS
  • RT-PCR

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Published Papers (4 papers)

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Research

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19 pages, 1236 KB  
Article
The Usefulness of Peripheral and Organ Perfusion Monitoring in Predicting Mortality in Patients with Severe SARS-CoV-2
by Mateusz Gutowski, Arkadiusz Lubas, Bartosz Rustecki and Jakub Klimkiewicz
Biomedicines 2025, 13(9), 2269; https://doi.org/10.3390/biomedicines13092269 - 15 Sep 2025
Viewed by 285
Abstract
Background: This study assessed whether repeated monitoring of peripheral and organ perfusion predicts mortality in severe SARS-CoV-2 patients. Methods: Peripheral perfusion was measured with finger oxygen saturation (SpO2), capillary refill time (CRT), and finger infrared thermography (FIT). Organ perfusion was measured [...] Read more.
Background: This study assessed whether repeated monitoring of peripheral and organ perfusion predicts mortality in severe SARS-CoV-2 patients. Methods: Peripheral perfusion was measured with finger oxygen saturation (SpO2), capillary refill time (CRT), and finger infrared thermography (FIT). Organ perfusion was measured with the color Doppler renal cortex perfusion (RCP) and Renal Cortical Resistive Index (RCRI). Patients with severe COVID-19 pneumonia were examined after a mean of 7 days of intensive treatment. Results: A total of 46 patients (16 women, 30 men, age 55.2 ± 12.7 years) completed the study. SpO2 and CRT emerged as independent key bedside indicators of prognosis, with an OR for death of 0.665 (CI 0.472–0.938) and 2.223 (CI 1.144–4.322). An SpO2 of 95% (sensitivity 58.3%, specificity of 64.7%) and CRT of ≥4 s (sensitivity 66.7%, specificity of 83.9%) were found as the best threshold values for the elevated risk of mortality. From estimated blood tests, only C-reactive proteins (OR 1.252, CI 1.023–1.542) and ferritin (OR 1.001, CI 1.000–1.002) were independently associated with mortality. Moreover, the elevation in CRP was a substantial death indicator (OR 1.707, CI 1.046–2.784). Conclusions: The estimation of peripheral perfusion using SpO2 and CRT after initial intensive treatment is helpful in the prediction of outcomes in patients with severe COVID-19. Full article
(This article belongs to the Special Issue Microbial Infections and Sepsis: Pathophysiological Mechanisms and Therapeutic Approaches)
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12 pages, 893 KB  
Article
A Retrospective Single-Center Analysis from Southern Italy on the Use of T2 Magnetic Resonance Assays as a Point-of-Care Method for Patients with Sepsis
by Mariarita Margherita Bona, Vincenza Maria Carelli, Nicola Serra, Salvatore Amico, Roberta Bartolini, Anna Giammanco, Paola Di Carlo, Teresa Fasciana and Maria Andriolo
Biomedicines 2025, 13(4), 999; https://doi.org/10.3390/biomedicines13040999 - 20 Apr 2025
Viewed by 650
Abstract
Background: The rapid and accurate identification of the pathogens responsible for sepsis is essential for prompt and effective antimicrobial therapy. The T2Bacteria® Panel (T2B) and T2Candida® Panel (T2C) are rapid molecular tests performed on whole blood that exploit T2 Magnetic [...] Read more.
Background: The rapid and accurate identification of the pathogens responsible for sepsis is essential for prompt and effective antimicrobial therapy. The T2Bacteria® Panel (T2B) and T2Candida® Panel (T2C) are rapid molecular tests performed on whole blood that exploit T2 Magnetic Resonance (T2MRsup®) technology. Objectives: This study evaluates the impact of the T2MR system as a point-of-care device for managing sepsis and septic shock patients. Methods: This single-center retrospective study was conducted at the Sant’ Elia Hospital of Caltanissetta from 1 January 2023 to 31 July 2023. The study population was composed of patients with suspected sepsis and septic shock according to the Sepsis-3 criteria and for whom concurrent T2MR and BC samples were requested for diagnosis. Results: A total of 81 consecutive patients were enrolled in this study. Concordant T2/BC results were obtained in 69/81 (85.2%) patients; 58/81 (71.6%) were concordant-negative and 11/81 (13.6%) were concordant-positive. Discordant T2MR+/BC− results were observed in 9/81 patients (11.1%), while T2MR−/BC+ results were detected in 3/81 patients (3.7%). Furthermore, the median time for reporting positive T2MR test results (5.2 h) was significantly shorter than that for BC (122 h). Conclusions: Due to its high reliability, faster detection time, and simple workflow, T2MR in combination with BC improved the etiological diagnosis of sepsis in the enrolled patients. Full article
(This article belongs to the Special Issue Microbial Infections and Sepsis: Pathophysiological Mechanisms and Therapeutic Approaches)
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19 pages, 3231 KB  
Article
Observational Study of Microbial Colonization and Infection in Neurological Intensive Care Patients Based on Electronic Health Records
by Alesya S. Gracheva, Artem N. Kuzovlev and Lyubov E. Salnikova
Biomedicines 2025, 13(4), 858; https://doi.org/10.3390/biomedicines13040858 - 2 Apr 2025
Cited by 1 | Viewed by 992
Abstract
Background/Objectives: Patients with central nervous system injuries who are hospitalized in intensive care units (ICUs) are at high risk for nosocomial infections. Limited data are available on the incidence and patterns of microbial colonization and infection in this patient population. Methods: To fill [...] Read more.
Background/Objectives: Patients with central nervous system injuries who are hospitalized in intensive care units (ICUs) are at high risk for nosocomial infections. Limited data are available on the incidence and patterns of microbial colonization and infection in this patient population. Methods: To fill this gap, we performed an electronic health record-based study of 1614 chronic patients with brain injury admitted to the ICU from 2017 to 2023. Results: Among the infectious complications, pneumonia was the most common (n = 879; 54.46%). Sepsis was diagnosed in 54 patients, of whom 46 (85%) were diagnosed with pneumonia. The only pathogen that showed an association with the development of pneumonia and sepsis in colonized patients was Pseudomonas aeruginosa (pneumonia: p = 7.2 × 10−9; sepsis: p = 1.7 × 10−5). Bacterial isolates from patients with and without pneumonia did not differ in pathogen titer or dynamics, but patients with monomicrobial culture were more likely to develop pneumonia than patients with polymicrobial culture (1 vs. 2 pathogens, p = 0.014; 1 + 2 pathogens vs. 3 + 4 pathogens, p = 2.8 × 10−6), although the pathogen titer was lower in monoculture than in polyculture. Bacterial isolates from all patients and all culture sites showed high levels of multidrug resistance (Gram-negative bacteria: 88–100%; Gram-positive bacteria: 48–97%), with no differences in multidrug-resistant organism (MDRO) colonization and infection rates. Conclusions: Our results highlight the high burden of MDROs in neurological ICUs and provide novel ecosystem-based insights into mono- and polymicrobial colonization and infection development. These findings may be useful for developing strategies to protect against infections. Full article
(This article belongs to the Special Issue Microbial Infections and Sepsis: Pathophysiological Mechanisms and Therapeutic Approaches)
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Review

