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

Purified polysaccharide from type III group B Streptococcus contains both a type III-specific determinant and another determinant that is common to strains of serotypes other than type III. The polysaccharide contains sialic acid, galactose, heptose, glucose, glucosamine, and mannose. Serum antibody to this antigen was measured by means of a radioactive antigen-binding assay. Sera from 36 (67.9%) of 53 women with healthy newoborns contained antibody, a prevalence significantly different from that in sera from 15 women (13.3%) whose neonates developed septicemia or meningitis due to type III group B Streptococcus. Complete concordance for presence or absence of anticapsular antibody in sera from 14 women at delivery and in their neonates' cord sera was demonstrated; this concordance indicates transplacental transfer of antibody. Sera from each of four adults with invasive infection who were studied during convalescence contained antibody to the capsular polysaccharide of type III group B Streptococcus. In contrast, antibody was absent from 10 infants who had recovered from bacteremia, septicemia, and/or meningitis due to type III group B Streptococcus.
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PMID:Immunological investigation of infants with septicemia or meningitis due to group B Streptococcus. 7 Apr 93

Sepsis is a major catabolic insult resulting in modifications in carbohydrate and fat energy metabolism, and leading to increased muscle breakdown and nitrogen loss. Insulin resistance, which develops in sepsis, decreases glucose utilization, but plasma insulin levels are sufficiently elevated to prevent lipolysis, resulting in a further energy deficit. The availability of fuels in sepsis is therefore limited, and the body resorts to muscle breakdown, gluconeogenesis, and amino acid oxidation for energy supply. Previous work has not defined, however, the exact alterations in amino acid metabolism. Therefore, the following studies were undertaken. Blood samples were drawn from fifteen patients in whom the diagnosis of sepsis was clinically established; the samples were analyzed for amino acid, beta-hydroxyphenylethanolamines, glucose, insulin and glucagon concentrations. The plasma amino acid pattern observed was characterized by an increase in total amino acid content, due mainly to high levels of the aromatic amino acids (phenylalanine and tyrosine) and the sulfur-containing amino acids (taurine, cystine and methionine). Alanine, aspartic acid, glutamic acid and proline were also elevated, but to a lesser degree. The branched chain amino acids (valine, leucine and isoleucine) were within normal limits, as were glycine, serine, threonine, lysine, histidine and tryptophan. Those patients who did not survive sepsis had higher levels of aromatic and sulfur-containing amino acids as compared to those patients surviving sepsis. On the other hand, those patients surviving sepsis had higher levels of alanine and the branched chain amino acids. In a second group of five patients with overwhelming sepsis accompanied by a state of metabolic encephalopathy, a parenteral nutrition solution consisting of 23% dextrose, and an amino acid formulation enriched with branched chain amino acids was administered. In these five patients, normalization of the plasma amino acid pattern and reversal of encephalopathy was observed. The following sequence of events may be postulated: The septic patient develops insulin resistance in the peripheral tissues, primarily muscle, while the adipose tissue is much less affected. The insulin resistance and the inability to utilize fat leads to increased muscle proteolysis. Muscle breakdown results in release into the blood of enormous amounts of various amino acids; the muscle itself is able to oxidize the branched chain amino acids, supplying the muscles' own energy requirements and alanine for gluconeogenesis. The extensive muscle proteolysis coupled with relative hepatic insufficiency occurring early in sepsis results in the appearance in the plasma of high levels of most of the amino acids present in muscle, particularly the aromatic and the sulfur-containing amino acids. The outcome of patients with sepsis might be positively affected by combined therapy with glucose, insulin and branched chain amino acids.
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PMID:Amino acid derangements in patients with sepsis: treatment with branched chain amino acid rich infusions. 9 98

A model was developed in the rhesus monkey to determine if the marked wasting of body proteins associated with sepsis could be prevented by an intravenous supply of various nutritional substrates. All monkeys were given a basic infusion of 0.5 gm of amino acid nitrogen/kg body weight via an indwelling catheter in the jugular vein. Three groups were given diets with no added calories, 85 calories/kg from dextrose or 85 calories from lipid. In each group, six monkeys were inoculated with 3 x 10(8) Streptococcus pneumoniae and four with heatkilled organisms. In the monkeys infused with the amino acids alone, pneumococcal sepsis resulted in a fourfold increase in loss of body proteins compared with calorie-restricted controls. Addition of 85 calories/kg/day of either dextrose or lipid reduced body wasting associated with infectious disease. The calories from lipid were utilized bythe septic host as a source of energy, with a slightly reduced efficiency when compared with the isocaloric infusion of dextrose. The nitrogen sparing of the fat emulsion could not be accounted for by its glycerol content. Therefore, the septic monkey seemed to utilize fatty acids as an energy substrate. It appears that the carbohydrate calories tend to favor the synthesis of peripheral proteins (associated mainly with skeletal muscle), while lipid calories favor synthesis of visceral proteins such as plasma albumin and acute-phase proteins.
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PMID:Protein-sparing therapy during pneumococcal infection in rhesus monkeys. 10 60

