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<p>Healthcare-associated infections (HAIs) pose significant risks, leading to increased morbidity, mortality, and costs, exacerbated by multi-drug-resistant microorganisms. This study aimed to evaluate pharmacological prophylaxis targeting sympathetic reflex control of immunity to mitigate systemic infections, offering a novel approach to combating HAIs. The study included animal experiments and a retrospective analysis of orthopedic surgery patients in Romagna, Italy. Young female pigs were intravenously inoculated with <i>Escherichia coli</i> (<i>E. coli</i>) and divided into two groups: propranolol-treated (non-selective β-blocker; 3&#xa0;mg/kg; 3x/day orally) and vehicle-treated, starting two days before infection. Parameters such as bacteraemia, serum cytokines, biochemical profile, blood count, lactate, glycemia, and flow cytometry were assessed. Additionally, a retrospective analysis of 92,649 orthopedic surgery hospitalizations (2017–2022) examined the association of non-selective and selective β1-blockers with HAI development using conditional logistic regression. Propranolol-treated pigs exhibited a disinhibited immune response to systemic infection, clearing circulating bacteria much earlier than vehicle-treated animals. The retrospective analysis showed that patients on non-selective beta-blockers had a 71.7% reduced risk of developing HAIs, while those on selective β1-blockers had an 18% higher risk. These findings suggest that targeting sympathetic reflex control of immunity via pharmacological prophylaxis may reduce HAIs in surgical patients.</p>

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Non-selective beta-blockers enhance resolution of induced infections in animals and healthcare-associated infections in humans

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月5日

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  • Alessandra Occhinegro,
  • Domenico Ventrella,
  • Simona Rosa,
  • Luca Alberti,
  • Roberto Amici,
  • Matteo Cerri,
  • Timna Hitrec,
  • Domenico Tupone,
  • Alessandra Cappellini,
  • Stefano Ratti,
  • Alberto Elmi,
  • Augusta Zannoni,
  • Silvia Felici,
  • Davide Golinelli,
  • Marco Luppi,
  • Yugeesh R. Lankadeva,
  • Clive N. May,
  • Robin M. McAllen,
  • Michael J. McKinley,
  • Patricia Passaglia,
  • Emiliana Piscitiello,
  • Ludovico Taddei,
  • Maddalena Giannella,
  • Pierluigi Viale,
  • Maria L. Bacci,
  • Paola Rucci,
  • Tiziana Lazzarotto,
  • Davide Martelli

摘要

Healthcare-associated infections (HAIs) pose significant risks, leading to increased morbidity, mortality, and costs, exacerbated by multi-drug-resistant microorganisms. This study aimed to evaluate pharmacological prophylaxis targeting sympathetic reflex control of immunity to mitigate systemic infections, offering a novel approach to combating HAIs. The study included animal experiments and a retrospective analysis of orthopedic surgery patients in Romagna, Italy. Young female pigs were intravenously inoculated with Escherichia coli (E. coli) and divided into two groups: propranolol-treated (non-selective β-blocker; 3 mg/kg; 3x/day orally) and vehicle-treated, starting two days before infection. Parameters such as bacteraemia, serum cytokines, biochemical profile, blood count, lactate, glycemia, and flow cytometry were assessed. Additionally, a retrospective analysis of 92,649 orthopedic surgery hospitalizations (2017–2022) examined the association of non-selective and selective β1-blockers with HAI development using conditional logistic regression. Propranolol-treated pigs exhibited a disinhibited immune response to systemic infection, clearing circulating bacteria much earlier than vehicle-treated animals. The retrospective analysis showed that patients on non-selective beta-blockers had a 71.7% reduced risk of developing HAIs, while those on selective β1-blockers had an 18% higher risk. These findings suggest that targeting sympathetic reflex control of immunity via pharmacological prophylaxis may reduce HAIs in surgical patients.