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

A case of successful therapy with ampicillin of maternal septicemia due to Listeria monocytogenes at 26 weeks' gestation with resultant delivery at term of a normal neonate is reported. The ability to positively influence the outcome of hematogenously acquired maternal-fetal infection is stressed.
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PMID:Successful treatment of maternal septicemia due to Listeria monocytogenes at 26 weeks' gestation. 402 17

Predisposing factors and clinical presentations associated with early-onset group B streptococcal (GBS) infections in 60 infants were reviewed. Over a three-year period, the incidence of these infections in The Royal Women's Hospital, Melbourne, was 2.0 per 1000 births. The clinical presentation ranged from fulminating sepsis to asymptomatic bacteraemia. In some cases, there was evidence of intrauterine fetal infection, despite intact membranes and a lack of clinical evidence of maternal infection. However, the over-all incidence of fever, before and after delivery, among the mothers of these babies was high. Early, or prophylactic, antibiotic therapy was generally associated with a favourable outcome. None of the infants who died from GBS infections had received antibiotic therapy before the onset of symptoms. The value of routine antenatal screening for vaginal carriage of group B streptococci, and the place of antibiotic prophylaxis, or immunoprophylaxis, are not yet established. However, prophylactic antibiotic therapy in mothers and babies considered to be at risk from GBS infection is recommended.
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PMID:Perinatal group B streptococcal infections. 634 14

Intraamniotic infection is a common (2-4%) event in labor. The predictors of IAI include preterm labor or rupture of membranes, abnormal vaginal flora (e.g., GBS, sexually transmitted disease, bacterial vaginosis), obstetric manipulations (e.g., vaginal exams, internal fetal monitoring) in the presence of ruptured membranes, and diminished host response (due to smoking, drug abuse, obesity, immunodeficiency states, etc.). Group B Streptococcus and Enterobacteriaceae are the most important organisms associated with the polymicrobial infection. Anaerobes predict post-cesarean section complications. Neonatal pneumonia (2-5%) and early neonatal sepsis (1-4%) are the outcomes of the greatest concern and are caused by group B streptococcal or aerobic gram-negative rod infections. These outcomes are kept to a minimum if maternal antibiotic chemotherapy is started interpartum with agents that are safe, cross the placenta, and are active against GBS and Escherichia coli (e.g., ampicillin plus gentamicin). Anaerobic coverage should be added (clindamycin) if a cesarean section is performed. Antipyretics such as acetaminophen will reduce the hyperthermic stress on the fetus, and persistent fetal tachycardia after antipyretics may indicate fetal infection. Continuous electronic fetal monitoring is appropriate in cases of IAI, and providers should be prepared for neonatal resuscitation, early neonatal intravenous antibiotics, and respiratory support at delivery.
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PMID:Chorioamnionitis and intraamniotic infection. 829 82

Citrobacter species have rarely been described as-etiological factors of intraamniotic infections. Citrobacter is not a normal inhabitant of the female genital tract. Vertical transmission of Citrobacter from mother to fetus has rarely been reported. A 21-year-old primigravida presented to labor and delivery at 40 6/7 weeks' gestation complaining of ruptured membranes, painful uterine contractions, and fever. An intraamniotic infection was diagnosed and antibiotics begun. She was subsequently delivered of a live male infant. Mother and infant had positive cultures for Citrobacter and overwhelming sepsis. Citrobacter species are rarely described as etiological factors of intraamniotic infections, and vertical transmission has rarely been reported. This pathogen should be considered in cases of chorioamnionitis or maternal sepsis as overwhelming maternal and fetal infection are possible sequelae.
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PMID:Vertical transmission of a Citrobacter infection. 937 7

This case illustrates 2 main points. Firstly, fetal infection can mimic exactly both the immediate and delayed signs of perinatal asphyxia. Secondly, the placenta may hold the key to the diagnosis of sepsis which may be made difficult in the neonate by labour ward practices such as the use of intrapartum and immediate newborn antibiotics. We strongly support the recommendation that newborn blood and fetal membrane cultures should always be obtained in babies with a diagnosis of 'intrapartum asphyxia and fetal distress' (1). To this we would add the recommendation that placental histology be performed in these circumstances.
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PMID:Group B streptococcus infection, not birth asphyxia. 1009 63

