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

Of 2160 intensive care unit patients, 36 patients with positive blood cultures had coagulase-negative staphylococcus in one blood bottle, whereas the organism was present in two or more bottles in 38 cases. The groups were not significantly different in 27 clinical variables, obtained at the time of their first positive blood culture. There was also no significant difference in the antimicrobial sensitivities. No initial clinical data supported the classification of coagulase-negative staphylococcus as either pathogen or contaminant. When the 74 patients with blood culture positive coagulase-negative staphylococcus were compared with three "control groups" ("absent septicemia," "probable septicemia" and "proven septicemia") they were not different from those with "probable septicemia." A discriminant analysis was performed comparing patients with "absent septicemia" and with "proven septicemia" in an attempt to classify patients with isolates of coagulase-negative staphylococcus in one of these groups at an early stage. Patients with two or more positive blood cultures were not statistically classified more frequently as septicemic than patients with one blood bottle positive for this organism. However, patients categorized as septicemic had a significantly higher mortality (59%) than those classified as non-septicemic (35%) (p less than 0.05).
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PMID:Early evaluation of coagulase negative staphylococcus in blood samples of intensive care unit patients. A clinically uncertain judgement. 366 73

The effect of human blood serum from patients with purulent infections (sepsis, purulent resorptive fever) has been studied on the electrical and mechanical activities of isolated auricles of guinea pig. The intracellular resting potentials (RP), action potentials (AP) and isometric contractions elicited by electrical stimulation (1 Hz) were measured. The patient serum diluted by Tyrode solution (1:1) didn't change RP values and AP amplitude but caused a decrease in the AP plateau phase duration (P less than less than 0.05). In 75% cases a replacement of the healthy donor serum by the serum from patients caused a decrease in the contraction amplitude. This cardiodepressive effect was reversible: washing of the preparation by the control Tyrode solution or by the donor serum restored the normal contractility. These data were compared with those obtained in studying the action of staphylococcus alpha-toxin on a preparation of guinea pig myocardium]
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PMID:[Cardiodepressive effect of blood serum in severe forms of purulent infection]. 368 53

Microbiological investigations showed a positive culture in 430 out of 1540 venous catheters and shunts for dialysis. In 21 cases, a mixed culture with two different specific organisms was present. Of the total of 451 isolated organisms, 362 were gram-positive cocci and only 56 gram-negative bacillaceae. Staphylococcus epidermidis was by far the most frequent pathogen (n = 228), staphylococcus aureus in second place (n = 94). Among the gram-negative organisms, germs of the Klebsiella-Enterobacter group and Pseudomonas aeruginosa dominated. Staphylococcus aureus represented 31% of all germs isolated from Scribner shunts and Brescia fistulas. On the other hand the causative organism could be isolated in only 18% of the infected venous catheters. Staphylococcus aureus was the most frequent pathogen in septicemia due to catheters; in 16 out of 24 patients this microorganism was found in both cultures drawn from the blood and from the catheter. In 16 cases, a venous catheter led to septicemia, a shunt for chronical dialysis in 2 cases only. The frequency of infections caused by catheters can be significantly lowered by prudent care of the site of insertion, sterile handling and short indwelling time.
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PMID:[Infections caused by intravascular catheters]. 391 97

The case histories of 3 elderly patients who developed haemarthrosis of osteoarthritic joints with subsequent infection with staphylococcus aureus, are described. Trauma to the affected joints was a predisposing factor in 2 patients and, while only one patient developed clinical signs of sepsis, all had marked elevation of the erythrocyte sedimentation rate. Although suspicion of joint sepsis was obscured by the presence of a coexistent haemarthrosis, routine culture of joint aspirates showed infection with staphylococcus aureus and all patients recovered well with antibacterial therapy.
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PMID:Staphylococcus aureus infection complicating haemarthroses in elderly patients. 398 3

Based on a three year surveillance in the neonatal intensive and transitional care nurseries (NICU) at the Hospital of the University of Pennsylvania (HUP), an analysis of all cases of nosocomial bacteremia was made. From January 1982 to September 1984, a total of 57 nosocomial bacteremic episodes were identified. This gave a rate of 3.6 episodes per 100 NICU admissions or 6.5 per 1000 live hospital births. While coagulase-negative staphylococci (CNS) accounted for approximately 40 percent of all positive blood cultures, it was responsible for 73 and 66 percent of the nosocomial bacteremias in 1982 and 1983, respectively. In 1984, coagulase-negative staphylococcus was the responsible pathogen for 92 percent of all nosocomial bacteremic episodes. Of 139 infants weighing less than or equal to 1250 g at birth, 30 (22 percent) developed CNS bacteremia. The risk of coagulase-negative staphylococcus bacteremia was associated with low birth weight, respiratory distress, prolonged hyperalimentation, and multiple supportive measures. Infants were treated with vancomycin hydrochloride, as most of the CNS were resistant to methicillin and/or gentamicin. There were no deaths related to coagulase-negative staphylococcal septicemia.
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PMID:Coagulase-negative Staphylococcus bacteremia--a rising threat in the newborn infant. 399 94

