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

Group B streptococci, a frequent cause of neonatal sepsis and meningitis, postpartum endometritis, and bovine mastitis, may be acquired by several modes of transmission. Detailed epidemiologic study is hampered by the lack of a sufficiently discriminatory typing system, especially for type III and nontypable strains. We examined 54 epidemiologically well-characterized strains by restriction endonuclease analysis (REA) and compared the results with those obtained by serotyping. REA patterns were inspected without knowledge of the epidemiological or serotyping data. Among 21 type Ia, Ia/c, and Ib/c isolates, we found 10 REA patterns; among 5 type II and IIc isolates, we found 5 REA patterns; among 13 type III isolates, we found 6 REA patterns; and among 15 nontypable human and animal isolates, we found 7 different REA patterns. Double digestion of type III isolates with EcoRI and BglII helped us to distinguish the isolates. In total, 28 REA patterns were found in six serotype groups and one nontypable group. Some geographically and epidemiologically separate isolates had identical REA patterns, suggesting dissemination of a limited number of clones. We conclude that REA is a promising tool for detailed epidemiological study of group B streptococci.
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PMID:Restriction endonuclease analysis of human and bovine group B streptococci for epidemiologic study. 266 44

The measurement of colloid-oncotic pressure (COP) in 160 women with pyoseptic disease (pyodermia, soft-tissue abscesses, suppurative mastitis, endometritis, sepsis) has demonstrated a regular pattern of change, depending on the clinical condition. A classification of COP disorders has been proposed, identifying the hyperoncotic state (COP above 3.29 kPa), normoncotic state (COP between 2.84 and 3.29 kPa) and hypo-oncotic state (COP below 2.84 kPa), on which a differential remedial therapy is based. A reliable assessment of COP values during the infusion therapy can only be made by means of oncometry, since estimations of any kind lead to considerable error.
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PMID:[Differential correction of disorders of colloid-oncotic blood pressure in pregnant women and puerperants with suppurative-septic diseases]. 273 6

The identification of risk factors for intra-amniotic infection may allow changes in obstetric management and reduce complications. In a pilot study, stepwise logistic regression identified duration of ruptured membranes and duration of interval monitoring as significant risk factors for intra-amniotic infection. Using the preliminary regression equation, we established critical durations (risk criteria) to predict a 20% or greater probability of intra-amniotic infection. Subsequently, 2908 patients were screened prospectively for risk criteria and/or the presence of intra-amniotic infection. Seven hundred five patients of the 2908 (24%) met the risk criteria, and 107 of 124 cases of intra-amniotic infection (86%) met the risk criteria. In patients meeting the risk criteria, the relative risk of intra-amniotic infection was 19.7. In addition, 81 of 705 (12%) of mothers developed endometritis. Ten neonates of mothers with criteria developed sepsis or pneumonia. A stepwise logistic regression performed on the prospectively gathered data showed that among patients meeting risk criteria, parity, duration of internal monitoring, and duration of membrane rupture were the significant risk factors for intra-amniotic infection.
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PMID:Logistic regression analysis of risk factors for intra-amniotic infection. 292 51

The efficacy of sulbactam plus ampicillin in the treatment of various gynecologic infections was evaluated in 24 women (median age, 35 years). Ten women had pelvic cellulitis plus vaginal cuff abscess; six, pyeloperitonitis; three, vaginal cuff abscess; three, surgical wound sepsis; one, tubo-ovarian abscess; and one, endometritis. Surgical procedures preceding infection included abdominal hysterectomy, ovarian cyst removal, ectopic pregnancy, correction of cystocele, and uterine dilatation and curettage. Twenty patients received 1 g of sulbactam plus 1 g of ampicillin per dose; four received 0.5 g of sulbactam plus 1 g of ampicillin per dose. The combination was given iv every 6 hr for three to four days and then im every 8 hr for three to five days (mean treatment duration, seven days). Pus cultures yielded Enterobacteriaceae (21 cases), enterococci (two), Bacteroides fragilis (12), other Bacteroides species (five), Peptococcus species (nine), Peptostreptococcus species (seven), and other anaerobes (five). Six infections were purely anaerobic; 18 were mixed. All but two infections were cured by both clinical and bacteriologic criteria, with no adverse reactions. Parenteral sulbactam/ampicillin seems safe and effective in the treatment of gynecologic infections of moderate severity.
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PMID:Efficacy of sulbactam plus ampicillin in gynecologic infections. 302 7

