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

We investigated 117 patients undergoing percutaneous nephrolithotomy, percutaneous nephrostomy, ureterorenoscopy, the push-back or push-bang procedure for ureteral stones, Double-J* ureteral stenting plus extracorporeal shock wave lithotripsy (ESWL), ESWL alone or cystoscopy. Blood samples obtained before, during and 1 hour after the procedure were cultured and assayed for endotoxin and tumor necrosis factor. Also, culture was done of the urine preoperatively and postoperatively, and the stones when they could be retrieved. There was a temporal relationship among bacteremia, endotoxemia and elevation of tumor necrosis factor. An unexpected finding was peroperative endotoxemia in a significant number of patients with stones. Risk factors noted for postoperative bacteremia, endotoxemia and/or elevation of tumor necrosis factor included preoperative endotoxin level, type of procedure, presence of preoperative bacteriuria and pyuria. With respect to the procedure the risk was greatest after the push-back method and least after cystoscopy (push-back method greater than percutaneous nephrolithotomy/percutaneous nephrostomy greater than Double-J stenting plus ESWL greater than ureterorenoscopy greater than ESWL greater than cystoscopy). If the risk factors are measured preoperatively it may be possible to identify the risk of postoperative bacteremia/endotoxemia and, therefore, septic shock postoperatively. Our patients appear to be a good clinical model to investigate the problems related to septicemia.
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PMID:Prediction of septicemia following endourological manipulation for stones in the upper urinary tract. 189 50

The frequency of asymptomatic bacteriuria increases with age, both in men and women. Most cases are benign, and antibiotics do not appear necessary. Symptomatic infections, however, obviously require treatment. Functional obstructions, such as benign prostatic hyperplasia or urethral stricture, should be ruled out. If present, surgery is recommended. In the absence of an obstruction, antibiotic treatment is indicated. The risk of septicemia from urinary tract infection is also high in the elderly. Preventive therapy will reduce the need for surgical treatment, which can be hazardous in elderly patients.
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PMID:Management of urinary tract infection in elderly men. 202 29

The first 400 patients treated on an inpatient basis at our center underwent bacteriological follow-up after extracorporeal lithotripsy (ECL) for ureteric or renal stones. 278 patients did not have any urinary tract infection on the urine culture before ECL. They did not receive any antibiotic prophylaxis and 4.8% of the patients developed infectious problems, with significant bacteriuria in only 1.5% of the cases. 89 patients had urinary tract infection on the preoperative cultures. 21.3% developed either fever or significant bacteriuria and this virtually always occurred in patients who were treated for less than 4 days before ECL, with septicemia in 4.5% of the cases. 33 patients with sterile urine received flush antibiotic prophylaxis and none of them developed postoperative infection. Two of these patients had infection at the time of the flush: one of them, who, by error, did not receive antibiotic treatment prior to ECL, developed bacteremia after the procedure. The rational use of antibiotics in conjunction with ECL should ensure effective prevention of urinary tract infections without requiring the excessive use of antibiotics.
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PMID:Use of antibiotics in the conjunction with extracorporeal lithotripsy. 217 40

Powdered milk for infants can contain very low numbers of Enterobacter sakazakii. Larger amounts of this organism can result in non-infective colonization. In infants, particularly the premature newborn, such colonization has been associated with abdominal distention and bloody diarrhoea or bacteriuria, but cases of sepsis and meningitis have also been reported. Infection has been associated with the use of contaminated spoons or blenders as well as the habit of keeping the ready-made milk hot in bottle-heaters. The risk of contamination of the milk can be eliminated by boiling bottles, teats and spoons as well as disinfecting the blender before use. The possibility of bacterial replication can be significantly reduced by keeping the ready-made milk in a refrigerator and warming it up immediately before use eg by using a microwave oven.
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PMID:[Neonatal meningitis caused by Enterobacter sakazakii: milk powder is not sterile and bacteria like milk too!]. 224 76

Three hundred and forty-three patients with suspected bacteriuria undergoing transurethral resection of the prostate (TUR-P) were randomized to treatment with either trimethoprim-sulfamethoxazole (TMP-SMX) or norfloxacin (NF) for 5 1/2 days beginning the evening prior to operation. It was possible to analyse 165 patients for efficacy. Elimination of bacteria on days 10 to 20 was achieved in 78.1% and 78.3% in the TMP-SMX and NF group, respectively. The accumulated elimination rates for the follow up period (days 10-42) were 68.5% for the TMP-SMX group and 76.2% for the NF group. The differences were not statistically significant. No patient had any clinical signs of upper urinary tract infection or septicemia. Three hundred and twelve patients were analysed for safety. Twenty-six patients reported 32 adverse drug events (ADEs). Four reactions in the TMP-SMX group were considered severe while in the NF group all the ADEs were of mild or moderate intensity. In this study NF seems to be at least as effective and safe as TMP-SMX.
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PMID:Norfloxacin versus trimethoprim-sulfamethoxazole. A study in patients with known bacteriuria undergoing transurethral resection of the prostate. 268 71

