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)

A 48-year-old man, hospitalized after experiencing subarachnoid hemorrhage secondary to a basilar aneurysm, received vancomycin for methicillin-resistant Staphylococcus aureus sepsis. He developed neutropenia 16 days after the start of vancomycin therapy, and his white blood cell count decreased to a nadir of 1200 cells/mm3. Vancomycin was discontinued, and granulocyte-colony stimulating factor (G-CSF) therapy was begun. The patient was rechallenged with a single dose of vancomycin 1 g in preparation for intraarterial aneurysm coiling. His white blood cell count dropped to 600 cells/mm3 but returned to normal with continued G-CSF therapy. A diagnosis of vancomycin-induced neutropenia was considered. Subsequent testing by granulocyte agglutination and granulocyte immunofluorescence assays revealed that his serum was positive for an antigranulocyte antibody. A test for HLA antibody reactivity was negative. Monoclonal antibody immobilization of granulocyte antigens assay failed to determine the antigen specificity of his granulocyte antibody.
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PMID:Vancomycin-induced neutropenia in a patient positive for an antineutrophil antibody. 1206 71

Coagulase negative Staphylococci (CONS) which were considered as laboratory contaminants and normal flora of skin in man, have emerged as opportunistic pathogens. The infection with CONS has been reported since 1950 with increasing frequency and has been implicated as the causative agents of certain categories of patients viz, neonates with sepsis, cardiac patients with prosthetic valves, immunocompromided patients which include end-renal stage disease, and renal transplantation, burns and cancer patient. These are causing problems to clinicians because of their drug resistance. 180 strains of CONS isolated from blood and CSF during the period of 2 years (Jan 1997-Dec 1998) were studied. Not only they were resistant to Penicillin (P), Ampicillin, (Amp), Oxacillin (Ox), but also developing resistance to Vancomycin (Van) which pose a therapeutic problem. So this study was undertaken and this area needs further exploration.
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PMID:Study of coagulase negative staphylococci isolated from blood and CSF cultures. 1258 18

The case of 40 years old man with subarachnoid hemorrhage with intraventricular bleeding and with consecutive cerebro-meningitis is presented. The bacterial pathogen was Enterococcus faecalis sensitive only to glycopeptide antibiotics. The standard therapy with intravenously administered Vancomycin and Teicoplanin was not effective. Because of the worsening of patient's clinical status and clinical symptoms of sepsis the intraventricular Vancomycin (20 mg/day) was introduced. At the second day of the therapy the gradual patient's recovery was observed. The symptoms typical for meningitis diminished as well as cerebro-spinal fluid (CSF) parameters normalized. There was no bacterial growth in the blood serum and in CSF. As we can observe the intraventricular administration of Vancomycin is efficient method of cerebro-meningitis treatment. In our opinion the blood-brain barrier, even pathologically changed by infection, do not allow antibiotics to penetrate CSF, even in the maximal intravenous doses. In the cases of cerebro-meningitis caused by bacteria sensitive only to glycopeptide antibiotics, the intraventricular administration of the drug might be an alternative way of therapy especially when the doses of intravenous antibiotics need to be reduced.
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PMID:[The efficacy of intraventricularly administered vancomycin in the case of central nervous system infection caused by enterococcus faecalis]. 1260 18

A 34-year-old female with end-stage renal disease was admitted for severe metabolic acidosis, uremic encephalopathy, pericarditis and severe anemia following a bout of acute gastroenteritis. She improved on aggressive medical management including intensive hemodialysis and was initiated onto maintenance heparin-free hemodialysis (twelve hours per week) and discharged. After a week, she presented with fever with chills and rigors for three days, was toxic, severely orthopenic and had a pulsus paradoxus of 36 mmHg. Echocardiography suggested cardiac tamponade. Aspiration revealed frank pus with polymorphonuclear predominance and Staphylococcus aureus on culture. CT of the thorax revealed pericardial effusion. In the absence of any obvious septic foci, concomitant pleuro-pulmonary sepsis, mediastinal or intra-abdominal pathology; a diagnosis of "acute primary purulent pericarditis" was made. Patient was put on parenteral antibiotics-ceftriaxone and metrogyl. Vancomycin was added after sensitivity results. Pericardial drainage was required initially. After toxemia improved, paradox decreased and fever subsided, the pericardial catheter was removed and antibiotics continued for a period of four weeks. Maintenance hemodialysis was continued during hospital stay and after discharge.
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PMID:Staphylococcal pericarditis in a chronic renal failure patient. 1280 14

Vancomycin Hydrochloride for Intravenous Infusion (VCM) was launched as a therapeutic agent for infections caused by Methicillin-Cephem Resistant Staphylococcus aureus (MRSA) in October 1991. The results of the post-marketing surveillance conducted in accordance with GPMSP for 6 years after the launch are as follows. The population studied included 3,037 patients administered this drug intravenously at 1,099 institutions across Japan from October 1991 through September 1997, and among which, 28 patients were excluded because the follow-up was impossible. Consequently, 3,009 patients were included in the safety evaluation and 2,827 patients in the efficacy evaluation, excluding 182 patients due to the off-label use, etc. The daily dosage of this drug was 40 mg/kg for pediatric patients and 1 or 2 g for adult/elderly patients, and the duration of treatment was commonly 1-3 weeks. The daily dosage and the duration of treatment tended to be decreased over years. The improvement rate by disease was in the 70 to 79% range for respiratory tract infections such as pneumonia, and 80% or more for other diseases such as sepsis and osteomyelitis. With respect to the bacteriological efficacy against MRSA, the eradication rate was 66.9%. The number of cases with adverse drug reactions including clinical laboratory abnormalities was 404 patients (13.43%) and a total of 561 adverse drug reactions were reported. Although there was no trend of particularly high frequency of adverse drug reactions even among elderly patients. Based on the above, VCM is a highly useful drug, which is reliably expected to be effective against MRSA infections, and it seems that VCM should be administered promptly to patients in which MRSA has been identified as a causative pathogen. For the use of VCM, if the optimum dose and mode of administration are selected while taking account of the age and renal function, adverse drug reactions can also be reduced.
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PMID:[Recent findings based on the results of the post-marketing surveillance of vancomycin hydrochloride for intravenous infusion]. 1456 50

