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)

Horses suffering from trauma, sepsis, and severe burns need 12% to 16% of protein (dry matter basis) in their diet. Since reduced appetite may be a problem, relatively energy dense (greater than 2 Mcal DE/kg) feeds should be offered. In hepatic failure, maintenance protein requirements (8% on a dry matter basis for adult horses) should be met with feeds that are high in short branched-chain amino acids and arginine but low in aromatic amino acids and tryptophan (for example, milo, corn, soybean, or linseed meal) in addition to grass hay. Vitamins A, C, and E should also be supplemented. In cases with renal failure, protein, calcium, and phosphorus should be restricted to maintenance or lower levels. Grass hay and corn are the best feeds for horses with reduced renal function. Do not offer free-choice salt to horses with dependent edema from uncompensated chronic heart failure. Following gastrointestinal resection, legume hay and grain mixtures are the feeds of choice. Horses with diarrhea should not be deprived or oral or enteral alimentation for prolonged periods of time. Liquid formulas may be used if bulk or gastrointestinal motility are a problem. Apple cider vinegar and a high grain diet may reduce the incidence of enteroliths in horses prone to this problem. Pelleted feeds will reduce fecal volume and produce softer feces for horses that have had rectovaginal lacerations or surgery. Horses with small intestinal dysfunction or resection should be offered low residue diets initially, but long-term maintenance requires diets that promote large intestinal digestion (alfalfa hay, vegetable oil, restricted grain). Geriatric horses (greater than 20 years old need diets similar to those recommended for horses 6 to 18 months old.
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PMID:Clinical nutrition of adult horses. 220 96

Staphylococcus aureus isolated from clinically diagnosed cases of toxic shock syndrome (TSS) showed susceptibility to phage types belonging to both I and III groups (90.5%). Phage typing patterns showed a wide diversity among 87 toxic shock syndrome toxin-1 (TSST-1) positive strains isolated from different non TSS clinical sources. Toxin producing strains isolated from both TSS and non TSS showed a remarkable ability to bind to crystal violet (pattern C/D, 97.2%) incorporated into brain heart infusion agar media at subinhibitory concentrations and these isolates were traced to biotype var. hominis. The cellular fatty acid compositions of TSS and non-TSS strains belonging to the three biotypes S. aureus var. hominis, S. aureus var. bovis and S. aureus var. canis did not differ. TSST-1 producing strains demonstrated a high salt aggregation test value (above 1.5) indicating a low cell surface hydrophobicity. Both TSS and non TSS strains demonstrated a high lipolytic activity. TSST-1 positive strains in general, showed significantly higher lipase activity than strains isolated from septicemia (p less than 0.0001) and superficial (p less than 0.0001) infections. The proteolytic activity is higher among TSS (median value 0.075 U/ml) than to non TSS (median value 0.045 U/ml) strains. There was no correlation with the quantity of toxin production in vitro and to the properties described.
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PMID:Crystal violet binding, cell surface properties and extracellular enzyme profiles of Staphylococcus aureus producing toxic shock syndrome toxin-1. 266 86

A total of 35 Escherichia coli isolates obtained from necropsy materials of hens with septicemia in the Konya region of Turkey were examined for hemagglutination (HA), cell-surface hydrophobicity, enterotoxigenicity, and drug resistance. HA tests were performed on live cultures with human (group A), bovine, avian (chicken), and guinea pig erythrocytes with and without mannose. Nine HA patterns were observed. Of the 35 isolates, 62.8% exhibited mannose sensitive hemagglutination (MSHA), 8.6% exhibited mannose resistant hemagglutination (MRHA), and 28.6% did not hemagglutinate. Of the isolates, 85.7% were hydrophobic by a salt aggregation test (SAT). Only three isolates were enterotoxigenic by a suckling mouse assay. The majority of the isolates were resistant to chloramphenicol, tetracycline, streptomycin, ampicillin, erythromycin, and trimethoprim + sulfamethoxazole but were highly sensitive to gentamicin and nalidixic acid.
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PMID:Hemagglutination, hydrophobicity, enterotoxigenicity, and drug-resistance characteristics of avian Escherichia coli. 269 47

Polymyxin B (PMB), an antibiotic, and sodium deoxycholate (NaD), a bile salt, are surface-active agents. Each protected mice against an otherwise lethal challenge with purified endotoxin (P less than .001). To determine if either of these agents was effective in treating established, overwhelming gram-negative septicemia, we infected rabbits by intraperitoneal injection of Escherichia coli K1. Animals were treated with moxalactam 1 hr after infection, then randomly assigned to groups receiving either saline, PMB, or NaD. Serial samples of blood were assayed for bacterial concentration, levels of plasma endotoxin, arterial blood gases, and complete blood cell counts. Physiologic functions were monitored continuously. Although levels of bacteremia and endotoxemia were similar in all three groups, rabbits receiving PMB had significantly higher mean arterial blood pressure, blood pH, and bicarbonate concentrations than did control rabbits (P less than .05). Rabbits receiving NaD fared no better than controls. In this model, PMB moderates some of the deleterious effects of established, overwhelming gram-negative bacterial sepsis.
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PMID:Polymyxin B moderates acidosis and hypotension in established, experimental gram-negative septicemia. 282 Nov 23

