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

30 children suffering from bacterial meningitis and 2 children suffering from septicemia were treated with 6-((R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetmido(-penicillanic acid sodium salt (mezlocillin, Baypen). The daily dose was 250 mg/kg, divided in three portions. Therapy was successful in all patients. Neither signs of toxicity nor side effects of any kind could be found. Mezlocillin concentrations were measured in serum and cerebrospinal fluid (CSF) mainly on days one and six or seven of therapy. Serum concentrations were in the expected range. CSF concentrations depended on the inflammation of the meninges. On the first day of treatment they ranged from 0.5 to 7.2 to 12.0 microgram/ml. After normalisation of CSF no concentrations of mezlocillin were detectable.
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PMID:Treatment of childhood meningitis with mezlocillin. 54 12

Forty-two patients were treated with intravenous cefoxitin, a new cephamycin antibiotic. These patients had postoperative abdominal sepsis (26), intrathoracic infections (6), urinary tract infections (5), gram-negative bacterial meningitis (2), septic arthritis (1), epidural abscess (1) and isolated septicemia (1). The antibacterial spectrum of cefoxitin was found to be one which included all gram-positive organisms except enterococci, most gram-negative organisms except Pseudomonas aeruginosa, and almost all of the important anaerobic organisms. The only five treatment failures included one patient with empyema and one with septic arthritis, both caused by Serratia marcescens, initially only moderately susceptible to cefoxitin, which subsequently developed increased resistance, two patients with contaminated intravenous catheters, and one patient with epidural abscess and cerebritis, who was treated late in the course. There was one serious clinical superinfection with P. aeruginosa. The drug levels noted in the pus and joint fluid were half to two-thirds of the simultaneous serum level. In inflamed meninges, up to 30% of the serum level was noted in the cerebrospinal fluid, and as the process resolved, 10 to 15% was noted. Toxicity of cefoxitin was mild and constituted skin rash in three patients (7%) and phlebitis in eight (19%).
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PMID:Use of cefoxitin, new cephalosporin-like antibiotic, in the treatment of aerobic and anaerobic infections. 74 74

Because of declining function of their immunologic and other organ systems, elderly individuals are more susceptible to certain types of infections of their heart valves, meninges, urinary tract, and skin. They may develop serious sepsis with subtle clinical signs and symptoms, which makes accurate diagnosis difficult. The antimicrobial agents of choice for use against the organisms most commonly responsible for these septic symdromes are listed in Tables 2, 3, and 4. Some methods of preventing these infections are discussed, but further studies to verify old techniques and establish new ones are needed.
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PMID:Host factors and infectious diseases in the elderly. 79 48

Thirty-six renal transplant recipients with 47 episodes of septicemia were studied carefully at the bedside, in the laboratory, and, all too frequently, at autopsy. Gram-negative bacilli were the pathogens most commonly responsible, folloed in order of frequency by gram-positive cocci, polymicrobic etiologic agents, Listeria monocytogenes, and fungi. Infections of the transplant site (urinary tract or transplant wounds) caused septicemia in 51% of the cases. Other portals of entry included the lung, the abdomen, the meninges, the endocardium, and miscellaneous sites. The outcome of septicemia was fatal in 36% of the episodes. There was a significantly higher mortality for episodes of septicemia associated with pneumonia, persistent bloodstream infection, leukopenia, metastatic abscesses, clinical shock, and acute respiratory failure. The high mortality of septicemia in renal allograft recipients demands that extremely careful attention be given to subtle clinical clues denoting the onset and predicting the course of the disorder.
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PMID:Septicemia in renal transplant recipients. 79 Jul 36

Three neonatal calves ranging in age from 4 to 14 days were examined pathologically and bacteriologically. The calves showed depression, anorexia, pyrexia, and difficulty or inability to stand followed by cloudiness of the ocular aqueous humor or cornea. Autopsy revealed congestion, petechiae, and cloudy areas in the meninges. Histologically, the central nervous system (CNS) lesions were prominent and limited to the meninges where fibrinous exudate and infiltrations of neutrophils, macrophages, and lymphocytes were present. There were mild or slight degrees of choroid plexitis and ependymitis. Endophthalmitis was seen as a concurrent lesion in all cases. Fibrinous or fibrinopurulent changes were found in the peritoneum and epicardium as well as in several other organs. Numerous Gram-positive cocci were detected in affected areas of the whole body. Bacteriologically, Streptococcus bovis was isolated from all examined materials consisting of the brain, cerebrospinal fluid, ocular aqueous humor, and several other organs. These results suggest that the lesions were associated with infection of the organism and that the present cases were in the process of septicemia.
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PMID:Clinicopathology of meningoventriculitis due to Streptococcus bovis infection in neonatal calves. 142 May 67

