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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aetiology, pathogenesis, diagnosis and therapy of sepsis are dealt with in this paper. These problems are discussed on the basis of 151 patients treated for sepsis. The cases with monoinfection are 73.6% and those with polyinfection are 24.4%. Monoinfection is caused mainly by Staphylococci -65,3%, followed by E. coli - 15.2%, Proteus - 13% and Klebsiella - 3.3%. For the cases of polyinfection the gram-negative bacteria are 3:1 in respect to the gram-positive bacteria. The bacteriological finding from the haemoculture (92.8% mono- and 7.2% polyinfection) is not equal to this from the input source. Here also the cases of monoinfection are mainly caused by Staphylococci - 70.9%, followed by Proteus - 7.7%, E. coli - 6%, Klebsiella aerogenes - 5.1% and Streptococcus 2.6%. The gram-negative bacteria prevail in the cases of polyinfection. The virulent aggressive infection, bacteria resistant to antibiotics, the aggressive local infection, hypoproteinemia, anaemia, diabetes, a prolonged corticosteroid treatment and unsuitable antibiotic treatment are discussed as main factors predisposing to sepsis. All the 151 patients were treated with the complex therapy, recommended in this paper. It includes a surgical cleaning-up of the initial nidus, intensive reasonable antibiotic treatment against the gram-positive and gram-negative aerobes and anaerobes. Additionally, substitution of infusion therapy, parenteral nutrition, regulation of the pathophysiological deviations and stimulating therapy are carried out. 74.2% from the patients were cured, 25.8% died. 16.6% of the patients who died had sepsis caused by gram-positive bacteria, and 46.1% had sepsis caused by gram-negative bacteria. 17% of the patients who died had septicaemia and 22% had septicopyaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical problems of surgical infection. The Pirogov Institute for Emergency Medicine, Sofia]. 615 Jun 8

Persistent diabetes was induced in male Slc:ddY mice by a single intraperitoneal injection of 200 mg/kg streptozotocin (STZ). In these mice, the numbers of aerobic gram-negative bacilli, staphylococci (including micrococci), and streptococci increased, while those of other bacteria were almost unchanged in both oral and caecal floras. The mice were vulnerable to oral infection of Salmonella enteritidis, intranasal infection of Klebsiella pneumoniae and Serratia marcescens, and contact infection with mice infected with S. enteritidis and K. pneumoniae. These findings suggest that STZ-treated mice might be a useful model for investigating opportunistic infection.
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PMID:Indigenous microfloras and resistance to bacterial infection in mice with experimentally induced diabetes: a possible animal model for opportunistic infection. 623 77

Slc:ddY mice that received a single intraperitoneal injection of 200 mg/kg streptozotocin (STZ) were examined for persistency of diabetes (changes of indigenous bacterial floras, and bacterial translocation. Significant diabetes (increase in plasma glucose and decrease in insulin) was recognized 2 weeks after the injection, and persisted for 12 weeks. The numbers of aerobic gram-negative bacilli, staphylococci (including micrococci), and streptococci in caecal and oral floras were significantly increased, but the numbers of anaerobic bacteria in caecal flora were hardly changed. Bacterial translocation of indigenous bacteria to the mesenteric lymph node, lung, or kidney was detectable in some mice 2 weeks after the injection. The incidence of bacterial translocation in these STZ-treated mice then increased; infection caused by several organisms, e.g., Klebsiella pneumoniae, Staphylococcus epidermidis, streptococci, or Lactobacillus sp., occurred in lung, liver, spleen, kidneys, and mesenteric lymph node. No indigenous bacteria were cultured from these organs of control mice. This endogenous infection may have been due to the over population of several bacterial strains caused by disruption of indigenous floras along with depression of immunological function.
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PMID:Endogenous infection in mice with streptozotocin-induced diabetes. A feature of bacterial translocation. 624 Mar 12

The in vitro effect of pH and glucose concentration on the antibacterial activity of norfloxacin in urine was studied. Norfloxacin effectively inhibited the growth of four gram-negative pathogens in urine in vitro at pH values of 6.0, 7.0, and 8.0. The antibacterial activity of norfloxacin in urine was reduced severalfold at pH 6, but minimum inhibitory concentrations (MICs) at this pH remained clinically significant. Glucose at concentrations of 200 mg/dl and 400 mg/dl (simulating glucosuria of diabetes) did not significantly affect the antibacterial activity of norfloxacin when tested against clinical isolates of Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, or Pseudomonas aeruginosa. Norfloxacin appears to be a highly effective antibiotic in vitro under conditions which simulate normal and diabetic states.
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PMID:In vitro effect of pH and glucose concentration on the antibacterial activity of norfloxacin in urine. 624 49

The number of patients admitted to hospital who harbour Pseudomonas aeruginosa, Proteus and Klebsiella, keeps rising. Of the factors predisposing to colonization, only diabetes and antibiotic therapy exert their effect equally in extrahospital and intrahospital environment. Malignant diseases, immune suppressive therapy and instrumental interventions play a predominant role in the hospital. In extrahospital environment, infancy and old age, poor general condition as well as in almost half of the cases, an inflammatory process caused by viruses or bacteria was found to create favourable conditions for the colonization of facultative pathogens. One of the main sources of the Gram-negative facultative pathogens studied was the faeces of enteric patients in the hospital. The frequency of P. aeruginosa, Klebsiella and Proteus positive cultures rose parallel in the faecal and non-faecal bacteriological samples in the period 1958 to 1977. The seasonal changes observed in the frequency of positive cultures revealed that the Gram-negative facultative pathogens had increased in number first in the enteral wards, spreading subsequently to the medical and paediatric wards, and finally they appeared in a high number in the surgical wards, originating from patients transferred there from the medical or paediatric wards.
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PMID:Extrahospital and intrahospital factors predisposing to the spread and colonization in patients of Pseudomonas aeruginosa, Proteus and Klebsiella in an infectious hospital. 679 65

