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

This is a retrospective study of 133 episodes of bacteremic infection in 112 hemodialysis patients. The frequency of bacteremic infection was 9.5% in patients with chronic renal failure and 10.9% in patients with acute renal failure. In patients with acute renal failure, pneumonia and intra-abdominal abscess were the most frequent sources of septicemia. Sepsis was usually due to Gram-negative organisms and mortality was high. In patients with chronic renal failure, infection of the shunt or fistula was the most common cause, was frequently due to Staphylococcus organism, and had a more favorable survival rate. Gram-negative septicemia from a nonaccess source in patients with chronic renal failure was associated with a higher mortality. Bacterial endocarditis and septic pulmonary emboli occurred in 3.6% of septic episodes and 0.35% of patients at risk and had very low mortality. A low threshold for obtaining blood cultures and early antibiotic treatment are believed to be important in the treatment of bacteremic infections in patients undergoing long-term hemodialysis.
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PMID:Bacteremic infection in hemodialysis. 50 22

Staphylococcus aureus resistant to bactericidal activity of antibiotics caused sepsis in three patients. Bacteriological and clinical responses were not achieved until serum and tissue fluid levels of administered antibiotics exceeded the minimum bactericidal concentration (MBC) of the infecting organism. Fifteen clinical isolates of S. aureus were tested in brain heart infusion broth and Mueller-Hinton broth for the MBC of gentamicin, vancomycin, clindamycin, oxacillin, cefazolin, and cephalothin. Results showed significant eightfold or greater broth-dependent differences in the MBC of at least one antibiotic against 87% (13/15) of strains tested. The MBC was unpredictable and varied with the strain, antibiotic, and medium used. No controlled studies are available to indicate the clinical significance of the MBC demonstrated in different media. The necessity for treating serious infection with bactericidal drugs has not yet been established; however, in septicemia such as that caused by bacterial endocarditis, bacteriostatic antibiotics have generally failed to eradicate the infection, whereas bactericidal agents have often been curative. Therefore, in patients unresponsive to usual antistaphylococcal therapy, we suggest that MBC testing be performed in at least two media and that treatment be instituted with antibiotics demonstrating the lowest MBC in all media used.
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PMID:Medium-dependent variation in bactericidal activity of antibiotics against susceptible Staphylococcus aureus. 66 94

PC-904 was administered to 16 pediatric patients and the following basic and clinical results were obtained. (1) PC-904 was administered 20 approximately 30 mg/kg. The serum peak level of PC-904 after drip intravenous infusion over 1 hour was 66.7 microgram/ml at 1 hour and T 1/2 of PC-904 was 67.8 minutes. PC-904 was administered 25 approximately 30 mg/kg intravenous one shot injection was 49.4 microgram/ml at 1 hour and T 1/2 of PC-904 was 52.2 minutes. (2) Urinary excretion rate was about 20% up to 6 hours after drip intravenous infusion of 20 mg/kg. In a case of intravenous one shot injection of 25 approximately 30 mg/kg, the excretion rate was 11.9 approximately 19.9%. (3) PC-904 was administered 60 approximately 120 mg/kg/day for 3 approximately 48 days to 5 cases of sepsis and bacterial endocarditis, 6 of pneumonia, 2 of sss syndrome (staphylococcal scald skin syndrome) and 3 of pyelonephritis. Clinical effects were excellent in 11 cases and good in 5 cases, effective ratio being 100%. (4) Pseudomonas aeruginosa, Staphylococcus epidermidis, Streptococcus viridans, Acinetobacter anitratus and Hemophilus influenzae isolated from clinical specimens disappeared by the treatment of PC-904, and Hemophilus influenzae isolated from clinical specimens disappeared by the treatment of PC-904. Escherichia coli and Klebsiella pneumoniae reduced. (5) As to the side effect by PC-904, s-GOT and s-GPT were elevated in 2 cases. Anemia, rash and fever were observed in each 1 case out of 16 patients though the causal relation with the agent was unknown.
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PMID:[Basic and clinical studies on new semisynthetic penicillin, PC-904, in pediatric field (author's transl)]. 69 Dec 65

Alpha-hemolytic Streptococci were associated with 29 episodes of sepsis (12 polymicrobial) in 27 patients with cancer during a nine year period. Only two patients had dental manipulation prior to the onset of sepsis, but each had received chemotherapy and 75% were granulocytopenic (PMN less than 500/mm3) at the time of the infection. None of the patients developed bacterial endocarditis. Unlike the normal host in whom a transient bacteria with alpha-hemolytic Streptococci may occur following dental extraction or periodontal procedures, the cancer patient is at risk for more clinically significant sepsis. This risk is probably related to the presence of chemotherapy-induced oral mucusitis and granulocytopenia, and our results suggests that isolation of alpha-hemolytic Streptococci in febrile cancer patients should not be dismissed as a contaminent.
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PMID:Alpha-hemolytic streptococci: clinical significance in the cancer patient. 72 99

The risk of bacterial endocarditis in infants with bacterial sepsis was assessed by review of clinical and autopsy records (1930 to 1972). There were 12 cases of bacterial endocarditis among 847 patients (1.4%) dying with bacterial sepis; a single survivor was noted during the entire period. Of the 12 autopsy patients, six had underlying congenital heart disease (CHD). Among 61 patients with bacterial sepsis associated with CHD, six acquired bacterial endocarditis (10%), whereas in 786 infants with sepsis but without underlying heart disease, only six developed bacterial endocarditis (0.8%) (P less than .01). There is a high mortality in infants with bacterial endocarditis, and an increased risk of it in infants with sepsis and CHD.
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PMID:Bacterial endocarditis in children under 2 years of age. 111 55

