How do viral infections predispose patients to bacterial infections?

    Research output: Contribution to journalArticle

    92 Citations (Scopus)

    Abstract

    Purpose of review: Bacterial sepsis is a leading cause of death in the United States, accounting for over 200 000 fatalities annually. Approximately half of bacterial sepsis cases occur following acute respiratory infections, and the lungs are the most common organs to fail. Notably, outbreaks of respiratory viral infections are associated with an increased incidence or severity of bacterial co-infections, with normally innocuous infections often becoming fatal. Understanding the 'lethal synergism' associated with concomitant infections may point the way toward improved anti-sepsis treatments. Recent findings: Murine models of viral and bacterial co-infection mimic the lethal synergism observed in humans and reveal at least two mechanisms of interaction. First, bacterial infiltration is heightened during acute viral infection. Secondly, the nature of responding cell populations is dramatically altered during concomitant infections. Although natural killer cells and macrophages are predominant cell populations responding to bacterial infection in a naïve host, there is also a large T cell component that is activated upon viral infection. Inflammatory cytokines produced by these cells contribute to lethal immunopathology, and therapeutic strategies need to target the initial causative microbes as well as subsequent inflammatory responses. Current therapies directed only at the host immune response have not been overly successful, owing largely to difficulties in reversing the severe immunopathology associated with sepsis. Summary: Respiratory viral infections may facilitate secondary bacterial infections and increase host immunopathology through the overproduction of inflammatory cytokines. Preventive measures, including vaccination and aggressive antimicrobial therapy early in the course of infection, may significantly reduce the morbidity and mortality of sepsis.

    Original languageEnglish (US)
    Pages (from-to)185-191
    Number of pages7
    JournalCurrent Opinion in Infectious Diseases
    Volume17
    Issue number3
    DOIs
    StatePublished - Jun 2004

    Fingerprint

    Virus Diseases
    Bacterial Infections
    Sepsis
    Coinfection
    Respiratory Tract Infections
    Infection
    Cytokines
    Cellular Structures
    Therapeutics
    Natural Killer Cells
    Population
    Disease Outbreaks
    Cause of Death
    Vaccination
    Macrophages
    Morbidity
    T-Lymphocytes
    Lung
    Mortality
    Incidence

    Keywords

    • Bacteria
    • Influenza
    • RSV
    • Sepsis
    • Synergism

    ASJC Scopus subject areas

    • Microbiology (medical)
    • Immunology

    Cite this

    How do viral infections predispose patients to bacterial infections? / Beadling, Carol; Slifka, Mark.

    In: Current Opinion in Infectious Diseases, Vol. 17, No. 3, 06.2004, p. 185-191.

    Research output: Contribution to journalArticle

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