Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten critically ill patients presenting with nosocomial infection caused by Serratia marcescens (SM) not responding to prior chemotherapy were treated in an open study with Moxalactam (MOX) alone [6] or in combination with an aminoglycoside [4]. In initial disc diffusion tests, all isolates of SM were highly susceptible to MOX. Clinically, three patients were cured and four improved. Three patients died: one from SM pneumonia, one from gangrenous cholecystitis and another from ARDS. Bacteriologically, SM were eliminated from blood cultures in all seven patients with septicemia but were recovered post mortem from the lung of one patient. In three cases with localized infection, SM were eliminated once and persisted twice. Selection of resistant SM was observed in three patients but became clinically relevant in one case only. Resistant SM strains also showed reduced susceptibility to other cephalosporins and aminoglycosides. Emergence of enterococci occurred four times, in two cases with clinical consequences. MOX is a useful drug for the treatment of SM infections, but a definite risk of selecting multiresistant SM strains and of enterococcal overgrowth must be kept in mind.
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PMID:Moxalactam in nosocomial infections with Serratia marcescens. 390 Jan 66

The indication for examination of blood cultures is discussed. The evaluation of clinical information with respect to the underlying diseases demonstrated that in most cases a microbiological etiology was suspected. Mostly we obtained diagnosis like chill, septic shock or suspicion of nosocomial infection. In most cases the infection origin was related to the gastrointestinal tract or the genitourinary tract. The examination of different specimens yielded the blood culture bottle as the best medium for diagnosis of septicemia. The laboratory diagnostic procedure is briefly presented. The rate of positive results, the contamination rate and the interpretation are discussed.
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PMID:[Blood culture: efficacy of the specimens for the analysis of bacteremia and sepsis]. 395 3

Parting surfaces between areas having different standards of hygienic requirements, represent naturally the weak points in the hygienic conception of operating theatres. These boundary areas between the operation room on the one hand and the adjoining entrance lock for the staff on the other are of specific interest in this connection. While opening the connecting doors, dust particles may be whirled up due to turbulence, thermic, constructional and other effects, which are difficult to be identified and may then settle down directly on the operating area after reaching there from the entrance lock through the airways. Since bacteria are in most cases attached to particles, it may be assumed that each air flow loaded with dust particles is also a potential carrier of air-borne germs (contact germs----contaminated dust particles----air borne germs----settling germs). Therefore, the present paper is to be understood as a contribution towards the application of methods for identifying air-borne routes of infection in the operating area and finding ways and means for their elimination. In comparison with the investigations done by Esdorn and Kanz during simulated and operating activities respectively, the experiments described in this paper have been carried out while the operating theatre was not running. It is to be assumed that even under these tranquil conditions, parting surfaces appear to act as permanent disturbing factors. Transmission of germs from the entrance lock for the staff to the operating room is only then possible, if the doors suffer functional disturbance and the entrance lock is found hygienically in objectionable condition. Functional measures regarding construction aim, therefore, at the principle of clear-cut separation of the clean side from the unclean in the design and running of operating theatres, as specified in the guidelines of the Bundesgesundheitsamt. The constructional conception of entrance lock can contribute to achieving almost automatically the necessary hygienic provisions. One of the principle purposes of air-handling systems in operating theatres is to keep a protecting pressure in areas with very high hygienic requirements in relation to those with lower standards of air cleanliness. Air-flow must always follow the direction from the clean to the less clean areas (2, 4, 9, 22, 24, 26, 30). A British-Scandinavian multi-centre study of ultra-clean air and sepsis following total hip replacement (19) showed that the risk of nosocomial infection increases directly with the air contamination.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Effect of parting surfaces on the transmission of airborne organisms at junctions between areas of different hygienic standards]. 409 54

Four cases of Pseudomonas cepacia septicemia were found in one hospital in 1971. Two were related to severe phlebitis of the arms due to intravenous catheters, a third to an infected central venous pressure catheter. The infections resolved after the catheters were removed in these three cases. Prophylactic antibiotics may play a partial role in predisposing to this kind of infection. Ps. cepacia may be a more common pathogen than previously recognized. Its antibiotic sensitivity pattern distinguishes it from other members of the Pseudomonas family. Nosocomial infection with this bacteria has been traced to quaternary ammonium solutions but the source of infections in the present cases was not found.
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PMID:Pseudomonas cepacia septicemia associated with intravenous therapy. 449 88

Echoviruses cause neonatal disease following intrauterine and intrapartum acquisition of the organism or by nosocomial infection. Dizygous twins apparently became infected following transplacental transmission of echovirus 11. At 5 days of age, both twins experienced poor feeding, lethargy and hypothermia, and evidence of coagulopathy and hepatitis. During the sixth week of illness, the convalescence of twin A was complicated by peritonitis and sepsis, and the infant died. Pathologic findings included scattered foci of dystrophic myocardial calcification, distortion of hepatic architecture with fibrous connective tissue surrounding regenerative nodules and large foci of dystrophic calcification, and adrenal hemorrhagic necrosis and calcification. Twin B recovered without sequelae. The disease in twin A was unusual because of the extensive myocardial involvement. Also of interest was the variability of disease in twins who presumably had received a similar inoculum of organism by the same route.
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PMID:Dissimilar manifestations of intrauterine infection with echovirus 11 in premature twins. 634 39

