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

Mortality from neonatal meningitis due to gram-negative microorganisms remains 50% despite use of aminoglycoside antibiotics. Blood was obtained on 238 occasions from 77 neonates with putative or documented sepsis; paired blood and cerebrospinal fluid (CSF) samples were obtained on 14 occasions from ten neonates with meningitis. Kanamycin and gentamicin were measured by a radioisotopic assay procedure. Kanamycin was administered at 15 mg/kg/day in three divided doses intravenously; serum concentrations peaked at one hour (mean, 7.77mug/ml). Gentamicin was administered at 7.5 mg/kg/day in three divided doses intravenously; serum concentrations peaked at two hours (mean, 5.34mug/ml). Both aminoglycosides generally were nondetectable within the CSF; survival of neonates with gram-negative meningitis correlated specifically with the sensitivity of their isolates to ampicillin which was administered concurrently. This study suggests that alternative approaches to the treatment of neonatal sepsis should be explored; administration of an antibiotic which crosses the blood-cerebrospinal fluid barrier more readily should be considered.
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PMID:Kanamycin and gentamicin treatment of neonatal sepsis and meningitis. 110 75

Biological properties of 142 Proteus strains isolated from patients were studied. Sensitivity of Proteus to II antibiotics was tested. The isolates were resistant to most of the antibiotics. The highest number of the isolates was sensitive to ampicillin (77.1 minus or plus 7.16) and especially to carbenicillin (82.6 plus or minus 6.16). This provided the use of carbenicillin for the treatment of experimental septicemia in albino mice and wound processes in rabbits with Proteus complications. The high therapeutic effect of the antibiotic was shown in experiments with 210 albino mice and 44 rabbits. The therapeutic effect of carbenicillin increased when it was used in combination with prodigiozan and especially in combination with prodigiozan and lysozyme.
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PMID:[Effect of carbenicillin and its combination with prodigiozan and lysozyme on the course of an experimental inflammatory process of Proteus etiology]. 111 92

A review of the literature reveals that glucocorticoids have: 1) a protective effect both in vitro and in vivo against bacterial endotoxins and exotoxins, and 2) a protective or therapeutic effect in sepsis/shock caused by Gram-negative microorganisms. At the Columbia Presbyterian Medical Center, the 1968-1973 mortality rate for general sepsis/shock due to Gram-negative organisms was 16.6 percent and for urologic sepsis/shock 15.3 percent. This low rate was the result of early diagnosis and early use of massive dosages of glucocorticoids (hydrocortisone, methylprednisolone, dexamethasone), beta-adrenergic isoproterenol, and bactericidal antibiotics (gentamicin, kanamycin, carbenicillin, cephalothin-cefazolin, ampicillin).
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PMID:Glucocorticoid therapy in sepsis/shock caused by gram-negative microorganisms. 117 49

Forty-seven strains of Citrobacter diversus were isolated during a 12-month period from clinical material obtained from patients in a general hospital in Israel. The majority of cultures (38) were recovered from urine and wound discharges. There was one case of septicemia. The biochemical reactions of all cultures were typical for this species, except one that was anaerogenic, and they could be divided into five biotypes (a through e). Thirty-nine strains were identified serologically and found to belong to one of seven O groups described by Gross and Rowe (1974). All cultures were sensitive to tetracycline and nalidixic acid. All strains were resistant to carbenicillin and ampicillin and produced beta-lactamase.
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PMID:Citrobacter diversus isolated from clinical material. 126 51

The authors report a nosocomial infection outbreak by Klebsiella pneumoniae, observed in neonates at a gyneco-obstetrical hospital from Mexico City. Forty six newborns presented one or more infections due to K. pneumoniae during their stay in neonatal care units, between October 3 and November 12, 1988. Sepsis was documented in 41 cases by clinical picture and routine laboratory exams, including one positive, blood culture at least. The most frequent invasive procedures practiced in these patients were catheterization and ventilatory support. K. pneumoniae was isolated as well from several environmental sources that could have led to infection of patients. Treatment of cases was initiated with ampicillin-amikacin, however, therapeutic failure with a lethality rate of 50% (14/28) and results of antimicrobial susceptibility conducted to treatment with cefotaxime. Fifteen out of 19 patients receiving the cephalosporin survived. To prevent outbreaks like the one presented here, we concluded that appropriate measures dealing with hygiene and education of personnel plus monitoring of bacterial susceptibility to antimicrobials, should prove successful in our environment.
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PMID:Neonatal septicaemia due to K. pneumoniae. Septicaemia due to Klebsiella pneumoniae in newborn infants. Nosocomial outbreak in an intensive care unit. 134 98

The choice of antimicrobial therapy for the treatment of bacteremia is often empirical and based on the knowledge of antibiotic susceptibility profiles of the most common bacteria causing such infections. It therefore is crucial to survey the susceptibility of bacteria causing sepsis. This study examines the susceptibility profiles of 941 gram-negative bacteria, isolated from septic patients in 10 Canadian hospitals, to 28 antimicrobial agents. Among the isolates, 30 different species were represented; Escherichia coli dominated, representing 52.5% of isolates. More than 50% of all bacteria were resistant to ampicillin. Only 67% of the E. coli isolates were susceptible to ampicillin, while 30% of all strains were resistant to ticarcillin. Of the cephalosporins, ceftazidime and cefoperazone/sulbactam were the agents to which isolates were the most susceptible (90%). Only 51% of the E. coli strains were susceptible to cephalothin, while 91% were still susceptible to cefazolin. A total of 93% and 98% of the strains were susceptible to aztreonam and imipenem, respectively. Aminoglycosides were highly active against most isolates, in general in the following order: netilmicin greater than tobramycin greater than gentamicin greater than amikacin. Tobramycin was the most active against Pseudomonas aeruginosa. Nearly all isolates were susceptible to the quinolones. Tolerance (MBC/MIC ratio, greater than or equal to 32) was rarely observed. This survey of the susceptibility of gram-negative bacteria causing sepsis provides valuable information for implementing the chemotherapy for gram-negative septicemia and demonstrates that several older and newer agents, alone or in combination, can be used as adequate initial therapy for gram-negative sepsis in Canada.
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PMID:Antibiotic susceptibility profiles of 941 gram-negative bacteria isolated from septicemic patients throughout Canada. The Canadian Study Group. 142 Jun 74

