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

There has been a gradual accumulation of reported Campylobacter fetus human infections since the first description in 1947. The taxonomy of these fastidious and morphologically confusing organisms has been recently revised and, in the past few years, through the use of selective culture medium for stool isolation C fetus has been implicated as a frequent paghogen in children. There are three relatively distinct patterns of human C fetus infection. The first, most frequent, pattern of disease is enteritis which is usually uncomplicated and due to C fetus subsp jejuni. A second form of disease consists of focal infections, often associated with vasculitis and/or chronic bacteremia. These infections, due to C fetus subsp intestinalis, are seen most often in older, debilitated, or chronically ill men. The third pattern, perinatal infections causing abortion, prematurity, and neonatal meningitis, is the least frequent, but these infections are usually fetal to the fetus or infant and are also due to C fetus subsp intestinalis.
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PMID:Campylobacter fetus infections in children. 39 Apr 87

Nine infants with early-onset Haemophilus sepsis were seen between January 1973 and July 1977. Of the five isolated strains that were typed, only one was type B. All infants had respiratory distress, metabolic acidosis, and large alveolar-arterial oxygen tension difference gradients. Eight infants weighed less than 1,500 gm and died; one infant weighed 1,701 gm and survived. Roentgenograms in six of eight showed hyaline membrane disease. Pulmonary pathologic specimens in eight infants revealed hyaline membranes in six and polymorphonuclear leukocytes in the alveolar spaces in four. In two infants, small Gram-negative bacilli were noted within proteinaceous exudates in alveolar ducts. The route and time of infection in these infants with early-onset Haemophilus sepsis are unclear. However, the possibility that the infection occurs before birth and that these infants represent septically aborted prematures is suggested by the high incidence of prematurity in infants with early-onset Haemophilus sepsis and early detection of bacteremia in three infants.
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PMID:Early-onset Haemophilus sepsis in newborn infants: clinical, roentgenographic, and pathologic features. 70 99

Awareness of the role of anaerobic bacteria in neonatal bacteremia has increased in recent years. The incidence of recovery of anaerobes in neonatal bacteremia varies, according to different studies, between 1.8% and 12.5%. Of the 178 cases reported in the literature, 73 were due to Bacteroides species (69 were the Bacteroides fragilis group), 57 Clostridium species (mostly Clostridium perfringens), 35 Peptostreptococci, 5 Propionibacterium acnes, 3 Veillonella species, 3 Fusobacterium species, and 2 Eubacterium species. Predisposing factors were perinatal maternal complications (especially premature rupture of membranes and chorioamnionitis), prematurity, and necrotizing enterocolitis. Organisms similar to those recovered in blood were concomitantly isolated in lung aspirates and cerebrospinal and peritoneal fluids. The overall mortality noted is 26% and is highest with B fragilis group (34%). Inappropriate antimicrobial therapy was often a contributory factor for such mortality. Correction of underlying pathology, surgical drainage, and the use of proper antimicrobials are critical to successful resolution of the infection. Penicillin G is the drug of choice for anaerobic infection other than beta-lactamase-producing Bacteroides. Antimicrobials useful for therapy of beta-lactamase-producing Bacteroides include clindamycin, metronidazole, chloramphenicol, imipenem-cilastatin, and the combination of a penicillin plus a beta-lactamase inhibitor.
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PMID:Bacteremia due to anaerobic bacteria in newborns. 227 80

Data on 109,312 singleton births at U.S. Army hospitals over 3 years were examined to determine differences in perinatal risk factors between infants with a diagnosis of sepsis confirmed by blood culture and those whose cultures remained negative. The incidence of confirmed sepsis (1.1/1000 live births) and the importance of perinatal complications and prematurity were consistent with other reported findings. No reliable indicators of bacteremia that could be used in conjunction with other clinical data were found. These findings support continued empiric therapy in infants at risk until infection can be verified by culture.
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PMID:A survey of infants with neonatal sepsis in U.S. Army hospitals. 251 12

With improved neonatal survival, especially of very low birth weight infants, our efforts should be directed toward reduction of morbidity. Sick preterm infants require total parenteral nutrition for prolonged periods of time due to extreme prematurity and feeding intolerance. However, the use of surgically placed Broviac catheters has been associated with a high complication rate. A prospective study of 53 percutaneous central venous Silastic catheterizations for administration of total parenteral nutrition was performed in 45 newborn infants. At the time of catheter insertion, 37 babies weighted less than 1,500 g and 19 weighed less than 1,000 g. Percutaneous central venous catheters were placed successfully the first time in 50 of 55 attempts. In three babies, insertion was successful on second attempt. The catheters remained in place for 25.4 +/- 16.7 days ([mean +/- SD] range two to 80 days). In babies weighing less than 1,000 g, the catheters remained in place for a longer period of time (34.0 +/- 18.0; range 12 to 80 days). Sixty-six percent of the catheters were removed electively. There were four cases of bacteremia (7.5%), and the overall incidence of mechanical complications was 26.4%. We conclude that percutaneous central venous catheters can be used safely and effectively in newborn infants for prolonged administration of total parenteral nutrition, especially in neonates weighing less than 1,000 g.
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PMID:Prospective evaluation of percutaneous central venous silastic catheters in newborn infants with birth weights of 510 to 3,920 grams. 309 May 11

