Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We undertook a phase I-II trial in elderly (age greater than or equal to 60 years) untreated acute myelogenous leukemia (AML) patients using brief, intensive therapy to improve induction rates and overall survival in older AML patients. Twenty-one patients ranging in age from 60 to 81 years (median, 66 years) were treated using either a 4- or 5-day course of high-dose cytosine arabinoside, 3 g/m2 intravenously (IV) every 12 hours; followed by daunorubicin, 45 mg/m2/d IV bolus for 3 consecutive days. Thirteen patients were entered at the first dose level (a 4-day course or eight doses of cytosine arabinoside), whereas eight patients underwent therapy at the second dose level (a 5-day course or ten doses). Patients who achieved a complete remission received a repeat course of high-dose cytosine arabinoside and daunorubicin within 4 weeks of attaining remission. Seven patients had an antecedant history of a myelodysplastic syndrome. Infection was the major complication experienced by this elderly patient group, and included ten episodes of bacteremia or fungemia (four of which were fatal) and five cases of pneumonia (one fatality). Nine of the 21 patients (three of 13 at the first dose level and six of eight at the second dose level) achieved a complete remission. Median remission duration was 9 months (range, 4-19+ months). Although high-dose cytosine arabinoside plus daunorubicin was an effective antileukemic therapy, it is too toxic to recommend for most elderly leukemic patients.
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PMID:High-dose cytosine arabinoside and daunorubicin as primary therapy in elderly patients with acute myelogenous leukemia. A phase I-II study of the Southeastern Cancer Study Group. 291 7

Infection in the granulocytopenic patient is often life-threatening, and the frequency and severity of infection are increased regardless of the cause of leukocyte suppression. Trimethoprim-sulfamethoxazole plus nystatin is known to be effective in preventing colonization and infection by the primary pathogens responsible for the morbidity and mortality associated with granulocytopenia. When treating granulocytopenic patients, clinicians should use proper barrier techniques to minimize nosocomial colonization. When foci of oral infection are present or bacteremia is predictable, appropriate antibiotics should be prescribed.
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PMID:The granulocytopenic patient: another consideration for antimicrobial prophylaxis. 316 30

Infection is a common cause of death after thermal injury. Therefore, we reviewed the records of 1108 patients who had sustained burns to determine the effect of bacteremia on mortality. Overall, 32 patients died due to sepsis, 26 of whom had positive blood cultures. During this period, 93 patients had 133 bacteremic episodes. The 26 bacteremic patients (28%) who died had larger burns (71% +/- 24%) than the 67 patients who survived (39% +/- 24%), as well as a higher incidence of inhalation injuries. The patients dying of sepsis also were more likely to have polymicrobial bacteremias than the survivors. The distribution of microorganisms causing bacteremia was different between the surviving and nonsurviving patients, with patients sustaining fatal bacteremias having a higher incidence of infections with gram-negative enteric organisms or Pseudomonas. Thus, increased burn size and the presence of an inhalation injury, polymicrobial bacteremia, or gram-negative bacteremia were associated with an increased mortality rate in bacteremic patients with burns.
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PMID:Effect of bacteremia on mortality after thermal injury. 317 85

Infections with salmonellae causing gastroenteritis rarely lead to bacteremia (1-4%), and serious courses are almost exclusively observed in patients with a compromised immune system. In 1986-1987 we observed 4 patients with no evidence of disturbed cell-mediated immunity, who presented with severe bacteremic salmonellosis (1 patient with S. Heidelberg and 3 with S. enteritidis). 1 patient had septic shock with rhabdomyolysis, 1 patient acute renal failure and 1 patient acute endocarditis.
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PMID:[Salmonella enteritis with a serious course in patients without a suppressed immune system]. 323 99

Group B streptococcal infection may result in significant morbidity and mortality in both infants and adults. The experience with group B streptococcal disease was analyzed at one medical center over a ten-year period from 1975 to 1984. Streptococcus agalactiae bacteremia was observed in 29 adults and 26 infants, with an attack rate of 0.2 cases per 1000 adult admissions and 3.2 cases per 1000 live births, respectively. The majority of adult infections apparently occurred as a result of nosocomial acquisition and was associated with a high mortality rate of 38%. Risk factors for group B streptococcal sepsis in adults include diabetes mellitus, malignancy, and hepatic failure. The majority (73%) of neonatal cases occurred within seven days of birth and occurred in a setting of maternal fever, prolonged rupture of membranes, or prematurity. The mortality rate in infants was remarkably low at only 15%. Fatalities occurred in both adults and infants, despite appropriate antimicrobial therapy. Infection control strategies against group B streptococcus must address potential nosocomial dissemination in adults as well as vertical transmission in infants.
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PMID:Group B streptococcal sepsis in adults and infants. Contrasts and comparisons. 327 72

