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

The clinical symptomatology of bacterial septicemias was analysed in 417 patients of a University Hospital in West Berlin. Sepsis was caused by Gram-negative organisms in 229 cases, and by Gram-positive bacteria in 177 cases; 11 cases presented with a mixed type sepsis involving both Gram-positive and Gram-negative pathogens. With the exception of a drop in blood pressure, observed appreciably more often in Gram-negative infections (42.4% of the cases as compared with only 25.4% in the case of septicemia due to Gram-positive organisms, (p less than 0.01), no significant clinical differences were seen between Gram-negative and Gram-positive sepsis. Pathophysiological changes (thrombopenia, leukopenia, coagulopathies) that are considered classical reactions to endotoxin, were also observed in Gram-positive infections. The overall prognosis of septicemia was determined largely by the severity of the underlying pathological condition.
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PMID:[Infection caused by gram-positive and gram-negative bacteria. A comparative study]. 279 23

The effect of an intravenous polyvalent immunoglobulin preparation given prophylactically to prevent neonatal sepsis was tested in preterm and low birth weight infants. Infants matched for gestational age, sex and birth weight (+/- 250 g) were randomly allocated into 3 groups of 50 each, one group (Group C) being used as control. Group A received Intraglobulin (Biotest Pharma, West Germany), 120 mg/kg intravenously, within 2 to 4 hours of delivery; Group B received the same on days 1 and 8. The control group received no immunoglobulin. The frequency of infection and serum immunoglobulin concentrations were determined in each group. Infection rate in the control group was 16% (8 of 50) while in each of the treated groups it was 4% (2 of 50) (P less than 0.005). The immunoglobulin concentrations achieved in the treated group were significantly higher than the control group. No adverse effect of the therapy was noted during the study and at a 6-month follow-up. It is suggested that in nurseries where the infection rate is high, prophylactic intravenous polyvalent immunoglobulin therapy for the preterm and low birth weight infants may provide protection from infection.
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PMID:Intravenous immunoglobulin for prevention of sepsis in preterm and low birth weight infants. 309 67

An analysis of the causes of death in the neonatal nursery of the Port Moresby General Hospital in Papua New Guinea from 1982-1985 is presented, and conclusions were enumerated. The nursery has beds for 24 babies, subdivided into intensive care, infection and growing areas. Dormitory space for 12 mothers is available, and breast feeding is encouraged, whether by sucking, cup or tube: no bottle feeding is done. Up to 9 sisters staff the unit. A total of 2948 infants were admitted, including 831 cesarean births. 343 deaths occurred. 80 deaths were previable babies less than 1000 g. The neonatal mortality was 10/1000. The most common causes of death were septicemia or meningitis (24%), perinatal asphyxia (20%), respiratory distress syndrome (15%), congenital abnormalities (12%), meconium aspiration 7%, apnea of prematurity (7%). Other causes included pneumonia, hypothermia, intrauterine infection syndrome, cerebral hemorrhage and kernicterus. Note that hypothermia can occur in tiny babies, even in the tropics. Both respiratory distress and jaundice appear to be rare in melanesians compared to caucasians. Infections were due to tetanus, E. coli, S. aureus a Strep. faecalis, rather than the Group B hemolytic Strep. more often seen in the West. It was concluded that several inexpensive measures can be put in place to markedly enhance survival: train birth attendants to prevent perinatal asphyxia; maintain body temperature by available means; feed adequately, using expressed breast milk if necessary; maintain oxygenation properly using simple equipment such as a nasal catheter or perspex head box; prevent infection by scrupulous hand washing, cord care and overall cleanliness; manage neonatal jaundice.
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PMID:Neonatal care in perspective: results of neonatal care at Port Moresby. 347 16

To study the etiology of neonatal septicemia and factors associated with outcome, all charts of neonates with bacteremia and clinical sepsis admitted to a neonatal unit in Saudi Arabia, from 1 November 1980 to 31 October 1984 were reviewed. The results were compared to a previous study period in the unit (1 November 1976-31 October 1980). Septicemia was diagnosed on 50 occasions in 49 neonates. The incidence of neonatal sepsis among patients born in the hospital was 2.5/1,000 live births. Mortality from sepsis was 33% and was associated with neutropenia in 63%. The most commonly isolated bacteria were E. coli, Klebsiella and Staphylococcus aureus. Salmonella enteritidis serotypes were isolated in 4% of the cases. Group B streptococci (GBS) were isolated, for the first time, from blood of 3 neonates. Salmonella species were less frequently and GBS more often isolated than previously. GBS have now appeared as etiologic organisms in neonatal sepsis also in Saudi Arabia. Salmonella septicemia remains more common in Saudi Arabia than in the West.
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PMID:Changing etiology and outcome of neonatal septicemia in Riyadh, Saudi Arabia. 352 8

Postoperative acute renal failure, especially associated with oliguria, carries a high rate of mortality and morbidity. This complication can frequently be avoided if physicians are knowledgeable about preventable or modifiable risk factors. Patients who have underlying renal disease, sepsis, volume depletion or other conditions associated with renal hypoperfusion, or who have severe liver disease, are at particular risk. Exposure to nephrotoxic agents and wide fluctuations of intravascular volume are key conditions that can usually be minimized. Managing patients with chronic advanced renal failure (creatinine clearance 10 to 25 ml per minute) requires close interaction between the internists, anesthesiologists and surgeons. Understanding associated metabolic and organ system disorders is necessary to prevent complications and preserve remaining renal function. Chronic renal failure should not be a contraindication to an elective or emergent surgical procedure.
West J Med 1987 Mar
PMID:Preserving renal function in surgical patients. 357 22

