The complex pathogenesis of bacteremia: from antimicrobial clearance mechanisms to the genetic background of the host.
Bacteremia develops when bacteria manage to escape the host immune mechanisms or when the otherwise well-orchestrated immune response fails to control bacterial spread due to inherent or acquired immune defects that are associated with susceptibility to infection. The pathogenesis of bacteremia has some characteristic features that are influenced by the genetic signature of the host. In this review, the host defense mechanisms that help prevent bacteremia will be described and the populations who are at risk because of congenital or acquired deficiencies in such mechanisms will be defined. A special mention will be made to novel insights regarding host immune defense against the most commonly isolated organisms from patients with community-acquired bloodstream infections.
Third Department of Internal Medicine; Aristotle University of Thessaloniki; Papageorgiou General Hospital; Thessaloniki, Greece; Infectious Diseases Division; Warren Alpert Medical School of Brown University; Providence, RI USA.
Eirini
E
Christaki
Fourth Department of Internal Medicine; Medical School; University of Athens; Athens, Greece; Integrated Research and Treatment Center; Center for Sepsis Control and Care; Jena University Hospital; Jena, Germany.
Evangelos J
EJ
Giamarellos-Bourboulis
D000890:Anti-Infective Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000235:genetics / Q000276:immunology*; D001419:Bacteria / Q000276:immunology*; D003165:Complement System Proteins / Q000276:immunology; D020022:Genetic Predisposition to Disease; D054884:Host-Pathogen Interactions / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate; D051192:Receptors, Pattern Recognition / Q000276:immunology
D000890:Anti-Infective Agents; D051192:Receptors, Pattern Recognition; D003165:Complement System Proteins
bacteremia; bloodstream infection; host defense; single nucleotide polymorphism