Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bacteria can invade the biliary tract by ascending from the duodenum and via the hematogenous route from the hepatic portal venous blood. The sphincter of Oddi, situated at the junction of the biliary tract and the upper gastrointestinal tract, forms an effective mechanical barrier to duodenal reflex and ascending bacterial infection. Conversely, Kupffer cells and the tight junctions between hepatocytes help prevent bacteria and toxic metabolites from entering the hepatobiliary system from the portal circulation. The continuous flushing action of bile and the bacteriostatic effects of bile salts keeps the biliary tract sterile under normal conditions. Secretory immunoglobulin A (sIgA), the predominant immunoglobulin in the bile, and mucus excreted by the biliary epithelium probably function as antiadherence factors, preventing microbial colonization. When barrier mechanisms break down, as in surgical or endoscopic sphincterotomy and with insertion of biliary stents, pathogenic bacteria enter the biliary system at high concentrations and take up residence on any foreign bodies. Intrabiliary pressure is a key factor in the development of cholangitis. Chronic biliary obstruction raises the intrabiliary pressure. This adversely influences the defensive mechanisms such as the tight junctions, Kupffer cell functions, bile flow, and sIgA production in the system, resulting in a higher incidence of septicemia and endotoxemia in these patients. Knowledge of biliary defense against infection is still quite primitive. Unclear are the roles of sIgA in the bile, mechanism of bacterial adhesion to the biliary epithelium, Kupffer cell function in biliary obstruction, and the antimicrobial activity of bile salts.
 ...
PMID:Defense system in the biliary tract against bacterial infection. 156 8

The role of gastric microbial colonization in nosocomial infections and endotoxemia was investigated prospectively in 40 neurosurgical patients requiring mechanical ventilation for greater than 48 h. Each was studied up to 7 d. Swabs from the nose and oropharynx were cultured at admission, and aspirates from the stomach and trachea were cultured daily until enteral alimentation was started. Patients were evaluated every second day for endotoxemia and coagulation activation. Of 153 gastric aspirates, 66.7% contained microorganisms at a mean quantity of 10(7) cfu/ml. Nosocomial pneumonia occurred in 15 patients, septicemia in 5, and meningitis in 1. The stomach was the evident source of infection in only 1 patient with pneumonia. Of 140 plasma samples, 12 (8.6%) from 10 patients showed detectable endotoxin levels, but there was no association between endotoxemia or coagulation activation and the presence of microorganisms in the stomach. The stomach was not an important source for nosocomial infections or endotoxemia, even in patients with high gastric pH.
 ...
PMID:Role of gastric colonization in nosocomial infections and endotoxemia: a prospective study in neurosurgical patients on mechanical ventilation. 276 Apr 97

Catheter-related sepsis is one of the major complications of total parenteral nutrition (TPN) therapy. The relationship between microbial colonization of the skin at the site of catheter insertion and colonization of the central venous catheter was investigated in 74 catheters used to administer TPN therapy in 53 patients. Semiquantitative culture specimens were obtained from the insertion site and intravascular and subcutaneous catheter segments at the time of catheter removal. Bacteria and/or fungi were recovered from 19 catheters and 19 insertion sites; of the 19 colonized catheters, 6 had sterile insertion sites. Organisms isolated from the remaining 13 catheters were isolated concurrently from the insertion site. Catheter-associated bacteremia or fungemia was observed in 10 of the 19 patients with colonized catheters. The association between colonization of catheters and the presence of more than 10(3) bacterial or fungal colony-forming units at the insertion site was significant (P less than 0.005). These results demonstrated that colonization of catheters by organisms present on the skin at the site of catheter insertion occurred twice as frequently as colonization by the hematogenous route. The results also suggested that colonization of catheters by organisms present at the insertion site occurred only after a threshold number of organisms was reached.
 ...
PMID:Association between microorganism growth at the catheter insertion site and colonization of the catheter in patients receiving total parenteral nutrition. 681 29

