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

Investigations of nursery outbreaks of Citrobacter diversus sepsis and meningitis have been hampered by lack of adequate epidemiologic markers for the organism. We studied outer membrane protein profiles from clinical isolates of C. diversus by sodium dodecyl sulfate-polyacrylamide gel electrophoresis to determine whether this method might be useful in the epidemiologic differentiation of strains. Paired cerebrospinal fluid isolates from each of three separate nursery outbreaks of C. diversus meningitis, paired isolates from the vagina of a postpartum woman and the cerebrospinal fluid of her newborn infant, one isolate from an infant with pneumonia and two from colonized nursery cohorts, and 30 epidemiologically unrelated clinical isolates were included. Eleven distinct profiles were differentiated by the presence or absence of five outer membrane proteins. Complete concordance of profiles was observed for epidemiologically related isolates. Unrelated epidemic strains had outer membrane protein profiles distinct from one another. Biotyping complemented determination of outer membrane protein profiles; the two markers differentiated each of the five epidemic strains from all but one of 30 unrelated nonepidemic isolates. Determination of outer membrane protein profiles is potentially useful in epidemiologic investigations of disease caused by C. diversus.
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PMID:Epidemiologic marker system for Citrobacter diversus using outer membrane protein profiles. 267 Oct 30

Diagnosis of acute cholecystitis in critically ill patients is often difficult; clinical signs are subtle, and radiologic tests are nonspecific and have a high incidence of false-positive results. This study reviews our experience with intravenous morphine sulfate as an adjunct to promote gallbladder filling in 18 critically ill patients who demonstrated nonvisualization of the gallbladder during cholescintigraphy performed as part of a diagnostic workup for occult sepsis. Findings suggestive of a biliary source included fever, leukocytosis, abdominal tenderness, abnormal liver function test results, fasting, and total parenteral nutrition. Morphine was administered to all 18 patients after nonvisualization of the gallbladder; in 17 cases prompt visualization was noted, thus excluding cystic duct obstruction. The remaining patient underwent operation for acalculous cholecystitis. None of the 17 patients whose gallbladders were visualized had a subsequent clinical course consistent with untreated biliary sepsis. Radionuclide cholescintigraphy with morphine appears to be useful in the evaluation of critically ill patients with suspected biliary sepsis. It is particularly helpful in confirming or excluding the diagnosis of acute acalculous cholecystitis in patients who are fasting or receiving total parenteral nutrition and initially demonstrate nonvisualization of the gallbladder and in patients who have previously documented gallstones.
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PMID:Use of cholescintigraphy with morphine in critically ill patients with suspected cholecystitis. 279 41

The effects upon survival of large doses of steroid administered to dogs prior to challenging them with lethal sepsis was evaluated in this study. Dogs were given 30 milligrams per kilogram of body weight per day of methylprednisolone sodium succinate for one, two or eight days and then were infused with 9.72 +/- 0.35 X 10(9) Escherichia coli per kilogram of body weight. All dogs in group 1 (n equals six) not given steroid died within 25 hours. Of the dogs in group 2 (n equals 12) given one or two doses of steroid previously, 42 per cent permanently survived (more than seven days). All dogs in group 3 (n equals five) given eight daily doses of steroid prior to infusion of Escherichia coli died within 17 hours. Dogs in group 4 (n equals six) were given eight daily doses of steroid prior to infusion of Escherichia coli and treated on the day of infusion of Escherichia coli with a regimen of methylprednisolone and gentamicin sulfate which results in a 100 per cent survival rate when given to dogs that have not received prior treatment with steroid. Thirty-three per cent of the dogs in group 4 permanently survived. One or two daily large doses of steroid did not detrimentally affect survival of the dogs. Eight days of steroid administration suppressed endogenous cortisol production. When the dogs were treated with six hours of steroid-antibiotic therapy, survival benefits were limited.
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PMID:Effects of prior administration of steroids upon recovery from lethal sepsis. 294 72

