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

In 1978 353 premature and mature newborns were admitted to our neonatal and intensive care unit. 34 children developed bacterial infections. B-streptococci were the offending organisms in 6 cases, pneumococci in 1 case, 5 of these 7 infections were of the early-onset type, 2 of the late-onset type. The early-onset type disease manifests itself by respiratory distress and shock. It is transmitted vertically from mother to child before or during birth. 3 of our 5 affected children died. The late-onset type disease occurs after 5-10 days, is transmitted as horizontal, mostly nosocomial infection, and presents as sepsis with meningitis or - as in one of our cases - with osteomyelitis. In addition to the 7 sick infants 8 of the 353 admitted newborns were colonized without signs of disease. Early diagnosis, therapy, and prophylaxis of these infections present still unsolved problems.
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PMID:[Haemolytic streptococci of the serological group B and pneumococci - new life-threatening bacteria in newborn wards (author's transl)]. 700 32

Outcomes of 65 patients after operation who had exhibited a clinical response to treatment for intra-abdominal sepsis were compared based on the presence or absence of leukocytosis and fever at the conclusion of antibiotic therapy. Fifty-one patients were afebrile when antibiotics were stopped. Intra-abdominal infection developed in 7 of 21 (33%) who had a persistent leukocytosis, but no intra-abdominal infections developed after operation in 30 patients who had normal WBC counts at the end of antibiotic treatment (p less than 0.005). Nosocomial infections developed in 6 (12%) of the 51 patients, and there was no difference in the incidence between patients with or without leukocytosis. Eleven of 14 (79%) patients who were still febrile when antibiotics were discontinued developed infections after operation. Nosocomial infections occurred in three (21%) and intra-abdominal infections in eight (57%). Of the 15 patients who developed intra-abdominal infection after operation, only four responded to appropriate antibiotic treatment without requiring further surgery. The other patients required surgical management for definitive control within two months of the initial operation. In conclusion, patients at risk of developing infection after operation after exhibiting a clinical response to treatment of intra-abdominal sepsis are those who are afebrile with a persistent leukocytosis or who are still febrile when antibiotics are stopped.
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PMID:Implications of leukocytosis and fever at conclusion of antibiotic therapy for intra-abdominal sepsis. 705 79

The average nosocomial infection rate during a four year prospective study period was found to be 26.4%. Most common hospital acquired infections were urinary tract infections, pneumonia, septicemia, infections of the skin and wound infections. The most common isolated organisms were: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Enterococci and Klebsiella pneumoniae. Infection control programs reduced the infection rate by 32%.
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PMID:[Nosocomial infections in an operative intensive care unit. Results of a four year prospective study (author's transl)]. 709 39

The past decade brought with it both highly sophisticated neonatal intensive care with improved perinatal mortality rates, and increased risk for nosocomial septicemia and meningitis among survivors. Although most of these infections were caused by multiple antibiotic-resistant gram negative enteric bacteria, Staphylococcus aureus "outbreaks" appeared sporadically. Risk for nosocomial infection was related primarily to factors which enhance infant contact with these bacteria (crowding and high nurse to infant ratios, poor handwashing practices, contaminated life support equipment, antibiotic exposure and prolonged hospitalization) in combination with those poorly defined determinants of bacterial virulence and host defense. Control measures for the prevention or reduction of these infections are aimed at decreasing the neonate's contact with the "outbreak" strains--improvement in handwashing practices and equipment sterilization processes, cohorting of infants, establishment of appropriate nurse:infant ratios, and in certain instances, modification of antibiotic practices. Future efforts should be directed toward better definition of bacterial virulence, host susceptibility and preventive measures.
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PMID:Nosocomial septicemia and meningitis in neonates. 721 2

The average nosocomial infection rate of 2,950 patients of a University Childrens Hospital (among them 672 patients of a newborn intensive care unit) was 16.4%. The most common infections were: of the skin and subcutaneous tissue (42%), upper respiratory tract infections (21.1%) gastrointestinal infections (12.6%) wound infections (6.8%), septicemia (5.6%) and pneumonia (3.3%). Bacterial species most commonly isolated were Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. The prevention and control of hospital acquired infection is of utmost importance for the care of children in hospitals.
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PMID:[Nosocomial infections in a children's hospital. Results of a prospective study covering 3 1/2 years (author's transl)]. 733 93

