Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Streptococcus agalactiae (group B streptococci [GBS]) is the leading cause of neonatal sepsis and meningitis in the United States. The surface-associated C proteins of GBS play a role in immunity, but their number, size, structure, function, and virulence properties have not been well characterized. A recombinant library of DNA fragments from GBS strain A909 (type Ia/C) was prepared in the plasmid pUX12, a specially constructed Escherichia coli expression vector. The library was screened with a rabbit antiserum shown to be protective for passive immunity to GBS infection in a mouse lethality model. Clones were divided into two distinct groups on the basis of DNA-DNA cross-hybridization, restriction enzyme analysis, and the expression of antigenic proteins in E. coli. A characteristic clone from each group was chosen for further study. Clone pJMS23 expresses gene products that biochemically and immunologically correspond to the trypsin-resistant, C-protein alpha antigen. Clone pJMS1 expresses a gene product that binds to immunoglobulin A and is similar to the trypsin-sensitive, C-protein beta antigen. Antisera raised in rabbits against E. coli containing each of the plasmid clones were able to elicit protective immunity in mice challenged by GBS strains carrying the C proteins but not by non-C-protein-bearing strains. Southern blot analysis shows no DNA homology between the clones, and there is no immunological cross-reactivity between the antigens they express. Therefore, pJMS23 and pJMS1 encode two different C proteins that define unique protective epitopes.
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PMID:Cloned alpha and beta C-protein antigens of group B streptococci elicit protective immunity. 167 38

During the last few years, among nosocomial pathogens, Acinetobacter spp. have given rise to an increasing number of nosocomial infections. Acinetobacter strains are widely distributed in nature; in hospitals, the human skin is the likely source for most outbreaks of hospital infections. The organism has been frequently found in the inanimate environment, especially in moist situations and it has been isolated from various types of opportunistic infections (septicaemia, endocarditis, meningitis, pneumonia, skin and wound sepsis and urinary tract infection). For epidemiological studies, various typing methods such as biotyping, bacteriocin typing and serology have been developed. More recently electrophoretic patterns of cell-envelope proteins and plasmid analysis have proved useful in differentiating outbreak strains. Antibiogram typing may be useful but the antibiotic resistance of Acinetobacter spp. has changed rapidly within the last few years and thus antibiotyping must be complemented by other typing systems. New methods such as electrophoretic analysis of isoenzymes, definition of plasmidotype profiles or restriction endonuclease digestion of chromosomal DNA are under investigation.
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PMID:Hospital infection with Acinetobacter spp.: an increasing problem. 167 90

We have recently cared for two patients with spinal sepsis secondary to infection with Streptococcus milleri. One patient had a spinal epidural abscess and the other had meningitis as well as a spinal subdural empyema. A review of the English-language literature revealed only two previously reported cases of spinal epidural abscess due to S. milleri and no cases of spinal subdural empyema due to S. milleri. We report two cases of spinal sepsis due to S. milleri and discuss pertinent literature.
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PMID:Spinal sepsis due to Streptococcus milleri: two cases and review. 168 78

Group B streptococci (GBS) are the leading causes of neonatal sepsis and meningitis in the United States, with a high rate of fatality and serious morbidity despite appropriate therapy. The C-protein antigens of GBS appear to be important in immunity to experimental infection, yet these antigens remain incompletely characterized with respect to their number, structure, and function. None of these proteins has yet been purified to homogeneity. We have developed a novel method for extraction of surface proteins from the A909 (Ia/c) strain of GBS by using mutanolysin. Antibodies raised in rabbits against these partially purified proteins conferred passive protection to lethal GBS infection in mice challenged with a GBS strain expressing C proteins with a heterologous capsule type. In addition, mouse monoclonal antibodies were produced and identified by reactivity with the mutanolysin-extracted proteins. One of these monoclonal antibodies (4G8) identifies an epitope on the alpha-antigen of the GBS C proteins (identified by protease susceptibility and mouse protection). On sodium dodecyl sulfate-polyacrylamide gels, this epitope appears as a series of regularly spaced bands ranging in apparent molecular mass from 160,000 to 30,000 Da. The monoclonal antibody 4G8 induces opsonic killing of GBS and protects mice from lethal challenge with GBS. Thus, the 4G8 monoclonal antibody identifies a fully protective epitope on the C-protein alpha-antigen of GBS.
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PMID:A monoclonal antibody identifies a protective C-protein alpha-antigen epitope in group B streptococci. 170 59

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

Despite significant advances in obstetric and pediatric health care, group B beta-hemolytic Streptococcus (GBS) remains one of the most prevalent and devastating pathogens in peripartum women and their newborn infants. It may cause urinary tract infection, chorioamnionitis and endometritis, bacteremia, and cesarean wound infection in the peripartum period. Moreover, GBS accounts for nearly 50% of serious neonatal bacterial infections. Approximately three in every 1,000 children born in the United States acquire pneumonia, sepsis, or meningitis from GBS, with combined mortality and morbidity exceeding 50% despite appropriate antibiotic and supportive therapy. Estimates indicate that more than 10,000 infants are affected annually, at a cost of more than $300 million. Neonatal disease is divided into early- and late-onset syndromes: The illness emerging after six days of age differs in terms of GBS serotype, clinical manifestations, and outcome from the disseminated process seen in earlier onset. We describe two infants infected with GBS and discuss risk factors, pathogenesis, diagnosis, therapy, and options for disease prevention in the peripartum woman and her infant.
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PMID:Group B streptococcus infection in mother and child. 174 82

