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

Mutants of Enterobacter cloacae, selected in vitro with ceftriaxone, ceftazidime, carumonam, or aztreonam, fell into several distinct classes. Three mutants highly resistant to nearly all beta-lactam antibiotics were stably derepressed for beta-lactamase production. Although no other changes could be detected, virulence in a mouse septicemia model was decreased in two of these mutants. One mutant, 908-Ssi, showed selectively decreased susceptibility to ampicillin and cefotetan. A change in beta-lactamase expression was thought to be responsible for this. Alterations in the production of two outer membrane proteins with molecular sizes of 36.5 and 39 kilodaltons were responsible for multiple antibiotic resistance in two mutants, both of which acquired a low level of resistance to beta-lactam antibiotics. Whereas one of the mutants, AMA-R, simultaneously acquired resistance to chloramphenicol and trimethoprim, the other, AZT-R, became hypersusceptible to these and other hydrophobic agents. Both strains had drastically reduced virulence in mice.
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PMID:Multiply resistant mutants of Enterobacter cloacae selected by beta-lactam antibiotics. 349 74

A 4-month-old infant with congenital heart disease and sepsis and arthritis, and subsequently meningitis, caused by an antibiotic-resistant strain of Haemophilus influenzae type b, failed to respond to sequential therapy with ampicillin and trimethoprim/sulfamethoxazole. Following treatment with ceftizoxime, the infant was well for 42 days, until he returned to the hospital and died. A total of 10 Haemophilus influenzae type b isolates, all outer membrane protein subtype 51, was isolated from the pretreatment blood and synovium, cerebrospinal fluid and subdural fluids, and the petrous pyramids at autopsy. Pretreatment isolates had no detectable plasmid DNA, chloramphenicol acetyltransferase or beta-lactamase; the minimal inhibitory concentration for ampicillin (AM) and chloramphenicol (CM) was 0.2 and 0.8 microgram/ml, respectively. However, all cerebrospinal fluid isolates had a 42-44 mD plasmid and produced chloramphenicol acetyltransferase and beta-lactamase; the minimal inhibitory concentration of these isolates to AM and CM were 12.5 and 25 micrograms/ml, respectively, and were also resistant to tetracycline and sulfonamide. Resistance to AM and CM was cotransferred by filter-mating conjugation at a frequency of one to two transconjugants per 10(5) to an Rd haemophilus recipient. Posttreatment isolates from the petrous pyramids also were resistant to AM and CM and produced chloramphenicol acetyltransferase and beta-lactamase activity, but had no plasmid DNA. These findings and data from genetic studies suggested that plasmid-bearing antibiotic-resistant Haemophilus influenzae type b was selected from a heterogenous population, and that the AM/CM resistance transposons were incorporated into the bacterial chromosome.
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PMID:Ampicillin-chloramphenicol-resistant Haemophilus influenzae: plasmid-mediated resistance in bacterial meningitis. 350 Apr 49

Although periorbital and orbital dog bites are rare, they most frequently occur in young children and commonly involve significant associated adnexal injuries. In most cases, the dog is either the family pet or is otherwise known to the victim. The exact precipitating event is usually unknown. Most victims are treated by a physician soon after injury, and can be reconstructed primarily following meticulous local wound care, including adequate irrigation. Infection is rare, but because of its potentially disastrous consequences, prophylactic treatment with penicillinase-resistant penicillin or cephalosporin seems indicated. Serious, potentially fatal consequences due to underlying intracranial injury in children under aged 2 years, fatal septicemia in splenectomized individuals, tetanus, and rabies must be considered by ophthalmologists who treat such patients.
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PMID:Orbital and periorbital dog bites. 350 36

