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

The case records of all neonates admitted to the neonatal unit at Aga Khan University Hospital (Karachi) in a 30 month period (Nov. 86-April 89) were analysed. Of 60 neonates with confirmed sepsis, 33 (55%) had non-nosocomial infection (NNC) whereas 27 (45%) had nosocomial sepsis (NC). The most common organisms causing early-onset NNC sepsis were Klebsiella species (53%) and Escherichia coli (10%), whereas the organisms causing late-onset NNC sepsis included Salmonella parathypi (21%), Group A Streptococcus (21%), Escherichia coli (14%) and Pseudomonas species (14%). Klebsiella was the most common organism causing NC sepsis, others being Staphylococcus aureus (15%) and Serratia species (15%). The mortality in NC sepsis, early-onset and late onset NNC sepsis was 44%, 26% and 43%, respectively. Risk factors associated with NNC sepsis included low birthweight, prematurity and prolonged and complicated deliveries. There was a high incidence of drug resistance to ampicillin and gentamicin among gram-negative organisms causing sepsis (mean 67%).
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PMID:Neonatal sepsis in Pakistan. Presentation and pathogens. 186 74

Infection and sepsis are generally considered as causally related to death in intensive care unit (ICU) patients, but in several studies a decrease in infection rates was not associated with lower mortality. We therefore investigated the causes of death in surgical ICU patients, with special regard to the relationship between infection and mortality. MATERIAL AND METHODS. During the investigation period of 6 months, 502 patients were treated in the ICU (cardiac surgery: 222, thoracoabdominal surgery: 125, vascular surgery: 84, others: 14). In all patients each antibiotic therapy and infection was documented, as was the sepsis score. Definitions of infection and bacteriological monitoring were described in detail previously. In all deaths, attention was paid to an infection that was causally related to or contributed to death. In unclear cases a postmortem examination was performed. RESULTS. Forty-two patients died (8.4%). During the first 4 days 23 patients died, 11 within 24 h, because of severe trauma with severe underlying disease (main reason for death: cardiac 30%, cerebral 32%). Infections were not significant in these patients. Nineteen patients suffered from 1 or more infections (total 30). They died after a median of 16 days. The leading cause of death was multiple organ failure. In 7 of these patients a life-threatening infection was the reason for admission and, later, death. In 8 patients a nosocomial infection was causally related to or contributed to death. In the 4 other patients a postmortem examination excluded an infection as being responsible for death. DISCUSSION. More than one-half of the deaths were caused by severe trauma or severe underlying disease. Nosocomial infections could only be related to death in 1.6% of the 502 treated ICU patients. The influence of new therapeutic regimens on infection and mortality can therefore only be investigated in multicenter trials.
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PMID:[Causes of death in intensive care surgical patients. A prospective study]. 192 18

We report the spread of a methicillin- and gentamicin-resistant Staphylococcus aureus strain (MGRSA) from the Middle East and its subsequent dissemination within two hospitals in Dublin. The index case, a 30-year-old male with serious blast injuries was transferred from a Baghdad hospital to a Dublin hospital in May 1985. He was heavily infected with two MGRSA strains, one of which spread and was responsible for numerous episodes of nosocomial infection. This strain was very similar to MGRSA isolates recovered in a Baghdad hospital during 1984. This imported strain has now spread to two hospitals in our group causing sepsis. This report emphasizes the difficulty of detecting an imported strain in an endemic area, but above all points to the potential for spread when there is considerable movement of patients and personnel.
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PMID:Importation of methicillin-resistant Staphylococcus aureus from Baghdad to Dublin and subsequent nosocomial spread. 196 34

Sepsis is a major cause of morbidity and mortality in patients with trauma. To elucidate factors that might lead to infection, we studied the epidemiologic characteristics of nosocomial infections in our patient population with trauma. During a 3.5-year period, 2496 patients were entered into our hospital trauma registry and cross-matched with hospital infection control surveillance information. Two hundred twenty-nine patients with trauma and nosocomial infections were identified (9.2%), a figure that was nearly twice the nosocomial infection rate for the general hospital population. The majority of those infected were either orthopedic (51%), general surgical (25%), or neurosurgical (13%) patients. The most common sites of first infection were urinary tract (61%) or respiratory system (14%). Patients developing nosocomial infections were significantly older and had a higher Injury Severity Score than those who did not. Injury site was related to risk of infection with injuries of the spine, chest, and extremity showing the most significant relationship. The length of stay as well as hospital charges were significantly related to the occurrence of infectious complications. By determining the patient with trauma at risk for infection, treatment strategies can be designed to minimize septic complications.
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PMID:The epidemiologic features of nosocomial infections in patients with trauma. 198 39

