Early cutaneous alterations in experimental sepsis by Pseudomonas aeruginosa.
BACKGROUND
To evaluate whether histopathologic findings of skin in sepsis by Pseudomonas aeruginosa correlate with the clinical course.


METHODS
Histological alterations after bacterial challenge by one susceptible (A) and two multidrug-resistant isolates (B and C) of P. aeruginosa were studied in 18 rabbits. Sepsis was induced by the intravenous infusion of 1 x 10(8) CFU by a catheter in the right jugular vein; blood was sampled for the estimation of tumor necrosis factor alpha (TNF-alpha) and malondialdehyde (MDA). Skin biopsies were collected along with a subcutaneous fat specimen for culture.


RESULTS
The mean survival was 0.85, 1.75 and 11.00 days after challenge by isolates A, B and C, respectively. The main histologic findings of skin were: inflammation and swelling of the dermis; thickening of the endothelium and infiltration of vessel wall and lumen by polymorphonuclear leukocytes; extravasation of red blood cells, and necrobiotic changes of the hair follicles. Serum TNF-alpha was elevated in animals challenged by isolate A compared to challenge by isolates B and C. Concentrations of MDA were similar for all isolates. Mean log(10) of viable cells isolated from subcutaneous fat were 5.74, 2.74 and 1.40 after challenge by isolates A, B and C, respectively.


CONCLUSIONS
Prolongation of survival was accompanied by lower serum TNF-alpha, decreased viable cells from subcutaneous fat and intensified inflammatory response in the dermis and subcutaneous tissue. These findings might be of importance for immunomodulatory intervention.
Department of Dermatology and Venereology, University of Athens, Medical School, Athens, Greece.
Haritini
H
Petropoulou
Evangelos J
EJ
Giamarellos-Bourboulis
Nicolaos
N
Kavatzas
Alexandros
A
Stratigos
Maria
M
Mouktaroudi
Theodoros
T
Adamis
Fotini
F
Baziaka
Andreas D
AD
Katsambas
Nicolaos G
NG
Stavrianeas
D000704:Analysis of Variance; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D001707:Biopsy, Needle; D004195:Disease Models, Animal; D024901:Drug Resistance, Multiple, Bacterial; D007150:Immunohistochemistry; D018836:Inflammation Mediators / Q000032:analysis; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D011336:Probability; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D011550:Pseudomonas aeruginosa; D011817:Rabbits; D012720:Severity of Illness Index; D012867:Skin / Q000382:microbiology* / Q000473:pathology*; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000900:Anti-Bacterial Agents; D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha; D008315:Malondialdehyde