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

The incidence of systemic or local infections due to gram-negative bacilli in an Infant Ward from September 1969 to December 1976 was 7.9%. The 29.34% were septicemia, most of them as epidemic outbreaks caused by Pseudomonas aeruginosa, Klebsiella-Enterobacter and Serratia marcescens. Two facts are to be emphasized: an almost complete disappearance of systemic infections with Pseudomonas starting from 1972, and the global predominance of the group Klebsiella-Enterobacter, particularly evident from 1970 to 1972.
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PMID:Gram-negative germs infections in infancy. 11 65

Over a 12-month period, 27% of patients in a new ICU grew bacterial pathogens from sputum or tracheal cultures. The commonest isolates were Pseudomonas aeruginosa and Klebsiella species. Endotracheal intubation, the length of time intubated, and antimicrobial therapy all predisposed to the isolation of organisms from sputum. No patient developed a gram-negative pneumonia, and there was no case of septicemia associated with a positive sputum culture. The presence of epithelial or pus cells in sputum was unrelated to the culture results. It was concluded that the growth of colonic bacteria from sputum or tracheal aspirates was of little prognostic or clinical significance. No significant common environmental site or cross-infection pathway was identified: sinks were contaminated by patients rather than vice versa. Most sputum isolates were probably endogenous in origin.
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PMID:Insignificance of colonic bacteria in the sputum of patients in a new ICU. 11 56

Septicemia caused by contaminated infusion fluid is a newly appreciated hazard of intravenous infusion therapy. Microorganisms of the tribe Klebsielleae (Klebsiella, Enterobacter, and Serratia) have predominated in these infections. Members of this tribe found to possess a selecive ability over common non-Klebsielleae microbial pathogens to proliferate rapidly in commerical parential fluids contaning clucose at room temperautre. Fifty-one Klebsielleae strains, washed twice before inoculation of approximately 1 organism/ml, attained a mean normalized 24 hr concentration of 1.11 x 10-5 organisms/ml in 5% dextrose in water at 25 C. In contrast, 48 of 49 non-Klebsielleae bacterial strains (clinical isolates of Staphylococcus, Proteus, Escherichia coli, Herelea, and Pseudomonas aeruginosa) slowly died (mean 24-hr concentration, 0.2 organism/ml). Five Candida albicans strains frew only very slowly (31.3 organisms/ml). Even with concentrations exceeding 10-6 organisms/ml, microbial presence was never visibly detectable. The significant increases in cases of nosocomial spticmia caused by Klebsiella, Enterobacter, and Serratia in recent years might be attribuatble in part to fluid-related spesis accompanying the expanding use of parenteral therapy.
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PMID:Nationwide epidemic of septicemia caused by contaminated infusion products. IV. Growth of microbial pathogens in fluids for intravenous infusions. 23 43

The experience with neonatal sepsis at The Johns Hopkins Hospital during 1969-1975 was reviewed. Major pathogens included Escherichia coli, group B streptococcus, other streptococci, and Klebsiella. Nineteen percent of coliform isolates were kanamycin-resistant. The frequency of recovery of E. coli was increased in early-onset sepsis, and the frequency of recovery of Klebsiella was increased in late-onset sepsis. The mortality rate was 23%. The frequency of recovery of E. coli was increased in fatal cases, and mortality was highly correlated with the presence of gastrointestinal catastrophe. Ampicillin and gentamicin are the initial antibiotics of choice for neonatal sepsis at this institution; a penicillinase-resistant penicillin should be added when Staphylococcus aureus involvement is likely, and addition of chloramphenicol or clindamycin should be considered for infants at increased risk for Bacteroides fragilis sepsis.
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PMID:Neonatal sepsis at The Johns Hopkins Hospital, 1969-1975: bacterial isolates and clinical correlates. 31 88

Fifty-nine children with congenital asplenia were reviewed for episodes of severe infection. Seven children had isolated asplenia and 52 had asplenia associated with complex congenital heart disease (asplenia syndrome). A control group of eusplenic children with comparable cardiac lesions were assembled and used for comparative statistical analysis. There were 16 instances of documented sepsis among 59 children (27%). In those less than six months of age, the invading organism was usually gram-negative (Escherichia coli or Klebsiella). In children six months of age or older, the infecting organism was usually a pneumococcus or H. influenzae. When those with asplenia syndrome were compared to the control population, the former group had a significantly greater incidence of sepsis. Children with asplenia syndrome who survived the first month of life were at greater risk of dying from sepsis than from their heart disease. It is recommended that prophylactic antibiotics be administered to children with congenital absence of the spleen, commencing at three months of age, to be continued indefinitely.
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PMID:Sepsis and congenital asplenia. 32 Feb 99

