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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of obligate anaerobes was studied prospectively in 60 patients with severe sepsis of intra-abdominal, soft tissue, female genital or oropulmonary origin. In addition, the efficacy of clindamycin (for anaerobes) plus gentamicin (for aerobic bacteria, especially coliforms) as initial empiric therapy in these patients was evaluated. Among 54 patients with cultural proof of infection, anaerobic pathogens were recovered from 52%. Nineteen patients had bacteremia; Bacteroides fragilis and Klebsiella pneumoniae were the most prevalent pathogens, being isolated in five patients each. Infection was eradicated in 56 of the 60 patients (93%). Mortality related to sepsis was 7% in the entire group, 16% in patients with bacteremia and 2% in patients without bacteremia. Eighty-five percent of aerobic isolates tested were susceptible in vitro to either gentamicin or clindamycin; 97% of anaerobic isolates were inhibited by 5 mug/ml of clindamycin.
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PMID:Clindamycin plus gentamicin as expectant therapy for presumed mixed infections. 100 Apr 57

Over a 12 month period, 61 isolates of methicillin-resistant Staphylococcus aureus (MR-SA) were obtained in 23 hospitalized patients. Eight-six per cent of the patients were over 50 years of age, and 91 per cent were in the postoperative period. In 10 patients (42 per cent), MR-SA was the major pathogen, producing either pneumonia, empyema, osteomyelitis, lung abscess, enterocolitis, wound infection or bacteremia with sepsis. Three patients in this group died despite therapy with antibiotics with in vitro activity against these organisms. All the patients probably acquired their MR-SA in the hospital, and five carriers of the organism were identified among hospital personnel. This outbreak demonstrates the ability of MR-SA not only to colonize many patients in a relatively brief period of time, but also to produce serious disease.
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PMID:Clinical, epidemiologic and bacteriologic observations of an outbreak of methicillin-resistant Staphylococcus aureus at a large community hospital. 104 60

A case of recurrent sepsis due to Aeromonas hydrophila in a patient with acute myelogenous leukemia is reported. The patient's first infection leading to bacteremia followed contamination of a mosquito bite by stagnant water. After recovery from the first bacteremia, the patient again became septic with a second strain of Aeromonas hydrophila, which again responded to antimicrobial therapy. It is hypothesized that contamination of the local water supply may have led to the establishment of a gastrointestinal carrier state that produced the second bout of Aeromonas sepsis when the patient was markedly leukopenic. The importance of the oxidase test to differentiate Aeromonas species from members of the family Enterobacteriaceae is re-emphasized.
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PMID:Recurrent Aeromonas sepsis in a patient with leukemia. 106 Mar 78

Cyclophospamide was given in two dose schedules to 25 patients with a variety of nonlymphoid solid tumors. Eleven patients were given 18 courses of cyclophosphamide at a total dose of 60 mg/kg. Sixteen patients received 26 courses at a total dose of 100 mg/kg. Two patients were treated with both regimens. Partial responses were achieved in two patients treated with 60-mg/kg dose of cyclophosphamide. One of these patients had osteogenic sarcoma and the other had renal carcinoma. The higher dose also produced two partial responses, one in a patient with anaplastic carcinom a of the lung and the other in a patient with anaplastic carcinoma of the lung and the other in a patient with embryonal testicular carcinoma. Mean leukocyte counts fell to a nadir of 1400 cells/mm after 60 mg/kg while they dropped to below 1000 cells/mm for 5 days after 100 mg/kg of cyclophosphamide. Mean platelet counts remained above 150,000 platelets/mm after both cyclophosphamide schedules. In fective complications were documented aftter three of the 18 courses at 60 mg/kg and after ten of the 26 courses at 100 mg5kg. In the latter group, there were three episodes of bacteremia, including one death from pseudomonas sepsis. Nonhematologic toxicity noted with the 100-mg/kg dose of cyclophosphamide included rare instances of electrocardiogram changes and serum enzyme alterations compatible with myocardial toxicity. The intensive cyclophosphamide therapy did not appear to result in an increased antitumor response in malignancies usually considered to be refractory to alkylating agents.
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PMID:Intensive cyclophosphamide (NSC-26271) therapy for solid tumors. 109

