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

On occasion, a patient may have two or more clinical cultures yielding a coagulase-negative staphylococcus If these multiple isolates have the same phenotype, one might conclude that the same strain was reisolated from the patient, indicating its persistent and pathological presence. We examined the validity of this conclusion when we applied a number of characterizing systems to a collection of 143 isolates of coagulase-negative staphylococci collected during an outbreak of intravascular catheter-associated sepsis. The probability of classifying two random isolates as the same phenotype or species was as follows: P = 0.356 for phage typing, P = 0.348 for Baird-Parker biotyping, P = 0.346 for the API STAPH-IDENT (Analytab Products) system, P = 0.327 for Bentley et al. biotyping, and P = 0.077 for antimicrobial susceptibility patterns. Although antimicrobial susceptibility patterns had the lowest probability, a variability in test results of 7.7% and a tendency for strains to have similar antibiograms effectively raised the probability to P = 0.897. The combination of the API STAPH-IDENT with antibiograms resulted in a probability of P = 0.037 to P = 0.147. When all of the above methods were used together a probability of P = 0.014 was achieved. Five patients had isolates from two or more blood cultures spaced more than 1 day apart that were identical by all of the above criteria, thus confirming prolonged bacteremia. The collection was also examined for the incidence of slime production. Slime production was not associated with any of the above groups, but was associated with symptomatic infections (P less than 0.05) and gentamicin resistance (P less than 0.01). Slime production was strain stable and was of assistance in typing strains of coagulase-negative staphylococci.
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PMID:Characterization of clinically significant strains of coagulase-negative staphylococci. 631 70

A clinical trial was conducted to assess the value of ceftazidime as a first-line antibiotic in a neonatal intensive care unit. Fifty-five infants less than 48 h old with suspected sepsis were randomly treated with ceftazidime or penicillin and gentamicin. A full septic screen was performed in all infants before treatment. Treatment was stopped after 48 h if cultures were sterile. A further 22 infants more than 48 h old, with clinical evidence of sepsis, were treated with ceftazidime in an open trial. Ceftazidime proved effective against all but two of the septicaemias. A group D beta-haemolytic streptococcus and a coagulase-negative staphylococcus proved resistant, but were also resistant to penicillin and gentamicin. No adverse response to ceftazidime was noted, and the incidence of later candidiasis was similar to that after other broad-spectrum antibiotic combinations. The avoidance of gentamicin assay in the ceftazidime group was an advantage in this age group.
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PMID:Ceftazidime or gentamicin plus benzylpenicillin in neonates less than forty-eight hours old. 635 43

The rate of absorption by polymorphonuclear leukocytes of different strains of staphylococci present in a homogeneous mixture was studied. The cells of one of the strains were radiolabeled and this made it possible to differentiate them from the cells of another strain by means of electron microscopic autoradiography. Different rates of absorption of cocci belonging to different strains by leukocytes of normal subjects and by those from patients with sepsis resulting from burn or wound were observed. The seizing capacity of leukocytes of such patients in relation to the autostrains of S. aureus and epidermal staphylococcus cultivated from the blood did not differ significantly from normal in numerous tests. The electron-autoradiographic examinations of the synthesis of nucleic acids in cultures of S. aureus and epidermal staphylococcus revealed different functional status of individual cells.
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PMID:[Several regularities of the interrelation of blood leukocytes and microbes in the infectious process]. 667 Sep 37

In recent years, the diffusion of antibiotic multiresistant staphylococcus strains in hospitals (especially aureus and epidermis) has created serious drawbacks as regards the treatment of severe septic forms and the systemic spread of these bacteria. The results of endovenous vancomycin treatment in three cases of sepsis with secondary localisations (endocarditis, osteomyelitis, pneumonia) caused by gram positive staphylococcus aureus are examined. The pharmaceutical was found to be effective in all cases and free from significant side effects.
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PMID:[Use of vancomycin in the treatment of severe Staphylococcus aureus infection. Description of 3 cases]. 670 17

Eighteen out of 1606 patients treated by valve replacement between January 1971 to June 1979 were admitted in Brugmann University Hospital for late prosthetic valve endocarditis. Of the 19 episodes (one patient had two distinct episodes four years apart), nine (group I) were treated medically and 10 (group II) by combined medical and surgical therapy. The infective organism was Staphylococcus epidermidis in two-thirds of our cases. Two cases in group I (22.2%) were long-term survivors. In group II, all 10 patients survived reoperation. There were four late deaths; six patients (60%) were still alive 1.8 to 4.4 years later (mean survival three years). Prompt prosthetic valve replacement is recommended in the presence of systemic emboli, evolving murmurs, uncontrolled sepsis or congestive heart failures (especially if the infective organism is a fungus or a staphylococcus), in late prosthetic valve endocarditis.
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PMID:Late prosthetic valve endocarditis: review of 19 cases and treatment. 686 71