To determine current opinions among experts in pediatric infectious diseases for treatment of bacterial sepsis, meningitis and acute otitis media, we polled directors of training programs in January, 1992. Responses were received from 69 centers in the United States and Canada. For initial treatment of presumed bacterial meningitis, the third generation cephalosporins alone or combined with ampicillin have become drugs of choice in all age groups. Most infectious disease programs include dexamethasone in the management of presumed bacterial meningitis for children 2 months of age and older. Third generation cephalosporins are also drugs of choice for presumed sepsis: combined with ampicillin for infants 5 weeks of age; used alone for children 5 months and 12 years of age. Amoxicillin remains the preferred drug for initial treatment of acute otitis media. The combination of amoxicillin and clavulanic acid is favored in the setting of an increased proportion of beta-lactamase-producing bacterial pathogens. Comparison of these results with polls in 1987 and 1989 indicates a shift in recommendations of therapy of presumed bacterial sepsis and meningitis from ampicillin alone or combined with an aminoglycoside or chloramphenicol to use of a third generation cephalosporin alone or combined with ampicillin.
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PMID:Therapy of bacterial sepsis, meningitis and otitis media in infants and children: 1992 poll of directors of programs in pediatric infectious diseases. 144 7

We report a prospective, non-blind, randomised, multicentre, parallel group, multinational investigation to compare ceftazidime to aminoglycoside based regimens as empirical treatment in 1316 cases of suspected sepsis in the newborn. In each of the 15 study centres either ceftazidime alone (CAZ) or ceftazidime + ampicillin (CAZ + AMP) was compared to an amino-glycoside/ampicillin combination (AG + AMP). In all cases treatment was based on "an intention to treat". Bacteria considered to be pathogenic were isolated from 176/1316 (13.4%) patients. The incidence of proven infection varied from 39% in a Yugoslav centre to 6% in a British centre; a further 489/1316 (37.1%) patients fulfilled the criteria for clinically suspected sepsis. A total of 210 bacterial isolates from 197 infection sites in 176 patients were considered to be clinically significant. The cure rate for evaluable patients with proven infection who were treated with CAZ + AMP (97%, 30/31) was significantly higher than that for the corresponding patients treated with AG + AMP (66%, 26/39), (P < 0.002). The difference in cure rate between CAZ monotherapy (79%, 34/43) and AG + AMP (86%, 32/37) was not significant. Treatment failed in 28/150 (18.7%) evaluable patients. There were significantly fewer failures (P < 0.001) with CAZ + AMP than with AG + AMP therapy. There were 55 staphylococcal infections. Treatment was successful in 16/19 evaluable patients treated with CAZ or CAZ + AMP and in 16/29 evaluable patients treated with AG + AMP. None of the study centres encountered problems with ceftazidime resistant bacteria. The cure rate for patients with only clinical and radiological evidence of sepsis was greater than 94% in all treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A comparison of ceftazidime and aminoglycoside based regimens as empirical treatment in 1316 cases of suspected sepsis in the newborn. European Society for Paediatric Infectious Diseases--Neonatal Sepsis Study Group. 147 40

A prospective study of burn wound sepsis was carried out on 31 consecutive patients with fresh burns. Wound swab cultures were assessed at weekly intervals for 5 weeks. The study revealed that while 96.7 per cent of burn wounds were sterile on admission, bacterial colonization reached 80.6 per cent within the first week after admission. Although the Gram-negative organisms, as a group, were more predominant, Staph. aureus (38.2 per cent) was the most prevalent organism in the first week. It was however surpassed by Pseud. aeruginosa from the second week onwards. Anaerobes were conspicuous by their absence. Similarly, beta-haemolytic streptococcus was not isolated from any patient. Proteus mirabilis was unusually preponderant, forming 19.4 per cent of all isolates. The antibiotic sensitivity pattern showed resistance of most of the organisms to ampicillin. Only 15 per cent of staphylococci were sensitive to cloxacillin. Most of the organisms cultured (93.5 per cent) were sensitive to ceftazidime.
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PMID:Bacterial flora of burn wounds in Lagos, Nigeria: a prospective study. 148 92

Toxic epidermal necrolysis (TEN) is a life-threatening bullous dermatosis characterized by the sudden onset of full-thickness epidermal necrosis. TEN is a disease of both children and adults, but TEN in early infancy is a rare event; only two well-documented cases in infants less than 6 months of age have been reported. We report a third case of a 6-week-old infant with Escherichia coli sepsis who received ampicillin and other antibiotics and subsequently developed TEN. Despite the withdrawal of ampicillin and aggressive systemic and wound care, the infant died. The infants in the other two reported cases also died, which suggests that TEN in early infancy has an extremely poor prognosis.
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PMID:Toxic epidermal necrolysis in early infancy. 151 1


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