A previously unreported complication of low anterior resection of the rectum, seminal vesicle-rectal fistula, was encountered one month after surgery in an elderly patient with adenocarcinoma of the midrectum. Antibiotic-induced colitis in the immediate postoperative period led to anastomotic leakage with abscess formation and ensuing fistulization to the surgically denuded right seminal vesicle. Pneumaturia, bacteriuria, and right testicular pain were treated by cutaneous vasostomy and antimicrobial therapy. Despite recurrent low-grade urinary sepsis controlled by alternating courses of various antimicrobials, and radiation therapy for local tumor recurrence, the patient remained reasonably healthy until his death two years later due to stroke associated with cerebral metastases.
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PMID:Seminal vesicle-rectal fistula. Report of a case. 291 Jun 63

Convenience to the hospital staff is certainly not an acceptable reason for the use of a potentially dangerous drainage tube. An indwelling urinary drainage catheter should be used only in patients who need multiple straight urinary catheterizations, develop urinary obstruction or incontinence, or are comatose and require frequent urinary output measurements. An indwelling catheter may also be needed for drainage or stenting during or following genitourinary surgery. Once it has been determined that urinary catheterization is necessary, a closed urinary drainage system catheter must be carefully and aseptically inserted by experienced hospital personnel after careful preparation. The closed drainage system must be meticulously maintained throughout the patient's hospitalization and catheterization. After the catheter is removed, a urinary culture should be performed to identify any postcatheter infection. If there is infection, the patient must be treated with antibiotics. If symptoms of a urinary tract infection, bacteremia, or sepsis ensue, treatment must be rapidly begun with antibiotics as appropriate on the basis of drug sensitivity testing. These techniques will not eliminate bacteriuria associated with urinary drainage catheters. However, they will reduce the incidence, morbidity, and mortality associated with urinary catheterization.
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PMID:Nosocomial urinary tract infections. 305 56

Renal infection is a common occurrence in autosomal dominant polycystic kidney disease (ADPKD) and often leads to serious complications, including perinephric abscess, septicemia, and death. Important predisposing factors include age, female sex, and recent instrumentation of the urinary tract. Renal infections in ADPKD are most commonly caused by gram-negative enteric organisms. Diagnosis of these infections may be difficult since some patients do not have bacteriuria. Eradication of cyst infections with conventional antibiotic therapy can be difficult despite in vitro sensitivity of responsible organisms to the agents administered. We review recent studies of the anatomic and functional characteristics of renal cysts and discuss their possible relevance to the treatment of renal cyst infections. Finally, we set forth guidelines for the use of diagnostic studies, antimicrobial therapy, and surgical intervention for polycystic kidney infections.
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PMID:Renal infections in autosomal dominant polycystic kidney disease. 330 Feb 96

Urinary infections, with a spectrum from covert bacteriuria to severe pyelonephritis, commonly complicate pregnancy. Serious infections follow untreated silent bacteriuria in a fourth of cases, and routine screening can be justified in high-risk populations, particularly those from lower socioeconomic strata. Despite an initial salutary response to a number of antimicrobial regimens, covert bacteriuria recurs in one-third of treated women whose risk of pyelonephritis remains at 25%. Acute cystitis may be unrelated to these other infections and responds readily to a number of regimens; however, single-dose therapy is not recommended since early pyelonephritis can be mistaken for uncomplicated cystitis. Pyelonephritis is the most common severe bacterial infection complicating pregnancy. These women are frequently quite ill, and hospitalization is recommended. Since 85% to 90% respond within 48 hours to intravenous fluids and antimicrobials, continued fever and evidence of sepsis after two or three days should prompt a search for underlying obstruction. Perhaps 20% of women with severe pyelonephritis develop complications that include septic shock syndrome or its presumed variants. These latter include renal dysfunction, haemolysis and thrombocytopaenia, and pulmonary capillary injury. In most of these women, continued fluid and antimicrobial therapy result in a salutary outcome, but there is occasional maternal mortality.
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PMID:Urinary tract infections complicating pregnancy. 333 Apr 91

Effect of prophylactic administration of antimicrobials on postoperative urinary tract infection was studied in 40 patients who had undergone transurethral surgery. Two gm of cefoperazone (CPZ) per day was administered intravenously starting on the day of surgery for 5 days consecutively. In group I, 1 g of CPZ was administered 1 hour before surgery and another 1 g after surgery, while in group II 2 g of CPZ was administered after surgery only. Thereafter, in either group, 1 g of CPZ was administered intravenously 2 times a day. Urinary tract infection (UTI) was diagnosed when urine specimens yielded 1 X 10(4)/ml or more cells. In group I, 8 patients (40%) had UTI before surgery. Of 8 patients, 3 had bacteria resistant to CPZ. Of the remaining 5 patients with bacteria sensitive to CPZ 4 patients were cleared of bacteria after surgery. All these patients had bacteria sensitive to CPZ and therefore all were cleared of bacteria after surgery. In either group of patients all without bacteriuria at the time of preoperative evaluation were free from bacteriuria after surgery. All bacteria yielded after surgery were weak pathogens. All patients except 1 had no postoperative infectious complication such as septicemia, epididymitis and UTI. One patient showed UTI with fever after surgery. Urine culture yielded S. faecalis. This study showed that the prophylactic administration of antimicrobials for patients undergoing transurethral surgery was valuable, but the both methods of administration were similarly effective.
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PMID:[Clinical study of urinary tract infections in transurethral surgery]. 344 55


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