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 group of children (112) at different phase of development, i.e. neonates, infants, preschool and school children were studied for symptomatic UTI. The most common clinical presentations were loin pain (56.4%), fever (50.0%), diarrhea and vomiting (47.4%) in school, preschool and infant groups respectively. In the neonatal group all patients presented with sepsis. In school children fever was more common in those with radiological abnormalities vs those without (p less than 0.005). In neonates intrauterine growth retardation was more common in those with radiological abnormalities (p less than 0.012). Radiological abnormalities were more common in male school children than in female (p less than 0.02). Renal scarring occurred mainly in school children whereas VUR occurred mainly in infants. As male children advance in age there is increased risk of radiological abnormalities. There is an increased percentage of E. coli as causative organism as age increases; from 48.3% in neonates to 74.5% in school children. We conclude that symptomatic UTI is age related in many aspect.
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PMID:Symptomatic urinary tract infection in pediatric patients--a developmental aspect. 391 42

This report summarizes the results of joint studies in pediatrics on aztreonam, the first monobactam antibiotic for practical use. Pharmacokinetics was studied in 53 cases administered with 10, 20, 40 and 50 mg/kg of aztreonam (AZT) by intravenous injection and 20 cases with 10, 20, 30, and 40 mg/kg by drip infusion. All the cases had normal hepatic and renal functions at the administration. T1/2 was in a relatively fixed range of 1.35-1.56 hours in intravenous injection cases and 1.30-1.55 hours in drip infusion. One hour after commencing administration of standard 20 mg/kg, the serum concentrations were 50.18 +/- 4.24 micrograms/ml in intravenous injection and 116.33 +/- 10.18 micrograms/ml in drip infusion and even 6 hours after the end of the administration, they were 5.80 +/- 1.16 micrograms/ml and 3.38 +/- 0.58 micrograms/ml, respectively. The cerebrospinal fluid penetration was studied on suppurative meningitis (5 cases) and nonbacterial meningitis (3 cases). The penetration was generally good with sufficient concentration for meningitis caused by E. coli and H. influenzae. Amount of the penetration decreased as the cases were improved. Twenty-nine (29) cases were excluded and 262 cases of total 291 were clinically assessed, and the pathogen-isolated 167 cases of 262 were principally analyzed. Efficacy of AZT was "excellent" for all 3 cases of E. coli sepsis and 1 case of N. meningitidis meningitis and "good" for 1 case of H. influenzae meningitis. The effective rate was 94.6% for 37 pneumonia cases, 94.7% for 76 UTI cases and 88.5% on the whole including as many as 98 "excellent" cases. However, the effective rate for 21 enteritis cases was only 52.4%. Similar trend was observed in the pathogen-unknown group and overall effective rate of total 267 cases was 86.8%. The clinical effect by pathogen was 97.7% for 44 E. coli cases and 97.1% for 34 H. influenzae cases, showing excellent results for the GNB group. AZT was also effective for 8 out of 11 P. aeruginosa cases. With regard to microbiological effect by pathogen, AZT showed a high rate of bacterial elimination for GNB, primarily 98.1% for E. coli and 100% for H. influenzae followed by 76.9% for P. aeruginosa. However, it was only 30.0% for Salmonella. Excluding the Salmonella cases, GNB elimination rate was 93.5%. Clinical and microbiological dose response was not clear partly because, same as the previous studies, the effective rate of AZT was high. It was considered, however, standard dose of 20 mg/kg X 3 approximately 4 times a day was recommendable.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Bacteriological, pharmacokinetic and clinical studies on aztreonam in the pediatric field. Pediatric Study Group of Aztreonam]. 391 24

Sulbactam, a new beta-lactamase inhibitor, in combination with cefoperazone was administered to 18 pediatric patients, 7 months to 10 years 6 months of age, at a daily dose of 56-320 mg/kg divided into 4 times by intravenous bolus infusion for 3 to 11 days, and the sum of 2.6-74.0 g of the drug was given. A total of 18 cases comprised 8 with RTI, 1 with gastric tract infection, 4 with UTI and 5 with sepsis (suspected). Clinical efficacy was excellent in 10 cases, good in 3 cases, fair in 1 case and poor in 4 cases, and efficacy rate was 72.2%. Out of 8 strains (1 of S. aureus, 1 of P. aeruginosa, 1 of Salmonella subgenus I, 2 of E. coli, 2 of P. mirabilis and 1 of K. pneumoniae), possible causative organisms isolated before the treatment, 6 strains were disappeared, 1 strain of K. pneumoniae persisted, and 1 strain of P. aeruginosa was replaced by S. aureus. Diarrhea was noted in 1 case as subjective side effect, and as abnormal laboratory findings, GOT and GPT elevations in 1 case, GPT elevation in 1 case and eosinophil elevation in 1 case were observed.
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PMID:[Clinical studies on sulbactam/cefoperazone in the pediatric field]. 609 61