During the clinical trials 8,861 patients have been treated with ciprofloxacin worldwide. 3,822 of the therapeutic courses were valid for analysis of efficacy according to FDA standards. The following dosages were usually administered: UTI: 100 to 500 mg twice daily orally or 100 mg twice daily intravenously; RTI: 250 to 1000 mg twice daily orally or 200 mg twice daily intravenously; septicemia: 200 mg intravenously twice daily; gonorrhea: 250 to 500 mg single tablet orally; all other infections: 500 to 1000 mg twice daily orally or 200 mg twice daily intravenously. Ciprofloxacin was administered to 762 courses of lower RTI, 88 courses of upper RTI, 108 courses of bacteremia, 766 courses of skin structure infection, 142 courses of bone and joint infections, 149 courses of intra-abdominal infections, 33 courses of gastrointestinal infections, 1,633 courses of UTI, 49 courses of pelvic infections, 279 courses of STD, mainly gonorrhea, and three courses of meningitis. The clinical response was resolution in 76%, improvement in 18% and failure in only 6%. Bacteriologic response by all sites evaluable: pathogens were eradicated from 74%, markedly reduced in 2%, persisted in 10%. Relapse occurred in 4% and reinfection was observed in another 6%. The overall response was favourable for 90% of the patients. Drug safety was established on a data base of 8,861 courses worldwide. The following side-effects according to COSTART terminology were observed: digestive 5%, metabolic nutritional 4.6%, central nervous 1.6%, skin 1.4%, hemic and lymphatic 1%, cardiovascular 0.4%, body as a whole 0.4%, urogenital 0.3%, special senses 0.3%, musculo-skeletal 0.1%, respiratory 0.08%. Several courses had more than one reaction. Thus the total incidence of side-effects for the treated patient population was 10.2%. Ciprofloxacin is a highly effective drug and a breakthrough in several areas of medical interest. It is relatively safe and side-effects are usually mild or moderate in intensity and transient.
Infection 1988
PMID:Worldwide clinical data on efficacy and safety of ciprofloxacin. 328 11

Methicillin-resistant S. aureus has emerged as a nosocomial pathogen of major importance in pediatric patients. Infection occurs most often in hospitalized individuals with underlying predisposing medical conditions. Any body site may be involved, and bacteremia frequently occurs concomitantly. Vancomycin is the antibiotic of choice for serious MRSA infections; PRPs and cephalosporins generally are not effective. The likelihood of an adverse outcome of infection increases with the severity of an underlying condition and delay in institution of appropriate therapy. Infection control measures have met with only limited success in eradicating MRSA from the hospital environment. Methicillin-resistant S. aureus is likely to remain of considerable clinical significance to physicians caring for seriously ill children.
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PMID:Methicillin-resistant Staphylococcus aureus: pediatric perspective. 328 17

