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Caspase-1 Inflammasome Activity in Patients with Staphylococcus aureus Bacteraemia
Örebro University, School of Medical Sciences. Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences.
Örebro University, School of Medical Sciences.
Alere Technologies, GmbH, Jena, Germany.
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(English)Manuscript (preprint) (Other academic)
National Category
Family Medicine
Identifiers
URN: urn:nbn:se:oru:diva-56197OAI: oai:DiVA.org:oru-56197DiVA: diva2:1079313
Available from: 2017-03-08 Created: 2017-03-08 Last updated: 2017-03-08Bibliographically approved
In thesis
1. Staphylococcus aureus bacteremia, molecular epidemiology and host immune response
Open this publication in new window or tab >>Staphylococcus aureus bacteremia, molecular epidemiology and host immune response
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Staphylococcus aureus is a major pathogen responsible for a considerable disease burden worldwide. It may cause a wide array of infections, from superficial skin infections to invasive bacteremia and complications such as infective endocarditis (IE) and osteomyelitis. This thesis aimed to investigate aspects of the molecular epidemiology of S. aureus and host immune response in relation to disease manifestation, severity, and over time during S. aureus bacteremia (SAB).

Genotypic characteristics in isolates causing colonization, bacteremia, and bacteremia with IE were studied. The S. aureus population was genetically diverse and certain clones with their set of often lineage-specific virulence genes were associated with invasive disease. Characterization of the long-term molecular epidemiology of MSSA bacteremia showed an increased prevalence of CC5 and CC15, while CC8, CC25 and CC30 declined. Antibiotic resistance pattern was favorable and unaffected.

Further, different aspects of host immune response were explored in patients with SAB during the acute phase of bacteremia. When investigating the NLRP3 inflammasome signaling, induced caspase-1 activity was found, with a great inter-individual variation between patients, and subsequent release of IL-18, indicating inflammasome activity. Finally, the dynamics of MHC class II related genes HLA-DRA and CD74 were analyzed as markers of immunosuppression. Patients with complicated SAB had significantly lower HLA-DRA expression than patients with uncomplicated bacteremia, demonstrating an association between complicated SAB and impaired immune function.

In conclusion, the S. aureus genotype, as well as host factors reflected by inter-individual variations in inflammasome signaling and immune function, may all contribute to disease manifestation and outcome during SAB. An ability to measure the immune response early and continuously during the hospital stay and course of bacteremia could offer a way to tailor patient management and treatment in an individualized way.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2017. 75 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 158
Keyword
Staphylococcus aureus, molecular epidemiology, DNAmicroarray, bacteremia, sepsis, NLRP3, inflammasome, caspase-1, HLA-DR, HLA-DRA, CD74
National Category
Family Medicine
Identifiers
urn:nbn:se:oru:diva-54675 (URN)978-91-7529-181-9 (ISBN)
Public defence
2017-03-31, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
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Supervisors
Available from: 2017-01-13 Created: 2017-01-13 Last updated: 2017-03-08Bibliographically approved

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