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)

An experimental study was undertaken of isolation of Salmonella typhi from artificially infected whole blood and blood clot prepared either with small numbers of freshly isolated strains or with the S. typhi Ty2 strain. Results showed that 8 ml of whole blood required a minimum of 50 ml of bile salt broth to dilute the bactericidal effect of the serum. However, the isolation rate for recovery in 210 cases of enteric fever was only 64% when 50 ml of medium was used, as compared to 92% recovery from blood clot from the same group incubated in streptokinase bile salt broth. This probably reflects a very low grade bacteremia in many of the patients. Further investigation showed that, ideally, between 150 and 200 ml of medium is required for satisfactory whole-blood culture. Both the experimental study of artificially infected clots and recovery rates from patients indicate that rapid clot dissolution with streptokinase is preferable to whole-blood culture; this experience has been amply confirmed by almost 5,000 cases over a 20-year period. A 15-ml volume of bile salt broth with 100 U of streptokinase is adequate for the clot from 8 ml of blood, and savings on media and incubator space have considerable cost benefits in developing countries.
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PMID:Laboratory and clinical investigation of recovery of Salmonella typhi from blood. 63 43

From May 1985 through July 1990, 28 episodes of Vibrio vulnificus infection in 27 patients were encountered in five major hospitals in Taiwan. The ages of patients ranged from 19 to 76 years; the ratio of male to female patients was 2:1. Eighteen episodes manifested as bacteremia and eight as wound infections alone. One patient each developed gastroenteritis and pneumonia after nearly drowning. Twenty-three patients exhibited skin manifestations. Twenty patients had underlying diseases. All patients were treated with antibiotics, and 14 also underwent some form of surgical treatment (incision and drainage, fasciotomy, debridement, or amputation). Thirteen of the 28 episodes were preceded by precipitating factors; most were due to ingestion of seafood or exposure of abraded skin to salt water. Ten of the 18 septicemic patients died--most within 48 hours of hospitalization. One patient without bacteremia who had a wound infection died. Results of in vitro susceptibility studies suggested that ampicillin or a third-generation cephalosporin would be effective. Susceptibility to aminoglycosides was observed for greater than 90% of isolates. We recommend combined therapy with a third-generation cephalosporin or ampicillin and an aminoglycoside along with appropriate surgical therapy for the treatment of V. vulnificus infection.
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PMID:Vibrio vulnificus infection in Taiwan: report of 28 cases and review of clinical manifestations and treatment. 145 57

Recruitment of inflammatory cells to the lung capillaries has been proposed as an important step in the sequence of events that lead to acute lung injury. Frequently, in the clinical setting, bacteremia and sepsis syndrome precede the acute lung failure and endotoxin priming may represent a comparable paradigm, useful for experimental pursuit. Following addition of the chemotactic tripeptide FMLP (10(-9) to 10(-6) M) to the cell-free, salt solution perfusate of isolated rat lungs, only a small degree of vasoconstriction was observed. However, in lungs isolated from rats that received 2 mg/kg intraperitoneal Salmonella enteritidis endotoxin 2 h before lung perfusion, FMLP dose dependently caused a large, transient pulmonary pressor response, edema formation, and release of large amounts of thromboxane and leukotriene B4. Since in vitro priming with endotoxin, direct vascular injury by neutrophil elastase, nor direct stimulation with FMLP of pulmonary artery rings from endotoxin-pretreated rats, mimicked the effects of in vivo endotoxin priming, we conclude that the presence of inflammatory cells in the lung capillaries accounted for the large amount of eicosanoids produced by the lungs after FMLP stimulation. In fact, by retrograde lavage of the lung circulation with a collagenase solution, previously adherent cell clumps were mobilized and identified. These cell clumps, composed of red blood cells, neutrophils, and platelets, were not seen in the vascular lavage sediment obtained from unprimed control lungs. Indomethacin, a thromboxane antagonist, AA861, a 5-lipoxygenase inhibitor, and WEB 2086, a platelet-activating factor (PAF) antagonist, reduced the thromboxane synthesis and release after FMLP (10(-7) M) in in vivo endotoxin-primed lungs. None of the inhibitors employed exclusively inhibited only one particular eicosanoid mediator but rather affected the release of several mediators, suggesting a close link between the different synthetic arachidonic acid pathways. An inhibitor of phospholipase C (2-nitro-4-carboxyphenyl-N,N-diphenylcarbamate), NCDC, but not an inhibitor of phospholipase D (Wortmannin) or of protein kinase C (staurosporine) inhibited the FMLP-stimulated pulmonary pressure rise and eicosanoid release in endotoxin-primed lungs in vivo. Our data suggest that eicosanoids (in particular thromboxane) released from cells trapped in the lung circulation, but not from constitutive lung cells, contribute to vasoconstriction and edema formation caused by the chemoattractant FMLP in endotoxin-primed lungs.
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PMID:FMLP causes eicosanoid-dependent vasoconstriction and edema in lungs from endotoxin-primed rats. 154 53

