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

Currently, infections caused by MRSA (methicillin-resistant Staphylococcus aureus) pose a great problem clinically. We present 4 patients with MRSA infections experienced by us. In these patients the infection was localized in the trachea and main bronchus. The first patient was a 62-year-old man. After undergoing operation for early gastric cancer, he had septic shock and was admitted to our center. The second was a 60-year-old man. After he underwent operation for advanced gastric carcinoma at another hospital septicemia developed due to suture failure and he was admitted to our center. The third was a 38-year-old woman who was admitted to our center because of grades II degrees-III degrees burns on 75 to 80% of her body surface area. The fourth was a 60-year-old man who was admitted to our center because of rupture of an aneurysm of the abdominal aorta. It is assumed that MRSA has quite different characteristics from the usual MSSA (methicillin-sensitive Staphylococcus aureus) in that it produces a new penicillin-bound protein (PBP-2') within cells. Thus, from the fiberoptic bronchoscopy findings of our own cases it is considered that there may be cases in which the observed lesion is localized in the central airway alone, without involvement of the segmental bronchi. We believe it necessary to take some prompt measures under a suspicion of airway infection caused by MRSA in the following cases: (1) compromised hosts under tracheal intubation, (2) patients who are under treatment with second or third generation cephalosporins, and (3) patients with production of bloody sputum, and (4) endotoxin-positive patients.
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PMID:[Four cases of airway infections caused by MRSA (methicillin resistant Staphylococcus aureus)]. 235 6

The frequency of MRSA (Methicillin cephem resistant Staphylococcus aureus) infection has increased recently. A case of septicemia caused by MRSA is reported with discussion on its prophylaxis.
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PMID:[A case report of septicemia caused by methicillin cephem resistant Staphylococcus aureus (MRSA)]. 275 97

A case of a traumatic carotid-cavernous aneurysm after removal of cancer of the upper jaw was reported. A 63-year-old male complaining of massive epistaxis from the left nostril was admitted to our clinic. He had suffered from cancer of the left upper jaw and had been treated with radical operation. During the surgical procedure, massive bleeding which was considered to be from the left internal carotid artery, suddenly occurred. The hemorrhage was somehow controlled by packing with oxidized cellulose. He experienced recurrent massive epistaxis after admission. Cerebral angiograms revealed an anterior-medially projecting aneurysm arising from the cavernous portion of the left internal carotid artery. He had a good cross circulation from right to left on compression of the left carotid artery. This aneurysm at the carotid-cavernous portion was produced as a result of injury during an operation for cancer of the upper jaw. To prevent disastrous bleeding from the aneurysm, the aneurysm was then successfully treated by the trapping of extra-and intracranial carotid ligation in combination with left STA-MCA anastomosis. There was no recurrence of epistaxis after the operation. However, a low-grade fever persisted before operation and a blood culture showed MRSA sepsis after the operation. Intensive chemotherapy was performed for this MRSA sepsis, he died of the accompanying DIC. Although aneurysmal epistaxis following a severe closed head trauma is a well-known phenomenon, an iatrogenic carotid-cavernous aneurysm presenting with recurrent massive epistaxis is rare. Several comments were made about the iatrogenic carotid cavernous aneurysm, and the necessity of early diagnosis and treatment was emphasized.
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PMID:[Traumatic carotid-cavernous aneurysm after removal of cancer of the upper jaw: a case report]. 760 35

A sixteen year old female was feverish from June 12, 1993. Methicillin-resistant Staphylococcus aureus was isolated from the blood, the diagnosis of MRSA sepsis was established. Vancomycin (2 g/day) was administered for eighteen days, but MRSA was not eradicated in the blood culture. Then she was administered a combination therapy of arbekacin (200 mg/day) and imipenem/cilastain (1 g/day) for seven days, but MRSA in the blood was cultured continuously. The sequential combination therapy of netilmycin (200 mg/day) and minocycline (200 mg/day) was started, MRSA was eradicated from the blood culture after four days. The sequential combination therapy netilmycin and minocycline was seemed to be effective for MRSA infection.
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PMID:[A case of MRSA sepsis treated by the sequential combination therapy netilmycin and minocycline]. 787 75

