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

A single preoperative dose of imipenem/cilastatin was compared with metronidazole for the prevention of infectious sequelae following emergency appendicectomy. Patients with established sepsis received in addition 72 h of either intravenous imipenem or ampicillin, gentamicin and metronidazole postoperatively. Two hundred and sixty-eight patients were studied. Wound infection rate in low-risk patients was 9% for metronidazole and 8% for imipenem. When sepsis was already established intraperitoneally the wound infection rate was 24% for the triple therapy regimen and 8% for imipenem. There was no statistically significant difference between the infection rates in the two groups of treatment whatever the state of the appendix, but there was a trend in favour of imipenem in those patients with a perforated appendix.
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PMID:A comparison between imipenem and metronidazole prophylaxis against sepsis following appendicectomy. 197 36

Eighty-one episodes of bacteremia and candidemia were recorded in 78 infants in our neonatal intensive care unit during the years 1984 to 1988. The species isolated from monomicrobial episodes were as follows: Enterobacteriaceae 38%, group B streptococci or pneumococci 12%, staphylococci 20%, Candida albicans 9%, and other species 15%. Polymicrobial bacteremia occurred in 6%. Group B streptococci and pneumococci were predominantly isolated from early infections, whereas Enterobacteriaceae, Staphylococcus epidermidis and C. albicans were associated mainly with late septicemia. More than 80% of the episodes occurred in premature infants. During the study period, initial empiric antibiotic therapy consisted of ampicillin plus gentamicin. In spite of the fact that Enterobacteriaceae isolates, often ampicillin resistant, and penicillinase producing staphylococci, were the dominant etiologic agents, choice of this initial therapy did not seem to contribute to mortality. Mortality was most convincingly associated with overwhelming infections caused by group B streptococci and pneumococci.
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PMID:[Neonatal sepsis at Rigshospitalet in 1984-1988]. 199 42

In a population of 1011 puerperal women, the significance of rectovaginal colonization by group B streptococci during pregnancy with respect to infective puerperal morbidity was analyzed. Patients who were found to be carriers during pregnancy (121) were randomly divided into two groups: women who received ampicillin during delivery (500 mg i.v./6 h) and patients without chemoprophylaxis. Compared with the non-carriers, the carrier patients without prophylaxis had a significant increase in the mild puerperal infective morbidity, when defined as the proportion of women with an index fever greater than or equal to 10 (10.6% vs. 25%). However, the increased incidence among the carrier women of premature rupture of the membranes and of other possible morbidity factors made it impossible to identify the role of group B streptococci. Mild puerperal infective morbidity in the carrier women who received prophylaxis was lower than in those without prophylaxis and very similar to that of non-carrier women. It is concluded that the use of chemoprophylaxis to prevent neonatal sepsis would probably be followed by a reduction in infectious puerperal morbidity.
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PMID:Maternal colonization by group B streptococci and puerperal infection; analysis of intrapartum chemoprophylaxis. 200 45

The advances in the antibiotic therapy of acute bacterial infections can be shown by the decreasing frequency of complications and fatalities in children. The annual death-rate from pneumonia in children aged one month to 15 years has fallen in Schleswig-Holstein from 1.8 (1954-1958) to 0.6 per 10,000 (1969-1973). At the same time the total death-rate in the same age group has fallen from 14.5 to 9.3 per 10,000 children. The percentage of pneumonia in the total death-rate was 5.3% in 1971-1973: 1.6% in the first month of life and after the sixteenth year 2.3%. Pneumonia was in fourth place (after accident, malformation and neoplasm) as a cause of death in children more than one month old. Of 245 children operated on for congenital heart disease in 1983-1984, bacterial and fungal infections occurred in 3.6% compared to 17.8% of 469 in 1968-1972. Staphylococcal infections decreased from 3.4% to 0.8% and those caused by gram-negative bacteria from 6.9% to 0. Perioperative prophylaxis was performed with cefotaxime plus piperacillin in 1983-1984 versus oxacillin plus ampicillin in 1968-1972. Between 1984 and 1989, 944 children (premature babies and term babies) were treated in the intensive care unit of the University Children's Hospital of Kiel. The incidence of sepsis was 5% (congenital sepsis 4%, sepsis acquired after birth 1%). Early diagnosis and treatment of severe bacterial infections with cefotaxime plus piperacillin reduced the mortality rate of sepsis to 2%. Sepsis never developed under treatment with cefotaxime plus piperacillin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Progress of antibiotic therapy in pediatrics]. 200 18