Ninety-five cultures of group JK bacteria isolated from clinical specimens were characterized morphologically and biochemically. The microorganisms were isolated primarily from blood cultures. The bacterial cultures produced positive reactions when tested for catalase, Tween hydrolysis, and carbohydrate fermentation. Glucose and galactose were fermented by more than 90% of the organisms. Gas-liquid chromatography of trimethylsilyl derivatives of whole-cell hydrolysates of some of the group JK cultures yielded nearly identical elution profiles. The group JK microorganisms were susceptible to vancomycin but were resistant to most of the other 17 antimicrobial agents tested. A method is presented for differentiating the group JK microorganisms from other similar bacteria encountered in clinical specimens. Although these bacteria rarely occur in clinical specimens, they are capable of producing fatal infections (endocarditis and sepsis) in humans.
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PMID:Characterization and identification of 95 diphtheroid (group JK) cultures isolated from clinical specimens. 11 Aug 26

The inhibitory effect of sodium acetate on microorganism growth in protein hydrolysate solutions was studied. Solutions of 5% protein hydrolysate and 5% dextrose in water (seven parts) and 50% dextose in water (three parts) containing 0, 30, 50 and 90 mEq/liter of sodium acetate were inoculated with Staphylococcus aureus, Escherichia coli, Candida albicans and Pseudomonas aeruginosa. The number of colony-forming units in the solutions after inoculation was compared with that after incubation for 24 hours at 37 C. Sodium acetate inhibited growth of S aureus and E coli. Growth of P aeruginosa was inhibited in protein hydrolysate solutions with and without sodium acetate; inhibition could not be attributed solely to sodium acetate and may have been releated to pH of the solutions (4.7 to 5.4). Growth of C albicans was not inhibited by sodium acetate. Sodium acetate reduced growth of some common contaminants of protein hydrolysates. Sodium acetate is known to reduce metabolic acidosis, a reported complication of parenteral nutrient therapy and a possible predisposing factor in C albicans sepsis. Addition of sodium acetate to protein hydrolysate solutions should be considered seriously.
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PMID:Sodium acetate as a preservative in protein hydrolysate solutions. 11 72

Septicemia caused by contaminated infusion fluid is a newly appreciated hazard of intravenous infusion therapy. Microorganisms of the tribe Klebsielleae (Klebsiella, Enterobacter, and Serratia) have predominated in these infections. Members of this tribe found to possess a selecive ability over common non-Klebsielleae microbial pathogens to proliferate rapidly in commerical parential fluids contaning clucose at room temperautre. Fifty-one Klebsielleae strains, washed twice before inoculation of approximately 1 organism/ml, attained a mean normalized 24 hr concentration of 1.11 x 10-5 organisms/ml in 5% dextrose in water at 25 C. In contrast, 48 of 49 non-Klebsielleae bacterial strains (clinical isolates of Staphylococcus, Proteus, Escherichia coli, Herelea, and Pseudomonas aeruginosa) slowly died (mean 24-hr concentration, 0.2 organism/ml). Five Candida albicans strains frew only very slowly (31.3 organisms/ml). Even with concentrations exceeding 10-6 organisms/ml, microbial presence was never visibly detectable. The significant increases in cases of nosocomial spticmia caused by Klebsiella, Enterobacter, and Serratia in recent years might be attribuatble in part to fluid-related spesis accompanying the expanding use of parenteral therapy.
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PMID:Nationwide epidemic of septicemia caused by contaminated infusion products. IV. Growth of microbial pathogens in fluids for intravenous infusions. 23 43

