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

A case of right-sided Pseudomonas cepacia endocarditis in a heroin addict is presented in which septic cutaneous vasculitis (ecthyma gangrenosum) is a prominent feature. Ecthyma gangrenosum, most commonly associated with sepsis due to P aeruginosa, has not been previously described with P cepacia septicemia.
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PMID:Pseudomonas cepacia endocarditis and ecthyma gangrenosum. 83 96

A modified bone marrow clonal cell culture technique was used to study granulocyte production during burn injury and sepsis. When rats were inflicted with a 30 percent third-degree scald burn, marrow cellularity and colony-forming units in culture (CFU-C) per 10(5) marrow cells increased progressively to four times normal by 7 days after injury. Conversely, When animals were burned and the burn wound immediately seeded with 10(8) Pseudomonas organisms, CFU-C declined steadily until the day of death and reflected a progressive loss in marrow cellularity. Further studies were conducted replacing or mixing standard colony-stimulating serum with burn, burn-infected, or normal rat serum. The results indicated that colony-stimulating activity could be supplied by postburn serum, but not with normal or burn-infected rat serum. Additionally, serum from burned-infected animals significantly inhibited colony formation when added to the standard colony-stimulating serum. Marrow failure appears to be the major cause for granulocytopenia in burn infection and may partly be serum mediated.
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PMID:Myelopoiesis in the infected burn. 83 11

Among the main aspects to be considered when treating burns, the problem of infection control remains unsolved. Considerable financial resources are needed to prevent the transmission of organisms. To justify such investments in buildings and antiseptic measures, an extensive epidemiological hospital study was carried out from 1970 to 1974, involving 930 patients, and more than 25,000 wound biopsies as well as 10,000 contact cultures and environmental swabs. Bacteria from the environment of severly burned patients were counted every week. Serotyping was used for a specialized study of Pseudomonas aeruginosa. In 200 patients wound organisms were counted. The most important organisms were: Streptococcaceae (pyogenic streptococci, less frequently faecal and salivary streptococci). Pseudomonadaceae, Enterobacteriaceae, and Micrococcaceae (especially Micrococcus aureus). Povidon iodine, gentamicin and silver sulfadiazine were used for local disinfection. Antibiotics used were gentamicin, carbenicillin and polymyxin. Whereas from 1970 to 1972 P. aeruginosa was the predominant organism found in wounds, other gram-positive organisms increased from 1972 on. Wounds were colonized mainly in the course of the first two weeks of treatment. Special studies regarding P. aeruginosa revealed a predominance of serotypes 5 and 13 between 1970 and 1973, whereas types brought into the hospital were dominant from 1973 on. An analysis of furniture and equipment, water faucets and drains showed that Pseudomonas strains found in the water did not coincide with those found in wounds. Therefore, a contamination from this source seems unlikely. Strains found on furniture and equipment, however, also appeared in the wound flora. When the therapeutic routine was changed (to prevent patients passing through common treatment areas such as bathrooms and dressing areas) hospital organisms 5 and 13 could be eliminated almost completely. Thus, it is possible to achieve a considerable reduction in the rate of cross-infection among patients by, for instance, excluding common treatment areas from the therapy programme. Nevertheless, in the majority of cases wounds will still be colonized, in particular by bacteria that were already in the anal region or on the skin before the patient was injured. For this reason, the elimination of such organisms by topical bactericidal agents constitutes an an important factor in efforts to reduce the rate of septicaemic complications. In view of the persisting high mortality due to generalized infections this therapeutic aspect must also be exploited thoroughly in the future. Although in comparative studies of topical therapy using povidon iodine, silver sulfadiazine and gentamicin, organisms did appear in the course of the first two weeks; in the case of the PVP-I the colonization never reached 10(5) organisms per cm2, i.e. the danger threshold for generalized sepsis. There was no evidence of a correlation between number of organisms and depth of burns.
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PMID:[Asepsis and antisepsis in the treatment of burn patients (author's transl)]. 85 28

We describe our experimental studies of a powder formulated to treat serious burn wounds on-the-scene. The wound powder comprises two parts silver-citro-allantoinate, two parts zinc allantoinate and 96 parts pure allantoin. The back skin of 62 rats was shaved and exposed to actively boiling water for ten seconds, resulting in third degree burns of 20% of the total body surface. Immediately, 1 ml of a culture containing 2 X 10(8) Pseudomonas aeruginosa was applied to the burn. The animals were isolated. Of the 30 control rats, six were powdered with allantoin only. Thirty-two rats were dusted with the silver-zinc-allantoin powder within 15 minutes of burning. Cultures were taken at 48 hour intervals. Eighty-seven percent of the control animals died an average of six days postburn. In the treated animals, the mortality was 15%. A mean of 27% of the applied silver (0.35 gm) became incorporated in the eschar. In all control rats, sepsis was detected under the eschar. In treated animals, bacterial concentration fell from an initial average of 5 X 10(4) at 4 hours postburn to 6 X 10(2) at 96 hours.
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PMID:The use of silver-zinc-allantoin powder for the prehospital treatment of burns. 87 Jul 34

