Abstract
Introduction. Nosocomial pneumonia (NP) is the second leading frequency and mortality among nosocomial infections. NP is a frequent complication of severe traumatic brain injury (TBI). The difficulty in diagnosis and monitoring of disease NP on the background of TBI is that the usual signs NP "masked" manifestations of the underlying disease. The aim of our study was to improve the diagnosis and assess the effectiveness of the treatment of nosocomial pneumonia with clarithromycin by studying of serum interleukins in patients with nosocomial pneumonia on the background of traumatic brain injury. Materials and methods. We determined levels of TNFα, IL-4, IL-6, IL-8, IL-10. We examined 45 patients with isolated TBI, 44 patients with NP (standard treatment scheme), 49 patients with NP, each therapy with clarithromycin. The control group was 33 relatively healthy people. Conclusions. The study revealed a significant increase in the concentration of interleukin TNFα, IL-6, IL-8, IL-10 in the serum of patients with NP on the background of TBI compared with patients with isolated TBI and healthy individuals. Our study found significantly lower concentrations of interleukin TNFα, IL-6, IL-8, IL-10 in the serum of patients after treatment with the addition of clarithromycin compared with patients with standard therapy.
Highlights
Nosocomial pneumonia (NP) is the second in frequency and the first in mortality among nosocomial infections
To assess the pathogenetic role of interleukins and their diagnostic value, we studied the contents of TNFα, I interleukin 6 (IL-6) and IL-8 in serum of patients with NP on the background of traumatic brain injury (TBI) and their changes in the dynamics of the treatment process [1, 5, 19−21]
The study revealed a significant increase in the concentration of interleukin TNFα, IL-6, IL-8, interleukin 10 (IL-10) in the serum of patients with NP on the background of TBI compared with patients with isolated TBI and healthy individuals
Summary
Nosocomial pneumonia (NP) is the second in frequency and the first in mortality among nosocomial infections. NP is one of the most common and dangerous infectious complications of severe traumatic brain injury (TBI). The clinical diagnosis of nosocomial pneumonia, diseases of the central nervous system in general and in particular TBI, remains a challenge that continues to develop [1−5]. Late diagnosis is one of the causes of complications and lethal outcome in this group of patients with clinical signs of pneumonia, hidden symptoms of the underlying disease, severity of general cerebral and focal neurological symptoms [1, 4−7]. Clinical signs NP include a local lung inflammation, extrapulmonary manifestations of pneumonia, laboratory and radiological changes; all the criteria listed above are nonspecific. Complication of NP diagnosis in this patient and the severity of the underlying disease, neurological symptoms and the need for prolonged use of mechanical ventilation are typical. That is why the search for markers of inflammation for the diagnosis and monitoring of NP on the background of TBI using informative and, if possible, non-invasive methods is urgent [1, 10−13]
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