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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three clinical pictures were found in ten cases of listeriosis after renal transplantation: septicemia (six cases), meningo-encephalitis (three cases) and asymtomatic but recurrent bacteriuria (one case). Several features demonstrate profound immunologic disturbances in the recipient: close relationship in 9 cases out of 10 between infection and high doses of immunosuppressive drugs, unfavorable outcome of graft (accelerated rejection in 4 cases out of 10) and association in one case with lethal pulmonary infection due to opportunistic agents (cytomegalovirus and Pneumocystis carinii).
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PMID:[Listeriosis in the kidney transplant recipients. Ten cases (author's transl)]. 39 56

In patients who undergo abdominal aortic operations, cultures have been recommended perioperatively to identify potential sources of graft infection. Bacteriologic monitoring was done in a group of patients receiving antibiotics prophylactically. Of 197 bowel bag cultures, 28 (14.2%) demonsrated small numbers of bacteria, usually Staphylococcus epidermidis, while of 31 aneurysm wall cultures, 7 (22.6%) grew bacteria. Four (6.6%) of 60 urine cultures done preoperatively indicated a significant bacteriuria, necessitating postponement of elective operations. Twenty-eight (46%) of 61 wounds revealed organisms of low pathogenicity, none of which caused overt infection. While the majority of 63 nasal cultures grew bacteria, this result did not influence the management of any patient. Eleven graft infections occurred in 517 abdominal aortic grafts inserted between 1967 and 1977. In three patients, infection was already present at the time of emergency operation while in another three, infections occurred subsequently, due to paraprosthetic-enteric fistulas in two and septicemia secondary to an operation on the genitourinary tract in the third. In the remaining five patients, no cause for infection was identified. Thus, no bowel bag culture and only one aneurysm wall culture was useful. This study has failed to demonstrate the value of routine cultures perioperatively in patients who undergo abdominal aortic operations.
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PMID:Bacteriologic monitoring in abdominal aortic surgery. 45 68

A group B streptococcus recovered from a blood specimen from a neonate with sepsis was used to evaluate the use of mice for studies characterizing the hematogenous virulence and the asymptomatic mucosal colonization of the vagina or of the respiratory tract by these bacteria. When injected intravenously, the 50% lethal dose for mice was 10(6); however, as few as 10(2) organisms produced septic deaths. In mice undergoing water diuresis, bacteriuria and pyelonephritis were not produced after direct bladder inoculation of the streptococci. Asymptomatic vaginal colonizations that persisted for 12 days were produced in both pregnant and virgin mice. Vaginal colonization before delivery did not result in transmission of infection to litters or in protection against subsequent oropharyngeal colonization in the suckling mice. In mice born of nonexposed mothers, oropharyngeal colonization was produced in both suckling and 3-week-old weaned mice. Whereas infection persisted for 14 days in all suckling mice, clearance occurred in over 50% of the weaned mice by day 14. The use of mice for studies on the virulence of the group B streptococci as well as for studies on the pathogenesis of disease by virulent strains is discussed.
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PMID:Experimental group B streptococcal infections in mice: hematogenous virulence and mucosal colonization. 77 31

The Esch. coli harboured in the gut constitute a reservoir of potential pathogens in the infant and child. The conditions required for these intestinal inhabitants to cause infection are not well understood. The presence of virulence factors such as capsular antigens, especially K1, may be of significance for the ability of Esch. coli to cause neonatal meningitis. The capacity of certain Esch. coli to attach to epithelial cells of mucous membranes may be important for their infective powers in the urinary as well as the intestinal tract. Furthermore, the ability of certain Esch. coli to produce enterotoxins similar to that of V. cholerae is of importance for their capacity to provoke diarrhoea. The importance of the immune defence mechanisms for prevention of these Esch. coli infections is suggested, especially in the form of local immunity provided by secretory IgA antibodies. Such antibodies directed against Esch. coli O and K antigens as well as enterotoxins are present in large amounts in human milk and may be of considerable importance for protection against Esch. coli in the breast-fed baby. Breast feeding may be of special significance until the baby has built up its own local immune defence preventing the micro-organisms from attaching to and invading the intestinal mucous membranes. SIgA antibodies in urine may have a similar protective effect against urinary tract infections. The variable pictures of Esch. coli infections in childhood are striking, ranging from severe sepsis/meningitis or diarrhoea to "asymptomatic" bacteriuria. This variability is obviously closely connected with the presence of various virulence factors and the function of different components of the immune defence.
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PMID:Esch. coli infections in childhood. Significance of bacterial virulence and immune defence. 79 81

Over 22-1/2 months an epidemic of at least 127 cases of nosocomial infection developed from a strain of Proteus rettgeri resistant to all antibiotics commonly tested in hospital laboratories. Although there were at least four cases of septicemia and one related death, the majority of cases consisted of asymptomatic bacteriuria or clinically mild urinary tract infection. Indwelling urinary tract devices and antibiotic therapy were important predisposing factors. Data supported an association between increasing use of gentamicin and increasing rates of resistant infection. No common source was found, and contact spread appeared more likely. Control measures included efforts to reduce unnecessary exposure to the incriminated risk factors and to improve asepsis in the management of catheterized patients. An additional 36 cases and one related death were identified in the 7-1/2 months following the investigation and institution of control measures. Nosocomial infection with extremely resistant organisms may pose a serious hazard wherever indwelling urinary tract devices and antibiotics are used together intensively.
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PMID:Nosocomial infection with highly resistant, Proteus rettgeri. Report of an epidemic. 96 94

