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

To determine the role of bacterial and host factors in the pathogenesis of shigellemia, blood and fecal Shigella isolates were compared for serum resistance and siderophore production, and shigellemic patients were examined for decreased serum bactericidal activity or increased serum transferrin saturation compared to control patients with non-bacteremic shigellosis. The majority of both blood (36/38) and fecal (36/48) Shigella isolates were sensitive to normal serum (greater than 2 log kill/60 min). Shigella dysenteriae type 1 strains were the most sensitive, and Shigella sonnei strains were the most resistant. Siderophore production was species- and serotype-dependent. Shigella dysenteriae type 1 produced only enterochelin; most Shigella flexneri expressed only aerobactin, and Shigella sonnei secreted both types of siderophores. No difference in siderophores was noted between blood and fecal strains within a given serotype. In contrast, shigellemic patients exhibited a 43-fold decrease in serum bactericidal activity and a two-fold increase in transferrin saturation compared to well-nourished control patients. These results indicate that the pathogenesis of Shigella septicemia is not related to serum resistance or siderophore production but may involve serum abnormalities associated with malnutrition.
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PMID:Role of bacterial and host factors in the pathogenesis of Shigella septicemia. 237 88

Thirty-seven children (median age, 2 years) with shigellosis in Bangladesh were subjected to postmortem examination to determine causes of death and the spectrum of intestinal histopathology. Infecting species were: Shigella dysenteriae 1, 7 cases; S. dysenteriae 2, 2 cases; Shigella flexneri, 23 cases; Shigella boydii, 4 cases; and mixed infection with Shigella boydii and Shigella sonnei, 1 case. Complicating conditions detected before death included malnutrition in 25 cases, pneumonia in 11 cases and septicemia in 8 cases. In all 37 cases the colon showed gross colitis, consisting of mucosal erythema and edema; superficial ulcerations were visible in 15 cases. Microscopically in the colon the lamina propria showed inflammatory cellular infiltration in 27 cases and crypt abscesses were present in 22 cases. In 9 cases each there were colonic glands in the submucosa and branching of colonic crypts, indicating increased regenerative activity of crypt cells. Severe lesions were mucosal denudation and deep ulceration in 15 cases with a pseudomembrane in 7 and pseudopolyposis in 2 of these patients. The most common underlying cause of death was colitis, whereas the most common immediate and associated causes were, respectively, septicemia and pneumonia. These results indicated that fatal childhood shigellosis results from severe colitis, often complicated by septicemia and concomitant malnutrition and pneumonia.
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PMID:Causes of death and the histopathologic findings in fatal shigellosis. 259 52

We have treated 42 episodes of pediatric infections with sulbactam/ampicillin since 1987. Included were 9 cellulitis, 9 urinary tract infections, 5 cervical lymphadenitis, 4 meningitis, 2 thoracic empyema, 2 osteomyelitis, 2 sepsis, 1 furuncle, 1 perianal abscess, 1 dental abscess, 1 peritonsillitis, 1 salmonellosis, 1 shigellosis, 1 peritonitis, 1 suppurative thyroiditis, 1 infective endocarditis. Responsible pathogens were Escherichia coli in 8, Staphylococcus aureus in 6, Hemophilus influenzae in 2, Streptococcus pneumoniae in 3, Streptococcus viridans in 2, Staphylococcus epidermidis in 1, Bacteroides fragilis in 1, Salmonella D1 in 1, Shigella sonnei in 1, Klebsiella pneumoniae in 1, Enterobacter agglomerans in 1, Acinetobacter calcoaceticus in 1, Enterobacter cloacae in 1, group A beta-hemolytic streptococcus in 1, and polymicrobial infection in 4 cases. Thirty-nine out of 41 (95%) clinically evaluable patients cured and all (34/34) bacteriologically evaluable patients eradicated their pathogens after treatment with sulbactam/ampicillin. Side reactions were seen in five patients; one maculopapular skin rash, one hemolytic anemia, two diarrhea, and one liver function impairment plus leukopenia. All these reactions were transient and did not require interruption of therapy. These results indicate that sulbactam/ampicillin is safe and effective in the treatment of common pediatric infections beyond the neonatal period.
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PMID:A clinical evaluation of sulbactam/ampicillin in the treatment of pediatric infections. 263 93