Pharmacokinetic and clinical studies of imipenem/cilastatin sodium (MK-0787/MK-0791), a new carbapenem antibiotic and a dehydropeptidase-I inhibitor, respectively, were carried out in a joint study in the pediatric field by a study group consisting of investigators at 16 institutions. The results were summarized below. Pharmacokinetic studies Peak plasma concentrations of MK-0787/MK-0791 were 27.7-190.0/28.3-216.4 micrograms/ml at doses of 10/10-50/50 mg/kg administered by a 30 or 60-minute drip infusion. The above findings proved that dose response was clearly observed. Over a period of 6 or 7 hours, the urinary excretion of MK-0787 and MK-0791 totaled 54.2-88.0% and 53.6-89.0% of the dose administered, respectively. Plasma half-lives of MK-0787 and MK-0791 in the beta-phase were 0.87-1.05 hours and 0.59-0.95 hour, respectively. The cerebrospinal fluid (CSF) levels of MK-0787 in patients with purulent meningitis were 2.0-14.4 micrograms/ml; however, the penetration rate of the drug into the CSF was relatively poor in patients with normal meninges. Clinical study Clinical efficacy was evaluated in 283 patients. In 112 patients the daily dosage ranged from 30/30 mg/kg to 59/59 mg/kg, and in 138 patients it ranged from 60/60 mg/kg to 99/99 mg/kg. The maximum dose administered was 222/222 mg/kg. The drug was administered either 3 or 4 times per day. The clinical efficacy rate was 92.5% among 187 patients with identified etiologic pathogens. The drug was effective in 3 out of 4 patients with purulent meningitis and in 7 out of 10 patients with septicemia. The clinical efficacy rate was 96.7% in 90 patients with respiratory tract infection (pneumonia, lung abscess, etc.), 96.5% in 57 patients with urinary tract infection, 90.9% in 11 patients with SSTI. The clinical efficacy rate in those with no identified etiologic pathogen was 97.0% among 101 patients. Bacteriologically, the eradication rate for S. aureus was 87.9% of 33 isolates. Comprehensively, the eradication rate for Gram-positive bacteria was 94.7% of 75 isolates. The eradication rate for P. aeruginosa was 87.5% of 8 isolates. Including these strains, the eradication rate for Gram-negative bacteria was 90.3% of 134 isolates. The MK-0787/MK-0791 exhibited an eradication rate of 91.9% among a total of 211 Gram-positive and Gram-negative bacteria including anaerobes.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Pharmacokinetic and clinical studies with imipenem/cilastatin sodium in the pediatric field. Pediatric Study Group for Imipenem/Cilastatin Sodium]. 346 85

During a two-year period, Streptococcus suis serotypes 1-8 were isolated from 108 pigs examined at the laboratory. S. suis serotypes 2 and 7 represented 75% of the isolates. S. suis serotype 7 was isolated more frequently than reported from other countries, and mostly from piglets less than 3 weeks of age. Experimental inoculation of 7-day-old piglets with S. suis serotype 7 provoked severe illness within a week in 6 out of 7 animals. By bacteriological and pathological examination it was found that S. suis serotype 7 was pathogenic to piglets, giving rise to septicemia with predilection for joints, serous membranes and meninges.
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PMID:Streptococcus suis infections in Danish pigs and experimental infection with Streptococcus suis serotype 7. 367 79

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

We have reviewed 107 cases of staphylococcal bacteraemia in order to assess the current clinical spectrum of serious staphylococcal sepsis in Zimbabwe, where staphylococcal bacteraemia is common. Infection was hospital-acquired in 35 cases and community-acquired in 72 cases. The mortality rate was 28%. Most patients were young, with predisposing conditions such as prematurity, protein-caloric malnutrition and measles. The length of the prodromal illness tended to be short and a primary site of infection, usually the lungs or skin, was obvious in 66% of patients. In 30% there was evidence of metastatic spread, usually to meninges, bone, joint and muscle, but endocarditis was uncommon. Metastatic infection was rare when infection was acquired in hospital. Death appeared to be associated with measles, protein-caloric malnutrition, acquisition of infection in hospital, absence of an obvious focus of infection and with inappropriate antibiotic therapy. Aggressive treatment with antibiotics intravenously was the rule. A combination of penicillin and an aminoglycoside was favoured until the nature of the infecting organism was established. Of those patients who died, 38% had received less than 72 h antibiotic therapy. Multiple antibiotic resistance is now widespread in Zimbabwe.
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PMID:Staphylococcal bacteraemia in Zimbabwe 1983. 403 14

Cefotiam (CTM) was evaluated for its safety and efficacy in children. Twenty-six patients were treated with 40 to 200 mg/kg per day of CTM by intravenous administrations. The diagnosis of the patients were acute pharyngitis (2), acute bronchitis (1), pneumonia (4), empyema (2), urinary tract infection (2), typhoid fever (1), acute enterocolitis (2), partially-treated purulent meningitis (1), and suspected septicemia in neuroblastoma (1); and the remaining ten patients were considered to have nonbacterial infections. The pathogens recovered were Streptococcus pyogenes (1), Streptococcus pneumoniae (1), Staphylococcus aureus (4), Haemophilus influenzae (4), Escherichia coli (1), enteropathogenic Escherichia coli (1), Salmonella typhi (1), and Campylobacter jejuni (1). All but two patients of bacterial infections were cured after the CTM therapy, and the rate of efficacy was 87.5%. Diarrhea (3), urticaria (1), transient elevation of GOT and GPT (1), and transient eosinophilia (3) were found to be associated with the CTM therapy. However, no severe adverse reactions were encountered. Half life of the serum CTM level was 0.93 +/- 0.13 hours, and excretion into the urine was rapid. CSF concentration obtained 1 hour after an intravenous injection of 21 mg/kg of CTM in a case with inflamed meninges was 1.5 mcg/ml, and the CSF/serum ratio was 9.0%. From these data, CTM appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections.
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PMID:[Clinical evaluation of cefotiam therapy in children (author's transl)]. 627 Apr 13


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