Vibrio vulnificus was isolated from United States West Coast estuaries at a low frequency (5.9%) from 529 samples of water, shellfish, and sediment. Four strains tested with iron-treated mice had 50% lethal dose values ranging from 7.6 to 360 CFU, compared with a 50% lethal dose of 4.9 CFU for a clinical isolate that caused the death of a septicemic patient. The presence of this pathogen may be a hazard to users of marine beaches and consumers of raw shellfish on the West Coast, especially to persons most susceptible to V. vulnificus septicemia. Species-specific antiflagellar serum and a gene probe for cytotoxin-hemolysin production were useful for screening these environmental isolates.
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PMID:Virulent strains of Vibrio vulnificus isolated from estuaries of the United States West Coast. 360 12

A 10-year review of all patients admitted to the West of Scotland Regional Burns Unit with serious electrical burns indicated an incidence of only 2.6 cases per million of the population served by the Unit per year. Injuries following electrocution or electric flash, but excluding injuries caused by grasping the hot heating element of an electric fire, were suffered by 70 patients, 52 of whom sustained electrocution which was not immediately fatal. Ninety-one per cent of the patients were male. The patients who died in hospital did so as a result of sepsis rather than as a direct result of the electrical injury. All those patients who had ECG changes on admission recovered completely. In view of the very deep injuries, the amputation rate was high with 12 out of 52 patients (23 per cent) with electrocution injury requiring one or more amputations. The events preceding the serious electrical injury in our patients suggest that, 57 per cent of all the injuries could have been prevented, and in patients under 20 years of age this percentage rose to 91.
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PMID:Electrical burns--incidence and prognosis in Western Scotland. 371 1

Central venous catheter-related infection and evidence for central venous thrombosis developed in five patients. On the basis of ongoing bacteremia after catheter removal and venographic confirmation, catheter-related septic central venous thrombosis (CR-SCVT) was confirmed. These patients were treated successfully with anticoagulation and antibiotics; none required surgical exploration or drainage.CR-SCVT is a complication of modern venous access techniques and is easily confused with sepsis from other anatomic sites. Even when recognized antemortem, CR-SCVT carries an excessive morbidity and mortality. The therapy for this complication is not standardized, but catheter removal, anticoagulation and a prolonged course of antibiotics are appropriate initial therapy. Surgical vein ligation or excision are reserved for refractory sepsis or abscess formation.
West J Med 1986 Aug
PMID:Catheter-related septic central venous thrombosis--current therapeutic options. 376 99

Pulmonary thromboembolism is a rarity in India. This common clinical impression has so far not been tested. Among 7000 autopsies between 1964 and 1980, a total of 218 cases (126 males and 92 females) were recorded to have thrombosis and/or embolism and/or infarction in the lungs. This incidence of 3.1% is far lower than that reported in the West and similar to the low incidence in Africa. Of the 218 cases, 42.6% had a cardiac disease, 18.3% had systemic septicemia, 13% had a malignancy, 12.8% had pulmonary disease, and the remaining suffered from diseases of liver, kidney, CNS, etc. Of the 218 cases, 141 (64.6%) showed only infarcts, 40 (18.3%) had only thromboemboli, and 37 (16.9%) showed both events. In view of the overlap among these three conditions and their essential pathophysiologic identity (thrombus/embolism/infarction), it is suggested that these be grouped under the name "pulmonary vascular episode."
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PMID:Autopsy incidence of pulmonary vascular episodes. A study of 218 cases. 376 65

A total of 222 cases of septicaemia was recorded at the University Hospital of the West Indies between June 1982 and June 1983. This gave an overall incidence of 16.1 per 1000 admissions. The 233 bacterial strains isolated comprised 100 Gram-positive and 133 Gram-negative organisms with Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus aureus being the most frequent. Highest rates of septicaemia were recorded in patients less than 1 year and over 50 years of age. Septicaemia caused by Gram-positive organisms was predominantly a disease of children whereas that caused by Gram-negative organisms arose more often in neonates and in patients over 50 years of age. A predisposing factor was noted in 104 patients of whom 42 had neoplastic disease. The most frequently identified initial sites of infection were the respiratory tract, the gastro-intestinal tract and the meninges. Most blood stream infections were community-acquired, three quarters of all septicaemic patients being admitted to the departments of medicine or paediatrics. There were 11 cases of polymicrobial septicaemia caused predominantly by Gram-negative organisms in patients with underlying disease. Appropriate antimicrobial drugs were administered to 57% of septicaemic patients whereas 17% received superfluous antimicrobial therapy. In those patients who received inappropriate antimicrobial therapy there was a marked increase in mortality. Forty of 61 deaths were attributed to septicaemia. Mortality from septicaemia caused by Gram-negative organisms was 21% compared with 13% for that caused by Gram-positive organisms. The organisms associated with the highest case fatality rates were Escherichia coli, 53%; Enterobacter sp., 27%; and beta-haemolytic streptococci 24%. There were no deaths from septicaemia caused by Haemophilus influenzae, Salmonella sp. or Serratia sp. The highest mortality rates were associated with neoplastic disease, diabetes, polymicrobial septicaemia, urinary tract infections and old age.
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PMID:Bacteraemia at the University Hospital of the West Indies--a report of 222 cases. 389 69


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