Dry heat forms a specific burn toxin in mouse and human skin from a naturally occurring precursor by a polymerization process and not by producing breakdown products. Precursor and toxin are both macromolecular lipid-protein complexes with similar chemical composition and physical structure both occurring in mouse and human skin as well as in serum of burned patients. Specific toxicity resides only in the apoprotein of the polymeric toxic form which also has new specific artificially produced antigenic site or sites. This phenomenon makes it possible to jump the species from man to mouse, shown by the success of specific immunotherapy. Neutral apolar lipids of the coat are contributing in an unspecific but significant manner to the toxic effect. Bacteria are not involved in toxin production nor in toxin activity. The target systems of the toxin are the cell wall membranes of all parenchymal cells of paractically all organs. The toxin apparently causes severe damage of the membrane verified by an increased permeability for compounds which otherwise do not penetrate. This basic cell damage itself is able to kill the animal, depending on the ratio of intact to damaged cells. Sublethal doses of toxin, however, prepare the background upon which bacteremia in burn injuries leads to a lethal sepsis. Finally, the direct toxic action as well as the enhancement of the susceptibility for gram-negative organisms both leading to the lethal outcome can be counteracted by specific passive antitoxic immunotherapy.
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PMID:Experimental evidence for a significant impairment of host defense for gram-negative organisms by a specific cutaneous toxin produced by severe burn injuries. 116 80

The diagnosis of urinary tract sepsis is being made more often today because of increased awareness of the condition and improved techniques in the detection and management of genitourinary disorders. Patients developing urinary tract sepsis (bacteremia or septicemia) usually demonstrate certain predisposing factors: underlying chronic disease, advanced age, general debility, or recent urinary tract sepsis is easily made in a patient who has a sudden onset of fever, chills, malaise, nausea, and vomiting, along with tachycardia and a drop in blood pressure. Cultures should be taken from urine and blood samples, but therapy should be instituted immediately rather than after obtaining the results of cultures.
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PMID:Treatment of genitourinary infections. 122 Sep 5

An experimental model was designed to evaluate a combined protocol of active immunization and granulocyte transfusions for treatment of Pseudomonas aeruginosa sepsis in the neutropenic host. One member of a pair of dogs was immunized with P. aeruginosa vaccine. Both dogs were then rendered transiently neutropenic with a single intravenous dose of cyclophosphamide (40 mg. per kilogram) and challenged with an intravenous inoculum of P. aeruginosa. Twenty-four and 48 hours after pseudomonas challenge each animal received granulocyte transfusions. Effectiveness of therapy was evaluated by observation of survival time, febrile response, and quantitative blood cultures. Results showed a significant increase in the survival period (P is less than 0.05), a lower febrile response (P is less than 0.025), negative blood cultures, and a greater recovery rate in the immune group. Immune dogs that died had negative blood cultures or less than or equal to 10 pseudomonas per milliliter of blood despite the presence of P. aeruginosa in tissues. In contrast, control dogs had septic deaths within 67 hours of pseudomonas challenge, marked febrile responses with 24 hours of infection, and positive blood cultures with 4,000 to 25,800 pseudomonas per milliliter of blood. These data show that combined therapy with immunization and granulocyte transfusions is effective in reducing the severity of P. aeruginosa infection and in preventing bacteremia during periods of leukopenia.
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PMID:Combined pre-immunization and granulocyte transfusion therapy for treatment of pseudomonas septicemia in neutropenic dogs. 127 Aug 91

We did a retrospective study of Staphylococcus aureus bacteremia--from removable foci of infection--treated with short course antimicrobial therapy. Patients with S. aureus endocarditis were excluded from our study. The majority of patients had sepsis from intravascular devices. After removal of the focus of bacteremia, antibiotics were administered for a mean period of 15.2 days. There were no relapses, and no patient developed endocarditis. A 10- to 21-day antibiotic regimen can be curative in S. aureus bacteremia associated with a removable focus of infection.
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PMID:Therapy of Staphylococcus aureus bacteremia associated with a removable focus of infection. 127 57

Many microorganisms are able to produce neuraminidase, which can uncover the T antigen on red blood cells and cause hemolysis. We studied T activation in 224 patients with positive blood cultures. Only those patients were included who had real bacteremia according to clinical parameters and microbiological results. None of our patients showed T transformation. We conclude that T activation is a rare or a very passing phenomenon which has less importance in routine diagnosis of sepsis.
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PMID:[Liberation of the T-antigen in bacteremia]. 128 44

Enterococci are a frequent cause of hospital-acquired infection, being associated with urinary tract infections, wound sepsis, bacteremia, and endocarditis. The source of infection is usually thought to be endogenous, but some evidence points to cross-infection between patients. A better understanding of the epidemiology of enterococci has been limited by the lack of a good discriminatory typing system. This report describes the application of two DNA-based typing methods to Enterococcus faecalis and Enterococcus faecium: comparison of restriction fragments from total DNA by conventional electrophoresis and comparison of restriction fragments hybridizing to an rRNA gene probe (ribotyping). Comparison of restriction fragments (from SstI digestion) by conventional electrophoresis was simple and highly discriminatory. The results of analysis of blood culture isolates and of repeat isolates from individual patients are reported. Ribotyping (with BscI digestion) was more applicable at the level of species discrimination.
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PMID:Typing of Enterococcus species by DNA restriction fragment analysis. 131 38


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