Document Detail

Stroke propagates bacterial aspiration to pneumonia in a model of cerebral ischemia.
MedLine Citation:
PMID:  16946159     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Bacterial pneumonia is the most common cause of death in patients sustaining acute stroke and is believed to result from an increased aspiration. Recently, stroke-induced immunodeficiency was described in a mouse model of cerebral ischemia, which is primarily caused by overactivation of sympathetic nervous system. We tested if stroke-induced immunodeficiency increases the risk of pneumonia after aspiration in a newly developed model of poststroke pneumonia. METHODS: Experimental stroke in mice was induced by occlusion of the middle cerebral artery (MCAO) for 60 minutes. Aspiration pneumonia was induced by intranasal application of 20 microL of a defined suspension of Streptococcus pneumoniae in phosphate-buffered saline 4 or 14 days after MCAO. Treatment comprised moxifloxacin (100 mg/kg body weight, six times every 2 hours after operation) or propranolol (30 mg/kg body weight, immediately before as well as 4 and 8 hours after MCAO). Readout was lung histology and bacterial counts in lung and blood. RESULTS: Nasal inoculation of only 200 colony-forming units of S. pneumoniae caused severe pneumonia and bacteremia after experimental stroke, whereas 200,000 colony-forming units are needed to induce comparable disease in sham animals. Aspiration pneumonia in stroke animals outlasted acute stroke state but was preventable by beta-adrenoreceptor blockade. CONCLUSIONS: Experimental stroke propagates bacterial aspiration from harmless intranasal colonization to harmful pneumonia. Prevention of infections by beta-adrenoreceptor blockade suggests that immunodepression by sympathetic hyperactivity is essential for progression of bacterial aspiration to pneumonia.
Konstantin Prass; Johann S Braun; Ulrich Dirnagl; Christian Meisel; Andreas Meisel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-08-31
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  37     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-26     Completed Date:  2006-10-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2607-12     Citation Subset:  IM    
Department of Experimental Neurology, Charité Universitaetsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany.
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MeSH Terms
Acute Disease
Administration, Intranasal
Adrenergic beta-Antagonists / therapeutic use
Bacteremia / etiology
Catecholamines / physiology
Disease Progression
Disease Susceptibility
Immunologic Deficiency Syndromes / etiology*,  physiopathology,  prevention & control
Infarction, Middle Cerebral Artery / complications*,  immunology
Nasal Cavity / microbiology
Pneumonia, Bacterial / etiology*
Pneumonia, Pneumococcal / etiology
Specific Pathogen-Free Organisms
Streptococcus pneumoniae
Stroke / complications*,  immunology
Sympathetic Nervous System / drug effects,  physiopathology
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Catecholamines

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