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

One hundred thirty-three febrile episodes in 115 neutropenic patients with hematologic malignancies were empirically treated with ceftriaxone and amikacin in a single daily dose. An indwelling central venous catheter (CVC) was present in 44 cases. Septicemia was documented in 18 (41%) patients with CVC (13 gram-positive, 5 gram-negative and 1 fungus) and in 30 (34%) patients without CVC (19 gram-positive, 10 gram-negative and 2 fungi). Coagulase-negative staphylococcus was observed in 10 out of 19 blood isolates in the presence of a CVC and in 6 out of 31 blood isolates in patients without CVC. Empiric therapy was successful in 56.4% of cases. Improvement after the addition of vancomycin or teicoplanin was observed in 38.6% of cases with a CVC and in 13.5% of those without (p less than 0.02). Only two patients died from gram negative septicemia, and the substitution of ceftriaxone with another beta-lactam was necessary in only 6% of the cases. Empiric therapy with single daily-dose ceftriaxone and amikacin appears to be effective in febrile neutropenic patients; our data, however, show the high incidence of Staphylococcus epidermidis septicemia and the frequent need to add an anti-gram-positive drug in patients with an indwelling CVC.
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PMID:Ceftriaxone and amikacin as single daily dose in the empiric therapy for febrile episodes in neutropenic patients. 233 90

Staphylococcus epidermidis is emerging as a cause of morbidity and mortality in immunocompromised patients. From January 1980 through June 1982, there were 150 episodes of septicemia in 92 children with leukemia and lymphoma at Memorial Sloan-Kettering Cancer Center, New York. Staphylococcus epidermidis was the fourth most common organism isolated, responsible for 12.7% of all septicemic episodes. Only nine of 53 isolates were sensitive to methicillin; all were sensitive to vancomycin. Staphylococcus epidermidis septicemia was associated with immunosuppressive chemotherapy (94.7%); broad-spectrum antibiotics (79.0%); catheters and drains (73.7%); neutropenia (63.2%); skin or soft-tissue infections (42.1%); prior septicemia (42.1%); concurrent polymicrobial septicemia (21.1%); and prolonged hospitalization (mean, 39 days). Of 19 patients, two died. Increased awareness of the pathogenic potential of S epidermidis in children with hematologic malignancies and prompt alteration of therapy to an effective antimicrobial agent, in most cases vancomycin hydrochloride, is required when the organism is isolated in patients known to be at risk with clinical evidence of septicemia.
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PMID:Staphylococcus epidermidis septicemia in children with leukemia and lymphoma. 674 85

Gas-liquid chromatographic (GLC) fatty acid profile correlation analysis was applied for the subgrouping of 169 coagulase-negative staphylococci collected during an outbreak of nosocomial sepsis in a hematologic unit. The fatty acid profile similarity index between six ciprofloxacin-resistant Staphylococcus epidermidis septicemia strains was as high as 98.39 +/- 0.68, indicating a high degree of resemblance. This finding corroborated the finding by conventional typing methods that the isolates shared the same strain characteristics and, therefore, could be derived from the same epidemiological origin. Further, the GLC fatty acid profiles were analyzed for coagulase-negative staphylococcal cutaneous isolates recovered from colonization cultures of the patients and personnel in that same unit. The similarity index between 88 ciprofloxacin-resistant Staphylococcus epidermidis skin isolates with similar plasmid profiles was as high as 95.47 +/- 3.78, whereas the correlation coefficient between 45 ciprofloxacin-susceptible Staphylococcus epidermidis skin isolates with different plasmid profiles was only 85.23 +/- 10.82. Cluster analysis grouped the ciprofloxacin-resistant Staphylococcus epidermidis isolates into one distinct cluster, while most of the ciprofloxacin-susceptible Staphylococcus epidermidis isolates were grouped into two separate clusters. When compared with the plasmid profiling, the GLC method congruously grouped 127 (87%) of the 146 Staphylococcus epidermidis isolates, thereby suggesting its potential value in subgrouping coagulase-negative staphylococci during nosocomial outbreaks.
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PMID:Use of gas-liquid chromatography for subgrouping coagulase-negative staphylococci during a nosocomial sepsis outbreak. 755 30

Obstruction of narrow vessels by rigid neutrophils may contribute to ischemic organ injury. In septicemia, a substantial portion of the neutrophils may become activated and the number of circulating immature neutrophils may rise sharply. Volume and deformability of mature (PMN) and immature neutrophils in healthy preterm and full-term infants and in septicemic neonates were studied by means of a micropipette system. Membrane cytoplasm tongues were aspirated into 2.5-microm (diameter) pipettes over a period of 60 s. Volume and tongue growth of mature resting PMN were similar in healthy preterm and full-term neonates and adults. Compared with mature PMN (about 360 fl), the volumes of band cells (415 fl), metamyelocytes (470 fl), and less mature cells (myeloblasts, promyelocytes, and myelocytes; 490 fl) were significantly increased (p < 0.005). Final tongue lengths of band cells, metamyelocytes, and less mature cells were decreased by about 50, 60, and 70%, respectively, when compared with passive mature cells. In septic neonates, the percentage of immature neutrophils was increased, but the deformability and volume of the cell subpopulations were not affected by septicemia. Active PMN were characterized by pseudopod formation. More active PMN were found in group B streptococcal (14% of total PMN), gram-negative (12%), and Staphylococcus epidermidis septicemia (8%) than in healthy neonates and adults (4%). The main bodies of active PMN were less deformable than passive PMN, and the pseudopods showed very little membrane deformation. The increased number of rigid active and immature neutrophils may contribute to impaired microcirculation and the high risk for organ injury in septic patients.
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PMID:Passive deformability of mature, immature, and active neutrophils in healthy and septicemic neonates. 985 33