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Pathogens
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Impact of Bacterial and Viral Pathogens on Sepsis Prevalence and...
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Impact of Bacterial and Viral Pathogens on Sepsis Prevalence and Outcome

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Vaccines and Therapeutic Developments".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 8430

Special Issue Editor

Dr. Björn Koos

E-Mail Website
Guest Editor
Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Bochum, University of Bochum, 44801 Bochum, Germany
Interests: method development; sepsis and molecular biology

Special Issue Information

Dear Colleagues,

Sepsis is a life-threatening acute condition that is one of the most common causes of mortality in industrialized countries. In 2016, sepsis has been redefined as an acute organ dysfunction generated by a dysregulated immune response to a pathogen. With this so-called Sepsis-3 definition, the focus of sepsis research has shifted to the hosts’ immune response and trials have been undertaken to modulate the immune response of the patient. While this worked well in rodents, the human immune system seems to be too complex for accurate modulation thus far. At the same time, it is clear that sepsis is very heterogenous and a range of different subgroups and grouping systems for sepsis have been described. The impact of the pathogen on sepsis subgroups is an intriguing but under-studied topic. In addition, there are pathogens affecting patients that are different from the main infection focus. Severe COVID-19 patients frequently suffer from bacterial superinfections and polymicrobial sepsis patients might face a viral re-activation of latent infections. This Special Issue therefore aims to study the impact of viral or bacterial pathogens on sepsis survival, subgrouping, prevalence and other outcomes. 

Dr. Björn Koos
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Published Papers (2 papers)

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Review

15 pages, 1318 KiB  
Review
Dengue-Associated Hemophagocytic Lymphohistiocytosis: A Narrative Review of Its Identification and Treatment
by Kay Choong See
Pathogens 2024, 13(4), 332; https://doi.org/10.3390/pathogens13040332 - 17 Apr 2024
Cited by 2 | Viewed by 3590
Abstract
Dengue’s lack of specific treatments beyond supportive care prompts a focus on uncovering additional pathophysiological factors. Dengue-associated hemophagocytic lymphohistiocytosis (HLH), characterized by dysregulated macrophage activation and cytokine storm, remains underexplored despite its potential to worsen disease severity and mortality. While rare, dengue-associated HLH [...] Read more.
Dengue’s lack of specific treatments beyond supportive care prompts a focus on uncovering additional pathophysiological factors. Dengue-associated hemophagocytic lymphohistiocytosis (HLH), characterized by dysregulated macrophage activation and cytokine storm, remains underexplored despite its potential to worsen disease severity and mortality. While rare, dengue-associated HLH disproportionately affects severe cases, significantly impacting mortality rates. To mitigate high mortality, early identification and familiarity with dengue-associated HLH are imperative for prompt treatment by clinicians. This narrative review therefore aims to examine the current clinical and therapeutic knowledge on dengue-associated HLH, and act as a resource for clinicians to improve their management of HLH associated with severe dengue. Dengue-associated HLH should be considered for all cases of severe dengue and may be suspected based on the presence of prolonged or recurrent fever for >7 days, or anemia without intravascular hemolysis or massive bleeding. Diagnosis relies on fulfilling at least five of the eight HLH-2004 criteria. Treatment predominantly involves short courses (3–4 days) of high-dose steroids (e.g., dexamethasone 10 mg/m2), with additional therapies considered in more severe presentations. Notably, outcomes can be favorable with steroid therapy alone. Full article
(This article belongs to the Special Issue Impact of Bacterial and Viral Pathogens on Sepsis Prevalence and Outcome)
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10 pages, 1105 KiB  
Review
The Impact of Pathogens on Sepsis Prevalence and Outcome
by Birte Dyck, Matthias Unterberg, Michael Adamzik and Björn Koos
Pathogens 2024, 13(1), 89; https://doi.org/10.3390/pathogens13010089 - 20 Jan 2024
Cited by 3 | Viewed by 4391
Abstract
Sepsis, a severe global healthcare challenge, is characterized by significant morbidity and mortality. The 2016 redefinition by the Third International Consensus Definitions Task Force emphasizes its complexity as a “life-threatening organ dysfunction caused by a dysregulated host response to infection”. Bacterial pathogens, historically [...] Read more.
Sepsis, a severe global healthcare challenge, is characterized by significant morbidity and mortality. The 2016 redefinition by the Third International Consensus Definitions Task Force emphasizes its complexity as a “life-threatening organ dysfunction caused by a dysregulated host response to infection”. Bacterial pathogens, historically dominant, exhibit geographic variations, influencing healthcare strategies. The intricate dynamics of bacterial immunity involve recognizing pathogen-associated molecular patterns, triggering innate immune responses and inflammatory cascades. Dysregulation leads to immunothrombosis, disseminated intravascular coagulation, and mitochondrial dysfunction, contributing to the septic state. Viral sepsis, historically less prevalent, saw a paradigm shift during the COVID-19 pandemic, underscoring the need to understand the immunological response. Retinoic acid-inducible gene I-like receptors and Toll-like receptors play pivotal roles, and the cytokine storm in COVID-19 differs from bacterial sepsis. Latent viruses like human cytomegalovirus impact sepsis by reactivating during the immunosuppressive phases. Challenges in sepsis management include rapid pathogen identification, antibiotic resistance monitoring, and balancing therapy beyond antibiotics. This review highlights the evolving sepsis landscape, emphasizing the need for pathogen-specific therapeutic developments in a dynamic and heterogeneous clinical setting. Full article
(This article belongs to the Special Issue Impact of Bacterial and Viral Pathogens on Sepsis Prevalence and Outcome)
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