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16 pages, 538 KB  
Review
Heparin Binding Protein in Sepsis—A Comprehensive Overview of Pathophysiology, Clinical Usage and Utility as Biomarker
by Foteini Tasouli, Eleni Georgopoulou, Christodoulos Chatzigrigoriadis, Dimitrios Velissaris and Christos Michailides
Biomedicines 2025, 13(9), 2315; https://doi.org/10.3390/biomedicines13092315 - 22 Sep 2025
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Abstract
The heparin-binding protein (HBP) is an enzymatically inactive protein of the serine protease family that plays an important role in host response to stress, especially infection and sepsis. It is produced by activated neutrophils due to a variety of stimuli and is part [...] Read more.
The heparin-binding protein (HBP) is an enzymatically inactive protein of the serine protease family that plays an important role in host response to stress, especially infection and sepsis. It is produced by activated neutrophils due to a variety of stimuli and is part of the immune response that leads to macrophage, lymphocyte, and neutrophil activation and monocyte adhesion. Its most common repository is the azurophilic granules of the neutrophils. HBP has been studied as a biomarker for several infections, including central nervous system infection, respiratory tract infection, and urinary tract infection, and in several settings, including the Emergency Department and Intensive Care Unit, with promising results. As a biomarker for infection and sepsis, HBP has been compared to other commonly used biomarkers such as Neutrophil to Lymphocyte Ratio, White Blood Count, C-reactive protein, and Procalcitonin, with at least comparable performance. Its sharp increase is promising for the early detection of sepsis. The ability to differentiate inflammatory conditions from infections and bacterial from non-bacterial causes of infection has also been demonstrated. The sepsis-related organ damage, as it is represented by the Sequential Organ Failure Assessment score, can also be reflected by the proportional increase in HBP. Consequently, HBP could be a helpful and promising biomarker for sepsis and infection. Full article
(This article belongs to the Special Issue Microbial Infections and Sepsis: Pathophysiological Mechanisms and Therapeutic Approaches)
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