A series of 23 confirmed cases of pyonephrosis initially treated by percutaneous nephrostomy drainage were reviewed. Presentation was extremely variable, ranging from sepsis to asymptomatic bacteriuria. Fever, flank pain and leukocytosis were often absent. Ultrasonography was diagnostic in only 3 of 12 patients. In all, 17 patients had associated nephrolithiasis, and 5 patients ultimately required nephrectomy. Renal urine cultures were positive in 16 of 21 instances, with multiple organisms found in 8 of 21, and added bacteriological data not provided by bladder urine cultures in 11 cases. A pre-existing history of urinary tract infection, hypertension and malignancy was common. Percutaneous drainage was a safe, quick and effective diagnostic and therapeutic method.
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PMID:Pyonephrosis: diagnosis and treatment. 145 Aug 41

Group B streptococci continue to be major perinatal pathogens, both for mothers and their infants, and are associated with significant morbidity, mortality, and its attendant cost to society. Approaches to prevention are directed toward either eliminating exposure to the organism or enhancing host resistance, that is, chemoprophylaxis and immunoprophylaxis. Intrapartum chemoprophylaxis has been shown to effectively interrupt vertical transmission of group B streptococci from the genitally colonized mother to the infant and to decrease the incidence of both maternal and early-onset neonatal group B streptococcal disease. To avoid unnecessarily exposing large numbers of colonized women to antibiotics, only those with defined risk factors should be selected for intrapartum chemoprophylaxis. This regimen is ampicillin given intravenously, 2 g initially at onset of labor or rupture of membranes, followed by 1 g every 4 hours until delivery. Risk factors include premature onset of labor or rupture of membranes before 37 weeks' gestation, rupture of membranes of more than 12 hours, intrapartum fever, group B streptococcal bacteriuria, or having previously delivered an infant with group B streptococcal disease. Detection of anogenital colonization is accomplished either by culture late in the second or early in the third trimester or by intrapartum group B streptococcal antigen testing of vaginal swabs from those previously culture-negative or not cultured. Although this approach combines the advantages of several proposed strategies, it will still miss those cases of group B streptococcal disease developing in the absence of discernible risk factors. Intrapartum prophylaxis does not prevent late-onset group B streptococcal disease. Prenatal and postnatal chemoprophylaxis have not been shown to be effective. Symptomatic infants born to mothers given chemoprophylaxis should be evaluated for neonatal sepsis and treated accordingly. This approach is also suggested for asymptomatic premature infants, those whose mothers have not received adequate prophylaxis or have previously delivered infants with group B streptococcal disease, and for twin siblings of infants developing group B streptococcal disease. Successful implementation of this approach may be limited by the availability and sensitivity of the rapid antigen test used. Immunoprophylaxis, and active immunization in particular, is the most promising method of preventing perinatal group B streptococcal disease in mothers and their infants, including late-onset disease. Immunization of pregnant women with type III polysaccharide vaccine has resulted in adequate provision of functional antibody to the infants born to responders.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Prevention of group B streptococcal infection. 157 22

490 living donor nephrectomies were performed during a 25-year period, all through a retroperitoneal approach. In this report, short-term complications and donor renal function are analysed. There was no mortality. The major complication rate was 1.4%. There were 5 cases of postoperative haemorrhage requiring reoperation, one of which developed non-A-non-B hepatitis. There was one case each of septicemia and pulmonary embolism. All these patients recovered. Minor complications were noted in 13.6% of the cases, mostly bacteriuria or minor pulmonary infiltrates. There were 5 cases of reversible heart disorders and 6 cases of mental disorders. After 6-12 months, all donors had satisfactory function of the remaining kidney, which had increased its GFR by 32-38%. We conclude that the short-term consequences of donor nephrectomy are acceptable. From previous reports, from this unit and from others, it is evident that the procedure does not carry any definite long-term health risks. With a permanent shortage of cadaveric organs and with continued superiority in the outcome of living donor transplantations, this important resource should not be disregarded.
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PMID:Living donor nephrectomy. Complication rates in 490 consecutive cases. 162 4

The authors report about 12 cases of long ureteral calculi, 16 to 39 mm in size, observed over 10 years. They were all made of a mixture of ammonium-magnesium phosphate and calcium phosphocarbonate. Infection was the revealing symptom, either in the form of simple bacteriuria or as acute pyelonephritis or sepsis. These calculi, found in a lumbar or pelvic location, were very long, radiopaque but with a moderate radiological density, homogeneous and have regular contours. They were straight, sometimes slightly bent, rarely (one case out of 12) arciform. In 11 of 12 cases, the affected patient was female. In most cases, the urine was infected by Proteus mirabilis. In spite of their size, the calculi caused total obstruction in 3 of 12 cases only. They were or were not associated to ipsilateral coral calculi of the same chemical type. Destruction was easily achieved with physical agents. The etiological, radiological and therapeutic characteristics of these calculi give them a specific place among ammonium-magnesium phosphate calculi.
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PMID:[Long ureteral ammonium-magnesium phosphate (struvite) and calcium phospho-carbonate calculi]. 180 76

Infectious complications following urologic surgery include bacteriuria, bacteremia, sepsis, acute pyelonephritis, and wound infection. Antimicrobial prophylaxis reduces the risk of some of these complications and is recommended in transrectal core biopsy of the prostate, transurethral surgery, open prostatectomy, and stone surgery. Prophylaxis does not appear to be beneficial in patients undergoing transrectal needle or transperineal core biopsy of the prostate, cystoscopy, orchiectomy, hydrocelectomy, and simple nephrectomy. Patients with urinary tract infection preoperatively should receive antimicrobial treatment prior to surgery.
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PMID:[Perioperative antimicrobial preventive treatment in urology]. 181 98


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