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

Many reports from the surgical literature document the incidence of catheter related sepsis varies between 1 and 10 per cent. In many instances sepsis is secondary to contamination from normal saprophyte cutaneous bacteria. In our Institute we set down a standardized methodology to reduce the contamination of venous central access from cutaneous bacteria. Of 31 patients studied, none had bacteria in the last 5 cm of central venous catheter, 2 had streptococcus alpha haemolytic colonies and coagulase negative staphylococcus colonies at the same time on skin over the region of venepuncture. With our paper we had attained one's awareness that it is very difficult to obtain zero per cent in contamination of central venous catheter, mainly in immunodepressed or critical patients, but with careful dressing and with new technology it is possible to reduce the contamination and following sepsis.
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PMID:[Further comment on central venous catheter infections]. 955 62

Bacterial and fungal infections in pediatric BMT recipients are major causes of morbidity and mortality, although less than those in the adult BMT population. Early in the post-BMT period, when patients are neutropenic, the predominant pathogens are Gram-negative bacteria, mainly E. coli, K. pneumoniae and P. aeruginosa; Gram-positive bacteria, mainly coagulase-negative staphylococcus, S. viridans and E. faecalis; and fungi, mainly Candida spp. and Aspergillus spp. The emerging resistance of a variety of pathogens is of major concern and limits the use of prophylactic antibiotics. Mortality from invasive fungal infections is much greater than that caused by bacterial pathogens. Many centers are currently using prophylactic fluconazole, which may lead to emergence of infections with C. krusei and T. glabrata. Patients with GvHD are at continuous risk from bacterial and fungal pathogens. Late in the post-BMT period, S. pneumoniae may cause septicemia, meningitis, pneumonia and other respiratory infections. This may occur months or years following transplantation, with a significant mortality rate in patients with chronic GvHD. Development of rapid and reliable diagnostic methods for identifying fungal pathogens and of new therapeutic approaches for treating invasive fungal infections are now our greatest future challenges.
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PMID:Bacterial and fungal infections in children undergoing bone marrow transplantation. 963 Mar 34

With a case of thoraco-lumbar defect, the authors discuss about different procedures to cover it. In this place, the better procedure is certainly the latissimus dorsi flap, in all combinations. The indication for omentoplasty at this spinal site should not be performed by first intention but by exclusion of other procedures, as in the case considered by the authors. It was a 37-year-old man, paraplegic from the age of 16, with a deep chronic spinal wound, secondary to sepsis of a posterior segmental fixations. A staphylococcus aureus infection which developed as a surgical complication was initially treated with antibiotics and surgical cleaning procedures without removing instrumentation. However, the infection remained active and the material was finally removed. Spinal immobilisation was strengthened by external fixation. The area was cleared of all suspect material, including bone graft, leaving a wide back-wound open to the spine. Spontaneous healing was first attempted, but the size and the chronicity of the wound led us to use pedicled greater omentum to close the defect. The omentum was pedicled on the right gastroepiploic vessels and transferred to the back wound through the posterior abdominal wall muscles, next to the right kidney. This procedure allows rapid healing. In association with suitable antibiotics, it has prevented any recurrent infection after 18 months of follow-up. It was no feasible to cover the wound with a latissimus dorsi flap, considering the importance of this muscle in the movements of a paraplegic and considering the initial impossibility of removing the external fixation.
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PMID:[Covering of a thoraco-lumbar defect by omentoplasty]. 976 39

105 consecutively admitted neonates with tetanus were screened for sepsis to determine the prevalence of sepsis in neonatal Tetanus (NNT) patients and identify the bacterial pathogens causing septicaemia in them. The presence of omphalitis, poor colour, hypothermia and hyperthermia were found to be sensitive predictors of septicaemia in NNT patients. 50 bacterial pathogens were isolated from 50 babies. Klebsiella pneumoniae (20.7%), and Enterobacter cloacae (19.0%) were the leading gram negatives, while staphylococcus aureus (19.2%) was the prevalent gram positive organism isolated. Antimicrobial susceptibility profile heavily favours ofloxacin but a combination of cloxacillin and gentamicin is recommended as first line. Ceftazidime with about 60% susceptibility across board is the favoured cephalosporin.
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PMID:Bacteria causing septicaemia in neonates with tetanus. 981 79

Pericardial abscess is a very rare complication of sepsis. Authors describe the case of a 69-year-old woman. In her case staphylococcus sepsis led to pericardial abscess. During the course positive blood cultures (3x) indicated the sepsis and pus was obtained from the left pleural cavity (pleuropneumonia). Concomitant purulent process in the left shoulder also was noted. Decline immunity due to long-standing corticoid therapy (prednisone) for proctocolitis idiopathica was observed. Following antibiotic treatment successful surgical evacuation of the pericardial abscess was performed.
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PMID:Pericardial abscess--a rare complication of sepsis. 1043 88