Fifty-five documented infections reported from an admission unit of a large skilled nursing facility (SNF) during a five-month period were analyzed. Of these, 45 (82 percent) were urinary-tract infections (UTIs), chiefly asymptomatic bacteriuria. Sixty-three percent of the UTIs were acquired in the SNF, and the remainder were acquired during the preceding stay in a general hospital. Statistically, Proteus species infections were more common among the SNF-acquired UTIs, whereas Pseudomonas aeruginosa infections were the most common among the hospital-acquired UTIs. The following recommendations are made: 1) for previously hospitalized elderly patients in whom urinary-tract sepsis develops soon after admission to an SNF, treatment should start with an antibiotic active against Pseudomonas aeruginosa while the results of cultures are pending; 2) symptomatic lower urinary-tract infections caused by SNF-acquired Proteus species should be treated with nalidixic acid or trimethoprimsulfamethoxazole; 3) the term "nosocomial infection" should be broadened to include infections acquired in long-term care institutions; and 4) infection surveillance should be started in selected long-term care institutions for the elderly as part of an expanded National Nosocomial Infections Survey.
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PMID:Nosocomial urinary-tract infections in a skilled nursing facility. 741 46

The perinatal histories and hospital courses of all neonates born at Grady Memorial Hospital who developed Pseudomonas aeruginosa sepsis or meningitis in the 5-year period 1989-1993 were reviewed. In addition a case-control study was performed to evaluate selected risk factors for this infection. Twenty-one patients had one or more blood cultures positive for P. aeruginosa. An additional patient had P. aeruginosa meningitis without bacteremia. All infections occurred after 5 days of age. The overall incidence of P. aeruginosa infection was 0.7/1000 live births. All cases occurred in infants < 1500 g at birth, for a birth weight-specific rate of 19.5/1000 livebirths in this weight class. Clinical manifestations of disease did not distinguish P. aeruginosa from other causes of fulminant neonatal sepsis. Fifty percent of cases died. Mortality was inversely related to postnatal age at diagnosis. The 22 cases were compared with 44 controls matched for birth weight, gestational age, sex, duration of hospital stay and admission date. Cases were more likely than controls to have a history of feeding intolerance, interrupted enteral intake and prolonged parenteral hyperalimentation. Case infants received intravenous antibiotics for a significantly longer period of time than did controls. There was an association between P. aeruginosa sepsis and necrotizing enterocolitis (36% cases vs. 7% of controls had prior or concurrent necrotizing enterocolitis, P < 0.01). In summary P. aeruginosa sepsis is primarily a late onset nosocomial infection in very low birth weight infants. The case fatality rate of 50% in this series emphasizes its continued importance.
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PMID:Pseudomonas aeruginosa infection in very low birth weight infants: a case-control study. 763 11

Central venous access devices are a major source of nosocomial infection. The skin and catheter hub are the two major sources for the introduction of the colonizing organisms. Staphylococci are the leading causative agents. The authors reviews classification of catheter-related infection complications, diagnostic problems of catheter sepsis and up-to-date trends in their treatment. Diagnosis of catheter-related sepsis remains still difficult, if device is not removed. Candida catheter related is associated with higher morbidity and mortality than infections with other organisms and the device should be removed if possible. Prophylactic measures include especially a skilled team, maximal barrier precautions during insertion.
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PMID:[Infections in patients with central venous systems for long-term venous access: pathogenesis, classification, diagnosis and therapy]. 767 65

The use of total parenteral nutrition (TPN) has increased considerably in recent years, resulting in greater demands on human and material resources. Current practice in most hospitals is to replace i.v. lines for TPN every 24 hours, whereas all other i.v. lines are changed every 72 hours. A prospective study was conducted in a pediatric hospital to compare the nosocomial infection incidence between 24- and 72-hour TPN line changes. The convenience sample of 279 patients receiving TPN was studied over two consecutive 12-month periods. A statistically significant decrease was found in the incidence of nosocomial septicemia in the 72 hour line change group. A substantial decrease also was demonstrated in the overall cost of TPN management.
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PMID:A prospective study evaluating the effects of extending total parenteral nutrition line changes to 72 hours. 770 74

The diagnosis of vertebral osteomyelitis is easily missed, particularly for the elderly in whom signs of sepsis may not manifest. The case records of 20 patients with vertebral osteomyelitis who were treated at our hospital between January 1989 and April 1993 were reviewed. The average age of the patients was 72 years. Infection was most commonly due to intravenous cannula-related sepsis. Eighty-five percent of patients presented with back pain, and only 30% had a fever. Computerized tomography and magnetic resonance imaging were the most useful radiological investigations; nuclear scanning was sensitive but insufficiently specific. Staphylococcus aureus was the infecting organism in 13 of 16 patients whose microbiological diagnosis was made by blood or bone cultures. Six (45%) of these 13 patients were infected with methicillin-resistant S. aureus (MRSA). Nosocomial infection occurred in 12 (60%) of the patients studied, including all patients with MRSA infections. Vertebral osteomyelitis may be largely preventable if infection-control aspects of intravenous cannulation are improved, attempts at reducing and preventing MRSA colonization are made, and therapy for bacteremias is optimized.
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PMID:Pyogenic vertebral osteomyelitis: analysis of 20 cases and review. 774 37


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