Catecolaminas y bacterias: una interacción poco conocida pero clínicamente relevante, revisión integrativa de la bibliografía

Catecholamines, historically known for their role in cardiovascular regulation and stress response, have poorly understood direct biological interactions with pathogenic bacteria, modulating key infectious disease variables such as pathogen growth, virulence, and antibiotic resistance.

The objective of this review is to uncover the current scientific evidence on this relationship, highlighting mechanisms such as the induction of iron uptake systems (siderophores), the activation of bacterial sensors, and the promotion of biofilms. We emphatically analyze key pathogens in human pathology such as Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis, whose response to catecholamines can exacerbate infections in critically ill patients. In addition, clinical implications are discussed, such as a new therapeutic dilemma in septic shock (catecholaminergic vasopressor support vs. exacerbation of infection) and new therapeutic strategies that derive from the understanding of the complex bacteria-catecholamine interaction, such as the early initiation of non-catecholaminergic vasopressors, virulence inhibitors, iron chelators and combination therapies.