This article has overviewed complications of rhinoplasty. Generally, these complications fall into two categories: aesthetic (that is, cosmetic sequelae that may require a revision rhinoplasty) and nonaesthetic. Of the nonaesthetic complications, infection has the widest span of severity. A localized Staphylococcus aureus abscess or Pseudomonas infection of the nose may occur postoperatively. Owing to the proximity of the nose to the cranium, a cavernous sinus thrombosis or basilar meningitis may result. Postoperative toxic-shock syndrome is a rare occurrence that surgeons should be aware of; most cases have occurred with the presence of nasal packing, but a case using only plastic nasal splints has been reported also. Bacteremia seems to be uncommon during rhinoplasty. Infection after rhinoplasty is generally much less frequent than one would expect from an operation in an unsterile field. Antibiotics are frequently utilized electively. Postoperative nasal-periorbital edema and ecchymosis are regarded as unavoidable but may be lessened significantly by postoperative head elevation and cold packs. The possibility of postoperative bleeding must be evaluated by the surgeon preoperatively. This sequela usually occurs either within 72 hours postoperatively or at around 10 days postoperatively. Many different causes exist for chronic postoperative nasal obstruction, from poorly supported nasal valves closing upon inspiration to an enhanced allergic rhinitis leading to chronic nasal mucosal edema. The latter may be treated by injection of steroid into the turbinates. Among aesthetic complications, supratip prominence, saddle deformity, and persistent hump are among the more commonly reported. Supratip prominence--"polly-beak"--can be caused by inadequate reduction of tip cartilaginous or soft-tissue elements, especially in relation to the reduction of the dorsum. An over-reduced dorsum will leave an otherwise normal nasal tip with a relative prominence. An accumulation of blood or a mucous cyst occurring under the skin of the tip will produce a prominence. Poor tip projection, tip ptosis, and alar collapse are the result of overreduction of tip elements. A dislocated alar cartilage can appear as an asymmetric nasal bossa. Saddle-nose deformity occurs after overaggressive bony and/or cartilaginous hump removal. Infractured nasal bones that subsequently drop into the piriform aperture can create a bony saddle. Persistent hump is due to inadequate reduction of a bony or cartilaginous hump. If the septal cartilage reduction is disproportionate to the bony septum reduction, the appearance of either a hump or a saddle is possible.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Postoperative sequelae and complications of rhinoplasty. 332 Aug 72

In order to study the effect of modulation of the intestinal flora on granulopoiesis, conventional mice were given drinking water with or without a combination of antimicrobial drugs, i.e. neomycin, polymyxin B, amphotericin B and nalidixic acid. These antimicrobial drugs, which selectively eliminate the aerobic gram-negative rods and suppress yeasts, are currently administered to our patients to prevent infection during granulocytopenia (nalidixic acid has been replaced by pipemidinic acid). After sublethal irradiation, mice on antimicrobial drugs were granulocytopenic longer than the controls. Although these differences were rather small, i.e. two days, the impact on the course of an experimental infection at the end of the period of granulocytopenia was substantial. After injection of 1 x 10(5) live bacteria into the thigh muscle, both groups of granulocytopenic mice exhibited an initial increase in the number of bacteria in the thigh muscle. After 18 h a further increase in the number of bacteria was found for 63% of the mice receiving antimicrobial drugs, whereas the number had dropped below the baseline in 77% of the controls. These differences were reflected in the incidence of bacteremia, i.e. positive blood cultures for the bacteria injected into the thigh muscle were found for 26% of the mice on antimicrobial prophylaxis versus only 2% of the control mice. Remarkably, the number of peripheral blood granulocytes correlated with the number of CFU isolated from the thigh 18 h after injection for the animals on prophylaxis but not for the controls. This might mean that modulation of the intestinal flora affects not only the number of circulating granulocytes, but also other host defense factors.
Infection
PMID:Prolonged granulocytopenia due to selective antimicrobial modulation of the intestinal flora of irradiated mice: the impact on recovery from infection. 340 39

Forty-nine episodes of bacteremia and fungemia occurred in 38 of 336 patients with the acquired immunodeficiency syndrome seen at our institution since 1980. There were five types of infections. Infections commonly associated with a T-cell immunodeficiency disorder comprised 16 episodes and included those with Salmonella species, Listeria monocytogenes, Cryptococcus neoformans, and Histoplasma capsulatum. Infections commonly associated with a B-cell immunodeficiency disorder included those with Streptococcus pneumoniae and Haemophilus influenzae. Infections occurring with neutropenia were caused by Pseudomonas aeruginosa, Staphylococcus epidermidis, and Streptococcus faecalis. Other infections occurring in the hospital were caused by Candida albicans, Staphylococcus epidermidis, enteric gram-negative rods, Staphylococcus aureus, and mixed S. aureus and group G streptococcus. Other infections occurring out of the hospital included those with S. aureus, Clostridium perfringens, Shigella sonnei, Pseudomonas aeruginosa, and group B streptococcus. Because two thirds of the septicemias were caused by organisms other than T-cell opportunists, these pathogens should be anticipated during diagnostic evaluation and when formulating empiric therapy.
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PMID:Bacteremia and fungemia in patients with the acquired immunodeficiency syndrome. 348 96


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