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Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a period of 21 months an analysis was made of bacteremia caused by Staphylococcus aureus in a teaching hospital for adults. During the observation period staphylococcal bacteremia was detected in 77 patients, i.e. in 1.83 cases per 1,000 admissions. Not less than 81.8% of staphylococcal bacteremia cases were hospital-acquired. The age-specific attack rate increased consistently from the sixth decade onwards. The male/female ratio was 1.96: 1. If this ratio was related to the sex ratio of patients admitted to the hospital during the observation period, statistical significance was reached for the surplus of males. Staphylococcal bacteremia contributed to death in 14 of 47 patients, i.e. 18.2%. Intravascular infection was the most prevalent source of infection (25 of 77 cases, i.e. 32.5%). Serious complications were observed in 14 cases of staphylococcal bacteremia. Eight of these patients had endocarditis and four died. Tolerance was observed with nine of 77 strains and may have influenced the reaction to antimicrobial therapy in at least one case.
Infection
PMID:Staphylococcus aureus bacteremia in a Dutch teaching hospital. 407 69

The results are reported of the incidence, severity, and description of infectious complications in 646 cases of acute renal failure (ARF). Infection was felt to represent an important cause of ARF in 34% of the cases. However, the frequency and extent of the infection varied according to the biologic classification. It was present constantly in postabortion ARF, was frequent in medical and in postoperative ARF, and was rare in traumatic and postpartum ARF. The renal lesions vary according to the cause of the infections. Staphylococcus septicemia, leptospiral infections, and rickettsial infections are the causes of interstitial nephritis; whereas gram-negative septicemia, probably via infectious shock, leads more readily to tubular lesions. Hemolytic septicemias most often cause tubular necrosis, although this is usually reversible. When the initial clinical picture is complicated by disseminated intravascular coagulopathy, bilateral cortical necrosis is a distinct possibility. During the established phase of ARF, infections are equally frequent, whether primary or secondary. The most frequent complications are septicemia and bacteremia--or local complications, most often pulmonary or urinary tract infections. The organisms are mainly Staphylococcus (often mephicillin-resistant) and gram-negative, usually E. coli. The most effective treatment is a combination of cephalothin and gentamicin. Pseudomonas infections are the most difficult to treat. The frequency of these serious infections and the difficulty with antibiotic therapy, often dangerous in renal insufficiency, stress the importance of preventive treatment of prophylactic measures. Infection was primarily responsible for 19% of the deaths in our series and may be also largely responsible for some of the persistent residual renal functional impairments.
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PMID:Infection in acute renal failure. 500 58

A complex interaction of host and microbial factors is unquestionably related to the pathogenesis of gram-negative rod bacteremia in neutropenic, immunocompromised patients. In this paper we summarize evidence that colonization of the gastrointestinal tract often precedes systemic invasion by klebsiellae and Pseudomonas aeruginosa, but that the factors directly responsible for the weakening of barriers to colonization remain poorly understood. Additionally, bacteremic isolates of Escherichia coli appear to segregate into commonly occurring groups by O and K antigens. A broadened investigation of E. coli surface (fimbrial) antigens indicates several common hemagglutination patterns of bloodstream isolates with various mammalian erythrocytes, but these patterns may also be strongly associated with commonly encountered O and K types. This epidemiologic and microbiologic information may be useful both in clinical management and in following measures to prevent infection in high risk immunocompromised patients.
Infection
PMID:Gram-negative bacillary colonization and bacteremia in the compromised host. 612 96

Cefoperazone was compared with the combination of cefamandole and tobramycin in a prospective, randomized study of putative, severe, gram-negative bacillary infections. We attempted to exclude patients with granulocytopenia or infections due to Pseudomonas species. A total of 118 isolates (94 gram-negative bacilli and 24 gram-positive cocci) caused infection in 99 of the 120 patients studied. Cefoperazone (16 micrograms/ml) was active against 93% of the organisms tested; cefamandole (16 micrograms/ml) and/or tobramycin (4 micrograms/ml) was active against 95%. Infection was cured or improved in 77% of cefoperazone-treated patients and 81% of cefamandole-tobramycin-treated patients. Bacteremia was cured or improved in 61% of cefoperazone-treated patients and in 63% of cefamandole-tobramycin-treated patients. Adverse reactions included five cases of probable antibiotic-associated nephrotoxicity in the cefamandole-tobramycin group; there were no such cases in the cefoperazone group. One patient given cefoperazone plus eight other drugs became granulocytopenic, but the condition resolved when all medications were stopped. This analysis suggests that cefoperazone alone may be as effective as cefamandole plus tobramycin in the treatment of severe infections with gram-negative bacilli and is less nephrotoxic. The role of cefoperazone in patients with granulocytopenia or infections due to Pseudomonas aeruginosa was not evaluated.
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PMID:A randomized, controlled trial of cefoperazone vs. cefamandole-tobramycin in the treatment of putative, severe infections with gram-negative bacilli. 622 88

