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

The objective of this study is to determine if the detection of interleukin-6 (IL-6) in maternal plasma prior to delivery predicts neonatal and/or infectious complications in patients with preterm premature rupture of membranes. Patients with preterm premature rupture of membranes between 24 and 35 weeks' gestation were asked to participate in the study. Maternal blood was obtained prior to delivery. All patients received Ampicillin-sulbactam and steroids. IL-6 concentrations were determined by enzyme-linked immunoadsorbent assay (ELISA) using 50 mL of plasma assayed in duplicate. ELISA sensitivity was 18 pg/mL. Neonatal and infectious complications examined were respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, intra-amniotic infection, presumed neonatal sepsis, neonatal sepsis, and congenital pneumonia. Fifty-seven patients' plasma was analyzed. Thirty-five had positive plasma IL-6 prior to delivery. Twenty-seven patients had at least one neonatal complication with 24 (89%) being positive for IL-6. Of the 30 patients without complications, only 11 (37%) were positive (p = 0.0001, OR 13.8. 95% CI, 2.93-74.7). A subanalysis of patients who received a course of corticosteroids was performed and significance was maintained. Ten of 13 patients (77%) with neonatal complications had positive IL-6 compared with 40% without complications (p <or=0.01). Infectious morbidity occurred in 32 patients with 24 having positive IL-6 values (75%). Only 11 of 25 (44%) without infections were positive (p <or=0.03, OR 3.82, 95%, CI 1.09-13.0). The presence of IL-6 in the maternal plasma predicted patients with neonatal complications. These correlations persisted when the data were stratified for those patients who received corticosteroids. It also predicted infectious complications.
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PMID:Detection of interleukin-6 in maternal plasma predicts neonatal and infectious complications in preterm premature rupture of membranes. 1173 92

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

Listeria monocytogenes is still a very rare opportunist infection in immunosuppressive patients. The clinical-epidemiological and therapeutic characteristics in 10 patients with infection produced by LM are reported--four of them had primary bacteriemia, three patients had a meningeal involvement, there were two patients with spontaneous bacterial peritonitis and one suffered from abdominal access. All of the patients had underlying disorders favouring the infection. Sepsis and meningeal syndrome were the most common presenting forms. Ampicillin was the most used antibiotic. The overall mortality was 40%.
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PMID:[Listeriosis in the adult. Revision of 10 cases]. 1497 93

In this study laboratory records of all positive blood cultures at Olabisi Onabanjo University Teaching Hospital between January 1993 and December 1998 were reviewed and analyzed. A total of 2057 samples of blood cultures were received in the laboratory during the period of study. 495 (24.1%) samples yielded significant growth of microorganisms. 87 (17.6%) of the positive cultures were from the out patients. Most of the positive blood cultures (99.6%) were mono-microbial. A total of 497 isolates were obtained. The predominant organisms isolated were Klebsiella species (30.8%), Staphylococcus aureus (30.8%), atypical coliforms (11.9%) and Pseudomonas species (7.5%). There were more gram-negative organisms 309 (62.2%) than gram-positive organisms 188 (37.8%). Staphylococcus aureus (30.8%) and Staphylococcus epidermidis (5.0%) were the predominant gram-positive organisms isolated. A large number (>50%) of the organisms isolated were resistant to Ampicillin and Gentamicin but were sensitive to third generation cephalosporins and quinolones. In conclusion, this study demonstrates the need for all hospitals to monitor the microorganisms causing septicemia so that the clinicians can be alerted to a suitable strategy for blind therapy.
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PMID:Bacteraemia--a Sagamu perception. 1503 95