An analysis of 385 fatal cases of sepsis in therapeutic institutions for the past 20 years was carried out. The septico-pyemic variant was found to be predominant. Bacteriological studies revealed that the predominant causative agent was pathogenic staphylococcus (54.9%), less frequently streptococcus, Escherichia coli, and Pseudomonas aeruginosa. Changes in the spectrum of the causative agents in the last two decades appear to reflect changes in the ecological conditions, immunologic responsiveness of the population, directed natural and therapeutic pathomorphosis. The analysis of the frequency and nature of divergencies in the clinical and pathoanatomic diagnoses indicate certain differences in sepsis diagnosis nowadays.
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PMID:[Clinico-morphologic forms of sepsis (analysis of autopsy material over the past 20 years)]. 708 92

Three cases of hematogenous cranial osteitis are described. The etiology in two cases was a staphylococcus aureus infection from meningeal septicemia. One of these patients died and chronic osteomyelitis developed in the second case. The third case was one of multifocal tuberculous infection, localized in the cranium but asymptomatic. The last case was a Gradenigo-Lannois syndrome, and its etiology, either chronic otitis or sphenoidal sinusitis, is discussed.
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PMID:[Cranial osteitis: a report on four cases, including a Gradenigo-Lannois syndrome (author's transl)]. 745 36

The following ultrastructural formations are found in the bacteria of various infections: fibrillar and drop-like microcapsules, an increase of nucleotide size and number, micropyles. The dynamics of staphylococcus L-form formation in sepsis as well as the phenomenon of incomplete phagocytosis and endocytobiosis were studied. The latter is observed in mixed infection: dysentery bacteria lamblia, gonococci and trichomonas. These alterations indicate increased bacterial pathogenicity and seem to reflect the evolution of the bacteria adaptive mechanisms under the conditions of antibiotic therapy.
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PMID:[The mechanisms of the pathogenicity of bacteria in different infections]. 769 86

Standard therapy of catheter-related sepsis of long-term, tunnelled, silicone dialysis catheters is catheter removal, parenteral antibiotics, and catheter replacement in a new venous site after documented clearing of bacteremia. This leads to loss of future venous access sites. Thirteen consecutive cases of dialysis catheter-related sepsis in 10 patients successfully managed by guidewire exchange with preservation of the same central venous access site are reported. Although the most common cause of catheter sepsis in this series was coagulase-negative staphylococcus, guidewire exchange also was successful in cases due to gram-negative rods and yeast. To preserve future venous access sites in the chronic hemodialysis population, long-term, tunnelled dialysis catheter-related sepsis should be managed by a short course of parenteral antibiotics and by changing the catheter over a guidewire using the same venous insertion site.
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PMID:Catheter-related sepsis complicating long-term, tunnelled central venous dialysis catheters: management by guidewire exchange. 770 56

Monophosphoryl lipid A (MPL) is a less toxic derivative of lipid A that enhances survival from endotoxemia. This study examined whether MPL induced resistance to Gram-positive sepsis and cytokines. Mice were administered MPL or saline (phosphate-buffered saline) and challenged 24 h later with live Staphylococcus aureus (SA), staphylococcus enterotoxin B (SEB), toxic shock syndrome toxin (TSST-1), and tumor necrosis factor (TNF). Survival was determined at 72 h. A separate set of animals was phlebotomized for determination of cytokines. MPL increased survival from S. aureus bacteremia from 20 to 87% (p < .05). Interleukin-6 (IL-6) and interleukin-1 (IL-1) and TNF were also significantly decreased. SEB and TSST survival were enhanced from 10 to 90% (p < .05). In SEB-treated animals, TNF and IL-6 levels were significantly decreased. Survival from TNF infusion was increased from 20 to 100% with MPL, however, no significant differences in cytokines were observed. These data suggest that MPL induces resistance to Gram-positive sepsis and cytokine-mediated activity.
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PMID:Monophosphoryl lipid A protects against gram-positive sepsis and tumor necrosis factor. 775 20


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