Ceftriaxone (Ro 13-9904), a newly developed cephalosporin with a long half-life, was evaluated for efficacy and safety in 19 patients with serious infections. Underlying illnesses were present in 16 patients. Ceftriaxone was given intravenously every 12 h. Infections treated included gram-negative bacillary pneumonias (two cases), staphylococcal and streptococcal soft tissue-skeletal infections (six cases), spontaneous peritonitis (two cases), and complicated urinary tract infections (nine cases). Bacteremia was present in three patients. Microbiological and clinical cures were achieved in all but one case, although three patients with urinary infection had recurrences 6 weeks posttherapy. The only failure occurred in a patient with pneumonia who had a Pseudomonas aeruginosa isolated from sputum with an initial minimal inhibitory concentration of 4 micrograms/ml, but after 9 days of therapy, a repeat isolate had a minimal inhibitory concentration of 32 micrograms/ml. The minimal inhibitory concentrations for the other isolates ranged from less than or equal to 0.6 to 8.0 micrograms/ml. The mean peak plasma level of ceftriaxone was 99.9 micrograms/ml. The only side effects noted were drug fever in one patient, phlebitis in two patients, and thrombocytosis in four patients.
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PMID:Ceftriaxone (Ro 13-9904) therapy of serious infection. 628 39

The suppression of pathogenic aerobes and the preservation of anaerobes provides a degree of infection prevention during granulocytopenia. Trimethoprim/sulfamethoxazole (TMP/SMZ) suppresses Enterobacteriaceae and probably maintains colonization resistance through sparing of anaerobes. TMP/SMZ (320/1600 mg/day) treatment was compared to placebo in a double-blind, randomized trial in patients with newly diagnosed small cell carcinoma of the lung during the initial courses of chemotherapy with cyclophosphamide, doxorubicin, and etoposide. Infections were evaluated as microbiologically documented, with or without bacteremia, and clinically documented and were correlated to granulocytopenia. Of the 61 patients evaluated, 32 were given TMP/SMZ and 29 were given placebo; both groups had similar characteristics with regard to disease extent, performance status, age, sex, chemotherapy, and days of granulocytopenia. Incidence of infection at less than 100 granulocytes/microliters was significantly reduced in the TMP/SMZ group (2 infections/100 days) compared to placebo (11 infections/100 days, p = 0.005). Also reduced were the number of bacteremias and the mean proportion of study time on broad-spectrum antibiotics (p less than 0.01). Compared to placebo, TMP/SMZ provided infection prophylaxis without an increase in marrow suppression among patients with small cell carcinoma of the lung receiving intensive chemotherapy.
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PMID:Trimethoprim/sulfamethoxazole versus placebo: a double-blind comparison of infection prophylaxis in patients with small cell carcinoma of the lung. 632 84

Infection is a frequent complication and cause of death in renal failure. Although it is widely accepted that uremia has an adverse effect on host resistance to infectious disease, this association has not been proven. In the present experiments, the relationship between uremia and susceptibility to infection has been investigated using an animal model of chronic, severe uremia. Lung infections (using Pseudomonas aeruginosa and Klebsiella pneumoniae), bacteremia, peritonitis and subcutaneous infection (using Escherichia coli) were induced in uremic and normal rats and the course of infection compared. The ability of the uremic host to clear Ps. aeruginosa from the lung was marginally impaired in the first 24 hr after the challenge but was normal in the later stages of the infection. Similarly, in the bacteremia study, secondary invasion of the lungs by several other species of bacteria occurred in 33% of the uremic animals. We found no other evidence of impairment of immunity in uremia in the infections that we studied and, taken overall, the results support arguments that uremia per se is unlikely to be an important factor predisposing patients with renal failure to infection.
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PMID:Host immune status in uremia. V. Effect of uremia on resistance to bacterial infection. 635 43