The mechanism of microbial colonization and sepsis is disputed. For many authors, catheter contamination results from poor aseptic technic during insertion or removal or from the descent of organisms along the catheter from the skin puncture site; we think with Michel that endogenous colonization of the thrombus at the tip of the catheter must be considered: a statistical correlation between infected foci remote from the catheter allows this hypothesis; tracheostomy may be considered as well as a percutaneous contaminant as a deep infected focus. The correlation between non specific immunity and contamination is another finding which allows the ability of endogenous colonization.
 ...
PMID:[Bacteriologic study of indwelling central venous catheters. Factors influencing the risk of microbial colonization and sepsis (author's transl)]. 730 40

Catheter-related sepsis is a common complication associated with the use of central venous catheters (CVC). In an attempt to overcome this problem benzalkonium chloride was incorporated into a CVC polymer. The effect of the presence of benzalkonium chloride on microbial colonization of the CVC was then assessed in vitro. MICs and MBCs of benzalkonium chloride for a range of organisms were performed and good activity against Gram-positive organisms was confirmed. In order to assess the antimicrobial activity of the benzalkonium-chloride-impregnated catheter, 2 cm lengths were placed on to nutrient agar plates inoculated with various micro-organisms. Zones of inhibition against five strains of Staphylococcus epidermidis and two strains of Staphylococcus aureus were demonstrated. Smaller zones of inhibition was also produced with Gram-negative species and Candida albicans. The zone sizes correlated with the MICs. Bacterial adherence to the benzalkonium-chloride-impregnated catheters was determined in both static and dynamic models and was significantly reduced compared with control catheters, containing no antimicrobial agent (P < 0.01). Inhibition of microbial adherence to benzalkonium-chloride-impregnated catheters placed in 25% human blood in phosphate-buffered saline (PBS), for up to seven days or PBS alone for 14 days was detected. The findings indicate that benzalkonium-chloride-impregnated catheters exhibit reduced microbial colonization by a range of organisms in vitro. The incorporation of benzalkonium chloride into a CVC may thus offer an effective method for the prevention of catheter related sepsis.
 ...
PMID:A novel antimicrobial central venous catheter impregnated with benzalkonium chloride. 814 34

Although the use of occlusive dressings in adults has been criticized in the literature, there has been little written on their use in the pediatric population. Management of dressing sites requires nursing judgement unique to this population. This study focused on the progression of microbial colonization and signs of inflammation occurring beneath repeated occlusive dressings applied to central venous catheter (CVC) insertion sites among 104 hospitalized children (neonate to 18 years). A noninvasive skin culture was obtained within 24 hours of CVC placement, 3 to 7 days later before the next routine dressing change, and at the time the CVC was discontinued or the child was discharged, whichever occurred first. Results showed a significant increase in microbial growth (p < or = .001) at the second dressing change, when serosanguinous drainage was heaviest, and continued significant growth (p < or = .001) when the dressing was discontinued. This microbial growth pattern was curious in the face of a 0.3% systemic sepsis rate. When neonates under 1,800 g were excluded from calculation, the pattern was not notable (p = .2119). Findings suggest the use of occlusive dressings during prolonged hospitalization for tunnelled CVCs does not lead to increased site infections in children over 1,800 g.
 ...
PMID:Use of occlusive dressings on central venous catheter sites in hospitalized children. 866 54

The incidence of catheter-related sepsis associated-with the use of Tegaderm or Opsite IV3000 dressings on 100 critically ill patients with liver disease was studied. All the patients had central venous catheters in situ and they were randomly assigned to one of the two dressings. In this study the sites of insertion were assessed at each dressing change, together with any fluid under the dressing. No statistically significant difference between the two dressings was found in accumulation of fluid, skin microbial colonization, local infection or systemic infection of patients in our sample. There was no apparent advantage to using the more permeable Opsite IV3000 dressing.
 ...
PMID:Do dressings with increased permeability reduce the incidence of central venous catheter related sepsis? 909 79