Thirty two patients (16 female and 16 male), ranging in age from 13 to 80 years, were treated with pefloxacin (Abactal) at The Clinic of Infectious Diseases and Febrile Conditions. Pefloxacin was applied parenterally in 21 patients with serious infections. 15 of the cases had the signs of verified septicemia, i. e. bacteriemia; 5 patients developed purulent meningitis, i. e. meningoencephalitis; and in one patient bronchopneumonia occurred. Isolated causative agents (Staphylococcus aureus, S. epidermis and Gram-negative aerobic bacteria), were sensitive to pefloxacin. In 11 patients with enterocolitis Abactal was also included in the treatment because of the increasing occurrence of the resistance of Salmonella spp. to various chemotherapeutics and excellent "in vitro" effects of pefloxacin to those multiple-resistant species. Salmonella virchow was isolated from the stools of 6 patients. Salmonella enteritidis from 3 patients, Shigella sonnei from one, and in one case the causative agent was not identified. Pefloxacin was applied per os or parenterally in the dosage of 800-1200 mg in the period from 5-9 days. In all the patients (100%) eradication of the causative agents found in stools was done as early as the third or fourth day of the therapy. There were no adverse effects.
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PMID:[Pefloxacin in the treatment of septicemia, purulent meningitis and salmonellosis]. 264 Feb 75

A total of 82 patients involving 83 episodes of proven or presumed bacterial infection were treated with sulbactam/ampicillin. These included 36 cases of soft tissue infection or abscess, four cases of joint or bone infection, 20 cases of respiratory tract infection (17 cases of pneumonia, two of otitis media, and one of tonsillitis), 15 urinary tract infections, three cases of enterocolitis, one case of infective endocarditis, two cases of septicemia, and two of peritonitis. The causative pathogen was isolated in 48 cases (49 infections). These pathogens included Staphylococcus aureus 13 cases, Staphylococcus epidermidis one, Streptococcus pyogenes two, Streptococcus pneumoniae two, Viridans group streptococcus two, peptostreptococcus one, Haemophilus influenzae one, Escherichia coli 12, Enterobacter cloacae three, Proteus mirabilis one, Acinetobacter calcoaceticus one, Salmonella spp. two, Shigella sonnei one, Bacteroides fragilis one, and polymicrobial infections of various combinations in five cases. No bacterial pathogens were isolated in 34 infections, 14 cases of pneumonia and 15 soft tissue infections. Sulbactam/ampicillin was given by intravenous bolus in a dosage range of 75-450 mg/kg/day in four divided doses for variable periods of time depending on the type and severity of the infection. Of a total of 83 episodes of infections, 80 (96.4%) cases were either cured or improved. Bacteriologic eradication also occurred in 46 (93.9%) of 49 infections. Side effects were diarrhea in two patients, acute hemolytic anemia in one patient, and transient elevations in SGOT and leukopenia in one patient. Side effects disappeared upon completion of treatment. Sulbactam/ampicillin is a safe and effective antibiotic for the treatment of common pediatric infections.
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PMID:Intravenous sulbactam/ampicillin in the treatment of pediatric infections. 268 18

Four cases of shigella septicemia are presented. In two children infection was caused by Shigella flexneri and in two adults, who had underlying diseases which caused immunosuppression, by Shigella sonnei and Shigella schmitzi. All four patients responded to intravenous antibiotic therapy. In one patient the organism persisted in the stool, but was eliminated after oral administration of chloramphenicol. Shigella septicemia is not uncommon and blood cultures should be obtained in suspected cases.
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PMID:Four cases of Shigella septicemia in Israel. 389 37