Neonatal sepsis is one of the major health problems throughout the world. Every year an estimated 30 million newborns acquire infection and 1-2 million of these die. The present review provides updates regarding neonatal sepsis to help paediatricians to protect the newborn from this deadly problem. The onset of sepsis within first 48 hours of life (early onset sepsis) is frequently associated with pre and perinatal predisposing factors while onset after 48-72 hours of life (late onset sepsis) frequently reflects infection acquired nosocomially. Some literatures say that early onset disease presents in the first 5-7 days of life. Klebsiella pneumoniae is the leading pathogen causing neonatal sepsis in Bangladesh and neighbouring countries. Among many risk factors the single most important neonatal risk factor is low birth weight. Other main risk factors are invassive procedures in the postnatal period and inadequate hand washing before and after handling babies. Sepsis score is a useful method for early and rapid diagnosis of neonatal sepsis which was developed by Tollner U in 1982. Antibiotics should be given to most of the neonates suspected of infection. Ampicillin and gentamicin are the first drug of choice. In Bangladesh context sepsis score may be used as a good parameter for the early and rapid diagnosis of sepsis and that will guide the treatment plan. Clean and safe delivery, early and exclusive breastfeeding, strict postnatal cleanliness following adequate handwashing and aseptic technique during invasive procedure might reduce the incidence of neonatal sepsis. Prompt use of antibiotic according to standard policy is warranted to save the newborn lives from septicaemia.
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PMID:Neonatal sepsis-- a global problem: an overview. 1646 76

We report a case of infective endocarditis caused by Acinetobacter baumannii complex in a 27-year-old male patient. The patient presented with fever of five days duration, palpitation, dyspnea, cough and chest pain. He had undergone a surgical repair of ruptured aneurysm of sinus of valsalva a month before. The transthoracic echocardiogram revealed a large vegetation on the aortic valve. Three samples of blood for culture grew gram-negative pleomorphic coccobacilli within 24 hours which were identified by cultural and biochemical characteristics to be Acinetobacter baumannii complex. Antimicrobial susceptibility was performed by Kirby-Bauer method and the isolate were found to be resistant to ampicillin, Ciprofloxacin, Ceftriaxone, Gentamicin, Amikacin, Augmentin, Levofloxacin, Piperacillin-Tazobactam, Netilimicin and sensitive to Imipenem. Patient was initially treated with Ceftraixone and Gentamicin and subsequently with Ampicillin and Amikacin but did not respond to treatment and died of sepsis before therapy with Imipenem could be started.
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PMID:Infective endocarditis due to Acinetobacter baumannii complex--a case report. 1718 61

As group B streptococci (GBS) prevalence varies from place to place and this organism is responsible for serious infections in newborns such as septicaemia and meningitis, the present study was carried out to find the prevalence of GBS in pregnant women and their neonates. From June 1998 to April 1999 a total of 317 pregnant women and their neonates were examined for GBS. GBS colonization rate was 2.52% and 1.26% in pregnant women and their neonates respectively. Four sites - viz. throat, external ears, external nares and stump of umbilicus from neonates were found to be equally colonized by GBS immediately after birth and at the time of discharge from hospital, except the umbilicus which was not swabbed at the time of discharge. None of the neonates developed GBS related sepsis. Selective broth medium (SBM) was found to be a superior transport method over Stuart transport medium and filter paper method. All the isolates were sensitive to Ampicillin, Erythromycin, Penicillin followed by Chloramphenicol 66.6% (12/18). All the strains were resistant to Gentamicin, followed by Tetracycline 94.4% (17/18) and Kanamycin 88.8% (16/18).
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PMID:Colonization of pregnant women and their newborn infants with group-B streptococci. 1766 97

