Protective effect of procysteine on Acinetobacter pneumonia in hyperoxic conditions

Objectives: Ventilator-associated pneumonia (VAP) is an important cause of morbidity and mortality in critical care settings. Acinetobacter has become a leading cause of VAP. In particular, the appearance and spread of multidrug-resistant Acinetobacter is of great concern. In this study, we examined the effect of the antioxidant procysteine on Acinetobacter murine pneumonia in hyperoxic conditions in order to simulate VAP.

Methods: Acinetobacter was administered intranasally to BALB/c mice kept in hyperoxic conditions. At designated timepoints, Bacterial number, cytokine production and histopathological findings in the lungs were examined. The effects of procysteine on survival rates, lung Bacterial burdens and the phagocytic activities of alveolar macrophages were evaluated.

Results: Drastic decreases in survival were observed when the infected mice were kept in hyperoxic conditions (P < 0.001). Significant differences in pulmonary Bacterial number and neutrophil accumulation were observed between mice kept in hyperoxic or normoxic conditions on day 3. Although all mice infected with Acinetobacter spp. and kept in hyperoxic conditions died by day 3, procysteine treatment significantly improved survival (60% survival on day 7, P < 0.01). Procysteine treatment decreased the lung Bacterial burden on days 2 and 3. Finally, improved uptake of FITC-labelled beads by alveolar macrophages from mice treated with procysteine and kept in hyperoxic conditions was noted.

Conclusions: These results suggest that hyperoxia increases mortality in mice with Acinetobacter pneumonia and that procysteine improves survival by increasing the phagocytic activity of alveolar macrophages in mice kept in hyperoxic conditions.

VAP; alveolar macrophages; phagocytic activity; ventilator-associated pneumonia.