Polymyxin B (PMB), an antibiotic, and sodium deoxycholate (NaD), a bile salt, are surface-active agents. Each protected mice against an otherwise lethal challenge with purified endotoxin (P less than .001). To determine if either of these agents was effective in treating established, overwhelming gram-negative septicemia, we infected rabbits by intraperitoneal injection of Escherichia coli K1. Animals were treated with moxalactam 1 hr after infection, then randomly assigned to groups receiving either saline, PMB, or NaD. Serial samples of blood were assayed for bacterial concentration, levels of plasma endotoxin, arterial blood gases, and complete blood cell counts. Physiologic functions were monitored continuously. Although levels of bacteremia and endotoxemia were similar in all three groups, rabbits receiving PMB had significantly higher mean arterial blood pressure, blood pH, and bicarbonate concentrations than did control rabbits (P less than .05). Rabbits receiving NaD fared no better than controls. In this model, PMB moderates some of the deleterious effects of established, overwhelming gram-negative bacterial sepsis.
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PMID:Polymyxin B moderates acidosis and hypotension in established, experimental gram-negative septicemia. 282 Nov 23

Bacteremia caused by Aeromonas species occurred in 24 hospitalized patients in a cancer institute during a 13-year period. All but one of these patients had a malignancy (88% had leukemia), and most were receiving chemotherapy for cancer. There was a striking numerical predominance of male patients (82%). Unlike some previously described patients with infections due to this organism, none of these 24 patients had recently been exposed to fresh or salt water or to fish. The source of the infecting organism was thought to be endogenous--i.e., from patients' own gastrointestinal tracts. The clinical presentation of sepsis caused by this organism was nonspecific, except that ecthyma gangrenosum occurred in several patients. The overall mortality rate was 28%. The combination of an aminoglycoside and a cephalosporin is appropriate therapy for bacteremia caused by Aeromonas species.
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PMID:Bacteremia caused by Aeromonas species in hospitalized cancer patients. 402 26

We studied the diphosphanilate salt of chlorhexidine (WP-973), as a 2% cream, for therapeutic activity in two rat models of fatal burn wound infection. Control treatments were infection and placebo cream; infection only; infection and 1% sulfadiazine silver; and burning only. Activity against Pseudomonas aeruginosa or Proteus mirabilis was tested in surface-inoculated rats with 20% scalds. Treatments were initiated 24 hours or four hours, respectively, after inoculation. Pseudomonas-infected rats were treated once a day for ten days. Proteus-infected rats were treated once a day for five days. In these experimental models, chlorhexidine diphosphanilate was equal to silver sulfadiazine, an established topical chemotherapeutic agent. In vitro activity was examined using bacteremia isolates from 65 burned patients. Using agar diffusion trench plates, chlorhexidine diphosphanilate was active against all strains. No evidence of cross-resistance between sulfonamide and chlorhexidine diphosphanilate or its components was observed.
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PMID:Topical chlorhexidine diphosphanilate (WP-973) in burn wound sepsis. 642 Dec 65