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

We studied the clinical and pathologic features of bacterial esophagitis in three index cases identified by endoscopic biopsy and in 20 autopsy cases. Fourteen of the 23 patients had malignant hematologic conditions, aplastic anemia, or solid tumors; ten were profoundly neutropenic (white blood cell count, less than 100/mm3 [less than 0.1 X 10(9)/L]). The organisms involved in bacterial esophagitis were gram-positive cocci in 14, gram-negative bacilli in three, mixed gram-negative bacilli and gram-positive cocci in five, and gram-positive bacilli in one. Four patients had bacteremic bacterial esophagitis; all were immunocompromised, three by profound neutropenia and one by gestational prematurity. Bacteria causing bacteremic bacterial esophagitis were all gram-positive: viridans-group streptococci. Staphylococcus aureus, Staphylococcus epidermis, and Bacillus species. Our study suggests that bacterial esophagitis is more common than has been recognized in the past and should be considered as a potential source of bacteremia in immunocompromised patients.
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PMID:Bacterial esophagitis in immunocompromised patients. 371 32

In an effort to ascertain important epidemiologic and prognostic risk factors, we analyzed 33 cases of Staphylococcus aureus meningitis occurring over an 8-year period (1976 to 1984). Staphylococcus aureus caused 6% of all bacterial meningitis at our University Hospital. Fifty percent of cases were pediatric and included 7 newborn infants, of whom 71% were either premature or had low birth weight. Major underlying diseases were: central nervous system (CNS) disorders (55%), endocarditis (21%, predominantly intravenous drug abusers), other sites of infection (27%), and prematurity (24%). Fifty-seven percent of patients were bacteremic and 41% of those had concomitant bacteriuria. Hypoglycorrhachia was present in 27% of cases, positive cerebrospinal fluid (CSF) Gram stain in 20%, disseminated intravascular coagulation (DIC) in 19%, and methicillin-resistant organisms in 18%. Cerebrospinal fluid cultures remained positive for a protracted period (mean, 6.7 days) regardless of the presence or absence of a CNS shunt. Overall mortality was 21%. Favorable outcomes were associated with the eventual presence of sterile CSF (15.4% vs. 100% mortality) and the removal of foreign bodies (10% vs. 67% mortality). Mortality was also associated (p less than 0.5) with the presence of diabetes mellitus, age greater than 60, obtundation or coma on presentation, bacteremia, or DIC. Cure correlated (p less than .05) with CNS shunt-associated infections, age less than 1, normal neurologic examinations on presentation, or the absence of DIC or bacteremia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Staphylococcus aureus meningitis: a broad-based epidemiologic study. 382 85

Early onset group B streptococcal disease was reviewed for the seven year period between 1975 to 1981 at Vanderbilt University Medical Center. One hundred and twenty cases were identified. The disease varied from asymptomatic bacteremia to fatal cardiopulmonary collapse. Factors associated with a poor outcome were prematurity, low Apgar score at 5 min, the presence of shock, leukopenia, rupture of membranes for more than 12 hours, and a delay in treatment after the onset of symptoms. A scoring system for probability of death based on these 6 factors was then developed. Over the seven year period mortality decreased from 50% to 10%. The only factor identified with the decrease in mortality was a significant decrease in the number of hours between the onset of symptoms and the beginning of treatment. Early recognition and prompt treatment seem to be the major causes of the decreasing mortality over the seven years of this report.
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PMID:Early onset group B streptococcal disease. Seven year experience and clinical scoring system. 635 49

During the 4-year period 1978-81, 14,527 neonates were born at Assaf Harofeh Hospital, including 793 (5.5%) premature infants. During the same period, 41 bacteremias were recorded, making an overall incidence rate of 2.8/1,000 live births. Thirty of the 41 bloodstream infections occurred in premature infants (incidence rate 38/1,000) and 11 in full-term infants (incidence rate 0.8/1,000). The overall case fatality rate was 19.5%, and in the premature group it was 26.7%. Aside from prematurity, the most common underlying conditions were respiratory distress syndrome and prolonged rupture of membranes. Premature infants were at much greater risk of becoming bacteremic (relative risk 47) than were full-term infants. The risk increased with a decrease in the weight of the infants. Of 43 pathogens, 31 were gram-negative (72.3%), and 11 were gram-positive (25.4%). The most common of the gram-negative pathogens belonged to the Klebsiella-Enterobacter group--19 of 43 (44.2%). Among the gram-positive pathogens, Enterococcus was most common--4 of 43 (9.3%). No increased incidence of Group B Streptococcus infections was noted. The Klebsiella-Enterobacter group had by far the highest incidence in our hospital, and the bacteremia caused by these pathogens was nosocomial in nature in all but one case.
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PMID:Neonatal bacteremia. A 4-year prospective study. 666 86


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