Exposure to radiation damages the immune, hematopoietic, and gastrointestinal components of the host defense system. This may lead to serious endogenous or exogenous
infections. When
radiation injury is combined with other
physical trauma, e.g.,
burn or
wound, the resulting damage to these systems is synergistic, and treatment for
infection requires multiple approaches. This paper reviews successful single and combined therapeutic modalities for
infections in irradiated mice and irradiated mice inflicted with
trauma that are currently conducted at the Armed Forces Radiobiology Research Institute. The models of endogenous and exogenous
infection and combined injury are described. The management of
wounds infected with bacteria, exogenous systemic
infection due to gram-negative enteric bacteria, and the
chemoprophylaxis of enteric-derived systemic
infection with
quinolones is described.
Infections can be treated successfully with proper antimicrobial
therapy. In gamma- and neutron-irradiated mice, the
immunomodulator trehalose dimycolate (TDM) was effective in treating endogenous
infection. TDM with the antimicrobial
ceftriaxone was effective in treating exogenous
infection due to Klebsiella pneumoniae. Improvement in managing
infection in irradiated and injured hosts will require further research using these diagnostic and therapeutic modalities. Accurate
biological dosimetry is critical in determining if victims are at risk of developing
infection. We found that radiation induced changes in plasma
diamine oxidase activity; monitoring these changes was a useful
indicator of the severity of
radiation injury.