To test the feasibility of a regimen of high-dose cisplatin, ifosfamide, and etoposide (VP-16; VIPP regimen), we registered 15 patients with advanced non-small-cell lung cancer in a phase I trial of the Northern California Oncology Group. One cycle of treatment consisted of high-dose cisplatin given at 100 mg/m2 i.v. on days 1 and 8, VP-16 given at 60-75 mg/m2 i.v. on days 1-3, plus ifosfamide given at 1.0-1.2 g/m2 i.v. on days 1-3; cycles were repeated every 28 days. There were 13 men and 2 women; the median age was 59 years (range, 47-72 years). The median Karnofsky performance status (KPS) was 90 (range, 70-100). All patients were assessable for toxicity and response. The median number of cycles delivered per patient was two (range, one to four). Hematologic toxicity was dose-limiting and required de-escalation of the ifosfamide and VP-16 doses. Ten patients developed a white blood count of < 1000/mm3 and seven patients developed a platelet count of < 50,000/mm3. The duration of cytopenia increased progressively with each subsequent cycle of therapy. Two patients required antibiotics for neutropenic fever with documented infections (pneumonia, bacteremia). Seven patients received red blood cell transfusions for a hemoglobin level of < 8 gm/dl. Grade III or IV non-hematologic toxicities were uncommon and involved one patient each with grade 3 ototoxicity and grade 3 neurotoxicity. Five patients developed laboratory evidence of renal salt wasting. The overall response rate was 33% (5/15) with a complete response being achieved by two patients (13%) and a partial response being attained by three (20%). The overall median survival was 44 weeks. We conclude that although this regimen demonstrated activity, hematologic toxicity limited its use in the palliative treatment of non-small-cell lung cancer. Using hemopoietic growth-factor support to permit dose escalation, this schedule of VIPP may be of interest in a number of different chemotherapy-sensitive tumor types.
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PMID:Phase I study of high-dose cisplatin, ifosfamide, and etoposide. 803

We report an unusual case of disseminated dermatitis, osteomyelitis, and bacteremia in an immunocompromised host. An infant presented with a pustular skin rash resembling chicken pox, but culture of a skin lesion yielded Mycobacterium marinum. Upon further evaluation, severe combined immunodeficiency was diagnosed. Radiographs of the hands and feet showed evidence of osteomyelitis. M. marinum was isolated from blood and synovial fluid. We recommend a high level of suspicion for this organism in immunocompromised hosts who have been exposed to fresh water or salt water, particularly those of aquaria. Drug susceptibility testing of serial clinical isolates from our patient revealed development of high-level resistance to isoniazid and rifampin during therapy. We believe that treatment of disseminated M. marinum infections should include combinations of antimycobacterial agents chosen on the basis of results of susceptibility testing done by an experienced laboratory, thereby limiting the emergence of drug resistance.
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PMID:Disseminated Mycobacterium marinum infection and bacteremia in a child with severe combined immunodeficiency. 858 69

Controversy persists over the role that the capsular polysaccharide plays in the pathogenesis of Staphylococcus aureus infections. To address this issue, we compared the mouse virulence of S. aureus Reynolds and capsule-defective mutant strains cultivated under conditions of high or low capsule expression. Strain Reynolds cells cultivated on Columbia salt agar plates expressed approximately 100-fold more type 5 capsular polysaccharide than did cells cultivated in Columbia salt broth. The relative virulence of strain Reynolds and its capsule-defective mutants after growth on either solid or liquid medium was examined in mice challenged intraperitoneally or intravenously. The results indicated that agar-grown Reynolds cells were cleared from the bloodstream of mice less readily than broth-grown Reynolds cells. When the parental and mutant strains were cultivated on solid medium, strain Reynolds sustained a higher level of bacteremia than did the capsular mutants. We performed in vitro opsonophagocytic killing assays to determine whether staphylococcal virulence for mice correlated with resistance to phagocytosis. S. aureus Reynolds cultivated on solid medium was susceptible to phagocytic killing only in the presence of specific capsular antibodies and complement. Strain Reynolds grown in broth showed opsonic requirements for phagocytic killing that were similar to those of the capsular mutants (grown in broth or on agar); i.e., the bacteria were opsonized for phagocytosis by nonimmune serum with complement activity. These studies indicate that optimal expression of capsule enhances bacterial virulence in the mouse model of bacteremia, probably by rendering the organisms resistant to opsonophagocytic killing by leukocytes.
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PMID:Staphylococcus aureus serotype 5 capsular polysaccharide is antiphagocytic and enhances bacterial virulence in a murine bacteremia model. 978 20

Vibrio vulnificus is responsible for severe infections in chronically ill patients. Organ transplant recipients are also at risk for severe infections due to V vulnificus. We report here the first case of V. vulnificus primary bacteremia due to raw shellfish consumption in a liver transplant recipient. All transplant patients should be cautioned against consuming uncooked seafood and warned about the risk of severe Vibrio infections from seemingly innocuous wounds acquired in a salt water environment.
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PMID:Primary Vibrio vulnificus bacteremia in a liver transplant recipient after ingestion of raw oysters: caveat emptor. 1053 53


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