title: Oxidative stress in immunocompetent patients with severe community-acquired pneumonia. A pilot study.
abstract: OBJECTIVE
  A comparison was made of the oxidative stress (OS) levels of patients with either viral or bacterial severe community-acquired pneumonia (sCAP) and of patients without infection (healthy volunteers (HV) and patients with acute myocardial infarction (AMI)).
  
  
  METHODS
  A prospective observational study was made.
  
  
  METHODS
  Critically ill patients with sCAP.
  
  
  METHODS
  The TBARS level was measured as an index of oxidative injury. SOD, CAT and redox glutathione system (GSH, GSSG, GR, GPx) activities were measured as reflecting antioxidant capacity. Severity of illness was assessed by the APACHE II, SOFA and SIRS scores.
  
  
  RESULTS
  Thirty-seven subjects were included: 15 patients with CAP (12 of bacterial origin [BCAP] and 3 due to 2009 A/H1N1 virus [VCAP]), 10 HV and 12 AMI patients. Intensive care CAP mortality was 26.7% (n=4). Plasmatic TBARS levels were higher in CAP patients than in HV, but similar to those recorded in AMI patients. In contrast, VCAP was associated with lower TBARS levels, and some components of the glutathione redox system were higher in BCAP patients and HV. The OS levels did not differ between survivors and non-survivors.
  
  
  CONCLUSIONS
  Our results suggest the occurrence of higher OS in sCAP patients compared with HV. In contrast, lower TBARS levels were observed in VCAP patients, suggesting an increase of antioxidant activity related to the redox glutathione system. However, further research involving a larger cohort is needed in order to confirm these findings.
authors.affiliation: Critical Care Department, Hospital Universitario Joan XXIII - IISPV, Tarragona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Trefler
authors.affiliation: Critical Care Department, Hospital Universitario Joan XXIII - IISPV, Tarragona, Spain; CIBER Enfermedades Respiratorias, Universidad Rovira i Virgili, Tarragona, Spain. Electronic address: ahr1161@yahoo.es.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez
authors.affiliation: Critical Care Department, Complejo Sanitari Parc Taulí/CIBERES, Sabadell, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Martín-Loeches
authors.affiliation: Farmacology Department, Facultad de Medicina y Ciencias de la Salud, Universidad Rovira i Virgili, Reus, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Sanchez
authors.affiliation: Critical Care Department, Hospital Universitario Joan XXIII - IISPV, Tarragona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Marín
authors.affiliation: Critical Care Department, Hospital Universitario Joan XXIII - IISPV, Tarragona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Llauradó
authors.affiliation: Farmacology Department, Facultad de Medicina y Ciencias de la Salud, Universidad Rovira i Virgili, Reus, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Romeu
authors.affiliation: Critical Care Department, Hospital Moises Broggi/CIBERES, Sant Joan Despí, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Díaz
authors.affiliation: Critical Care Department, Complejo Sanitari Parc Taulí/CIBERES, Sabadell, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Nogués
authors.affiliation: Critical Care Department, Complejo Sanitari Parc Taulí/CIBERES, Sabadell, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Giralt
mesh_terms: D000328:Adult; D017714:Community-Acquired Infections / Q000378:metabolism; D005260:Female; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010865:Pilot Projects; D018410:Pneumonia, Bacterial / Q000378:metabolism*; D011024:Pneumonia, Viral / Q000378:metabolism*; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: 2009 Influenza A/H1N1 virus; Bacterial pneumonia; Community-acquired pneumonia; Estrés oxidativo; Gripe A 2009/H1N1; Neumonía bacteriana; Neumonía comunitaria; Oxidative stress