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

One hundred newborns and their mothers were subjected to aerobic bacterial cultures and sensitivity study from different sites. Out of 36 clinically suspected neonatal septicemia cases, the blood culture was positive for bacterial growth in 24 neonates. The incidence of septicemia in PT-AGA, FT-AGA, FT-SFD and postterm-AGA babies was found to be 50.0, 13.5, 28.1 and 50.0%, respectively. The incidence of septicemia in LBW and FT-AGA babies was found to be 45.3 and 13.5%, respectively. The single major isolate in the positive blood culture was Staphylococcus aureus. In Gram positive septicemia the commonest site for colonization of the same organism in newborn was found to be umbilicus followed by nose, throat and external auditory canal, while in Gram negative septicemia rectum and umbilicus were the commonest sites.
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PMID:Bacterial flora in mothers and babies with reference to causative agent in neonatal septicemia. 259 13

A boy, aged 14 1/2 years, presented with Burkitt leukemia. His renal status was normal before treatment. Chemotherapy (SFOP LMB 86 protocol) was begun Oct. 9, 1986. After the first 2 courses of chemotherapy, the patient had Gram negative sepsis treated with cefotaxime, netilmycine, Vancomycin and ornidazole. During sepsis, nephrotic syndrome developed (albumin 25 g/l, non selective proteinuria 15 g/24 h), with moderately high blood pressure, functional renal failure (creatinine 141 mumols/l, U/P urea = 20), polyuria and tubular damage. Kidney ultrasonography was normal. Needle biopsy showed minimal glomerular lesions, acute tubular lesions, and no deposits in immunofluorescence. The nephrotic syndrome disappeared within 3 weeks, with treatment of leukemia. He is at present in complete remission with a follow-up of 25 months.
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PMID:[Nephrotic syndrome and B leukemia]. 262 44

Gram-negative septicemia/endotoxemia remains a serious clinical disorder that is often complicated by disseminated intravascular coagulation (DIC). Plasma antithrombin-III (AT-III) levels usually decrease during gram-negative septicemia/endotoxemia, and even moderate decreases in this major inhibitor of the coagulation system are associated with serious DIC. We demonstrated in an earlier study that prophylactic treatment of rats with 250 U/kg of AT-III followed by endotoxin challenge markedly attenuates DIC, indices of organ damage, and metabolic dysfunction. The present study was to determine whether treatment with 250 U/kg AT-III 1 hr after endotoxin challenge would be similarly efficacious. Rats treated with 250 U/kg of AT-III inactivated by human sputum elastase (ATX) served as protein controls. Blood samples for analysis were obtained 4 hr after AT-III or ATX treatment (5 hr after endotoxin challenge). Rats in the ATX treatment group exhibited abnormalities characteristic of endotoxemia, i.e., decreased fibrinogen levels and platelet counts, increases in prothrombin time and activated partial thromboplastin time, elevated serum glutamic oxaloacetic transaminase (SGOT) and alkaline phosphatase (AKP), and hypoglycemia. Treatment with AT-III markedly and significantly (P less than .05) attenuated all of these abnormalities, although survival was not increased. This study strongly suggests that supplementation of plasma AT-III is efficacious after the development of sepsis, although not as efficacious as prophylactic treatment.
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PMID:Antithrombin-III treatment limits disseminated intravascular coagulation in endotoxemia. 273 21

Severe hypophosphatemia (serum phosphorus less than or equal to 0.48 mmol/L [less than or equal to 1.5 mg/dL]) was found in 120 patients admitted to a major university hospital, during a period of 16 months. Fifty-one patients (42.5%) developed hypophosphatemia postoperatively. Medications known to precipitate hypophosphatemia were a causative factor in 82% of the patients, with glucose administered intravenously, antacids, diuretics, and steroids being the most common agents associated with profound hypophosphatemia. Gram-negative septicemia was observed in 16 patients, and it was the second most common cause of severe hypophosphatemia. The mortality rate was 20% in patients with a serum phosphorus concentration between 0.36 and 0.48 mmol/L (1.1 and 1.5 mg/dL) (group A) and 30% in patients with a serum phosphorus concentration of less than or equal to 0.32 mmol/L (less than or equal to 1.0 mg/dL) (group B). The cause of death and its temporal association with the lowest observed values of phosphorus concentration indicate that severe hypophosphatemia might be a contributory factor to mortality. Our data indicate that severe hypophosphatemia in hospitalized patients is the result of a combination of factors. Surgery, followed by a period of fasting with intravenous administration of glucose, and gram-negative septicemia are the most common causes.
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PMID:Severe hypophosphatemia in hospitalized patients. 312 79

Gram negative sepsis is a leading cause of human newborn morbidity and mortality. The clinical signs and glucose and lactate concentration during the late phase of newborn rat endotoxicosis has not been well characterized. In order to define a late phase model of sepsis, simultaneous clinical signs (loss of response to pain [RP] and/or righting reflex [RR]), and metabolic (glucose, lactate) concentrations were studied in the 10 day old Sprague-Dawley rat. The rats were fasted for four hours and then injected with either saline (control) or 0.1 mg per kg Salmonella enteritidis (LD90 @ 24) endotoxin intraperitoneally. Rats were then examined every 15 minutes beginning two hours post injection for the presence or absence of loss of RR and/or loss of RP. Central blood samples were collected for determination of glucose and lactate at the moment of loss of the predetermined clinical parameter. Metabolic parameters were also determined on saline treated controls time matched to the experimental groups. Rats were grouped as follows: GrI, (n = 10), saline three hours post injection; GrIII, (n = 10), saline five hours post injection; GrII, (n = 45), endotoxin at the moment of loss of RR; GrVI, (n = 14), endotoxin at 8.5 hrs post injection (termination of experiment, all with loss of RR); GrIV, (n = 11) endotoxin at loss of RP; and GrV, (n = 10) saline at 8.5 hr post injection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Concurrent clinical and metabolic derangements in the newborn rat: a late phase sepsis model. 338 18