Ampicillin-sensitive or -resistant Staphylococcus aureus and Klebsiella strains were cultured in various nutrient media as prototypes of the agents of sepsis isolated in bacteriological routine analysis. In each case, 2 ml of defibrinated human blood containing 100 and 1000 cells, 8 gamma and 80 gamma ampicillin/1 ml blood respectively were added to 50 ml of nutrient medium. The following media were used. 1. casein soya-bean meal peptone broth (Oxoid), 2. tryptose-phosphate medium (Oxoid), 3. dextrose broth (Oxoid), 4. brain-heart-dextrose medium (Oxoid), 5. brain-heart infusion, autoclaved (Difco), 6. brain-heart infusion, after sterile filtration (Difco), 7. vacutainer culture bottles (BD) prepared medium, 8. micrognost blood culture bottles (Biotest) prepared medium. While the sensitive staphylococcus strain exhibited a slower growth than the sensitive Klebsiella strain in all nutrient media, the growth rate of the two resistant variants was approximately the same for an initial count of 100 cells per ml of blood. Among the resistant staphylococci the higher initial count of the inoculum resulted in an improved growth. After addition of 8 gamma or 80 gamma ampicillin/1 ml blood the sensitive staphylococcus strain did not show any grwoth irrespective of the inoculated number of cells while the sensitive Klebsiella strain multiplied irrespective of the initial number of cells. After 24 hours the resistant staphylococci and Klebsiella strains of which 1000 cells each had been used for inoculation exhibited growth in almost all media used.
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PMID:[Experimental studies to culture bacteria from blood specimen with an addition of ampicillin in various nutrient media (author's transl)]. 37 22

Four patients from a larger group of 18 patients receiving dextrose-free isotonic (3%) amino acid solution as nutritional support, form the basis of this report. An additional seven patients received intravenous isotonic (5%) dextrose as their sole support in the postoperative period following major elective surgery (average nitrogen balance = -12.3 +/- 2.7 g). All patients were well-nourished as determined by anthropometric measurements. The nonseptic patients receiving infusions of isotonic amino acids demonstrated an improvement in nitrogen balance (= delta 8.5 +2, P less than 0.001) when compared to the postoperative use of 100 to 150 g of glucose. However, sepsis produced a decreased net utilization of the infused crystalline amino acids such that nitrogen balance was similar to the intravenous glucose group (- 10.6 +/- 2.1). This septic response was associated with decreased plasma free fatty acid concentrations and the absence of starvation ketosis and ketonuria. While the nitrogen balance was not different in the septic and the dextrose control groups, deficiencies in plasma amino acid concentrations were observed in the group receiving intravenous infusion of glucose.
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PMID:Effect of deep surgical sepsis on protein-sparing therapies and nitrogen balance. 40 78

In order to quantitate the effect of sepsis and skeletal trauma on gluconeogenesis, four septic and five skeletal trauma patients were evaluated for their ability to convert 14C-L-alanine to 14C-glucose while receiving 5% dextrose by peripheral vein. In the septic group, the mean glucose pool size increased by 35% and the glucose turnover rate increased by 85% over normal. The alanine conversion averaged 11.1% of the dose. The skeletal trauma group showed a glucose pool size increase of 61%, a 100% increase in glucose turnover rate and a 11.7% conversion of the alanine dose to glucose. The increased conversion of 14C-alanine to 14C-glucose in both sepsis and skeletal trauma in the face of an exogenous glucose infusion indicates an abnormal unsuppressible response. Each of the above parameters when compared to normal values was found to be significant at levels greater than 97.5%. The percentages of the dose expired as 14CO2 in three hours were not significantly different from the normals.
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PMID:Gluconeogenic response during glucose infusions in patients following skeletal trauma or during sepsis. 57 25

1. Hepatic carbohydrate metabolism was studied by an intravenous galactose test in control patients, malnourished non-septic patients, patients with prolonged severe sepsis and patients after recovery from sepsis. 2. Blood galactose half-life was not significantly increased in the septic group despite abnormal liver-function tests, whereas it was approximately doubled in the malnourished patients. 3. The rise in blood glucose after galactose injection was less in both the septic and malnourished groups, as compared with that in the control subjects. 4. Fasting blood glucose, lactate and pyruvate concentrations were similar in all groups, whereas blood ketone bodies were increased in the malnourished and septic groups, and blood alanine was decreased only in the septic group. 5. The changes in hepatic metabolism and function were reversible on recovery from sepsis. 6. It is suggested that alterations in hepatic blood flow and the metabolic fate of galactose within the liver may explain the changes in the metabolic response to galactose observed in malnourished or septic patients.
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PMID:Galactose and hepatic metabolism in malnutrition and sepsis in man. 67 28


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