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

This study deals with sepsis caused by coagulase-negative stapylococci in a neonatal intensive care unit over a period of four years and eleven months. The global incidence was 20.7/1000 (50 cases out of a total of 2,416 admissions) and was higher in newborns with lower weight and with a shorter gestational age. The most significant clinical manifestations were fever, paleness, and apnea/bradycardia. In all cases the germ was sensitive to vancomycin. Evolution was favourable in all patients, in spite of the initial gravity of some cases. Sepsis due to coagulase-negative staphylococci is the most frequent cause of nosocomial infection in our environment.
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PMID:[Sepsis caused by coagulase-negative Staphylococcus in the newborn infant. Clinical and therapeutic aspects]. 836 75

Nosocomial infection is a major problem affecting many hospital personnel and patients. Surveillance of intensive care areas such as burns wards is important due to the immunocompromised status of the patients. Since infection has been found to be a major cause of death in our burns ward, bacteriological surveillance of the area was carried out over a 1-year period. This indicated the various sources of infection, which included a contaminated container of disinfectant, and transient pathogenic flora on one of the staff members involved in changing dressings. Pseudomonas aeruginosa was the most commonly isolated pathogen from infected wounds as well as from the blood of patients developing sepsis. Autogenous spread of this organism was confirmed by similar pyocin typing results of the strains isolated from wounds, blood and faeces of the patients. Necessary changes were implemented based on these findings and the infection rate was reduced remarkably. The results suggested that strict vigilance by the personnel involved in the care of burns patients reduces the incidence of invasive sepsis and shortens the hospital stay.
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PMID:Laboratory data from the surveillance of a burns ward for the detection of hospital infection. 843 17

We studied nosocomial infection in a group of 608 pediatric surgical patients over a 14-month period. All inpatients and outpatients who received an operation with an incision by the pediatric general surgical service were entered into the study. Demographic, nutritional, clinical, and laboratory data were collected. Surveillance was conducted for wound infection, septicemia, infections of the respiratory tract, urinary tract, and abdomen, and infectious diarrhea. A total of 676 operative procedures was performed. Nosocomial infection occurred in 38 of the 608 patients (6.2%). A total of 53 infectious complications was tabulated. The number and percent risk per operation were wound 17 (2.5%), septicemia 14 (2.1%), pulmonary 10 (1.5%), urinary tract 5 (0.7%), abdominal 5 (0.7%), diarrhea 2 (0.3%). Broviac catheter sepsis occurred in 7 of 61 lines (11.5%). The highest overall occurrence of infection was in the infant group (1 mo to 1 yr), (13/161, 8.1%). The probability of septicemia was highest in neonates (4.2%) compared with infants (3.1%) or older children (1.2%) (P < .05). The most common isolates were Staphylococcus epidermidis (10/17) from septic patients, and gram-negative enteric bacteria (27/50) from organ and wound infections. Infection was associated with impaired nutrition, multiple disease processes, and multiple operations. The risk of nosocomial infection in this population was comparable to that reported in adult surgical patients. These baseline data may aid the development of strategies to lower infection risk in children.
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PMID:Nosocomial infection in pediatric surgical patients: a study of 608 infants and children. 846 43

A 12-year review identified 21 patients with nontyphoidal, nonparatyphoidal salmonella septicemia. Eight of the patients had no predisposing factors. Factors identified included malignancy in five, recent surgery in four, alcoholism with aspiration pneumonia in two, chronic lung disease in two, diabetes in two, systemic lupus erythematosus in one and burns in one. Ten patients presented with gastroenteritis, two with localized abscesses, two with aspiration pneumonia and the remainder with nonspecific septicemia. Three patients died of underlying diseases and three died shortly after the septicemia of related causes. Six cases were nosocomial infection and were not related to hospital outbreaks. Salmonella septicemia with these serotypes is uncommon (1 per 14,000 admissions, 1 per 4000 blood cultures) and can occur in patients without diminished host resistance.
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PMID:Nontyphoidal, nonparatyphoidal salmonella septicemia in adults. 850 19

Thirteen clinical and four environmental isolates of third-generation cephalosporin-resistant Enterobacter cloacae (CREC) together with single isolates from the hands of a nurse and from a blood gas analyser were associated with two clusters of nosocomial infection. With an unrelated CREC isolate they had been typed by serotype, biotype, ribotype and phage-type and were examined by pyrolysis mass spectrometry (PYMS) as described here. PYMS data yielded two clusters, major and minor. All except one isolate in the major cluster corresponded to type group identity (serotype 07, biotype 62, ribotype D) which had caused neonatal sepsis and colonization. Multivariate analysis showed a homogeneous group consisting of this strain plus two outliers. The minor cluster included four different strains, one of which, serotype 03, biotype 62, ribotype C had caused excoriation of the buttocks and colonization.
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PMID:Pyrolysis mass spectrometry of cephalosporin-resistant Enterobacter cloacae. 855 Oct 27