A clinical investigation on MRSA infections, and the determination of the efficacy and usefulness of arbekacin (ABK) were performed an "MRSA Forum" composed of 18 groups including 115 institutions in Japan. Patients with infectious diseases clearly related with MRSA, a total of 348 (males: 237, females: 111), were evaluated, 74/274 patients were treated with ABK alone/combination with ABK. Most of them (94.6%/96.4%) had underlying diseases and they had pneumonia (38/175), sepsis (6/35) or other infections (30/64). Infections by MRSA alone were noted in 41/159 and polymicrobial infections including with MRSA were in 33/115. 53.6%/56.4% of MRSA were eradicated and bacteriological clinical efficacies were 75.6%/67.9% in single infections and 63.6%/71.3% in polymicrobial infections. The clinical efficacies were obtained in 70.3%/69.3% of total and in 60.5%/72.0% of pneumonia and in 90.0%/80.8% of the patients pretreated with other drugs within 3 days previously. Efficacy rates were 78.6%/71.4% in 30 minute's div and 63.2%/66.4% in 60 minute's div. Adverse effects were found in 4.76%/5.70% including renal function disorder (2/11) but no case was serious. Abnormal laboratory test results were noted in 15.4%. ABK is effective against MRSA infections.
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PMID:[Nationwide investigation in Japan of the status of MRSA infections and usefulness of arbekacin]. 807 67

Clinical efficacy of arbekacin (ABK) was examined on patients with MRSA infection during hospitalization in Nagoya University Hospital. A total of 15 analysed cases of 5 sepsis, 3 pneumonias, 6 wound infections and one abdominal abscess. ABK was administered intravenously by drip infusion of 200 mg per day divided into 2 doses with or without other antibiotics. Overall clinical efficacy rate was 76.9%, and eradication rate for the MRSA was 54.5%. Adverse effects were noted in 3 cases (one each case of urticaria, disorder of liver function, and renal disorder). The renal disorder was found in the case where ABK was used in combination with vancomycin.
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PMID:[Clinical efficacy of arbekacin on MRSA infections]. 807 81

Availability of arbekacin (ABK) was analyzed in the chemotherapy of 24 MRSA-infected patients with symptoms of pneumonia (12), sepsis (6) and others (6). Most patients had background diseases such as malignant tumors or cerebrovascular disorders. 47% (7/15) of them were immunologically abnormal. 17 of them had been previously treated with cephems, imipenem, minocycline or fosfomycin. The ABK therapy was performed with doses ranging 50-400 mg a day, divided into 1-3 times (mostly 100 mg x 2), and for 5-24 days. (18 patients were treated between 5 and 14 days). 14 patients (58%) received combined therapy with other antibiotics (mostly with beta-lactams, 12). The clinical efficacy rate of the ABK therapy was 62% (good, 13; fair, 4; ineffective, 4; unknown, 3). The bacteriological efficacies were: eradicated, 7 (44%); decreased, 4; no change, 5; unknown, 8. Side effects were found in 3 patients (oliguria, 2; eruption due to drug, 1) and one case resulted in serious renal disorder. Abnormal laboratory data were found in 7 cases. Above results have indicated that ABK is a useful antibiotic in chemotherapy of MRSA-infections.
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PMID:[An evaluation study on arbekacin for MRSA-infectious diseases including pneumonia, septicemia and others]. 807 84

