Abstract：
Some data, mostly originally derived from animal studies, suggest that low glucose intake is protective in bacterial sepsis but detrimental in overwhelming viral infections. This has been interpreted into a broad belief that different forms of sepsis may potentially require different nutritional management strategies. There are a few mechanistic differences between the host interactions with virus and bacteria which can explain why there may be opposing responses to macronutrient and micronutrient during the infected state. Here, we aim to review relevant evidence on the mechanisms and pathophysiology of nutritional management strategies in various infectious syndromes and summarize their clinical implications.
Newer literature - in the context of the SARS-CoV-19 pandemic - offers some insight to viral infections. There is still limited clinically applicable data during infection that clearly delineate the role of nutrition during an active viral vs bacterial infections. Based on contrasting findings in different models of viruses and bacteria, the macronutrient and micronutrient needs may depend more on specific infectious organisms that may not be generalizable as bacterial versus viral. Overall, the metabolic effects of sepsis are context dependent, and various host-specific (e.g., age, baseline nutritional status, immune status, comorbidities) and illness variables (phase, duration, and severity of illness) play a significant role in determining the outcome besides pathogen-specific (virus or bacterial or fungi and combined infections) factors. Microbe therapy (probiotics and prebiotics) seems to have therapeutic potential in both viral and bacterial infected states, and this seems like a promising area for further practical research.
Newer literature - in the context of the SARS-CoV-19 pandemic - offers some insight to viral infections. There is still limited clinically applicable data during infection that clearly delineate the role of nutrition during an active viral vs bacterial infections. Based on contrasting findings in different models of viruses and bacteria, the macronutrient and micronutrient needs may depend more on specific infectious organisms that may not be generalizable as bacterial versus viral. Overall, the metabolic effects of sepsis are context dependent, and various host-specific (e.g., age, baseline nutritional status, immune status, comorbidities) and illness variables (phase, duration, and severity of illness) play a significant role in determining the outcome besides pathogen-specific (virus or bacterial or fungi and combined infections) factors. Microbe therapy (probiotics and prebiotics) seems to have therapeutic potential in both viral and bacterial infected states, and this seems like a promising area for further practical research.
摘要：
目的：一些数据，主要来自动物研究，建议低葡萄糖摄入对细菌性败血症有保护作用，但对压倒性的病毒感染有害。这已被解释为广泛的信念，即不同形式的败血症可能可能需要不同的营养管理策略。宿主与病毒和细菌的相互作用之间存在一些机制差异，这可以解释为什么在感染状态下可能会对大量营养素和微量营养素产生相反的反应。这里,我们旨在回顾各种感染性综合征营养管理策略的机制和病理生理学的相关证据，并总结其临床意义。
结果：在SARS-CoV-19大流行的背景下，较新的文献提供了对病毒感染的一些见解。在感染期间，仍然存在有限的临床适用数据，这些数据清楚地描述了在活跃的病毒与细菌感染期间营养的作用。根据不同病毒和细菌模型的对比发现，大量营养素和微量营养素的需求可能更多地取决于特定的感染性生物，这些生物可能无法推广为细菌和病毒。总的来说,脓毒症的代谢作用取决于环境，和各种特定于宿主的(例如，年龄,基线营养状况，免疫状态，合并症)和疾病变量(阶段，持续时间,和疾病的严重程度）除了病原体特异性（病毒或细菌或真菌以及合并感染）因素外，在确定结果方面也起着重要作用。微生物疗法（益生菌和益生元）似乎在病毒和细菌感染状态下都具有治疗潜力。这似乎是一个有希望进一步实践研究的领域。
结果：在SARS-CoV-19大流行的背景下，较新的文献提供了对病毒感染的一些见解。在感染期间，仍然存在有限的临床适用数据，这些数据清楚地描述了在活跃的病毒与细菌感染期间营养的作用。根据不同病毒和细菌模型的对比发现，大量营养素和微量营养素的需求可能更多地取决于特定的感染性生物，这些生物可能无法推广为细菌和病毒。总的来说,脓毒症的代谢作用取决于环境，和各种特定于宿主的(例如，年龄,基线营养状况，免疫状态，合并症)和疾病变量(阶段，持续时间,和疾病的严重程度）除了病原体特异性（病毒或细菌或真菌以及合并感染）因素外，在确定结果方面也起着重要作用。微生物疗法（益生菌和益生元）似乎在病毒和细菌感染状态下都具有治疗潜力。这似乎是一个有希望进一步实践研究的领域。
