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Association between HLA-DR Expression and Multidrug-resistant Infection in Patients with Severe Acute Pancreatitis

Zhu-Xi Yu1, Xian-Cheng Chen1, Bei-Yuan Zhang1

  • 1Department of Critical Care Medicine, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China.

Current Medical Science
|August 4, 2018
PubMed

Insights

Persistent low human leukocyte antigen-antigen D-related (HLA-DR) expression is linked to multidrug-resistant (MDR) bacterial infections in severe acute pancreatitis (SAP) patients. This finding may aid in predicting and managing MDR infections in SAP.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Multidrug-resistant (MDR) bacterial infections are a significant complication in severe acute pancreatitis (SAP).
  • Understanding the immune response, specifically human leukocyte antigen-antigen D-related (HLA-DR) expression, is crucial for managing these infections.

Purpose of the Study:

  • To investigate the association between HLA-DR expression and the occurrence of MDR bacterial infections in patients with SAP.

Main Methods:

  • Flow cytometry was used to determine the percentages of CD4+, CD8+, natural killer (NK), and HLA-DR (CD14+) cells in 24 SAP patients over 28 days.
  • Cellular immune markers were compared between patients with and without MDR infections.

Main Results:

  • Patients with MDR infections showed persistently down-regulated HLA-DR expression compared to those without infection or with non-MDR infections.
  • While CD4+/CD8+ cell ratio and NK cell percentages were similar between non-MDR and MDR groups, HLA-DR levels were significantly lower in the MDR group throughout the study period.
  • Enterobacter cloacae and Acinetobacter baumannii were the most common MDR organisms identified.

Conclusions:

  • Persistent down-regulation of HLA-DR expression is a potential biomarker associated with MDR bacterial infection in SAP patients.
  • Monitoring HLA-DR levels could help identify patients at higher risk for developing MDR infections.
Keywords:
human leukocyte antigen-antigen D-related (HLA-DR)immunomonitoringmultidrug-resistant infectionsevere acute pancreatitis (SAP)

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