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

Screening tests have had a major role in the diagnostic microbiology laboratory during recent years. Many factors have contributed to the increased use of these methods. The primary factor is the need for rapid detection and identification of the etiologic agent in life-threatening infections, which include bacterial meningitis, infective endocarditis and septicemia, and pneumonia. Various direct screening methods are also available for eliminating negative specimens rapidly. These methods have had an impact on laboratory work flow and the outpatient population by eliminating the possibility of bacterial infections of the urinary, upper respiratory, and gastrointestinal tracts. Screening methods have also been applied to isolated colonies for the rapid differentiation and identification of certain groups of organisms. Finally, many of these screening methods have contributed to cost-savings for both the laboratory and the patient. In this era of prospective pricing, and until the entrance of biotechnology into the diagnostic microbiology laboratory, the microbiologist must rely upon these rapid, inexpensive screening procedures. The role of these screening tests in the diagnostic microbiology laboratory and their impact on patient care and cost are reviewed herein.
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PMID:Role of screening tests in rapid testing. 242 68

We have studied prospectively the C-reactive protein values in the cerebrospinal fluid of 54 patients with bacterial meningitis, tuberculous meningitis, and severe malarial infection and convulsions without infections of the central nervous system. CSF CRP above 1 mg/l was observed in 23 out of 28 patients with bacterial meningitis (sensitivity of 82%). The specificity was 73% at the 1 mg/l level. Five out of 19 patients with severe malarial infection had CSF CRP levels above 1 mg/l. Two patients with TB meningitis were also studied. Both of them had CSF CRP above 1 mg/l. Five patients with febrile convulsions or sepsis without meningitis had CSF CRP below 1 mg/l. It is concluded that CSF CRP would not be used as a useful discriminatory test in areas where malaria and TB meningitis are common.
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PMID:C-reactive protein and bacterial meningitis. 246 9

The usefulness of serum C-reactive protein (CRP) in the early detection of neonatal infection was studied using a special laser nephelometric apparatus (CRP-1), by which CRP concentrations could be quickly determined in the nursery, with only a small amount of serum (20 microL). Initial serum CRP concentrations of samples obtained from 90 infants suspected to have sepsis and/or meningitis were evaluated. Of the 90 infants, 25 showed culture-proven septicemia and/or bacterial meningitis, while 18 were considered to be infectious based on clinical signs and positive sepsis work-up even though cultures were negative. 47 infants had negative cultures and sepsis work-up and showed a favorable clinical courses. Statistical analysis for the evaluation of serum CRP at the level of one mg/dL was performed. False negative CRP was demonstrated in seven of 25 infants with culture-proven sepsis and/or meningitis (28%) and in 4 of 18 infants with other infections (22%). On the other hand, seven of 47 (15%) non-infected infants showed false positive results. The specificity and sensitivity of serum CRP determination were 85% and 74%, respectively, for all patients, and 85% and 72%, respectively, for patients with sepsis and/or meningitis. The sensitivity varied with the pathogens. We conclude that, while the initial CRP values alone are unsatisfactory for deciding the need for antibiotic therapy, CRP is useful in the early detection of neonatal infections, and its measurement by this new equipment should available in the nursery.
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PMID:Serum C-reactive protein in the early diagnosis of neonatal septicemia and bacterial meningitis. 251 35

Twenty-three newborn and young infants, including 13 low-birth-weight infants, were treated with cefmenoxime (CMX) and the clinical efficacy and side effects were evaluated. The ages of the patients ranged from 1 to 102 days, and their weights ranged from 0.83 to 4.19 kg. Doses given were 18-42 mg/kg every 6 to 12 hours for 2 to 16 days. Among 12 infants with bacterial meningitis and sepsis, the results were excellent in 2, good in 7 and fair in 3 patients. The drug was well tolerated and no adverse effects were observed in the 23 patients. Pharmacokinetic studies of CMX were done in 5 infants whose mean body weight was 3.03 kg (range 2.4 to 4.2 kg). Serum concentrations at 15 minutes after 10 mg/kg intravenous bolus injections were 35.6 and 55.7 micrograms/ml in two 12- and 18-day-old patients. In 3 patients with ages of 7, 7 and 24 days, serum concentrations were 54.6, 102 and 100 micrograms/ml, respectively, at 15 minutes after 20 mg/kg doses. Elimination half-lives of the drug were 1.3 to 1.5 (mean 1.4) hours in these patients. Excretion rates into urine in the first 8 hours were 30.3, 74.2, 77.6 and 85.6% in four patients given 10 or 20 mg/kg doses. The cerebrospinal fluid level at 3 hours after the dose was 0.4 micrograms/ml on 15th day of treatment in 1 patient with bacterial meningitis given 20 mg/kg every 6 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical and pharmacokinetic evaluation of cefmenoxime in neonates and young infants]. 261 14