Twenty-five isolates of Staphylococcus aureus, 24 isolates of Escherichia coli, and 25 isolates of Klebsiella pneumoniae obtained from clinical material were tested in vitro for susceptibility to cefamandole, tobramycin and combinations of the two antibiotics utilizing an automated microdilution system. Synergistic or partially synergistic bactericidal effects of the combination were observed against 15 of the S. aureus isolates (60%), 23 of the E. coli isolates (96%), and 19 of the K. pneumoniae isolates (76%) tested. No antagonistic effects of the combination were noted. This study suggests that cefamandole-tobramycin combinations are capable of acting synergistically in vitro against certain gram-positive and gram-negative organisms and may have potential usefulness in clinical situations such as gram-negative rod and staphylococcal sepsis.
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PMID:In vitro synergy of cefamandole-tobramycin combinations. 33 94

All of the febrile episodes occurring in 494 adults with acute leukemia were reviewed. There were an average of 2.39 febrile episodes per patient and the patients spent 28% of their days in the hospital with fever. Sixty-four percent of the febrile episodes were due to infection. The most common types of infection were disseminated infection and pneumonia, which together accounted for 69% of the total episodes of documented infection. The etiologic agent was identified in 73% of the documented infections and gram-negative bacilli were responsible for the great majority. The most common gram-negative bacilli causing infection were Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa. During the course of their leukemia, 31% of the patients had repeated episodes of infection caused by the same organism and 13% ahd repeated FUO's. Fever occurred most often when the patients had neutropenia (less than 500/mm3). The fatality rate from septicemia decreased from 84% in 1966 to 44% in 1972. The fatality rate for major infections caused by gram-positive cocci was 16%, for gram-negative bacilli was 37% and for fungi was 86%. Although infection remains a serious problem in leukemia patients, considerable progress has been made.
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PMID:Fever and infection in leukemic patients: a study of 494 consecutive patients. 34 1

The case of a kidney allograft recipient, who suffered from several episodes of Salmonella dublin sepsis following massive immunosuppressive therapy to overcome a transplant rejection crisis, is presented. The focus of sepsis was the chronic inflamed gallbladder. The Salmonella dublin strain isolated from the blood during the last episode was found to exhibit multiple resistance to antimicrobiol drugs. Because the resistance phenotype was characteristic for the gramnegative flora of the university hospital, it was suggested that transfer of a resistance plasmid, frequently found in gramnegative enterobacterial isolates, to the Salmonella strain had occurred in the patient. The comparative examination of a Klebsiella pneumoniae strain, representing the hospital flora, and Salmonella dublin revealed that both strains produced the aminoglycoside 3'-phosphotransferase type 1, the 2''-nucleotidyltransferase and the 3''-adenylyltransferase, enzymes responsible for resistance to aminoglycoside antibiotics. Furthermore, in both strains a TEM type beta-lactamase was found to render the organism resistant to penicillins and cephalosporins. Transfer experiments showed that the host ranges of the R-plasmids of both strains were identical. Furthermore, both plasmids were found to be the fi+ type. These data support the view of in vivo transfer of an R-plasmid from the enterobacterial hospital flora to a potential pathogen in a patient.
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PMID:Acquisition of multiple antibiotic resistance by Salmonella dublin from the gramnegative hospital flora, in a kidney allograft recipient. 36 85

A patient with alcoholic cirrhosis had multiple episodes of sepsis with Klebsiella pneumonia. Repeated searches for the source of infection finally revealed the organism in the root of a tooth. Evidence indicated that this site was the primary source of infection. The importance of dental infections in alcoholics and the difficulty in diagnosing those infections are emphasized by this case.
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PMID:Dental infection in a cirrhotic patient. Source of recurrent sepsis. 36 35

Because of the persistently high mortality from sepsis in cancer patients, a retrospective study was designed to identify the causative organisms and to determine the factors affecting the outcome of sepsis. A total of 84 episodes of septicemia in 61 children with cancer were studied. The more frequently isolated organisms were: Staphylococcus aureus (21.4%); Escherichia coli (18%); Klebsiella (7.1%); Pseudomonas (6%); and Bacteroides fragilis (6%). Other isolates included Proteus, Serratia, Acinetobacter, hemolytic Streptococcus, and Bacillus cereus. In 10.7% of septic episodes, mixed bacterial infections were documented. Twenty-four (28.6%) resulted in death; in 13 (54%) death occurred within 24 hours after admission. The fatality rate was high in cases associated with absolute polymorphonuclear leukocyte counts of less than 100/cu mm, in neoplastic relapse, and when infection with gram-negative, anaerobic and mixed bacterial flora occurred.
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PMID:Septicemia in children with cancer. 37 Oct


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