The analysis of the treatment of 900 patients with large festered wounds of various genesis and location for the period from 1973 to 1998 years in the intensive care department has shown, that infection of respiratory ways is encountered in 30% of cases (in patients with nonsporeforming anaerobic bacteria--in 11-12%), bacteriuria--in 70-80%, bacteriamia--in 75% of patients with sepsis. In acute pyogenous diseases of soft tissues microbes from the wounds in monoculture were isolated out in 83.3% of cases, associations of gram-positive and gram-negative bacteria--in 16.7%, in chronic pyogenous diseases of soft tissues--in 60 and 40% of cases, respectively. In sepsis associations of gram-positive and gram-negative microbes were isolated in 55.6% of cases. Most often (91%) pathogenic staphylococcus was found in hemocultures. Uring in 62% of cases contained association of gram-positive and gram-negative microorganisms, in sputum gram-positive microflora in monoculture (69%) prevailed. In the group of patients with peritonitis, phlegmon of the anterior abdominal wall, diabetic phlegmon and gangrene, crush syndrome the association of anaerobic and aerobic microflora (from 57.1 to 98.8%) prevailed in the wounds. Application of up-to-date antimicrobial means in the intensive care unit resulted in a decrease of mortality rate in sepsis and complicated course of wound infection up to 23%, and in anaerobic nonsporeforming infection--up to 15%.
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PMID:[Antimicrobial chemotherapy in patients with pyo-septic diseases in intensive care units]. 1054 May 50

Twenty-four children (aged 6-15 years, M:F = 1:11) with systemic lupus erythematosus (SLE), who had respiratory symptoms, were retrospectively reviewed. Chest radiographs obtained from all patients revealed pleural effusion in 13, alveolar infiltration in 9, pericardial effusion and cardiomegaly in 6, interstitial infiltration in 4, hilar adenopathy in 3, lung abscess in 2 and pneumatocele with pneumothorax in 1. Etiologic organisms were identified in 7 cases; (3 cases of nocardia isolated from pleural effusion and sputum, 2 cases of tuberculosis, 1 case with staphylococcus aureus septicemia and 1 case with salmonella septicemia). All except one patient improved with medical treatment. One patient died from pneumonitis. Although pulmonary involvement is increasingly recognized in children with SLE, neither roentgenogram nor clinical findings were specific. The differentiation of pulmonary infiltrates caused by lupus lung disease from pulmonary infection should be carefully evaluated.
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PMID:Pulmonary involvement in childhood systemic lupus erythematosus. 1073 May 34

High dose corticosteroids have been the mainstay in the treatment of fulminant ulcerative colitis (UC) for a long time. In the last years intravenous cyclosporine (CyA) has been reported to be rapidly effective and relatively safe in patients with severe corticosteroid-resistant UC. We report on a 64 year old patient with a severe flare-up of UC who responded well to intravenous CyA after a standard therapy with high dose corticosteroids alone had been ineffective. However, recurrent staphylococcus aureus sepsis developed during CyA therapy. Despite a long-time antibiotic therapy two further episodes of staphylococcus aureus sepsis occurred after discontinuation of CyA treatment. Being in remission with his UC the patient died 14 months later of staphylococcus aureus sepsis despite intense antibiotic treatment. Infectious complications of this therapeutic regime in severe UC are known but to our knowledge a recurrent sepsis complicating this therapy even after cessation of CyA has not been reported in the literature so far.
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PMID:Recurrent septicemia with lethal outcome during and after cyclosporine therapy in severe ulcerative colitis. 1089 89

High incidence of nosocomial infections in children is largely explained by immunodeficiency, particularly in newborns. Central venous catheter is the main risk factor and coagulase negative staphylococcus the main pathogen in cause. Large variations of nosocomial infection incidences are observed by Nososcomial Infection Surveillance Networks and depend on the pediatric speciality. The highest rate is observed in neonatal intensive care, where incidence density of catheter-related sepsis varies from four to 23 infections for 1000 catheter-days. Local surveillance in each ward, risk factors and knowledge of bacterial epidemiology allow the development of rational preventive and therapeutic protocols. However, prophylactic use of vancomycin is dangerous and immunoglobulins are inefficient.
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PMID:[Nosocomial infections in pediatrics. Problems and perspectives]. 1120 23

Intravascular catheters are increasingly important causes of nosocomial infections. Catheter related complications range from local exit site or tunnel infections to frank bacteremias. A semiquantitative method of culture of central venous catheters (CVC) was done in our hospital from January to December 1996. A total of 119 catheter tips sent to the Microbiology Department were cultured and 11 (9.24%) showed significant growth with associated blood stream infection. 14 (11.76%) of the CVCs showed scanty or less than 15 colonies in roll or contents and there was no associated blood stream infection. 7 (5.88%) showed moderate to heavy growth in roll and contents and there was no blood stream infection. The age groups ranged from 2 months to 66 years. The results of the study indicate that Gram negative organisms formed the predominant isolates. Gram negative isolates included Klebsiella species, Enterobacter species, E. coli species, Serratia and non-fermenting Gram negative bacilli. Coagulase negative staphylococcus which is often believed to be an important pathogen was not associated with bacteremia or septicemia in our hospital, during this study period. Considering the fact that 1553 operations were performed during the study period, the infection rate through CVC's would work out to a negligible 0.71%.
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PMID:Central venous catheter related infections in a tertiary care hospital. 1127 87


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