Chlamydia trachomatis is now recognized as the most common sexually transmitted disease organism in the United States. Although the potential for vertical transmission of C. trachomatis from pregnant women to their infants is well established, the extent to which infection adversely affects pregnancy and causes perinatal complications remains controversial. We report herein the results of a prospective study of 270 pregnant women with endocervical C. trachomatis compared with 270 matched control subjects (age +/- 1 year, race, and socioeconomic status). Among the entire group (n = 540), the rates of pregnancy complications were: premature rupture of the membranes, 54/270 (10%); preterm delivery, 55 (11%); amnionitis, 20 (4%); intrapartum fever, 23 (4.3%); small for gestational age, 76 (14.5%); postpartum endometritis, 31 (6%); and neonatal sepsis, 10 (1.8%). No statistically significant differences were noted between cases and controls for any of these variables. In the subset of women with recent or invasive chlamydial infection, indicated by the presence of IgM antibody against C. trachomatis, preterm delivery occurred in 13/67 IgM-positive versus 8/99 IgM-negative (p = 0.03) cases. Premature rupture of the membranes was present in 13/67 IgM-positive versus 8/99 IgM-negative (p = 0.03).
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PMID:Chlamydia trachomatis infection and pregnancy outcome. 310 88

The aim of the present study is, to describe the morbidity and mortality of 196 patients with an acute abdominal condition who underwent surgery at the Department of Gynecology and Obstetrics of the TU Munich between 1982 and 1986. This is a percentage of 2.7 of all 7,167 operations carried out during this period. 118 of these patients had an extrauterine pregnancy and were therefore excluded from the study. The second group of 79 patients, mostly with inflammatory diseases, were analyzed. In most of these cases the acute abdominal condition was caused by a tuboovarian abscess (48.1%), followed by peritonitis because of a bowel-disease (11.4%). 6 patients suffered from an abscessing endometritis due to a caesarean section with sepsis in 5 cases. A generalized peritonitis occurred in 5 cases and was treated with a planned relaparatomy with lavage. 63% of the patients had no complications within 28 days after operation, 13% developed a subileus; in 7% a relaparatomy was necessary. 6% of the patients had problems of wound-healing. One patient with stomach-cancer died 3 weeks after the operation because of a fulminant lung-embolism. Thus the mortality rate was 1.5%. A further 27% were treated at the intensive care-unit and 18% needed artificial respiration. The average postoperative period of hospitalisation was 15 days. In comparison, patients with elective operations remained 13 days. The morbidity and mortality of patients due to surgery of an acute abdominal condition was relatively small; postoperative complications could be well treated in all cases and is probably the result of a positive and early indication for surgical intervention.
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PMID:[Acute abdomen in gynecology]. 318 9

Decreases in plasma fibronectin levels following surgery and subsequent to trauma and sepsis have been previously reported. There have been no reports, however, regarding plasma fibronectin levels following cesarean section. Plasma fibronectin levels were followed for 3 days postpartum in 49 patients including cesarean section control patients, patients with cephalopelvic disproportion, pregnancy-induced hypertension, and endometritis. Cesarean section and cephalopelvic disproportion were not associated with a change in postpartum fibronectin levels. Pregnancy-induced hypertension and endometritis did show a significant increase (p less than 0.05) in plasma fibronectin levels. These levels are probably not decreased because of the large fibronectin pool in these otherwise healthy women.
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PMID:Postcesarean section plasma fibronectin levels. 334 22

