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Comment & Response
August 16, 2016

Secondary Infection in Patients With Sepsis—Reply

Author Affiliations
  • 1Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, the Netherlands
  • 2Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands

Copyright 2016 American Medical Association. All Rights Reserved.

JAMA. 2016;316(7):772. doi:10.1001/jama.2016.9279

In Reply Drs Sweeney and Kalil argue that our genomic analyses do not support the existence of immunosuppression. However, although the blood genomic response on ICU admission was not different between patients with sepsis who either did or did not develop an ICU-acquired infection, the gene expression signatures of both groups showed features of immune suppression. In addition, at the time of the ICU-acquired infection, blood leukocytes showed decreased expression of genes involved in glucose metabolism, suggestive of immune suppression.1