A total of 841 febrile neutropenic patients from 20 centers were randomized to receive carbenicillin (or ticarcillin) plus amikacin or these antibiotics plus cefazolin to compare outcome and incidence of nephrotoxicity. Infection with Escherichia coli, Klebsiella species, Pseudomonas aeruginosa, or Staphylococcus aureus accounted for most of the microbiologically documented febrile episodes. The response to therapy was similar in the two treatment groups for all infections and for bacteremia. Improvement occurred in 35 (64%) of 55 bacteremic patients treated with two antibiotics and 39 (65%) of 60 treated with three antibiotics. An increase in serum creatinine to 2 mg/dL over baseline occurred in eight (2.1%) of 381 patients in the former and in 50 (2.4%) of 364 patients in the latter group. Thus, the two antibiotic regimens were equal in efficacy and in nephrotoxicity. Although not the primary focus of this study, a significant decrease in incidence of infection, including bacteremias, was found in neutropenic patients treated with any oral intestine decontamination regimen.
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PMID:Combination of amikacin and carbenicillin with or without cefazolin as empirical treatment of febrile neutropenic patients. The International Antimicrobial Therapy Project Group of the European Organization for Research and Treatment of Cancer. 636 26

Pasteurella multocida, a small, gram-negative coccobacillus , is part of the normal oral flora of many animals, including the dog and cat. P. multocida is the etiologic agent in a variety of infectious disease syndromes. We have reported 34 cases of infection caused by P. multocida and have reviewed the English literature. P. multocida infections may be divided into three broad groups: 1. Infections resulting from animal bites and scratches : The most common infections caused by P. multocida are local wound infections following animal bites or scratches . Cats are the source of infection in 60 to 80% of cases and dogs in the great majority of the remainder. Local infections are characterized by the rapid appearance of erythema, warmth, tenderness, and frequently purulent drainage. The most common local complications are abscess formation and tenosynovitis. Serious local complications include septic arthritis proximal to bites or scratches , osteomyelitis resulting from direct inoculation or extension of cellulitis, and the combination of septic arthritis and osteomyelitis, most commonly involving a finger or hand after a cat bite. 2. Isolation of P. multocida from the respiratory tract: The isolation of P. multocida from the respiratory tract must be interpreted differently than its isolation from other systemic sites. Most commonly P. multocida found in the respiratory tract is a commensal organism in patients with underlying pulmonary disease, but serious respiratory tract infections including pneumonia, empyema, and lung abscesses may develop. Most patients with respiratory tract colonization or infection have a history of animal exposure. 3. Other systemic infections: P. multocida is recognized as a pathogen in a variety of systemic infections including bacteremia, meningitis, brain abscess, spontaneous bacterial peritonitis, and intra-abdominal abscess. P. multocida often acts as an opportunistic pathogen with a predilection for causing bacteremia in patients with liver dysfunction, septic arthritis in damaged joints, meningitis in the very young or elderly, and pulmonary colonization or invasion in patients with underlying respiratory tract abnormalities.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pasteurella multocida infections. Report of 34 cases and review of the literature. 637 40

Of 545 patients expected to develop prolonged neutropenia and randomized to received trimethoprim-sulfamethoxazole (TMP-SMZ) or placebo, 342 were evaluable for occurrence of infection or bacteremia. Some centers used oral nonabsorbable antibiotics in addition. Infection occurred in 64 (39%) of 165 placebo recipients and 46 (26%) of 177 TMP-SMZ recipients (P = .016), whereas bacteremia occurred in 32 (19%) and 22 (12%), respectively (P = .106, difference not significant [NS]). In the 139 patients with acute nonlymphocytic leukemia (ANLL), infection occurred in 35 (55%) of 64 placebo-treated patients and 31 (41%) of 75 TMP-SMZ-treated patients (P = .162, NS), whereas bacteremia occurred in 15 (23%) and 18 (24%; NS), respectively. Excluding patients with ANLL, infection occurred in 29 (29%) of 101 placebo-treated patients and 15 (15%) of 102 TMP-SMZ recipients (P = .038), whereas bacteremia occurred in 17 (17%) and four (4%; P = .005), respectively. Gram-positive cocci were isolated less frequently from TMP-SMZ-treated, bacteremic patients, but more of their isolates were resistant to TMP-SMZ than were those from placebo recipients.
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PMID:Trimethoprim-sulfamethoxazole in the prevention of infection in neutropenic patients. EORTC International Antimicrobial Therapy Project Group. 638 77


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