In a study of 312 women with acute chorioamnionitis, 152 women received antibiotics before delivery, 90 received antibiotics after cord clamping, and 70 did not receive antibiotics. Antibiotics were administered during labor rather than after cord clamping if delivery was not imminent. Although endometritis developed more frequently in the patients receiving antibiotics after cord clamping, the difference was not statistically significant (5.6% versus 3.9%, difference not significant). There were two cases of verified sepsis in the group of infants (35 weeks) born to mothers receiving intrapartum antibiotics and there were eight cases in the no antibiotics group (p = 0.06). More importantly, in neonates greater than or equal to 35 weeks' gestational age, there was a significant difference in the frequency of positive blood cultures for group B streptococci (0/133 versus 8/140, p less than 0.05). We conclude that administration of antibiotics to the mother during labor may result in a decreased incidence of neonatal sepsis.
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PMID:Intrapartum treatment of acute chorioamnionitis: impact on neonatal sepsis. 342 Dec 56

Microflora of pathological biosubstrates from 25 patients aged from 18 to 41 years with criminal abortion complications such as sepsis, septic shock, septicemia, and septic pyemia, peritonitis and endometritis of various severity was studied. Obligate anaerobic organisms in association with facultative anaerobes were detected in 84 per cent of the patients. Bacteroids were isolated from operation materials of 36 per cent of the patients. Bacteroids in association with Staphylococcus aureus, peptostreptococci and enterococci were recorded in 16, 8 and 24 per cent of the patients, respectively. Composition of the anaerobic and facultative anaerobic microflora was analyzed in the patients with local and general infections. Antibiotic sensitivity assay of the bacteroids showed that rifampicin, metronidazole, levomycetin (chloramphenicol) and clindamycin were the most active drugs. The use of anaerobic techniques enabled to demonstrate that in patients with purulent septic complications of criminal abortion there prevailed anaerobic-aerobic associations. The results should be considered in treatment of gynecological patients with purulent septic infections.
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PMID:[Anaerobic microflora of patients with suppurative and septic complications after non-hospital abortions]. 343 93

Certain infections, such as UTI, may have an increased incidence during pregnancy owing to physiological changes. Between 2 and 10% of pregnant women have covert or asymptomatic bacteriuria which is associated with an increased incidence of acute symptomatic UTI in later pregnancy if left untreated. Thus antenatal screening to detect the presence of bacteriuria is justified. Most women will remain abacteriuric throughout the remainder of pregnancy after a single course of antibiotic therapy but a small percentage will fail to respond or have recurrent UTIs. Maternal infection with certain organisms, namely those which resist phagocytosis, may result in transplacental infection of the fetus in utero. Congenital syphilis is preventable and antenatal serological screening is usually routinely performed. Listeriosis following maternal infection in pregnancy is less predictable and the epidemiology of L. monocytogenes remains unclear. Genital tract carriage of sexually transmitted organisms, such as N. gonorrhoeae or C. trachomatis, may also be detected during pregnancy and antibiotic therapy will be indicated to eradicate such organisms and prevent maternal and neonatal morbidity. Antibiotic therapy during pregnancy will not, however, eradicate carriage of GBS from the genital tract, although carriage status at term can now be reliably predicted by using enriched culture techniques and swabbing multiple sites on more than one occasion. Where carriage is confirmed, the administration of intrapartum antibiotics to the mother appears a useful approach in the prevention of early onset neonatal GBS disease. Broad spectrum intrapartum antibiotics may also be indicated when there are complications, such as prolonged labour or premature rupture of membranes, which are associated with a higher incidence of maternal postpartum endometritis and morbidity than in women following uncomplicated vaginal delivery. Serious postnatal sepsis and shock is fortunately now rare. The pharmacokinetics of antibiotics in late pregnancy and the puerperium are altered and maternal serum levels may be reduced by 10-50%. Most antibiotics cross the placenta and are excreted in breast milk. Some agents, such as the beta-lactams, are considered safe in pregnancy and breast-feeding women while other antibiotics are contraindicated owing to risk of toxicity (often rare) or teratogenicity (often theoretical). Caution is necessary with many agents which may cause side effects or toxicity although this does not necessarily contraindicate their use in pregnancy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Prescribing in pregnancy. Bacterial infections in pregnancy. 352 53


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