Perinatal infections with bacteria belonging to the genus campylobacter are being increasingly recognized. We present a case of early onset neonatal sepsis with Campylobacter jejuni (previously C. Fetus ss. jejuni or Vibrio jejuni). The infant was born prematurely at 31 weeks of gestation and presented with respiratory distress and frequent apnoea from birth. The chest X-ray film demonstrated reticulogranular pattern consistent with hyaline membrane disease. The infant was successfully treated with ampicillin and gentamicin. C. jejuni infection should be considered in the differential diagnosis of early onset sepsis in the neonate and can mimic the radiological picture of hyaline membrane disease.
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PMID:Early onset neonatal sepsis with Campylobacter jejuni: a case report. 202 21

Two similar cohorts of low birth weight infants whose size was appropriate for gestational age randomly received either aztreonam-arginine plus ampicillin (n = 15) or gentamicin plus ampicillin (n = 15) for empiric treatment of neonatal sepsis. The regimens were infused together with glucose at greater than 5 mg/kg per minute, and immediate (4 hours) and cumulative (3 days) effects were assessed. Serum arginine and insulin values rose immediately after administration of aztreonam (containing 0.15 mmol of arginine per kilogram), but there were no changes in the gentamicin-treated cohort; no differences occurred in either cohort in serum concentrations of glucose, ammonia, potassium, creatinine, and bilirubin. After 3 days of antibiotic therapy (n = 13), the baseline serum arginine concentration was almost twice as high in the aztreonam group and showed a similar further rise and fall during the 4 hours after infusion; arginine urinary fractional excretion (normalized to creatinine clearance) decreased in the gentamicin group. The indirect bilirubin concentration rose more (p less than 0.001) in the aztreonam-treated infants (5.1 to 11.5 mg/dl (87 to 196 mumol/L] than in the gentamicin-treated infants (5.5 to 8.1 mg/dl (94 to 138 mumol/L)). Thus a modest differential bilirubin response and modestly elevated baseline serum arginine level occurred after the 3-day low-arginine doses of this study; serum ammonia and glucose concentrations were not affected. Aztreonam-arginine in neonates was well tolerated metabolically, and we believe that it can be used safely in conjunction with attention to glucose and bilirubin metabolism.
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PMID:Metabolic tolerance to arginine: implications for the safe use of arginine salt-aztreonam combination in the neonatal period. 204 Sep 35

Production of beta-lactamase is the most common mechanism of bacterial resistance to beta-lactam antibiotics. Virtually all bacteria have the capability of synthesizing the enzyme. Microorganisms may already possess the native genetic information necessary for beta-lactamase production (i.e., chromosomal), or may acquire the capacity by transfer of DNA from another organism (i.e., plasmid-mediated). The level of beta-lactamase production may be stable and noninducible (constitutive enzyme production), or may be stimulated on exposure to selected beta-lactam antibiotics (inducible enzyme production). Inhibitors such as clavulanic acid and sulbactam prevent antibiotic degradation by the beta-lactamases of many clinically significant pathogens. Therefore, currently available beta-lactam-beta-lactamase-inhibitor combinations exhibit broad spectra of in vitro activity. Ticarcillin-clavulanate possesses clinically significant activity against many bacteria, including streptococci, Staphylococcus aureus, Bacteroides fragilis, and numerous Enterobacteriaceae. Amoxicillin-clavulanate and ampicillin-sulbactam demonstrate clinically significant activity against streptococci (including enterococci), S. aureus, B. fragilis, and some Enterobacteriaceae. Ticarcillin-clavulanate is indicated for treatment of serious infections, including septicemia. Amoxicillin-clavulanate is useful in the treatment of upper respiratory, urinary tract, and skin and soft tissue infections. Ampicillin-sulbactam may be used for treatment of intraabdominal, gynecologic, urinary tract, and skin and soft tissue infections.
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PMID:Effects of beta-lactamase-mediated antimicrobial resistance: the role of beta-lactamase inhibitors. 204 31