The in vitro effect of a purified endotoxin preparation from culture fluids of Shigella sonnei, phase I (purified free endotoxin, PFE) and of three endotoxin preparations chemically extracted from the intact parent cells on human blood mononuclear leucocytes and platelets was investigated. PFE, like cell-extracted preparations, caused generation of strong procoagulant activity (tissue factor) by human mononuclear cells. PFE-stimulated cells, however, developed significantly greater activity than cells stimulated by the other endotoxins. they had about 4-fold more activity. Neither free nor cell-extracted preparations induced aggregation in human citrated or heparinized platelet-rich plasma (PRP) or unmasking of platelet factor 3 (PF3). These findings suggest that free endotoxin from Shigella sonnei, phase I resembles endotoxin extracted from cells by conventional procedures in their interaction with human platelets and mononuclear leucocytes. In view of the possible contribution of free endotoxin to endotoxemia in human and experimental gram-negative sepsis, our data that free endotoxin stimulates human mononuclear leucocytes to produce a potent trigger of blood coagulation (tissue factor) may be relevant to the understanding of the mechanism(s) responsible for the initiation of intravascular coagulation in severe human infections.
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PMID:In vitro effect of endotoxin from Shigella sonnei. phase I on human blood platelets and mononuclear leucocytes: comparison of "free endotoxin" with cell-extracted preparations. 705 Jun 35

The epidemiological, clinical, and bacteriological aspects of shigellosis were studied in a population of hospitalized children in northern Israel. During the 6-year period 1987-92, 262 children were hospitalized due to shigella infection. Shigellosis represented 10% of pediatric admissions for diarrhea. Admissions for the disease peaked during the summer and autumn. The median age of the patients was 3 years. Shigella sonnei was isolated in 74% of patients and S. flexneri in 21%, compared with relative frequencies of 87% and 10%, respectively, in the non-hospitalized population of the area, detected during the same period (p < 0.001). Shigella sonnei represented 82% of isolates of hospitalized Jewish patients but only 60% of hospitalized Arab children, many of whom live in poverty and overcrowding (p < 0.001). Shigella flexneri was particularly frequent among hospitalized infants, and was associated with Arab origin, large families and residence in agricultural settlements. Duration of hospitalization was 4.7 +/- 2.3 days for S. sonnei infections and 5.8 +/- 3.6 days for S. flexneri (p < 0.005). No cases of shigella sepsis, hemolytic uremic syndrome, or fatalities were observed. Overall 37% of all shigella isolates from hospitalized children were resistant to ampicillin, 71% to cotrimoxazole, 28% to both and 13% were resistant to > or = 3 different drugs. It is concluded that shigellosis is an important cause of hospitalization in northern Israel. Resistance to antimicrobial drugs is widespread among all Shigella spp. Although S. sonnei is the most common species, S. flexneri is particularly frequent in infants.
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PMID:Epidemiological, clinical and microbiological features of shigellosis among hospitalized children in northern Israel. 766 77

Bacteremia during infection with Shigella is relatively rare and usually self-limited. Bacteremia during shigellosis bearing a high fatality rate has been reported in young infants and in persons with malnutrition or with the acquired immunodeficiency syndrome. We report a case of Shigella sonnei septicemia in a severely neutropenic patient who had fever, abdominal pain, diarrhea, malnutrition, and dehydration. She died after five days despite intensive care. We emphasize that Shigella should be considered among the possible pathogens causing sepsis in neutropenic patients.
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PMID:Fatal Shigella sepsis in a neutropenic patient. 796 32

Shigellemia is rare in developed countries and might result from the emergence of unusually virulent strains. We compared systemic invasiveness markers of isolates from the blood of 3 temporally clustered patients with Shigella sonnei bacteremia in Boston with those of 11 unrelated contemporaneous strains from stools of people in New England. We found no difference between the two groups in O-chain length by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, mouse 50% lethal dose, in vivo response to iron, and susceptibility to serum, which varied from moderately susceptible to ultrasusceptible. Mean intraperitoneal 50% lethal doses of smooth form I colonies for mice were equally low (10(5.8) CFU) in both groups, and the 50% lethal doses were lowered equally further in the two groups by predosing with iron to levels useful in mouse model sepsis studies. S. sonnei bacteremia may reflect compromised host defenses, not bacterial virulence.
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PMID:Comparative virulence of blood and stool isolates of Shigella sonnei. 819 2


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