The nephrotoxicity of the aminoglycoside amikacin sulfate was evaluated in an open, controlled study of newborns with presumed neonatal sepsis. One hundred twelve neonates were randomly allocated to receive either amikacin-ampicillin or mezlocillin, a semisynthetic penicillin. Neonates receiving amikacin, in contrast to those receiving mezlocillin, showed significant nephrotoxicity as evidenced by a delayed postnatal fall in mean serum creatinine level (82 to 80 mumol/L [0.93 to 0.90 mg/dL] vs 84 to 72 mumol/L [0.95 to 0.82 mg/dL]) and a delayed postnatal rise in mean creatinine clearance per kilogram of body weight (12% vs 38%). Furthermore, 40% of neonates receiving amikacin-ampicillin compared with 19% of neonates receiving mezlocillin had a decline in creatinine clearance (greater than 25%). There was no relationship between amikacin nephrotoxicity and either peak or trough amikacin levels. In summary, in a controlled study of the use of amikacin and mezlocillin in neonates, the combination of amikacin and ampicillin proved more nephrotoxic to the newborn kidney.
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PMID:A controlled study of the nephrotoxicity of mezlocillin and amikacin in the neonate. 331 75

An oral colonic lavage solution containing sodium sulfate and polyethylene glycol was compared with whole-gut irrigation using saline via a nasogastric tube in a randomized blinded study of 34 consecutive well-matched patients undergoing elective colorectal surgery. Both methods were safe and rapid. Patients receiving oral colonic lavage, however, had significantly less (P less than 0.05) water retention, overall distress, cramps, and other complaints. No significant differences were found with regard to fullness, nausea, and rectal discomfort. The bowel cleansings were equally adequate, and most patients achieved a good-to-excellent preparation. Surgical complications appeared not to be related to the preparation used, and wound sepsis were equally frequent. Oral colonic lavage proved to be the most attractive preoperative cleansing method.
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PMID:Preparation for elective colorectal surgery. A randomized, blinded comparison between oral colonic lavage and whole-gut irrigation. 355 4

Intraabdominal sepsis in rats was induced as a sublethal infection (mortality rate of controls: 60%-80%) and as a lethal infection (mortality rate of controls: 100%). The effectivity of different immunoglobulin (IgG) preparations alone or together with an antibiotic combination therapy (gentamicin + piperacillin) was then tested. In sublethal infection, 5 intravenous administrations of three 7S-IgG preparations and a plasmin-treated preparation at a dosage of 0.5 g/kg b.w. were able to reduce lethality only slightly, whereas a 5S-IgG preparation was able to reduce lethality by 30% significantly. Intraperitoneal administration of two 7S-IgG preparations (s-sulfitolysis, 42 degrees C/ammonium sulfate) and the 5S-IgG preparation reduced lethality to 27%, 37% and 47%, respectively, whereas another 7S-IgG (iodoacetamide/dithiothreitol) and a plasmin-treated preparation failed to reduce lethality significantly. The convincing results obtained with the 5S-IgG preparation are probably due to the fact that Fc-mediated side-effects could be avoided. The better effectivity of intraperitoneal compared to intravenous administration can be explained by much higher concentrations of specific antibodies at the site of infection. In the lethal infection model the mortality of animals treated with antibiotics only was 50%. The additional intravenous administration of 7S-IgG (42 degrees C/ammonium sulfate), a plasmin-treated preparation and a 5S-IgG was unable to reduce mortality any further. These findings are in contrast to several publications which postulate synergism of antibiotics and immunoglobulins.
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PMID:[Effectiveness of various immunoglobulin preparations administered by the intravenous route in peritonitis in the rat model]. 358 20

We have previously shown that experimental peritonitis secondary to fecal bacteria plus barium sulfate suppresses delayed cutaneous hypersensitivity (DCH) in rats. We examined herein the role of barium sulfate. In a series of experiments presensitized rats were simultaneously skin tested with intradermal keyhole limpet hemocyanin and given an intraperitoneal injection of either (1) a mixture of four fecal bacteria in their nutrient broths, (2) bacteria and broths plus barium sulfate, (3) sterile broths plus barium, (4) sterile barium alone, (5) nutrient broths, or (6) saline. In rats given sterile barium we measured phagocyte delivery to subcutaneous polyvinyl alcohol sponges. We found that (1) the coadministration of barium sulfate was necessary for rats given bacteria to die (P = 0.03) or develop abdominal abscesses (P less than 0.005), (2) suppression of DCH occurred in 70% of rats receiving sterile barium sulfate vs 0% in saline controls (P = 0.0001), (3) early suppression of DCH was associated with subsequent death and abscess formation in rats given bacteria plus barium (P = 0.00002) and with intraabdominal barium collections in rats given barium alone (P less than 0.02), (4) barium sulfate administration caused suppression of phagocyte delivery to subcutaneous sponges: 23.2 X 10(6) cells/site vs 43.1 X 10(6) cells/site in saline controls (P less than 0.005). We conclude that barium sulfate itself has profound systemic effects in the rat model of intraabdominal sepsis. Early suppression of DCH is associated with a poor outcome in septic rats.
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PMID:Suppression of delayed cutaneous hypersensitivity and inflammatory cell delivery by sterile barium peritonitis. 368 6