Human infection with Pasteurella multocida is the leading cause of animal bite wound infection. Life-threatening infection may occur in patients with a variety of underlying disorders and an immunocompromised state. Infective endocarditis with P. multocida is very rare and only a few clinically diagnosed cases have been reported. Described here is an autopsy case of a 61-year-old man with polycystic kidney disease who had P. multocida bacteremia and acute infective endocarditis with multiple bacterial clumps involving bicuspid aortic valve. The organisms were gram negative. Apparently the sepsis with P. multocida was acquired via licking of leg ulcers by his pet dog, establishing an animal-related causal relationship. Because P. multocida is a very common flora of many animals, infection with this organism probably occurs more frequently than is commonly appreciated. High index of suspicion and early diagnosis, especially in immunocompromised patients, are warranted because the disease is potentially life threatening, yet is a readily treatable infection.
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PMID:Pasteurella multocida endocarditis. 146 53

A strain of Methicillin-Resistant Staphylococcus aureus (MRSA) was first isolated in our hospital in March 1986. Since then, MRSA has become a difficult pathogen and a cause of sepsis, bacterial endocarditis, and pneumonia in 1988. Rigorous hospital-wide control measures have been planned. The major control measures, based on the various investigations reported, consist of the following three points; improvement of environmental control, reinforcement of handwashing practices during care and control usage of antibiotics. The frequency of isolation of MRSA among the S. aureus isolates was 43.3% in 1988 and this was further reduced to 31.7% in 1990. The total number of MRSA isolates from decubitus, bile, and blood samples have also declined. This decline resulted in a reduction of cases of severe MRSA infection. As yet, MRSA strain are still isolated on incubation. There may be a limit to complete control by measures in a single hospital. It is desired that regional measures and national consensus on nosocomial infection be established.
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PMID:[An attempt to control nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection]. 150 24

Infected (mycotic) aortic aneurysms are infrequent and, without surgical intervention, usually lead to uncontrolled sepsis or catastrophic hemorrhage. Symptoms are frequently absent or non-specific during the early stages, and a high index of suspicion is essential to make the diagnosis. Surgery performed after rupture carries high morbidity and mortality rates. Bacterial endocarditis with streptococcus pyogenes was the most common cause of infected aortic aneurysm in the pre-antibiotic era. Today, arterial trauma due to iatrogenic manipulation and depressed immunocompetence have become more common risk factors. Staphylococcus aureus and Salmonella are the most frequent bacteria identified. The authors' recent experience in six patients with infected aortic aneurysms who underwent arteriography and computed tomography was reviewed and these diagnostic methods compared. Computed tomography was found to be more sensitive in the diagnosis of the early stages of the disease, allowing for follow-up by serial scans in a noninvasive and less costly manner. Successful treatment, in four of these patients, was accomplished by aneurysmal resection and extra-anatomic bypass or in situ prosthetic reconstruction. A higher clinical awareness of this disease, leading to early computed tomography evaluation and prompt surgical intervention under appropriate and intensive antibiotic therapy, appears to offer the best chance of survival in patients with this difficult condition.
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PMID:Infected aortic aneurysms. A changing entity. 161 80

A 61-year-old female developed subarachnoid hemorrhage after trans-sphenoidal surgery for Rathke's cleft cyst. Neuroradiological examination revealed a large aneurysm at the C1 portion of the right internal carotid artery. Autopsy revealed marked proliferation of aspergillus hyphae in the wall of the aneurysm. A review of previously reported cases of fungal aneurysm proposes two developmental processes. Aneurysms secondary to fungal meningitis tend to be large in size and located in the major cerebral artery trunk, but aneurysms following fungal sepsis tend to be small and in peripheral branches. The former aneurysms are probably caused by fungus invasion into the intracranium, usually from the paranasal sinus, and the latter may be due to fungal emboli like bacterial emboli in bacterial endocarditis. Ruptured fungal aneurysms are difficult to treat, so fungal meningitis or sepsis must be eradicated before an aneurysm develops.
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PMID:Aspergillus mycotic aneurysm--case report. 172

Septic complications after cardiac catheterization and percutaneous transluminal coronary artery angioplasty are distinctly uncommon. However, we have recently treated nine patients with sepsis and life-threatening complications after cardiac catheterization alone or after catheterization and subsequent percutaneous transluminal coronary angioplasty. The common denominator in all patients was either repeat puncturing of the ipsilateral femoral artery or leaving the femoral artery sheath in for 1 to 5 days after the procedure. Two patients died as a direct result of their septic complications. One death occurred in a patient in whom bacterial endocarditis with congestive heart failure developed, and the other patient had a large retroperitoneal hematoma that became secondarily infected. Infected aneurysms that were successfully treated developed in three patients. Our study suggests that colonization of the needle tract by skin flora predisposes to septic complications if repeat arterial punctures are required or if a femoral artery sheath is left in place for more than 24 hours. Patients in whom sepsis develops after these procedures should be initially treated with antibiotics effective against gram-positive organisms. CT scanning or angiography should be considered for patients with persistent sepsis, septic emboli, and abdominal or flank pain. Infected aneurysms require resection or ligation because of the propensity of these aneurysms to rupture.
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PMID:Septic complications after cardiac catheterization and percutaneous transluminal coronary angioplasty. 186 27


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