In July and August 1981, five patients in the cardiac surgery unit of the Bristol Royal Infirmary developed septicemia caused by Morganella morganii, Proteus mirabilis, or both of these species. Three of the patients had serious wound infections, and three of the patients died. Typing of the M. morganii isolates by O-serotyping and of the P. mirabilis isolates by O-serotyping, proticine production and sensitivity, and the Dienes reaction confirmed cross infection by both species. Although M. morganii has been regarded as a relatively unimportant human pathogen in the past, it may prove to be an important cause of nosocomial infection in the future.
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PMID:Serious nosocomial infection caused by Morganella morganii and Proteus mirabilis in a cardiac surgery unit. 635 Mar 54

Among 12,500 babies born in our hospital from 1977 to 1982, there was one case of neonatal sepsis due to Group B beta-hemolytic Streptococcus (GBS), an incidence which is significantly lower than that reported in Western countries (3 to 6 per 1,000 live births). Among 385 pregnant women from Jerusalem and Haifa, the vaginal colonization rate with GBS was 2.8%, in contrast with 4.6 to 36% reported in Western countries. Umbilical and ear cultures were obtained from the infants of the 85 mothers who were examined in Haifa. These cultures were repeated at 3 to 5 days of age in 60 of the 85 babies. From the above data, mother-to-infant transmission rates and neonatal nosocomial infection rates with GBS were found to be 66 and 6.6%, respectively, which correlates well with 60 to 75% and 12 to 27% reported in the literature. The low incidence of GBS neonatal sepsis in our survey may be related to the low maternal colonization rate with GBS. The low maternal colonization rate could be related to still unidentified epidemiological and environmental factors.
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PMID:Perinatal group B streptococcal infections in Israel. 636 45

An outbreak in a neonatal intensive care nursery of severe infections caused by Klebsiella pneumoniae type K-17 has been studied. Over a 9-month period 20 epidemiologically linked cases of severe septicemia, meningitis and pneumonia were diagnosed. The specific epidemic strain could be identified. After introduction of a policy of hygienic measures the nosocomial infection could be eradicated although colonization still occurred. Thorough handwashing before and after the nursing care of each infant, individual gowning and disposable gloves in the care of infants below 1 500 g were important. The changing bacterial ecology of a neonatal unit should be followed closely by weekly routine throat cultures as well as by cultures of incubators and ventilation equipment. The present investigation has shown the importance of this procedure, which is mandatory for appropriate choice of antimicrobial agents when treating infections in critically ill or very low birth weight infants in the neonatal intensive care unit. Prophylactic antimicrobial treatment is not indicated. Control of K. pneumoniae nosocomial infections can only be achieved by maintaining a high standard of hygiene in the neonatal care.
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PMID:Nosocomial Klebsiella pneumoniae infection: clinical and hygienic measures in a neonatal intensive care unit. 636 26

Eight hundred twenty-nine patients were monitored for nosocomial surgical infections from January to December 1980 at the University Hospital of the West Indies. Two hundred twenty-five patients (27%) had 189 postoperative wound infections (POWI) and 295 other nosocomial infections, with an average of 2.1 infections per infected patient. The incidence of POWI was 22.8%, varying from 7.3% in clean to 82.2% in infected wounds. The most common organisms isolated were gram-negative bacilli and Staphylococcus aureus. The most frequent nosocomial infection other than POWI was urinary tract infection (27.8%). A statistically significant number of urinary tract infections and septicemias were associated with the use of medical devices such as indwelling urethral catheters and central venous pressure lines (p less than 0.001). Septicemia was frequently associated with operations on the lower gastrointestinal and hepatobiliary tracts (p less than 0.001). The postoperative stay of an infected patient was prolonged by an average of 18 days. The total excess cost of hospitalization for the infected patients was U.S. $170,000.
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PMID:Nosocomial surgical infections: incidence and cost in a developing country. 655 84

Aminoglycosides often are employed for empiric therapy of nosocomial infection because of their activity against a wide spectrum of gram-negative aerobic bacilli (GNAB). New beta-lactam antimicrobials also are active against many GNAB. As toxicity appears less likely for the beta-lactams than for aminoglycosides, their use might be preferable if susceptibility profiles were equivalent. We studied susceptibility of 90 GNAB recovered from blood culture during a three-month period. All were susceptible to aminoglycosides; 93% were susceptible to at least one of the following: ampicillin, carbenicillin, ticarcillin, cephalothin, chloramphenicol or trimethoprim-sulfamethoxazole. All were susceptible to at least one of our newer beta-lactams (cefamandole, cefoxitin, cefotaxime, moxalactam, piperacillin), but the percentage susceptible to any single beta-lactam was lower than that for any of the aminoglycosides tested. All of the isolates were susceptible to combinations of two beta-lactam drugs. In our hospital, beta-lactams may be reasonable alternatives to aminoglycosides in selected cases where susceptibility has been demonstrated. However, aminoglycosides continue to provide the broadest single-drug coverage for empiric therapy of known or suspected sepsis with GNAB. The utility of combinations of beta-lactam drugs for empiric therapy requires further assessment by clinical trials.
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PMID:Role of aminoglycosides in face of introduction of new beta-lactam antibiotics in treatment of nosocomial infection. 655 23


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