Arbekacin (ABK) was administered to 17 patients with MRSA infections that complicated underlying hematopoietic disorders, and the efficacy and safety were evaluated. The underlying diseases included acute myelocytic leukemia (8 cases), acute lymphocytic leukemia (1) myelodysplastic syndrome (3), chronic myelocytic leukemia (1), non-Hodgkin's lymphoma (2), Hodgkin's disease (1) and adult T cell leukemia (1). The infections consisted of septicemia (5 cases), pneumonia (4), upper respiratory tract infections (6) and urinary tract infections (2). ABK was administered by i.v. drip infusion in daily doses of 150-200 mg, given in two divided dosages. The therapeutic efficacies were: excellent in 2 (2 septicemias), good in 7 (1 septicemia, 4 upper respiratory infections, 2 urinary tract infections), fair in 2 (septicemia and pneumonia) and poor in 6 (1 septicemia, 3 pneumonias, 2 upper respiratory infections). As a side effect, reversible renal dysfunction was detected in four cases. Causative bacteria were isolated from six cases. They were all coagulase type II and MIC's of ABK were from 0.25 microgram/ml to 4.0 micrograms/ml. Arbekacin therapy was found to be effective even in patients with hematopoietic disorders accompanied by MRSA infections.
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PMID:[Clinical efficacy of arbekacin on MRSA infections with hematopoietic disorders. The Hanshin Study Group of Hematopoietic Disorders and Infections]. 807 85

We analyzed the efficacy of arbekacin (ABK) using monotherapy or combined therapy on deep MRSA infection to find the most adequate usage of the drug. We also followed-up the isolation incidence of MRSA after the end of chemotherapy. The results are summarized as follows: 1. Clinical efficacy of ABK on 29 pneumonia and 3 septicemia due to MRSA was 42.9% in ABK monotherapy (9 patients), 62.5% in combined therapy with ABK and minocycline (9 patients), 100% with ABK and imipenem/cilastatin (IPM/CS) (7 patients), and 100% with ABK and other drugs (7 patients). 2. As for microbiological efficacy, combined therapy with ABK and IPM/CS or other drug was superior to other methods. Among patients from whom two or more species of bacteria were isolated, causative bacteria persisted in many cases, and some replacements occurred. 3. Kidney functions deteriorated in two patients that underwent monotherapy or combined therapy with ABK and IPM/CS, but they recovered when therapy was completed the completion. 4. In the three month follow-up study after ABK therapy, we found four cases of renewed infections after disappearance of MRSA. When just decreases in the number of MRSA resulted upon the chemotherapy, the relapse occurred in all cases. 5. Above results indicate that ABK is effective in MRSA infection, and combined therapy with beta-lactams is superior to other methods in serious MRSA infections. We also suggest that chemotherapy should be continued until the complete disappearance of MRSA is achieved.
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PMID:[Clinical efficacy of arbekacin in deep MRSA infection. Including follow-up study after the termination of chemotherapy]. 807 86

From January 1983 to December 1991, 94 cases of Staphylococcus aureus septicemia were identified at Matsue Red Cross Hospital and were evaluated. Methicillin-resistant Staphylococci aureus counted 49%. Seventy two percent of the patients were 60 years or over in age. Intravascular catheters were the most common foci (33%), respiratory infections in 25% and so on. Administration of antibiotics before isolation of Staphylococcus aureus were thought to be the most significant factor in producing the methicillin-resistant septicemia, used in 41% of MSSA and 91.3% of MRSA cases. Especially, the trend of unproper usage of the 3rd generation cephems derivative antibiotics had a major role in producing multi-drug resistant bacteria. No significance was seen in the clinical background, underlying diseases, primary site of infection in between the two groups of methicillin resistant and sensitive cases. Mortality due to septicemia was 47.9% in the MSSA group of patients, while it was much higher in cases of MRSA (73.9%). In conclusion, as the administration of antibiotics even in non-infectious episodes is common in daily clinical activities in some out-patient clinics, the indications should be restricted, in order to prevent the further MRSA infections.
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PMID:[A prospective study of septic episodes due to Staphylococcus aureus and the background of the patients]. 815 Nov 41


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