During a 14 month period there were 364 episodes of bacteremia and fungemia at Memorial Sloan-Kettering Cancer Center. The first nine months of the study were retrospective, and the next five prospective. In patients with leukemia or lymphoma (group 1), Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus were the most frequently isolated organisms. The mortality in this group was 40.5 per cent. In the patients with solid tumor (group 2), Esch. coli, Staph. aureus, Bacteroides sp. and Candida sp. were most frequent. Mortality was 27.8 per cent. The source of infection in both groups was often indeterminate. High mortality was associated with pulmonary and intraabdominal infection and with Ps. aeruginosa, K. pneumoniae or polymicrobic sepsis. Factors of prognostic significance were the causative microorganism, source of infection and shock. Although mortality was higher in patients with leukopenia than in those with normal leukocyte counts, the differences were not significant. The mortality in this series was low considering the severity of the underlying diseases and the immunosuppressed state of many of the patients. In a prospective, randomly controlled study, mortality was further diminished by infectious disease consultation at the time the positive blood culture was reported. Severe fungal superinfection, predominantly aspergillosis and candidiasis, was found in 52 per cent of the autopsy patients with leukemia or lymphoma (group 1), but in only 8 per cent of those with solid tumors (group 2).
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PMID:Bacteremia and fungemia complicating neoplastic disease. A study of 364 cases. 87 Nov 28

The hematologic and histologic features of two, nontwin, male siblings with severe combined immunodeficiency and variable granulocytopenia are compared to the four previously reported cases of reticular dysgenesis. These sibs died at 50 and 3 days of age, respectively, with Pseudomonas sepsis and congenital cytomegalovirus infection, respectively. A maternal uncle has selective IgA deficiency. Cord blood from the second sib contained a normal percentage of E-rosetting lymphocytes; however, these lymphocytes failed to respond to mitogenic stimulation in vitro. Erythrocyte and lymphocyte levels of adenosine deaminase were elevated in the father and the second sib. Serum immunoglobulin concentrations were low in both siblings.
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PMID:Severe combined immunodeficiency with leukopenia (reticular dysgenesis) in siblings: immunologic and histopathologic findings. 95 62

Tobramycin was used in the treatment of 35 severe infections. Its clinical effectiveness was confirmed in broncho-pulmonary infections without septicemia and in septicemia without lung involvement. Poor results were obtained in septicemia where the initial site 9 infection was in the lungs. This antibiotic appeared as a very good antistaphylococcal agent. In vitro superiority over gentamicin against Pseudomonas was not be confirmed clinically. Tobramycin deserves to be administered initially in serious infections because of the possibility that the causative organism might be a gentamicin-resistant, tobramycin susceptible strain. Three such cases were observed in our 35 patients. This susceptibility dissociation in favor of tobramycin was demonstrated in two strains of Klebsiella and one strain of Enterobacter. A dosage regimen in patients with impaired renal function is proposed. It requires confirmation.
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PMID:The use of tombramycin in the management of severe infections. Clinical and pharmacological data. 96 73

Twenty-five patients with severe urinary tract infections were treated with 3 mg of tobramycin/kg per day (given in two doses). Susceptible organisms were Escherichia coli, Proteus, Klebsiella, Pseudomonas, Streptococcus, and enterococcus. Clincal conditions in which treatment produced excellent bacteriological results included a wide range of urological disorders; the most common were pyelonephritis, cystitis, and epididymo-orchitis, Three patients had septicemia, and 12 had an infection that was the result of urinary tract obstruction requiring surgery.
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PMID:Evaluation of tobramycin in severe urinary tract infection. 97 85

The minimal inhibitory concentrations of gentamicin and minocycline alone and in combination were determined by a broth microdilution method for 100 aerobic, facultative, and anaerobic isolates representative of pathogens recovered from patients with intra-abdominal sepsis. Gentamicin inhibited all strains of Klebsiella, Enterobacter, and Pseudomonas aeruginosa in concentrations of 0.4 to 3.1 mug/ml and all strains of Escherichia coli and Proteus mirabilis in concentrations of 0.8 to 12.5 mug/ml. Whereas minocycline did not consistently inhibit these organisms in concentrations of 1.6 mug or less/ml, it did act synergistically with gentamicin against 43% of the Enterobacteriaceae tested in clinically achievable concentrations; significant synergy was most common with E. coli (60%). Minocycline inhibited 62% of Bacteroides fragilis, 71% of Clostridium, 40% of anaerobic cocci, and 40% of enterococci tested in concentrations of 1.6 mug or less/ml. Whereas gentamicin rarely inhibited these organisms in concentrations of 6.2 mug or less/ml, it did act synergistically with minocycline against 20% of B. fragilis, 67% of Clostridium, 22% of anaerobic cocci, and 22% of enterococci (which had minimal inhibitory concentrations of minocycline within the range tested) at clinically achievable concentrations. Although only four (13%) of the 30 isolates resistant to both gentamicin and minocycline alone were inhibited by clinically achievable concentrations of the combination, the observed synergy, particularly against strains of E. coli, was considered to be of potential clinical usefulness. Antagonism between gentamicin and minocycline was not observed at the concentrations tested.
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PMID:In vitro activity of gentamicin and minocycline alone and in combination against bacteria associated with intra-abdominal sepsis. 98 55

During January and February 1975, nine patients on a single ward of a rural Tennessee hospital unexpectedly developed sepsis. The aseptic technique employed in the management of intravenous infusions was implicated. Pseudomonas cepacia was recovered from the following: bloodstream, inuse intravenous infusions and the antiseptic, aqueous benzalkonium chloride. The outbreak again calls attention to the infection risk associated with the use of this product. Selection of less hazardous antiseptics and disinfectants is strongly recommended.
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PMID:Contaminated aqueous benzalkonium chloride. An unnecessary hospital infection hazard. 98 60


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