Laboratory and clinical studies were performed on cefmenoxime (CMX), a new cephalosporin antibiotic, and the following results were obtained. 1. Susceptibility of clinically isolated bacteria to CMX and cefotiam (CTM) or cefazolin (CEZ) Antimicrobial activity of CMX was compared with that of CTM and CEZ against S. aureus, S. epidermidis, S. pneumoniae, H. influenzae and E. coli. CEZ and CTM were more active than CMX against S. aureus, S. epidermidis and S. pneumoniae. But CMX was found to be more active by 1-10 tubes than CEZ and CTM against H. influenzae and E. coli. 2. Clinical efficacy. CMX was intravenously administered to 19 patients; 3 with lacunar tonsillitis, 2 with acute bronchitis, 8 with bronchopneumonia, 3 with UTI, 1 with septicemia, 1 with acute panperitonitis, 1 with S.S.S.S. at daily doses of 30-115 mg/kg (64.6 mg/kg on an average) t.i.d. or q.i.d. for 3-17 days (6.1 days on an average). The overall efficacy rate was 94.7%, i.e., efficacy was excellent in 10 cases (52.6%), good in 8 cases (42.1%), and poor in 1 case (5.3%). Bacteriological efficacy was good, i.e. 16 of the 19 strains disappeared. Transient eosinophilia was observed in 1 patient, but no other laboratory abnormality was observed during treatment. The above results suggest that CMX is 1 of the useful antibiotics in treatment of pediatric infections, especially due to Gram negative bacteria.
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PMID:[Laboratory and clinical studies of cefmenoxime in the pediatric field]. 630 38

A study of the pharmacokinetics of cefoperazone (CPZ), used as the sole antibiotic, was performed in 17 children and neonates. The types of infections treated were 7 UTI, 2 otitis media, 2 RTI, 4 septicemia or severe neonatal infections. Causative bacteria included 6 E. coli, 3 Pseudomonas aeruginosa, 1 C perfringens, 1 Klebsiella pneumoniae and 2 Staphylococcus aureus. Cefoperazone was administered by means of rapid IV injections (over 5 min) or IV infusions BID. The blood samples were taken by means of capillary microtubes at time 0, 0.25, 0.50, 0.75, 1, 2, 4, 6, 8 and 12 hours after the end of the first injection. After centrifugation and freezing at -80 degrees DEG method using modified Difco M2 Agar (Nall plus sodium citrate) and stock organinism Bacillus subtilis Atcc 6633. The results achieved in children and neonates were compared, in the 11 children (mean age 6.5 years). The mean single dose was 53 mg/kg. The mean maxima concentration was 145 mcg/ml and was obtained at 0.5 h. Mean serum half-life is 2.4 h. For the neonates mean age was 16 days and the dosage was 47 mg/kg, the maxima concentration was 232 micrograms/ml and was obtained at 0.6 h. The mean serum half-life was 3.4 h in the 2 groups, serum levels at 12 h were still high with a mean of 6.2 micrograms/ml for the 17 children. It appears that doses of 25-50 mg/kg given BID would be satisfactory.
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PMID:[A study of pharmacokinetics of cefoperazone in children]. 635 26