Septicemia is a rare but serious complication of infection with Yersinia enterocolitica (Y.e.). Seven cases of Y.e. septicemia are presented. Five of the patients had no underlying disease predisposing to septicemia. Five patients displayed recurrent episodes of septicemia, despite treatment with recommended doses of antibiotics to which the isolates were sensitive in vitro. One patient developed endocarditis which required surgical replacement of the aortic valve. Other clinical manifestations were arthritis, diverticulitis and pulmonary abscesses. The outcome was fatal to 3 elderly patients. The serological response to Y.e. was followed by tube agglutination and a diffusion-in-gel enzyme-linked immunosorbent assay. One patient, with a benign course of illness, had transient elevated Y.e. antibody titres, while the 3 cases with a protracted disease showed sustained antibody responses for 6-18 months. Blood isolates of Y.e. had ordinary virulence characteristics identical to fecal isolates and produced extracellular beta-lactamase. All isolates were sensitive in vitro to trimethoprim-sulfamethoxazole, mecillinam, piperacillin, cefotaxime, ceftazidime, chloramphenicol and gentamicin. The lowest MIC values were recorded for mecillinam. Full synergistic activity was demonstrated when mecillinam was combined with trimethoprim-sulfamethoxazole, cefuroxime or rifampicin.
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PMID:Yersinia enterocolitica septicemia: clinical and microbiological aspects. 353 2

The experience with septicemia due to coagulase-negative Staphylococcus at a 623-bed primary care hospital between 1980 and 1984 was reviewed. A total of 38 episodes in 37 patients were documented; data were available on 37 episodes in 36 patients. The organism accounted for 3.8% of all cases of septicemia and 6.7% of cases of nosocomial septicemia and was associated with 0.03% of all admissions. The incidence remained stable over the 5 years. The rate of survival 28 days after the episode was 78%. Most of the episodes (31) originated from infected vascular access sites. Of the 37 isolates 15 (41%), all S. epidermidis, were slime producing. S. epidermidis accounted for 33 of the isolates; of the 33, 5 were methicillin-resistant and slime producing. Various in-vitro susceptibility testing methods and testing for beta-lactamase production yielded conflicting results. Methicillin resistance, slime production and speciation as S. epidermidis were not confirmed as virulence markers. Five patients with methicillin-resistant organisms were treated with cephalosporins, and all recovered. These findings as well as examination of the literature do not support the recommendations that laboratories report such isolates as resistant to all beta-lactam agents and that vancomycin be given in all such infections. The different case mix in community hospitals as compared with university centres results in different patterns of nosocomial infection. Since the community hospital patient population is much larger, more information on the patterns of infections in these centres is needed.
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PMID:Septicemia due to coagulase-negative Staphylococcus in a community hospital. 359 42

It is generally accepted, that Streptococcus pneumoniae is very sensitive to penicillin G; minimal inhibitory concentration (MIC) is normally about less than = 0.01 microgram/ml. Some years ago strains relatively resistant to penicillin (MIC 0.1 to 1.0 microgram/ml) were reported on. In 1977 strains isolated from blood and cerebrospinal fluid in South-Africa were found to have a higher resistance to penicillin (MIC 0.5-4 micrograms/ml). We report on an 6-year-old girl with septicemia and meningitis caused by a strain of S. pneumoniae relatively resistant to penicillin (MIC 0.5 microgram/ml). Aged 5 years the girl had a first meningitis caused by S. pneumoniae. The girl was then treated with penicillin (450,000 IU/d) to prevent a new infection. During this time the second meningitis caused by S. pneumoniae took place. In the agarose gel electrophoresis a plasmid was found (4.2 X 10(6) Dalton). No beta-lactamase-activity was detected (nitrocefin-test and acidimetric measurement). It is unlikely that there is a plasmid-dependent resistance to penicillin.
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PMID:[Recurring meningitis caused by Streptococcus pneumoniae during preventive penicillin therapy]. 364 7