Vancomycin-resistant Enterococcus faecium (VRE) is increasing in incidence in solid organ transplant recipients and has a high (up to 83%) associated mortality rate. Until recently, there have been no consistently effective antimicrobial therapies for VRE infection. Linezolid is a new antibiotic that belongs to the class of oxazolidinones approved by the FDA for the treatment of VRE infections, including those with bacteremia. Here, we report the experience with linezolid in an open-label, compassionate-use trial at 53 US centers for the treatment of documented VRE infections in patients with solid organ transplants. Eighty-five patients with solid organ transplants and documented VRE infections were studied. Blood cultures were positive for VRE in 43 patients, while 42 patients had other, non-rectal, sites of infection. Fifty-three patients responded well to treatment, with clinical resolution of the infection (62.4% survival rate). Of these, 47 had documented negative cultures post therapy. The mean duration of therapy for cured patients was 23.5 days. Thirty-two (37.6%) patients died, 28 due to sepsis and organ failure (32.9% failure rate), and 4 due to unrelated causes. Mortality rates for patients with bacteremia were comparable to mortality rates observed with patients who had positive cultures from other sites. Adverse reactions to linezolid included thrombocytopenia (4.7%), decreased leukocyte count (3.5%), and an increase in blood pressure (1.2%), none of which led to discontinuation of therapy. Linezolid appears to be a safe and effective treatment option for VRE, even in the presence of bacteremia, and may lead to decreased mortality in solid organ transplant recipients with VRE infection.
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PMID:Linezolid in the treatment of vancomycin-resistant Enterococcus faecium in solid organ transplant recipients: report of a multicenter compassionate-use trial. 1461 99

Vancomycin and metronidazole have been used for treating Clostridium difficile-associated disease (CDAD) for the past 25 years, but approximately 20 % of patients develop recurrent disease. The increasing incidence of nosocomial outbreaks, cases of recurrent CDAD and other complications (toxic megacolon, ileus, sepsis) has fuelled the search for different types of treatments. As the understanding of the pathogenesis of this disease has matured, newer treatment strategies that take advantage of these mechanisms have been developed. This review will describe such treatments and examine the evidence for each strategy.
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PMID:Alternative treatments for Clostridium difficile disease: what really works? 1567 2

A 6-year-old girl with community-acquired disseminated infection caused by methicillin-resistant Staphylococcus aureus (MRSA) is described. She had sepsis, meningo-encephalitis, pyomyositis, osteomyelitis, pericarditis and pulmonary embolisation caused by a multi-resistant strain of MRSA. Vancomycin is not routinely recommended as the first-line antimicrobial agent for suspected Staphylococcus aureus infection; however, it should be considered pending susceptibility results in patients presenting with severe sepsis in areas where the prevalence of MRSA is high.
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PMID:Community-acquired disseminated methicillin-resistant Staphylococcus aureus infection: case report and clinical implications. 1581 50

The physiologic process of wound healing is impaired and prolonged in pediatric patients receiving chemotherapy. Due to profound immunosuppression, wound infection can easily spread and act as the source of sepsis. Referring to in vitro studies, which confirmed the antibacterial potency of special honey preparations against typical isolates of nosocomially acquired wound infections (including Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant enterococci) and considering the encouraging reports from other groups, Medihoney has now been used in wound care at the Department of Pediatric Oncology, Children's Hospital, University of Bonn for 3 years. Supplemented with clinical data from pediatric oncology patients, this article reviews the scientific background and our promising experience with Medihoney in wound care issues at our institution. To collect and analyze the available experience, we prepare an internet-based data documentation module for pediatric wound care with Medihoney.
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PMID:Wound care with antibacterial honey (Medihoney) in pediatric hematology-oncology. 1607 53

Vancomycin resistant enterococcus (VRE) was recovered from the urine culture of a 61 years old female patient, who was being treated for sepsis, on the 15th day of hospitalization in Ondokuz Mayis University Hospital Infectious Disease Unit. The underlying diseases of this patient were chronic renal failure and diabetes mellitus. The patient died due to septic shock on the day of VRE isolation. Since this case was the first VRE infection in our hospital, a point prevalence study was planned. For this purpose, rectal swab samples collected from 10 patients from the same unit and 27 personnel who worked in the same unit, were screened for the presence of VRE. Nasal swabs and finger tip samples were also taken from the staff to determine if the transmission has occured in this way. As a result, a second VRE strain was isolated from another patient with chronic renal failure who was under treatment due to multiple pulmonary abscesses. Immediate isolation of this patient prevented a possible epidemic in this specific unit. In this report, the importance of VRE screening and isolation of the patients after the recovery of VRE has been emphasized.
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PMID:[Case report: a nosocomial infection caused by vancomycin resistant enterococcus]. 1635 96


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