Enterococci are important causes of community-acquired and nosocomial infection. They cause endocarditis, bacteremia, urinary tract infections and neonatal sepsis. As causes of intra-abdominal and pelvic infection, enterococci are more commonly associated with abscess, biliary tract infection, spontaneous bacterial peritonitis, post-operative infection, post-partum endomyometritis and chronic or recurrent infection. As causes of soft tissue infection, enterococci are more commonly identified in burns, decubitus or diabetic foot ulcers, and wounds associated with intestinal surgery. Enterococci are often cultured in association with other pathogens when identified in intra-abdominal, pelvic or skin and soft tissue infection. Enterococcal superinfection after therapy with cephalosporins has been well described, and occurs as a result of the low in vitro activity of cephalosporins against enterococci. The epidemiology of enterococcal infection is complex and includes both endogenous and exogenous acquisition of the organism. Antibiotic resistance is an ever-increasing problem complicating therapy in patients with enterococcal infection.
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PMID:Clinical manifestations of enterococcal infection. 218 Jul 6

Clinicopathologic correlations for 71 cases of fatal pneumonia in children were determined. The mechanism of death for these patients was multifactorial. Severe pneumonia alone accounted for 11 deaths (15.5%). Pneumonia associated with sepsis occurred in 42 children (59.2%). Heart failure (8.5%), hypovolemia (4.2%), and nosocomial infection (12.6%) were also seen in children with fatal acute lower respiratory tract infection. Extensive consolidation, squamous metaplasia, and hyaline membranes were present in the lungs of these children. Patients with severe disease must receive, in addition to antibiotics for acute episodes, individualized intensive respiratory and supportive care. Since these types of care are not available in poor communities, vaccination against measles and vitamin A supplementation for malnourished children may ameliorate the conditions that appear to predispose these children to severe or fatal disease.
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PMID:Clinicopathologic studies of children who die of acute lower respiratory tract infections: mechanisms of death. 227 Apr 5

Nosocomial infection with aerobic Gram-negative bacilli is a major cause of morbidity and mortality in neonates. Few prospective studies have been undertaken in neonatal surgical units to investigate colonization and infection rates and the pathogenesis of infection. We prospectively studied 40 infants admitted to a neonatal surgical unit. Ninety-eight percent became colonized in throat/intestine with aerobic Gram-negative bacilli. Thirty-five percent developed infections, with wound and surface infections predominant (61%). Ninety-one percent of infections were caused by Gram-negative bacilli or yeasts. Severe infections (septicemia, pneumonia, meningitis) occurred in 13% of infants. The mortality rate was 5%. In all infections, the pathogenesis was found to be endogenous, and in most, three stages were distinguishable. Neonates always acquired potentially pathogenic organisms in throat/intestine (stage 1) before colonization (stage 2) and infection (stage 3) of other systems occurred. Reduction of digestive tract colonization by these potentially pathogenic microorganisms by means of successful selective decontamination may therefore reduce subsequent infection.
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PMID:Pathogenesis of colonization and infection in a neonatal surgical unit. 230 49

Authors registered the occurrence of nosocomial infections in altogether 1000, randomly selected case records at the surgical, gynecological, urological and intensive care wards of four county hospitals plus one large hospital in the capital in 1988. They found the proof of a total of 117 nosocomial infections occurring in 100 case records. The three most common infections in diminishing order were: urogenital-, wound- and respiratory infections. Twenty three infected patients developed sepsis, with a fatal outcome in every second among them. A nosocomial infection extended the period of hospital treatment in average by a week. In more than half of the cases microbiological examination for detecting the causative agent failed. Four fifth of the isolated bacteria were Gram-negative. Presented data of informatory nature suggest more decades arrearagement compared to the highly-developed countries.
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PMID:[Information data on the incidence of nosocomial infections in Hungary]. 237 64

Over a 12 months period, out of 25,411 livebirths, 155 neonates (6.1 per 1000 livebirths) had proven septicemia by blood culture. The mortality rate was 26.5%. Septicemia was more common among the very low birthweight and preterm neonates of gestation of 30 weeks or less. 45.8% of the septicemia occurred during the first 48 hours of life. Staphylococcus epidermidis was the most common causative organism. However, mortality was highest among neonates who acquired multiresistant nosocomial infection during the later part of neonatal life.
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PMID:Pattern of neonatal septicemia in a Malaysian maternity hospital. 262 33

Burn wound sepsis can be due to exogenous or endogenous bacteria. When rare organisms cause infection, exogenous sources are implicated. This sets into motion hospital infection control team searches, which are both exhausting and harassing to patients and staff. This study examines the skin bacteria present at admission and the frequency of endogenous infection in burn patients. Sixty-two patients with burns up to 92% of the total body surface area underwent unburned skin bacterial surveillance on admission and at weekly intervals using RODAC contact plates. Burn wounds were biopsied for quantitative and qualitative analyses. Morphologically dissimilar colonies were isolated and identified using standard gram-positive and gram-negative identification strips (Analytab Products, Inc. [API]). On admission, the patients harbored Staphylococcus species, many of which were burn wound sepsis were infected with the same organisms cultured from their unburned skin on admission. A subset of patients (14) grew methicillin-resistant Staphylococcus aureus from their wounds or other sites. A comparison with admission isolates showed identical susceptibilities. These data suggest skin is an endogenous source of infection in the burned patient.
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PMID:The effect of endogenous skin bacteria on burn wound infection. 276 60


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