CMZ is a derivative of cephamycin antibiotics having a potent resistance to beta-lactamase, so that it exerts strong effect on beta-lactamase producing resistant strain, and it is an antibiotic agent having wide antibacterial spectra. Highly effective and safe properties were proved and identified in children (Presented at 11th I.C.C.), so that a study group was organized to examine the usefulness of CMZ for the various infections of the newborn and immature infants. Blood level and urinary excretion: A half life (T 1/2) of the intravenously administered CMZ (20 mg/kg) in blood was 4.18, 2.39 and 1.78 hours in less than or equal to 3 days, 4 to 7 days and greater than or equal to 8 days old newborn infants, respectively. Immature infants reveals longer T 1/2 by 3 days after birth but normalizes fairly soon. Urinary excretion of CMZ was examined in 10 infants up to 7 days old. The relation between the urinary volume and urinary recovery were well correlated. Clinical effect: CMZ was administered to respiratory infections, septicemia, meningitis, urinary tract infections, and other infections in 51 cases of newborn and immature infants. A daily dose, 60 to 100 mg/kg, was divided in 2 to 4 times, and administered intravenously. The causative organisms were E. coli, Klebsiella, Serratia and Staph, aureus and 97% of eradication rate was obtained. CMZ was clinically effective in 100% for respiratory infections (17 cases), septicemia (7 cases) and purulent meningitis (4 cases), and in 91.7% for UTI. The overall effective rate was 94.1%. No notable adverse effect was found. Cefmetazole is a safe and effective antibiotics in treating severe infections in newborn and immature infants.
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PMID:[Clinical usefulness of cefmetazole in newborn and immature infants (author's transl)]. 694 49

Cefsulodin (CFS) was evaluated for its safety and efficacy in 14 children with Pseudomonas aeruginosa infections. The diagnoses included pneumonia (4), sepsis (1), presumed sepsis (4), acute postoperative ascending cholangitis (1), acute postoperative peritonitis with wandering pneumonia (1), acute enterocolitis with acute UTI (1), recurrent UTI (1), and acute cystitis (1). CFS was administered intravenously with a daily dose of 93 to 299 mg/kg in the cases with normal renal functions. CFS was effective in all but one case both clinically and bacteriologically. A case of pneumonia whose isolate was resistant to CFS responded poorly. Mild transient eosinophilia was observed in 3 cases, but no severe adverse reactions were encountered. Peak MIC values of 18 clinical isolates of P. aeruginosa were 1.56 mcg/ml, 0.39 to 0.78 mcg/ml and 12.5 mcg/ml for CFS, gentamicin, and sulbenicillin, respectively. A half life of the serum CFS levels was 1.09 hours after intravenous bolus injection of 20 to 25 mg/kg of CFS (n = 2). A cerebrospinal-fluid level and biliary levels measured in cases with inflamed meninges or with cholangitis were well above the MIC value. From the present study, CFS appeared to be a safe and effective antibiotic when used in children with susceptible Pseudomonas infections. Combined use of another antibiotic should be considered in the case with polymicrobial infections because of the CFS's very narrow spectrum.
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PMID:[Clinical evaluation of cefsulodin in Pseudomonas infections in children]. 716 64

We investigated pharmacokinetics and clinical effectiveness of a newly developed cephem antibiotic cefozopran (SCE-2787, CZOP) against various pediatric infections in 18 institutions and their affiliates. We obtained the following results. 1. Serum concentration and urinary excretion rates Pharmacokinetics of CZOP in children was examined after intravenous injection and 30-minute drip infusion of 10, 20 and 40 mg/kg of CZOP. Peak serum concentrations of CZOP in 30 minutes after intravenous injection were 21.7, 51.5 and 77.8 micrograms/ml, respectively, showing a clear dose response. Half-lives were 1.99, 1.85 and 1.67 hours, respectively. In the first 6 hours after administration, urinary excretion rates of CZOP were 87.3, 67.4 and 84.1%, respectively. In the cases of 10, 20 and 40 mg/kg administration of CZOP 30-minute drip infusion, peak serum concentration of CZOP in 30 minutes, when the infusion was completed, were 38.1, 72.8 and 95.6 micrograms/ml, respectively. Again, there was a clear dose response. Half-lives were 1.67, 1.69 and 1.43 hours, respectively. In the first 6 hours after administration, urinary excretion rates of CZOP were 53.9, 59.7 and 77.3%, respectively. Cerebrospinal fluid concentrations of CZOP administered by intravenous injection of 50 mg/kg to patients with purulent meningitis were 1.6 to 43.4 micrograms/ml in 1 to 1.5 hours after administration. 2. Clinical study Clinical efficacy was evaluated in 337 cases. The largest number of cases, 138 cases, were found in 2 to < 6-year olds. The majority of the patients were under age 9, and 70 cases were of less than 1-year old infants. 183 cases were males and 154 cases were females. In terms of illness, a majority, or 185 cases, suffered from pneumonia, followed by 39 cases of UTI and 23 infections of the skin and soft tissue. There were 7 cases of purulent meningitis. In 218 cases, CZOP was administered at a daily dose of 60- < 80 mg/kg. The drug was administered for 6-10 days, the most frequent duration, in 188 cases. In the cases where causative organisms were identified (group A), the efficacy rates ("excellent" and "good") obtained were 100% (5/5) against purulent meningitis, 100% (2/2) against sepsis, 98.3% (119/121) against pneumonia, 100% (13/13) against acute bronchitis, 100% (11/11) against upper respiratory tract infection, 96.3% (26/27) against UTI. Overall, "excellent" and "good" responses were observed in 97.5% (197/202) of cases with known causative organisms.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Pharmacokinetic and clinical studies with cefozopran in the pediatric field. Pediatric Study Group of Cefozopran]. 811 68