Listeria monocytogenes causes sepsis and meningitis in immunocompromised hosts and a devastating maternal/fetal infection in pregnant women. In recent years a more benign gastroenteritis in normal hosts has been described. Listeria has been increasingly identified as a food-borne pathogen, and large-scale contamination of processed foods with resulting outbreaks has occurred in recent years, possibly as a result of consolidation of the food industry. Experimental listeriosis in mice has proven to be an extraordinarily useful model for analyzing cell-mediated immune host defenses. Contrary to original concepts, we found that neutrophils, not macrophages, are the prime effectors during early infection. CD8+ T cells are then responsible for lysing infected hepatocytes through perforin-related (early primary and secondary infection) or Fas-L/Fas mechanism (late primary). Of interest, non-classical MHC class Ib restricted recognition mechanisms exist early, whereas MHC class Ia mechanisms can be detected throughout infection.
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PMID:An updated model of cell-mediated immunity--listeriosis: clinical and research aspects. 1095 86

Listeria monocytogenes, a small gram-positive bacillus, causes sepsis and meningitis in immunocompromised patients and a devastating maternal/fetal infection in pregnant women. Recent outbreaks demonstrated that L. monocytogenes can cause gastroenteritis in otherwise healthy individuals and more severe invasive disease in immunocompromised patients. Centralized processing in the food industry may be the cause of these large-scale listeriosis outbreaks. The mouse model of listeriosis, which was developed in the 1960s, has been extraordinarily useful for studying T cell-mediated immunity. Contrary to the original concept that macrophages are the principal effector cells in listeriosis, we found that immigrating neutrophils play the predominant role in early liver defenses. At later time points, CD8(+) T cells lyse infected hepatocytes by both perforin- and Fas-L/Fas--dependent mechanisms. Of interest, nonclassical major histocompatibility complex (MHC) class Ib--restricted cytolytic activity is expressed early during primary infection, whereas MHC class Ia--restricted activity is predominant through late primary and secondary infections.
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PMID:Listeria monocytogenes: clinical and experimental update. 1186 36

Typhoid fever is rare in Europe, but well-recognized endemic disease in tropical zones. We report our findings in a series of 25 cases of typhoid fever during pregnancy observed in French Guiana and reviewed the literature on clinical signs, diagnosis and treatment. Salmonellea typhi causes septicemia of digestive origin that can cross the placenta resulting in chorioamniotitis. Maternal-fetal infection with S. typhi can lead to miscarriage, fetal death, neonatal infection, as well as diverse maternal complications. In order to avoid maternal complications and possible fetal transmission, treatment with ceftriaxone should be initiated as early as possible
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PMID:[Typhoid fever and pregnancy]. 1237 34

Infection due to Campylobacter fetus subsp. fetus during pregnancy is uncommon in humans. We report a case of a pregnant woman who experienced premature labor. The infant was diagnosed with neonatal sepsis due to C. fetus subsp. fetus, and was successfully treated with carbapenem. Maternal clinical symptoms and severe villitis suggested that the route of fetal infection was hematogenous spread. We also review previous reports in the literature that describe this infection during pregnancy.
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PMID:A case of perinatal sepsis by Campylobacter fetus subsp. fetus infection successfully treated with carbapenem--case report and literature review. 1654 30

To better understand the transmission and epidemiology of human listeriosis, 647 Listeria monocytogenes isolates obtained from human listeriosis cases in four U.S. locations (Michigan, Ohio, New York State, and New York City) over 61 months (1998 to 2003) were characterized by automated EcoRI ribotyping. A total of 65 ribotypes were differentiated among the characterized isolates; 393, 227, and 24 isolates were classified into lineages I, II, and III, respectively, and 3 isolates were not classified to lineage. The three most common ribotypes (responsible for 39% of all cases) represented L. monocytogenes epidemic clones, each of which had previously been linked to at least two human listeriosis outbreaks. Categorical analyses revealed that ribotypes and lineages were nonrandomly distributed among the four locations. Temporal cluster analysis of cases identified 13 statistically significant temporal subtype clusters, which represented 26% of all cases. Three of these clusters matched previously described human listeriosis outbreaks. Isolates involved in clusters belonged to nine ribotypes. Four, eight, and one cluster were caused by lineages I, II, and III, respectively. The two largest clusters were both caused by the epidemic clone representing ribotype DUP-1044A. Categorical analyses revealed no significant associations between lineage or ribotype and clinical manifestation (central nervous system infection, septicemia, fetal infection, or other infection) or disease outcome (fatal or not fatal). Although human listeriosis cases are caused by isolates belonging to a diversity of EcoRI ribotypes, specific lineage I epidemic clones cause a large number of human listeriosis cases. Many human listeriosis cases can be grouped into statistically significant temporal clusters, including widely distributed and region-specific clusters associated with isolates of various ribotypes. L. monocytogenes lineages and EcoRI ribotypes do not appear to differ in their likelihood of causing different clinical manifestations or mortality.
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PMID:Molecular epidemiology and cluster analysis of human listeriosis cases in three U.S. states. 1686 4


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