All cases of neonatal bacteremia occurring at Neonatal Department of Pediatric Clinic, Catholic University of Rome, from January 1976 to December 1983 were examined retrospectively. Twenty-seven (30%) newborn infants with positive blood cultures for coagulase-negative staphylococcus were identified. Seven (25.9%) of the 27 infants were born at term, 4 AGA and 3 SGA; mean birth weight was 2,804 gm (range 2,280-3,670). All of these neonates had clinical evidence and laboratory signs of sepsis, and one had the cerebrospinal-fluid culture positive for coagulase-negative staphylococcus. In the remaining 20 infants (74.1%) the mean birth weight was 1,445 gm (range 810 - 2,400) and mean gestational age was 32 weeks (range 27 - 36). In 15 of the 20 preterm infants clinical signs of septicemia were associated with positive blood culture, and sixty percent of these had received an umbilical artery catheter. An half of coagulase-negative staphylococci isolated from our neonatal sepsis were DNAse-positive and/or phosphatase-positive and/or mannitol-positive. Two full-term infants, one with Down syndrome and one with cardiac malformation, died at 9 days and at 2 weeks of age, respectively. Three of 15 preterm infants with coagulas-negative staphylococcal septicemia died; deaths were among infants of very low birth weights and immature gestations who had severe respiratory syndrome. These data show that coagulase-negative staphylococcus can be important cause of septicemia in patients with compromised host defenses as newborn infants, and especially in the premature babies receiving invasive procedures.
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PMID:[Neonatal sepsis caused by coagulase-negative staphylococci]. 408 16

23 postabortion and 4 postpartum patients who developed septicemia were treated in the Hospital Claude-Bernard, Paris from 1961-1972. These could be distinguished easily from cases of infectious shock because the disease developed over several days or weeks; only 1 patient had both shock and secondary staphylococcal septicemia. All infections were provoked by intrauterine manipulation, such as induced abortion, as sisted delivery, or cesarean section. Organisms cultured were usually staphylococcus (46%), Ristella pseudoinsolita (26%), or enteric organisms (30%); streptococcus was totally absent. Clinical signs were variable, described at length in pelvic, pulmonary, and cardiac categories. 2 women died of endocarditis and of renal thrombosis; 4 were cured by antibiotics only; the rest had surgery. 13 had thrombophlebitis, 5 had no venous lesion, 3 had infectious lesions such as retained placenta and a ruptured uterus. Antibiotics were continued 2 weeks after fever abated. Exploratory surgery in case of persistently positive culture or clinical thrombophlebitis resulted in 16 hysterectom ies, 16 salpingectomies, 16 venous ligatures, and 3 prosthetic cardiac valves in 24 operations in 22 patients. The authors urged that antibiotic therapy be thorough and based on cultured organisms.
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PMID:[Post-abortion and post-partum septico-pyemia. Apropos of 27 cases]. 472 Apr 14

The finding of mycotic aneurysms creates a major problem in surgery for both active bacterial endocarditis and prosthetic valve endocarditis. The value of local treatment of such aneurysms by a suspension of fibrin glue and an antibiotic was examined in an animal study since a previous in vitro investigation had indicated that such a suspension may discharge sufficient quantities of the antibiotic for up to 12 days. In 3 groups of 6 rabbits each, the entrance to the left atrial appendage was occluded subtotally. The endothelium within the cavity thus created was mechanically injured and the tip of a thin transthoracic catheter was placed in the cavity. In all animals, aliquots of staphylococcus aureus were injected through the catheter. All rabbits developed fever, and positive blood cultures were obtained in 16. The animals in group 1 were left without treatment. All 6 animals lost weight progressively, 4 animals died from sepsis, 2 rabbits were sacrificed after 6 days. Active endocarditis was demonstrated by histology and bacteriology in each animal. In group 2, 12.5 mg cephalotin were injected via the catheter 24 hours after the infection. Four animals died from sepsis, one rabbit had a positive tissue culture, and only one animal was free of infection on postoperative day 10. In group 3, 12.5 mg cephalotin suspended in fibrin glue was injected via the catheter 24 hours after the infection. All animals survived, became afebrile and resumed gain of weight. At autopsy after 10 days no infection was detectable. We conclude that a suitable antibiotic suspended in fibrin glue may allow for the sterilization of mycotic aneurysms in bacterial endocarditis.
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PMID:A suspension of fibrin glue and antibiotic for local treatment of mycotic aneurysms in endocarditis--an experimental study. 608 32

The efficiency of vancomycin hydrochloride in the treatment of septicemia due to polyresistant aureus staphylococcus is illustrated by the observation of a patient affected with a necrotic and hemorrhagic acute pancreatitis and post-operative septicemic syndrome, which has been cured after a one-month treatment with a daily dose of two grammes. The vancomycin hydrochloride, because of its potential toxicity on the kidneys and cochlea should be reserved to the treatment of major staphylococcic infections. It could be prescribed either alone or in association, with a mean daily dose of 30 milligrammes a kilo, slowly administered by intravenous way. The side effects are prevented by adjusting the doses in case of renal insufficiency and by controlling the serous concentrations in case of a long continued treatment.
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PMID:[Septicemia due to polyresistant Staphylococcus aureus (author's transl)]. 625 90

Septicemia due to the anaerobic gram-negative bacillus Fusobacterium necrophorum is exceptional. It may originate in tonsillitis or intestinal or gynecological infection. We report one case in a young man with head injury. Fusobacterium necrophorum is frequently associated with aerobic pathogens such as streptococcus or staphylococcus (more than fifty per cent of the cases). Metastatic localizations are numerous, often pleuro-pulmonary (infarction, abscess), hepatic (cytolysis) and meningeal (purulent meningitis, cerebral abscess), and in some instances articular (joint swelling) or embolic. Hypercoagulability is often associated. Prognosis is severe (45% mortality rate). Penicillin G seems to be the best antibiotic but erythromycin is effective, as well as imidazole which was very active in our case.
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PMID:[Septicemia due to Fusobacterium necrophorum. A case report]. 630 52


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