A case is reported of contained rupture of an infected abdominal aortic aneurysm as a result of vascular catheter-associated candidiasis. Candida was identified in the mural thrombus taken from the aneurysm during surgery. Since Candida has played an important role in nosocomial infection and catheter-associated sepsis during the past decade, it is becoming an increasingly significant pathogen in microbial arteritis. Successful treatment included axillobifemoral bypass grafting followed by a complete excision of the infected aneurysm, retroperitoneal drainage and long-term antifungal therapy. Although infected abdominal aortic aneurysm is not common, without surgical intervention it may lead to serious consequences, such as rupture or uncontrollable sepsis. As the clinical symptoms of this disease are minimal and non-specific during the early stages, a high index of suspicion for this condition is essential for precise diagnosis and successful treatment. Moreover, initial treatment of candidiasis is especially important to prevent this rare but fatal late complication, infected abdominal aortic aneurysm.
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PMID:Contained rupture of infected abdominal aortic aneurysm due to systemic candidiasis. 874 99

Teicoplanin was used for the treatment of multiresistant Gram-positive-Staphylococcus aureus, coagulase negative Staphylococcus and Enterococcus-infections in 15 cases of kidney transplantations. The motive of the application was the once per day dosage and the spare of the transplanted kidney. Nosocomial infections were the most common. Clinical and microbiological diagnosis was the criteria in order to begin the 5-21 days treatment. These patients which were infected with Gram positive bacteria, teicoplanin was also effective in methicillin-resistant cases. In some mixed infections, after several courses of antibiotics, teicoplanin even if combined with other antibiotics could not prevent fatal sepsis.
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PMID:[The use of teicoplanin for Gram-positive infections in patients with kidney transplantation]. 875 82

Nosocomial disseminated candidiasis was diagnosed in 6 out of 200 (3%) children receiving pediatric intensive care over a period of 9 months. The ages of patients ranged between 20 days to 3 years; 4 were < 2 months. Therapy with broad spectrum antibiotics (in all), indwelling cannula (in all), peritoneal dialysis (in 3), low birth weight (in 3) and invasive hemodynamic monitoring were recognizable predisposing factors. The diagnosis was suspected on an average after 14 days, PICU stay (range 8-20 days). All the patients showed a secondary worsening after evidence of improvement from the primary illness. It was characterized by lethargy, fever (in 3), weight loss (in 3), loose stools (in 2) and respiratory distress (in 3), and was indistinguishable from any bacterial sepsis. Presumptive diagnosis was made on basis of KOH wet mount and Gram stained smear findings of mycelia, and was confirmed later on isolation of candida species from one or more body sites and blood culture. All the patients showed disappearance of symptoms and mycological cure within 6-14 days of oral itraconazole therapy, (10 mg/ kg/day in 2 divided doses). The therapy was continued for upto 14 days after sterile fungal blood culture, and was well tolerated. Fungal superinfection especially with candida must be looked for in hospitalized patients suspected of nosocomial infection. Early oral itraconazole is effective in disseminated candidiasis and well tolerated by children.
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PMID:Disseminated nosocomial candidiasis in a pediatric intensive care unit. 877 63

In hospital settings in Africa the many other concerns of sanitary officials and the lack of available resources often make hospital hygiene and nosocomial infection secondary problems. To illustrate the importance of these issues in an African pediatric setting, this report describes a series of 32 cases of nosocomial septicemia that occurred within a 2-month period in the Pediatric Department of Principal Hospital in Dakar. There were 10 deaths. The infecting organisms were similar to those observed in industrial countries. Klebsiella Pneumoniae was identified in 16 cases, Escherichia coli in 5, and an association of both bacteria in 5. A profile of beta-lactamase enzymes with a classic epidemiologic spectrum was observed in 15 of 21 strains of Klebsiella pneumoniae and in 3 of 10 strains of Escherichia coli. The authors discuss the conditions that may have encouraged the outbreak of septicemia, regret the lack of a service to monitor hospital hygiene, and propose prophylactic measures using laboratory tests that are feasible in a hospital setting in Africa.
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PMID:[Nosocomial septicemias due to multiresistant enterobacteria: preliminary considerations in 32 cases observed in the African hospital environment]. 883 Feb 20

Fifteen patients with severe hospital infections such as postoperative pneumonia or intraabdominal sepsis were treated with ofloxacin in a dose of 400 mg once a day for 7 to 14 days (11 days at the average). The drug was administered intravenously for the first 3-5 days and then orally till the end of the treatment course. The clinical effect was observed in 14 patients (93 per cent) and the positive bacteriological effect was stated in 11 out of 13 patients (85 per cent). Before the treatment 18 microbial cultures were isolated from the patients. 94 per cent of them was susceptible to ofloxacin. The isolates of Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were the most frequent. The treatment resulted in the eradication of 15 cultures (83 per cent). The adverse reactions were observed in 3 patients but only in 1 of them they were for certain due to the drug use. All the adverse reactions were insignificant or moderate and did not require the treatment discontinuation. The trials showed that ofloxacin was a highly efficient agent useful in the empirical monotherapy of patients with severe hospital infection.
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PMID:[Clinical trials of ofloxacin in sequential use (intravenous and oral) in patients with serious hospital infection]. 900 88


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