Infections associated with central venous catheters continue to be a major source of sepsis, particularly in hospitalized patients. In developing a strategy for the prevention of these infections, the source and route of invasion of the causative micro-organisms need to be considered. The main source of micro-organisms is the patient's skin. They can gain access to a catheter at the time of insertion, as well as via the external or internal catheter surfaces. Attempts to reduce the incidence of infections range from the type of skin preparation selected, to care of the insertion site post-catheterization. Improvements in catheter design have also reduced the likelihood of infection and include the development of non-leachable smooth catheters with anti-adhesive coatings. More recently, catheters containing antimicrobial agents have become available and preliminary studies have demonstrated a reduction in microbial colonization and associated sepsis. Future preventative strategies may include the application of low voltage electric current in combination with antimicrobials.
 ...
PMID:Prevention of central venous catheter-related infection. 983 May 90

Wounding of normal skin initiates an acute inflammatory response that ordinarily contributes to the healing process. The underlying process is orchestrated by the specific and nonspecific immune response. Inflammatory cells provide growth factors and stimulate the deposition of matrix proteins and phagocytose debris. However, the maturation and resolution of a wound may be complicated by micro-organisms. The effects of micro-organisms on oxygen consumption and pH, or toxin production, may interrupt the natural course of wound healing. Thus, a wound may not progress from the acute phase and heal, but may become a nonhealing chronic or recalcitrant wound as long as the antigens from micro-organisms or underlying pathology remain. Depending on the underlying disease pathology and the micro-organism's virulence, microbial growth in acute or chronic wounds may lead to invasive wound infection. Wound infection is a complex interaction involving the host as well as the numbers and types of micro-organisms present. The literature suggests that micro-organisms alter the course of acute wound healing, and a body of evidence exists that suggests that large numbers of organisms in chronic wounds delay the healing process. However, other evidence suggests that, despite bacteria, most chronic wounds progress toward healing, depending upon the wound care strategy employed. Current therapy seeks to alter the relationships between microbial colonization and host defenses by providing an environment that tips the balance in favor of healing. The role of bacteria in acute and chronic wounds may span the spectrum from initiation of inflammation and the healing process, to colonization, invasive infection, systemic sepsis, organ system failure, and death. Understanding the interaction of the wound, wound micro-organisms, and the immune response is central to understanding how best to develop therapeutic approaches.
 ...
PMID:Immunology, microbiology, and the recalcitrant wound. 1073 42

It is now clear that antibiotic treatment in the antenatal period significantly does prolong pregnancy during conservative management of preterm premature rupture of membranes and reduces neonatal infectious diseases as well as neonatal-related morbidities. In the same way, prophylactic intrapartum antibiotherapy reduces the incidence of early-onset group B Streptococcus-induced sepsis. Nevertheless, on the other hand, antibiotics in the perinatal period are associated with an increase of neonatal sepsis by organisms resistant to maternally administered antibiotics. In addition, antibiotic treatment in this period of time is emerging as one of the possible sources of the dramatic increase in atopic disorders in infants and children owing to the interference with the normal process of intestinal microbial colonization. So, guidelines for using antibiotics in the perinatal period can be said as one of the major priority in public health. Antibiotics have therefore to be rightly choosen and must be used in a rational manner. Local microbial epidemiology, period of infection onset, clinical evaluation, all together allow the physician to use antibiotics, always in association, according to the "well-thought-out wager". In addition, the pharmacodynamic/pharmacokinetic relationship of each drug has to be known, in order to increase efficacy, decrease toxicity and reduce microbial resistance. It is especially mandatory in neonatology where the differences in drug distribution and drug elimination are of great concern, as compared to children and adults. The aim of this paper is to point out such very important aspects using antibiotics in the perinatal period.
 ...
PMID:[Antibiotics in pregnancy: importance of rational utilization]. 1105 74


1 2 3 Next >>