The peak and trough levels of bactericidal activity of the serum of 74 severely granulocytopenic patients (less than or equal to 500 polymorphonucleates per microliter) with hematologic malignancies and Gram-negative septicemia were measured using the patient's infectious organism and serum containing the given antibiotics. When the peak titer of bactericidal activity in the serum was greater than 1:8 the septicemia was cured in more than 90% of the cases. However, in order to achieve a satisfactory rate of cure, patients with less than 100 polymorphonucleates/microliter required higher peak levels than patients with 100-500 polymorphonucleates/microliter. Serum bactericidal activity was influenced by the in vitro susceptibility of the offending pathogen and by the presence of in vitro synergism between the given antibiotics. These two variables showed a correlation with the clinical outcome that proved to be increasing with the degree of granulocytopenia. Furthermore, synergistic combination of the antibiotics appeared essential when the in vitro susceptibility shown by the offending pathogen was moderate. These data suggest (i) that determination of the bactericidal activity of the serum may prove to be a useful method to predict the clinical outcome in severely granulocytopenic patients with Gram-negative septicemia; and (ii) under the same conditions, antibiotic combinations that have demonstrable in vitro synergy against the offending pathogen should be given the utmost consideration.
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PMID:Serum bactericidal activity as a therapeutic guide in severely granulocytopenic patients with gram-negative septicemia. 389 60

The clinical surgeon is required to assume important responsibilities in the management of microbial infections. To be effective, antibiotics should be used against sensitive organisms, the lesion should be infused adequately, and, ideally, the antibiotic should be bactericidal and compatible with other antibiotic agents in combination. A survey of commonly used antibiotics disclosed that penicillin in its synthetic and natural forms is still the drug of choice in most cases, particularly since, in its different forms, it may be used in combination with other agents to give a wide antibacterial spectrum. As a major surgical problem, Gram-positive septicemia has been superseded by Gram-negative septicemia and attendant endotoxin shock. Most authorities advocate a combination of bactericidal and bacteriostatic antibiotics in the treatment of endotoxin shock. However, while antibiotic therapy is considered crucial in the treatment of this condition, the mortality rate is still high and no uniform regimen of antibiotic therapy has been accepted.
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PMID:Antibiotic therapy in current surgical practice. 531 76

From 1980 to 1982 Acinetobacter calcoaceticus (A.c.) derived from blood cultures and venous catheters of 29 patients could be grown. 6 patients with clinical signs of Gram-negative septicemia had two or more blood cultures positive for A.c. Thus, the role of A.c. as the etiologically relevant pathogen seems to be evident. In 14 cases with clinical signs of septicemia but only one set of blood cultures positive for A.c. it is felt to be the causative agent since no other cause could be found. In 9 cases isolation of A.c. seems to be due to contamination - most likely from skin -, because neither evidence of septicemia nor relationship to the diseases present of A.c. existed.
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PMID:[Clinical importance of Acinetobacter calcoaceticus isolations from blood and venous catheters]. 636 83

Neutropenia often accompanies septicemia in burned patients. This paradox suggests a defect in the regulation of granulopoiesis. Colony stimulating factor (CSF) produced by the monocyte-macrophage system is an important regulator of granulocyte production. We followed serial serum CSF levels and peripheral blood leukocyte differential counts in 22 patients with greater than 30% burns. Six patients (mean burn, 58%) developed Gram-negative septicemia and died (Group I). Sixteen patients (mean burn, 38%) had no fatal septicemias (Group II). Nonsurvivors had initially low levels of CSF and developed persistent monocytopenia. Survivors, in contrast, had prompt rises in CSF and developed monocytosis. The presence of monocytopenia and low CSF levels in Group I suggests an abnormality in the stimulatory arm regulating granulopoiesis. Such a defect may play a role in the development of fatal septicemia following severe thermal injury.
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PMID:Regulation of granulopoiesis following severe thermal injury. 640 16

The kidneys of rhesus monkeys, infused either with a single bolus of endotoxin(10 mg per KG) or continuously at the rate of 10 mg per kg per hour for periods of up to 22 hours, have been examined by light and electron microscopy. Monkeys infused continuously with Ringer's lactate were used as controls. Only minor morphologic changes were observed in those animals receiving a bolus of endotoxin. In the animals continuously infused, sequestration of neutrophils and monocytes was observed in the peritubular capillaries and, to a lesser extent, in the glomeruli. These changes were associated with phagocytosis of endotoxin, occasional fibrinous deposits, and extensive endothelial damage with focal capillary disruption. In the advanced stages, interstitial edema and early necrosis of tubular epithelium were observed. Our data indicate that endothelial damage and associated events relating to the sequestration of phagocytic leukocytes involve the peritubular capillaries primarily and that this process plays a role in the genesis of acute tubular necrosis associated with endotoxemia. In preliminary studies involving the study of kidneys from patients dying with documented Gram negative sepsis and acute renal failure, sequestered nucleated cells have been observed in the peritubular capillaries of the renal cortex and upper medulla. This suggests that similar patterns of endotoxin mediated vascular injury may be occurring in human sepsis.
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PMID:New Concepts in the pathogenesis of acute tubular necrosis associated with sepsis. 701 67


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