The authors report a case of Pasteurella multocida meningoencephalitis in a 5 week-old female infant, with special attention to clinical, laboratory and evolutive features. A moderate neurological sequel was observed at follow-up examinations. A brief review of the importance of P. multocida in human pathology is presented on the basis of the international literature, since the authors did not find any Brazilian reports. The most important feature on P. multocida is the prevalence of bacterial meningitis at the extremes of age. Otherwise, significant mistaken was found between Gram stained smears of body fluids for P. multocida and Haemophilus influenzae or Neisseria meningitidis. Because its role in infections following animal bite or scratch and its opportunistic feature, P. multocida must be included among the possible etiologic agent of bacteremia or sepsis in patients with liver cirrhosis or immunosuppression.
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PMID:[Meningoencephalitis due to Pasteurella multocida: clinico-laboratory study of a case in an infant]. 263 88

A review of two third-generation cephalosporins, ceftazidime and cefotaxime, is presented. Ceftazidime, often used as a single agent, has shown greater activity than cefotaxime against Pseudomonas aeruginosa and other Pseudomonas species, Enterobacteriaceae, Acinetobacter sp, and Enterobacter sp. It has been effective as monotherapy in the treatment of peritonitis, gynecologic infections, chronic bronchitis, and infections in patients with leukemia and granulocytopenia, as has cefotaxime when in combination with an aminoglycoside. Cefotaxime has shown good activity against most aerobic gram-negative bacilli and against Staphylococcus. It has been used in respiratory infections, urinary tract infections, and septicemia. In contrast to first-generation and most second-generation cephalosporins, third-generation cephalosporins have proven useful in some types of meningitis. Ceftazidime and cefotaxime successfully penetrate into the cerebrospinal fluid and cures of bacterial meningitis have been reported with both drugs. Both ceftazidime and cefotaxime have been successfully used in children, infants, and neonates, as well as adults. Safety profiles of ceftazidime compare favorably with those of other third-generation cephalosporins.
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PMID:Ceftazidime and cefotaxime--the clinician's choice. 266 Sep 95

Bacteroides fragilis is an obligated anaerobic bacillus which forms part of the normal intestinal flora of the colon and is often seen as a common pathogen in intraabdominal infections. It is an infrequent pathogen in cases of meningitis; a review of the literature reports only eight cases of this disease in children, especially in neonates with conditioning factors such as abdominal sepsis, chronic middle ear otitis and atrial-ventricular derivations. A case of a newborn baby girl with lumbosacral myelomeningocele is reported. After the defect was surgically corrected, the wound became infected, the stitches opened, the child began to have fever, became irritable and suffered convulsions. The spinal tap showed changes compatible to bacterial meningitis, the bacteria was grown on Shaedler medium. The child was treated with cefotaxime and amikacin showing no satisfactory improvement. Afterwards, a second spinal tap showed Bacteroides fragilis.
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PMID:[Meningitis caused by Bacteroides fragilis in children]. 269 35

Twenty-seven newborns had an episode of late-onset sepsis (septicaemia or bacterial meningitis after 48 h of age) over an 18 month period. Preceding or simultaneous surface cultures were available from 26 babies. Colonization with the organism causing sepsis could only be documented in 10 cases. Colonization with aminoglycoside-resistant Gram negative organisms was common but there were only two cases of systemic sepsis with a resistant organism. Pseudomonas aeruginosa frequently colonized babies over the first 8 months of the survey, but subsequently virtually ceased to colonize babies, although it continued to be a common cause of late-onset sepsis. These findings do not support the utility of routine surveillance of organisms colonizing neonates in predicting bacteria causing late-onset sepsis. They also cast doubt on the value of eliminating colonizing organisms by expensive infection control measures.
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PMID:Surveillance of colonization and late-onset septicaemia in neonates. 288 63

Septicemia complicating infected hemangiomas was diagnosed in two children aged 2 months and 2 years. The younger also developed bacterial meningitis. Group A beta-hemolytic Streptococcus non-M protein typable was isolated in both patients. Neither had leukocytosis and in only one was the erythrocyte sedimentation rate elevated. The children recovered after intravenous antibiotic therapy. Use of systemic antibiotics should be considered in infected hemangiomas in childhood even in the absence of elevated acute-phase reactants.
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PMID:Group A beta-hemolytic streptococcal septicemia complicating infected hemangioma in children. 329 26

We evaluated fever in 342 hospitalized infants less than 8 weeks of age. Sixteen infants (5%) had bacteremia or bacterial meningitis. Fifty-two percent of the infants were admitted during the months of July through September. We found no significant relationship between season, sex, height of fever, or erythrocyte sedimentation rate and the recovery of bacteria from the blood or CSF. A WBC less than or equal to 5,000/cu mm or a ratio of immature to total neutrophils greater than or equal to 20% correlated significantly with bacteremia or bacterial meningitis, though the sensitivities of these tests were unacceptably low. Prospectively, of 61 infants whose clinical appearance did not suggest sepsis, none had bacterial pathogens in the blood or CSF, whereas four of 36 infants with a septic appearance did have pathogens. Recent investigations support the initial clinical impression as important in assessing these febrile infants. We found that bacteremia is more likely to occur in infants less than 4 weeks of age (8%) than in the older infants (2.9%).
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PMID:Evaluation of fever in infants less than 8 weeks old. 330 62


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