Sepsis is a systemic inflammatory response syndrome (SIRS) when an infection is the etiology of SIRS. Our previous studies have indicated that the release of the sympathetic neurotransmitter, norepinephrine (NE), from the gut is increased in sepsis, and that NE potentiates endotoxin-induced tumor necrosis factor (TNF)-alpha upregulation via the A subtype of alpha(2)-adrenoceptors (i.e., alpha(2A)-AR) expressed on the surface of Kupffer cells. A specific antagonist for alpha(2A)-AR, 2-[(4,5-dihydro-1H-imidazol-2-yl) methyl]-2,3-dihydro-1-methyl-1H-isoindole maleate (BRL-44408 maleate), reduces TNF-alpha secretion in cultured Kupffer cells. We, therefore, hypothesize that administration of BRL-44408 maleate inhibits inflammatory responses and reduces organ injury in sepsis. To study this, sepsis was induced in male rats by cecal ligation and puncture (CLP). At 5 h after CLP, BRL-44408 maleate (0.3125, 0.625, 1.25, 2.5, or 5.0 mg/kg BW) or vehicle (1-ml normal saline) were administered intravenously over a period of 30 min. Blood and intestinal samples were collected at 20 h after CLP. Serum levels of TNF-alpha, interleukin (IL)-6, IL-10, keratinocyte-derived chemokine (KC), macrophage inflammatory protein-2 (MIP-2), liver enzymes (i.e., aspartate aminotransferase (AST) and alanine aminotransferase (ALT)), and lactate were measured. The intestinal levels of TNF-alpha, IL-6, and myeloperoxidase (MPO) activities were also analyzed. In additional groups of animals, the necrotic cecum was excised at 20 h post-CLP, and the 10-day survival was recorded. Our results showed that serum levels of proinflammatory cytokines (TNF-alpha and IL-6), anti-inflammatory cytokine (IL-10), chemokines (KC, MIP-2), liver enzymes (AST and ALT), lactate, and intestinal levels of TNF-alpha, IL-6, and MPO were significantly elevated at 20 h after CLP. Administration of BRL-44408 maleate significantly reduced serum levels of proinflammatory cytokines, chemokines, liver enzymes, and lactate, and dramatically decreased TNF-alpha, IL-6, and MPO levels in the gut. However, it has no statistical effects on the elevated serum levels of IL-10. Moreover, BRL-44408 maleate at the doses of 2.5 or 5.0 mg/kg BW significantly increased the survival rate after CLP and cecal excision. In conclusion, modulation of the sympathetic nervous system by blocking alpha(2A)-AR appears to be a novel treatment for inflammatory conditions such as sepsis.
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PMID:Antagonism of alpha2A-adrenoceptor: a novel approach to inhibit inflammatory responses in sepsis. 1989 27

For the period 2008-2010 in the University Hospital "Maichin Dom" EAD were born 10 774 babies. The newborns in the intensive care clinic (according to Apgar 1-5 min, the severity of RDS, the birth weight, gestational age, C-reactive protein and the values of blood tests) were screened for mother-fetal infections immediately after birth. The tests performed were blood culture, stomach aspirate, ear, anal and nose secretion, throat and tracheal aspiration (if intubation was performed). In case of meningitis liquor was tested. Standard therapy included Ampicillin/Sulbactam. The healthy, eutrophic children were also screened for bacterial mother-fetal infections--routinely ear and stomach aspiration. The babies, without clinical and paraclinical symptoms, but positive for GBS colonization, were also treated with Ampicilin. As a result from the screening and therapy no cases with meningitis were detected, as well as late neonatal sepsis caused by GBS.
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PMID:[Group B streptococcus (GBS) infection in newborns in university hospital "Maichin Dom" EAD Sofia for the period 2008-2010]. 2248 56

Background. Ongoing surveillance of antimicrobial sensitivity patterns of bacteria isolated in bloodstream infections guides empiric antibiotic therapy in neonatal sepsis. Methods. Sensitivity profiles of neonatal bacterial bloodstream infections in a tertiary hospital were reviewed between 01/06/2009 and 30/06/2010 . Results. There were 246 episodes of bloodstream infection in 181 individuals-(14.06 episodes in10.35 patients/1000 patient days or 14.4 episodes in 10.6 babies/1000 live births. The majority were (93.5%) were late onset and most (54.9%) were gram positive. There were 2.28 sepsis-related deaths /1000 patient days or 2.3/1000 live births. Death was significantly associated with gram-negative infections (P < 0.001), multiple gestation (P < 0.001), shock (P = 0.008), NEC (P = 0.002), and shorter duration of hospital stay (P < 0.001). Coagulase-negative staphylococcus was isolated in 19.1%, K. pneumoniae ESBL in 12.1%, and A. baumanni in 10.9%. S. agalactiae predominated in early onset sepsis. Methicillin resistance was present in 86% of CoNS and 69.5% of S. aureus; 46% enterococcal isolates were ampicillin resistant. The majority (65%) of K. pneumoniae isolates were ESBL producers. Ampicillin resistance was present in 96% of E. coli. Conclusions. Penicillin and an aminoglycoside would be suitable empiric therapy for early onset sepsis and meropenem with gentamycin or ceftazidime with amikacin for late onset sepsis.
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PMID:Bacterial bloodstream infections in neonates in a developing country. 2291 9


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