The new semi-synthetic oral cephalosporin, CGP 9,000, has been evaluated in a large number of hospitalized patients with urinary infections. A total of 57 of these patients suffering from concomitant diabetes was matched with an equal number of non-diabetic patients. Patients were treated for 10 days with either 500 mg or 1.0 g CGP, or 1.0 g cephalexin. The predominant pathogens isolated were E. coli, Strep. faecalis, Proteus mirabilis and Klebsiella spp. Comparison of the results showed that the eradication rate was similar in diabetic and non-diabetic patients and there were no significant differences between the three treatment groups. There was a similar improvement in pyuria, and therapeutic response was equally as good in diabetic patients on 500 mg CGP 9,000 per day as in non-diabetic patients and in the other treatment groups. No unwanted effects on renal function were observed in the high-risk diabetic group.
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PMID:Efficacy and tolerability of CGP 9,000 ("Oraspor') in diabetic patients treated for urinary tract infections: a case control study. 726 75

The incidence and clinical course of urinary tract infections in postmenopausal diabetic patients in comparison to non-diabetic women have been evaluated. All cases with former history of urinary instrumentation or underlying conditions favoring urinary infections were rejected. Urinary tract infection was present in 14.9 percent of postmenopausal diabetics versus 10.5 percent in the non-diabetics. The incidence of urinary tract infection in premenopausal women was 12.5 percent. Urinary pathogenes showed similar incidence rate in both groups: E. coli (41 versus 57 percent), P. mirabilis (20 versus 28 percent) and Klebsiella (11 versus 20 percent). Diabetic women showed a higher rate of sepsis and infection recurrence than non-diabetic (10.7 and 17.8 percent versus 2.6 and 2.6 percent, respectively). Severe impairment of renal function (plasma creatinine clearance > 2 mg/100 ml) was registered in 12.5 percent of postmenopausal patients with diabetes mellitus, but none of the non-diabetics suffered renal damage (p < 0.01).
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PMID:[Urinary tract infection in postmenopausal diabetic women. Clinical survey of hospital and nonhospital populations (author's transl)]. 742 60

A 63-year-old male was admitted to our hospital because of high fever and delirium. He had been diagnosed as diabetes mellitus five years before but not treated at all. An abdominal CT scan showed gas-containing abscess in the right lobe of the liver. Klebsiella pneumoniae and Bacteroides distasonis were cultured both from the punctured specimen of the abscess and from arterial blood. Catheter drainage was carried out percutaneously under guidance with ultrasonography and antibiotics was administered intravenously. He was diagnosed as purulent meningitis by lumbar puncture on admission and as endophthalmitis because of swelling of the left eyeball on hospital day 4. CT scan also showed multiple metastatic lesions in the cerebrum and in the lung. After three months, he was discharged from the hospital in good condition, except for loss of vision of the left eye.
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PMID:[A case of gas-containing liver abscess with multiple metastatic lesions]. 759 94

A retrospective study on patients with pyogenic liver abscesses was conducted to clarify the different clinical presentations among patients with Klebsiella pneumoniae abscesses and those with non-K. pneumoniae abscesses. From 1981 to 1993, the medical records of 146 adults with culture-confirmed pyogenic liver abscesses who attended Tri-Service General Hospital in Taipei were studied. Abscesses due to K. pneumoniae accounted for 114 (78%) of pyogenic liver abscesses. When compared to patients with non-K. pneumoniae abscesses, patients with K. pneumoniae liver abscesses had significantly higher proportions of monomicrobial infections, unknown sources of infection and solitary abscesses. Patients with K. pneumoniae liver abscesses were found to have diabetes mellitus more often than patients with non-K. pneumoniae liver abscesses (66% vs 19%). Septicemia was found more frequently in patients with K. pneumoniae liver abscesses than in patients with non-K. pneumoniae liver abscesses (50% vs 27%). The clinical presentations among the two groups were, otherwise, not significantly different. Regardless of the microbial etiology, patients with diabetes mellitus had longer periods of fever after treatment and hospitalization than patients without diabetes. The reason for the high relative frequency of liver abscesses in Taiwan and its more frequent occurrence in diabetes mellitus remains unclear.
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PMID:Comparison of pyogenic liver abscesses caused by Klebsiella pneumoniae and non-K. pneumoniae pathogens. 761 55

I present the only comprehensive review of hepatic abscess from Klebsiella pneumoniae. The world literature contains 46 individually reported cases and 3 large studies of K pneumoniae liver abscess. The source of the abscesses frequently was not found. Diabetes mellitus was a frequent underlying condition and may predispose patients to the development of liver abscess with this organism. The exact mechanism is unclear, and further investigation is necessary. In addition, extrahepatic metastases, such as septic endophthalmitis, often occurred with serious complications, particularly in patients with diabetes. The association between K pneumoniae liver abscess and diabetes is so close that a search for underlying diabetes mellitus is warranted in all patients with K pneumoniae liver abscess. Fortunately, earlier diagnoses and better treatment modalities have improved the outcome for these patients.
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PMID:Review of hepatic abscess from Klebsiella pneumoniae. An association with diabetes mellitus and septic endophthalmitis. 772 4


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