Risk factors, clinical syndromes and the case-fatality rates associated with Group B Streptococcus (GBS) infections in infants managed at the University of Rochester Medical Center during 1979 to 1989 were reviewed. Overall 92 episodes of early onset disease (EOD) and 54 of late onset disease (LOD) were diagnosed in 143 infants (3 infants with EOD presented later with LOD). About one-third of patients with EOD and controls were non-white compared with two-thirds of patients with LOD that occurred in racial minority groups. Prematurity and low birth weight were significantly more common in patients with invasive GBS disease than in controls. Eighty-three of 92 (90%) cases of EOD were detected during the first day of life and 10 of 54 (19%) cases of LOD occurred in infants older than 3 months of age. At the time of diagnosis 4% of infants with EOD were asymptomatic, 54% had respiratory disease, 27% had sepsis without a focus, 15% had meningitis and 1% had urinary tract infection or omphalitis. Among infants with LOD 46% had sepsis, 37% meningitis, 7% urinary tract infection, 6% osteomyelitis and/or septic arthritis and 4% cellulitis or pneumonia. Leukopenia and shift to the left were observed in 43 and 61% of episodes of EOD and in 28 and 57% of episodes of LOD, respectively. All infants were promptly treated with antibiotics and vigorous supportive therapy. The case-fatality rate was 13% in EOD and 0 in LOD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The changing spectrum of group B streptococcal disease in infants: an eleven-year experience in a tertiary care hospital. 174 91

Between April and September 1991, 415 injured patients were treated at the University Hospital Rebro, Zagreb, 362 at the Department of Surgery and 53 at the Department of Neurosurgery. Infections developed in 15.7% of the injured patients (wound infections in 14.6% and sepsis or meningitis in 1.1% of the injured patients). 88.2% of wound infections as well as all sepsis and meningitis were hospital-acquired infections, while 7.95 of wound infections occurred within 48 h of injuring. The major pathogens, in 90% of cases, were the aerobic bacteria (Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter species) while 9% of infections were caused by mixed aerobic-anaerobic flora. One injured patient developed clinical features of gas gangrene. Neither streptococcal wound infections nor tetanus were present in this group of the injured patients.
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PMID:[Infections in war injuries]. 176 86

Maternal mortality is examined from June 1980 to December 1986 at Mulago, Nsambyo, Old Kampala, Rubaga, and Mengo Hospitals in Kampala, Uganda. Clinical or immediate causes, direct and indirect, were recorded from case summary forms based on ICD9 definitions of obstetric complications. The nonabortion maternal mortality rate (NAMMR) was 2.65/1000 deliveries (580 deaths); the abortion-related maternal mortality rate (ARMMR) was 3.58/1000 abortions. The hospital maternal mortality rate was 2.0/1000 deliveries. 75% of maternal deaths of women of 28 weeks' gestation or more had delivered outside the hospital. NAMMR doubled between 1980-86, a statistically significant increase. ARMMR increases were almost significant. 75% were direct obstetric and 21% were indirect obstetric causes. 38% had clinical anemia, 29% had some sepsis, 18% had substantial bleeding, and 14% had obstructed labor. Other contributing conditions were pneumonia, ruptured uterus, laparotomy, evacuations and curettage, malaria, preeclampsia, sickle cell anemia, pulmonary embolism, malnutrition, tetanus, meningitis, prolonged labor, and hepatitis. At admission, 48% were in poor condition, 30% in good condition, and 22% in fair condition. 27% had sickle cell anemia, high blood pressure, multiple pregnancy, or malaria at admission. 64% were admitted within 24 hours after delivery, 67% 1-7 days after delivery, and 92% 7-42 days after delivery. Those in good condition were all admitted 7 days postdelivery. 41% of deaths were due to lack of drugs, 7% lack of fluids, 20% with theater problems, 14% with doctor-related factors, and 3% with midwife-related factors. Better information is needed on mortality before delivery, mortality in hospitals vs. outside, and mortality from abortion, and ectopic and hydatidiform molar pregnancies. An explanation given for the increase in maternal mortality is the decline in economic conditions. Abortion complications may be due to the concealment practiced. Causes are consistent with trends from the 1950s, 1960s, and 1970s in Uganda and developing countries in general. Availability and accessibility of gynecological and obstetric services needs great improvement. Training traditional birth attendants and obtaining rural ambulance services are also needed. Health workers lack creativity and imagination for developing country conditions; scarce resources are not the only problem.
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PMID:Incidence and causes of maternal mortality in five Kampala hospitals, 1980-1986. 176 15

Strictly enforced antibiotic formulary restriction in combination with formulation of agreed guidelines for antibiotic use in common infection problems such as septicemia, febrile neutropenia, urinary tract infection, biliary sepsis, liver abscess, peritonitis, nosocomial pneumonia, soft tissue infection and purulent meningitis, generated a combined savings of 307,748.5 bahts or 13.5 per cent cost reduction over a 6 month period, and improved quality of use, appropriate 54.8 vs 67.5 per cent, statistically significance (P less than 0.002). Although this saving was offset in part by increased spending of unrestricted antibiotics, such as Penicillin and Gentamicin, an overall cost saving remained. In the months during the restrictions, no significant changes occurred regarding patients response and mortality. However, after the onset of the controls, it was revealed that antibiotics were more appropriately used afterwards. This study has shown, most importantly, that savings were achieved with no negative effect on good patient care. Moreover, the antibiotic use control was operationally successful, most house-staff and attending physicians, not only antibiotic evaluating team, have accepted the program in a very positive way. Overall, this program successfully achieved its initial goal, cost saving without compromising good medical practice. We are now continuing our program and also trying to modify so that it will be useful to all departments in the hospital.
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PMID:Effect of a selective restriction policy on antibiotic expenditure and use: an institutional model. 176 42


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