A multivariate analysis of 3334 Escherichia coli strains originating from different clinical materials revealed that 50.2% of isolates belonged to the most common 12 (O1, O2, O4, O6, O7, O8, O15, O18, O45, O75, O78, O83) out of 133 serogroups. Haemolysin (Hly) production, mannose resistant haemagglutinating activity for human erythrocytes (MRHA) and colicinogenicity (Col) were recorded in 30, 30 and 36%, respectively. Antigens K1 and K5 were present in 11% and 6.6%, respectively. Association were found among certain serotypes and virulence markers (O1, H-, H7, K1, MRHA, Col; O2, H-, Kl, Col; O4, H-, H5, MRHA, Hly; O6, H-, H1, MRHA, Hly; O6, K5, MRHA, Col; O7, H-, H4, K1, MRHA, Col; O18ac, H7, K1, Col; O18ac, H-, K5, MRHA, Hly; O78, H-, Col (V-type); O83, H-, K1, Col). There were associations among clinical specimens, age of patients, nosocomial group of diseases, serogroups and virulence markers, too (cerebrospinal fluid-CSF-O7, O18ac, O45, O83-K1-newborn meningitis; O78-ColV-meningitis, sepsis, inflammations diseases of premature babies; CFS-O6, MRHA, Hly-adult-meningitis, sepsis, urinary tract infection-UTI-, pneumonia, other inflammatory diseases; blood-O2, O4, O6, O18ac, ONT, K5, MRHA, Hly-sepsis, UTI, hepatic diseases; urine-O1, O2, O4, O6, O18ac, O75, virulence markers fall to differ among upper and lower UTI; faeces-O1, O4, O6, O18ac, O78, virulence markers rare). Associations were also found among animal pathogenicity tests, specimens, serogroups and virulence factors: highly virulent group strains (i.e. LD50 below 10(6)) belonged to serogroups O2, O6, O18ac, possessed antigen K1 (less frequently the presence of MRHA, Hly, K5) and originated mainly from CSF. With mouse lung toxicity test correlations of serogroups (O4, O6, O18ac), antigen K5, MRHA, Hly and specimens (blood) were also shown. However, association was found between the lack of virulence factors and phage insensitivity and also between K5 positivity and sensitivity to phages 16, 17, there were no correlations between serogroups and phage patterns. On the basis of the above-described associations one can find correlations among virulence markers, serotype, and nosological group of diseases. Animal pathogenicity tests give additional data in understanding the pathomechanism of diseases. Correlations between phage patterns and serogroups reveal certain epidemiological relatedness and also virulence of strains.
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PMID:Computerized complex typing of Escherichia coli strains from different clinical materials. 819 67

Urinary tract infections are common clinical problems which result in significant morbidity and even mortality. UTI's can range from minimal disease to life-threatening sepsis and it is important to differentiate between the former which usually involves the lower urinary tract and the latter which invariably involves the upper urinary tract. Diagnosis depends on an abnormal urine microscopy and demonstration of bacteria in the urine. Pre-therapy urine cultures are not mandatory in young women with uncomplicated UTI and many studies support the efficacy of short-course therapy in this groups of patients. For other patients, microbiological and radiological investigations are required and there is insufficient data to support short course therapy in these patients. Treatment guidelines are different in special situations such as prostatitis, pregnancy, catheter-related infection and recurrent infections.
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PMID:Urinary tract infections. 855 1


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