Three mistakes are commonly made in managing metabolic disorders. 1. Oral fluids may be pushed to treat simple volume depletion. However, almost all fluids used for this purpose are sodium-poor and do not restore salt and water balance. 2. The physician may not be aware of common causes of hypophosphatemia, such as hyperventilation, sepsis, stress, use of antacids or diuretics, and alcoholism. If the patient is not monitored adequately, severe hypophosphatemia may develop with serious consequences. 3. Low serum bicarbonate levels may be attributed to metabolic acidosis only, when in actuality metabolic acidosis may coexist with respiratory alkalosis. Arterial blood gas studies differentiate the conditions and direct attention to the cause of respiratory alkalosis when present.
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PMID:Common mistakes in managing metabolic disorders. 318 62

Prolonged postoperative peritoneal lavage has been used as a part of the management of 55 patients with diffuse peritonitis. The lavage technique consisted of 60 min cycles of instillation and drainage of a lavage fluid into the peritoneal cavity via a peritoneal dialysis catheter. The lavage fluid was a slightly hypertonic salt solution containing antibiotics, usually cefotaxime and metronidazole. The overall mortality rate in the series was 11% (6/55). Only one of these patients had residual abdominal sepsis present at post-mortem, the remaining deaths being due to a progression of the pre-existing disease. Five patients showed evidence of further intra-abdominal sepsis. In three of these patients this was associated with the presence of a previously well established abscess cavity. The overall results indicate that, for this group of patients recognized to be at high risk of mortality or further sepsis, the use of prolonged postoperative peritoneal lavage is associated with an improved outcome.
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PMID:Management of diffuse peritonitis by prolonged postoperative peritoneal lavage. 347 71

V vulnificus is a halophilic or salt-requiring vibrio that has been isolated repeatedly from seawater and shellfish in coastal waters. This vibrio, first described by Hollis et al in 1976, can be differentiated from other similar vibrios by its ability to ferment lactose and by its lower tolerance for sodium chloride. V vulnificus, unlike most other vibrios, has seldom been incriminated as a cause of gastroenteritis but is a particularly virulent organism that causes severe wound infections in mostly healthy persons, or causes primary septicemia in persons with an underlying chronic disease, particularly chronic liver disease. Wound infections may range from relatively mild to severe and rapidly progressive cellulitis and myositis. Approximately 50% of patients with wound infections have some type of chronic underlying disease and the mortality rate is in the range of 15%. Wound infections are almost always associated with contact with seawater or the handling or cleaning of shellfish. Patients with primary septicemia have fever, chills, and prostration, and rapidly become hypotensive. Over 70% have distinctive bullous skin lesions that can strongly suggest the diagnosis in a patient with the appropriate history. The mortality rate is over 50%. There is a striking association between eating raw oysters and primary septicemia, with patients usually reporting having eaten raw oysters (or other shellfish) 24 to 48 hours before onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Vibrio vulnificus. 366 22

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

To identify risk factors for Vibrio vulnificus infections, we performed a regional case-control study of 19 patients identified by isolates received at a state reference laboratory. Interviews with patients or surviving relatives and with three controls for each patient were compared in a matched analysis. Patients with V vulnificus wound infection were more likely than controls to have sustained a puncture wound while handling fresh seafood or to have been exposed to salt water. More patients with primary septicemia than controls had eaten raw oysters before the onset of illness. Other risk factors for septicemia included underlying liver disease, hematopoietic disorders, chronic renal insufficiency, use of immunosuppressive agents, and heavy alcohol consumption. Although V vulnificus infection is unusual, with a regional incidence of 0.8 per 100,000 population in this study, septicemia in the immunosuppressed patient is a devastating illness that can be prevented by not eating raw seafood.
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PMID:Vibrio vulnificus. Man and the sea. 398 59

Bacteremia caused by Aeromonas species occurred in 24 hospitalized patients in a cancer institute during a 13-year period. All but one of these patients had a malignancy (88% had leukemia), and most were receiving chemotherapy for cancer. There was a striking numerical predominance of male patients (82%). Unlike some previously described patients with infections due to this organism, none of these 24 patients had recently been exposed to fresh or salt water or to fish. The source of the infecting organism was thought to be endogenous--i.e., from patients' own gastrointestinal tracts. The clinical presentation of sepsis caused by this organism was nonspecific, except that ecthyma gangrenosum occurred in several patients. The overall mortality rate was 28%. The combination of an aminoglycoside and a cephalosporin is appropriate therapy for bacteremia caused by Aeromonas species.
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PMID:Bacteremia caused by Aeromonas species in hospitalized cancer patients. 402 26


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