The occurrence of Klebsiella oxytoca resistant to ampicillin, piperacillin, aztreonam and cefuroxime in a neonatal intensive care unit, including two cases of septicemia, was shown to consist of a spread on three consecutive occasions caused by three different biochemical Klebsiella oxytoca phenotypes. All isolates, except six surface isolates from one infant belonging to phenotype 1, were sensitive to cefotaxime (MIC 0.5-4 mg/l) and ceftazidime (MIC 0.25-1 mg/l). Isolates of phenotypes 1 and 2 produced a beta-lactamase with an isoelectric point of 5.5 and isolates of phenotype 3, a beta-lactamase with an isoelectric point of 7.9. The beta-lactamases of all three phenotypes hydrolysed benzylpenicillin and more slowly cephalothin. All phenotype 1 isolates carried a 2.9 Md plasmid and most isolates also a 36 Md plasmid. All phenotype 2 isolates carried a 4.8 Md plasmid and one isolate also a 30 Md plasmid. The phenotype 3 isolates carried only one 85 Md plasmid.
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PMID:Characterization of beta-lactam-resistant Klebsiella oxytoca isolated in a neonatal intensive care unit. 205 70

Salmonella typhimurium infections encountered at the neighbourhood of Bursa since January 1987 were evaluated in regard to the antibiotic resistance and treatment. High proportion of resistance was determined to the antibacterial agents such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, tetracycline and more sensitivity to ofloxacin, amikacin, ceftriaxone and cefotaxime was established in 383 Salmonella typhimurium strains isolated within two years of period. No antibiotic therapy was required to adult uncomplicated patients. A combination therapy with cefotaxime and amikacin was found to be satisfactory in the newborn cases with septicemia.
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PMID:[Salmonella typhimurium infections in the area of Bursa]. 208 38

Although listeriosis is an uncommon infection in patients with human immunodeficiency virus (HIV) infection, the frequency of listeriosis in New York City has increased because of the increase in the number of HIV-infected patients. The medical records of 30 patients admitted to three medical centers in New York City from 1981 to 1988 with infections due to Listeria monocytogenes were reviewed. Six patients had AIDS, one was seropositive and asymptomatic, and four had risk factors for HIV infection. While the annual number of cases of listeriosis in patients without risk factors for HIV infection was constant, 9 of the 11 patients with AIDS or with risk factors for HIV infection presented with listeriosis between 1985 and 1988, the last half of the survey period. These patients were male homosexuals or intravenous drug abusers, and all but one were black or Hispanic. Manifestations of listeriosis in patients with AIDS or with risk factors for HIV infection included bacteremia without apparent source in seven, meningitis in three, and endocarditis in one, syndromes that were similar to those in patients without risk factors for HIV infection. Ten of 11 patients were treated with penicillin or ampicillin, and 7 were also given an aminoglycoside. All patients responded well to therapy and no relapses were observed. Physicians should include antibiotics effective against L. monocytogenes when treating AIDS patients with meningitis of unknown origin and consider the diagnosis of listeriosis in patients with sepsis of unknown origin.
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PMID:Listeriosis in patients with HIV infection: clinical manifestations and response to therapy. 210 31


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