The safety and effectiveness of Timentin were evaluated in 34 adult patients with symptomatic complicated urinary tract infections, principally due to multiply-drug-resistant bacteria. Although a wide variety of organisms, particularly gram-negative bacilli, were found, Escherichia coli was the most frequent, accounting for 14 of 45 (31 percent) pathogens isolated. Ten (22 percent) isolates were Pseudomonas aeruginosa; 11 (24 percent) were Proteus or Morganella species; three (7 percent) were Citrobacter; one (2 percent) was Klebsiella pneumoniae; two (4 percent) were Staphylococcus aureus; and two (4 percent) were enterococci. Ninety-three percent of all pathogens isolated produced a beta-lactamase. Eight (24 percent) infections were polymicrobial; seven (21 percent) were associated with bacteremia. Clinical improvement occurred in 30 of 34 (86 percent) patients. All bacteremias were cured. Although bacteriologic cure occurred in only 32 percent of patients, control of sepsis and temporary eradication of bacteria (bacteriologic improvement) occurred in 96 percent. Not surprisingly, the rates of relapses and reinfections were high. It was concluded that Timentin is a useful agent in the management of complicated urinary tract infection and offers clinicians an alternative to more toxic antibiotics, such as aminoglycosides.
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PMID:Timentin in the treatment of symptomatic complicated urinary tract infections in adult patients. 385 37

A patient with erythema multiforme developed septicemia with two strains of Staphylococcus aureus. Six blood cultures, obtained during 14 days, yielded a mixture of both strains. The strains differed in the ability to hemolyze human erythrocytes, in the production of beta-lactamase and in the susceptibility to antibiotics and bacteriophages. Following therapy with gentamicin, a Dwarf colony variant auxotrophic for vitamin K, tryptophan and p-aminobenzoic acid appeared in some of the blood cultures. This variant was apparently derived from one of the offending strains (phage Type 55/71). From other blood cultures, a different type of Dwarf colony variant was obtained; this variant was of the same phage type as the other offending S. aureus strain (Type 85). The metabolic deficiencies of this strain were not unraveled. Both events, the double infection with distinct S. aureus strains, and the emergence of Dwarf variants during antibiotic therapy, are unusual in clinical practice, and will be detected only if laboratory staff pays particular attention to the possible occurrence of such events.
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PMID:Septicemia with two distinct strains of Staphylococcus aureus and dwarf variants of both. 401 28

Aspoxicillin (ASPC) was evaluated for its efficacy and safety in 30 infants and children with acute bacterial infections. The disease categories included acute respiratory tract (22), soft tissue (3), urinary tract (3) infections, sepsis with pyothorax (1) and purulent meningitis (1). ASPC was effective in all but 1 case of pneumonia due to beta-lactamase-positive H. influenzae (effective rate; 96.7%). Adverse reactions and abnormalities of the laboratory tests were not associated with the ASPC therapy in any of the cases. The serum half-life of ASPC after an intravenous bolus injection was 0.883 +/- 0.194 hour and excretion into urine was rapid. From the present results, ASPC is a safe and effective antibiotic when used in patients with susceptible bacterial infections.
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PMID:[Clinical evaluation of a new parenteral penicillin, aspoxicillin, in children]. 406 22

The antibiotic resistance of Staphylococcus aureus isolated in Bristol from primary skin sepsis and nasal carriers outside hospital was recorded between 1949 and 1969. The proportion of penicillinase-forming strains rose to about 60% but resistance to other antibiotics remained un-common except for a peak about 1957, due to the spread of multiresistant phage-type 80 staphylococci. Reasons are discussed for the failure of other multiresistant staphylococci to increase outside hospital.Recently isolated strains from inside and outside hospital were tested with sulphonamide and trimethoprim. All were sensitive to trimethoprim but 5% of non-hospital strains and 40% of hospital strains were resistant to sulphonamide. It is suggested that sulphonamide-resistant staphylococcal infections should not be treated with sulphonamide-trimethoprim mixtures because of the risk of breeding trimethoprim-resistant strains.
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PMID:Changes in the drug resistance of Staphylococcus aureus in a non-hospital population during a 20-year period. 557 2


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