A total of 209 strains of Staphylococcus aureus isolated from infections and 23 strains from nose cultures of healthy laboratory personnel were compared for relative surface hydrophobicity in the salt aggregation test (Lindahl et al., Biochim. Biophys. Acta 677:471-476, 1981). In the standard method, bacterial cell suspensions from blood agar-grown cultures were tested for visible aggregation by "salting out" in serial dilutions of ammonium sulfate (0.1 to 1.6 M [final concentration]). Bacteria were defined as extremely hydrophobic when showing autoaggregation in saline or in 0.002 M sodium phosphate buffer (pH 6.8). Using this definition, we found a large number of strains isolated from various infections to be very hydrophobic: 123 of 135 strains from patients with septicemia (91%), 54 of 60 strains from wound infections (90%), and 12 of 14 strains from urinary tract infections (86%). In contrast, only 9 of 23 strains from nose cultures of healthy carriers (39%) were autoaggregating. A total of 12 autoaggregating strains were grown on various solid and liquid media. Only growth on hematin agar was found to completely suppress surface hydrophobicity as revealed by our salt aggregation test method, and growth in liquid media prevented the expression of hydrophobicity in most strains. Growth at 20 or 42 degrees C or under anaerobic conditions did not affect hydrophobicity. Cells harvested from various phases of growth did not differ significantly in surface hydrophobicity. Heating washed cell suspensions at 56 degrees C did not affect the salt aggregation test values, whereas heating the cell suspensions at 80 and 100 degrees C caused a significant decline in hydrophobicity. The addition of ethylene glycol (25% [vol/vol] final concentration) prevented the autoaggregation of 10 of the 12 strains. Likewise, treating the cell suspensions with proteolytic enzymes decreased the surface hydrophobicity, indicating that surface proteins contribute to high surface hydrophobicity of autoaggregating strains.
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PMID:High surface hydrophobicity of autoaggregating Staphylococcus aureus strains isolated from human infections studied with the salt aggregation test. 388 53

In early 1983, an outbreak of illness caused by raw milk contaminated with multiple-antimicrobial-resistant Salmonella typhimurium occurred in Arizona. One of the cases involved a 72-year-old woman who died with Salmonella enteritis and sepsis that had not responded to treatment with chloramphenicol. The S typhimurium isolates from this patient, from other ill persons, and from raw milk were resistant to ampicillin, chloramphenicol, kanamycin sulfate, streptomycin, sulfonamide, and tetracycline. These resistances were mediated by a 105-megadalton R plasmid. During the epidemic period, 43% of the S typhimurium isolates submitted to the Arizona Department of Health Services were resistant to chloramphenicol, and 80% of these possessed the same plasmid resistance. Although there was evidence of spread of the S typhimurium in the community, there was no evidence of spread of this Salmonella R plasmid to the normal flora of patients or their family members a median of 14 weeks after the infection. This outbreak demonstrates the ability of drug-resistant Salmonella to spread from the animal to the human reservoir and, in a suitable host, produce a fatal infection.
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PMID:An outbreak of multiple-drug-resistant Salmonella enteritis from raw milk. 388 21

Gelatine capsules containing Escherichia coli and Bacteroides fragilis in a standardized mixture with rat colonic content and barium sulfate were implanted intraabdominally into rats. Capsules of 0.75 g gave approximately 50% mortality whereas 0.35 and 1.10 g caused no or 100% mortality, respectively. In subsequent experiments, using the 0.75 g capsule, all animals became ill with signs of tachypnea, piloerection, low physical activity and hypersecretion of saliva 6-8 h after the implantation. The animals reduced their water and food intake substantially and the body weight decreased. A significant reduction in blood pressure, glucose and leukocyte and platelet counts was found 12 h after challenge. Blood cultures obtained at 12, 24, 48 and 60 h all grew E. coli but none B. fragilis. Succumbed animals revealed diffuse peritonitis with growth of E. coli and B. fragilis at autopsy, whereas surviving animals showed abscess formation at investigation on day 8 after challenge. It was concluded that the model closely resembled intraabdominal abscess formation with sepsis in man.
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PMID:Standardized intraabdominal abscess formation with generalized sepsis: pathophysiology in the rat. 388 37


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