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

The incidence of pelvic inflammatory disease (PID) attributable to IUD use has been increasing, especially after the removal of the Dalkon shield from the market, but this relationship has not been settled conclusively. In recent decades PID included a variety of infections, but lately the definition of PID has meant acute ascending infections of the female genital tract. Its most common risk factors include promiscuity of IUD use, although this can be reduced to one fourth by regular checkups and proper hygiene. The frequency of PID is estimated at 2-5% of IUD users. Microorganisms contributing to PID include Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Escherichia coli, Proteus, Staphylococcus epidermis, Haemophilus influenzae, Bacteroides, Peptococcus, Peptostreptococcus, Clostridium, and Actinomyces israelii, The differentiation of actinomycosis (AC) and pseudoactinomycosis (PAC) is well advised. The potential of IUD use in increasing the risk of AIDS should not be discounted. The clinical picture of PID is varied, it can be mild requiring conservative drug therapy; with medium severity requiring removal of the IUD and drug therapy; severe necessitating removal, antibiotics and sulfonamide treatment and laparotomy; and very severe with potentially fatal generalized sepsis. In addition to antibiotics, e.g., penicillin, treatment can include the so called catastrophy combination of Mandokef- Metronidazol-Gentamycin. An analysis of the data of 8536 IUD fittings in Debrecen, Hungary showed 1.4% removals due to PID after 4 years, 694 patients (8.1%) had lower abdominal pain 73 of which (0.9%) had palpable resistance, and suppuration occurred in only 30 cases (0.4%). Treatment included Semicillin or Tetran, or removal of the IUD, and even surgery if no improvement resulted. Prevention of PID include elimination of risk factors, the careful selection of IUD users, regular checkups, the use of copper (Cu) T device, and strict adherence to professional standards.
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PMID:[The role of intrauterine contraceptive devices in the development of inflammatory processes in the small pelvis]. 376 5

The safety and effectiveness of Timentin were evaluated in 34 adult patients with symptomatic complicated urinary tract infections, principally due to multiply-drug-resistant bacteria. Although a wide variety of organisms, particularly gram-negative bacilli, were found, Escherichia coli was the most frequent, accounting for 14 of 45 (31 percent) pathogens isolated. Ten (22 percent) isolates were Pseudomonas aeruginosa; 11 (24 percent) were Proteus or Morganella species; three (7 percent) were Citrobacter; one (2 percent) was Klebsiella pneumoniae; two (4 percent) were Staphylococcus aureus; and two (4 percent) were enterococci. Ninety-three percent of all pathogens isolated produced a beta-lactamase. Eight (24 percent) infections were polymicrobial; seven (21 percent) were associated with bacteremia. Clinical improvement occurred in 30 of 34 (86 percent) patients. All bacteremias were cured. Although bacteriologic cure occurred in only 32 percent of patients, control of sepsis and temporary eradication of bacteria (bacteriologic improvement) occurred in 96 percent. Not surprisingly, the rates of relapses and reinfections were high. It was concluded that Timentin is a useful agent in the management of complicated urinary tract infection and offers clinicians an alternative to more toxic antibiotics, such as aminoglycosides.
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PMID:Timentin in the treatment of symptomatic complicated urinary tract infections in adult patients. 385 37

Febrile episodes in 147 patients undergoing first remission induction therapy for acute leukemia were analyzed. Febrile episodes occurred 254 times in 136 patients. The cause of fever could not be identified in 54.3% of all episodes. Antibiotic therapy was effective in 81.1% of these episodes with no cause determined. Postmortem examinations proved infections in 65.2% of patients who had fever of unknown origin before death. Sepsis and pneumonia together accounted for 53.4% of documented infections. Sepsis and pneumonia occurred most often when the patients had neutropenia (less than 500/mm3). Increase in neutrophil count and achievement of hematologic remission produced good prognosis of the infections, and the reverse was also true in some patients. Fifty percent of fetal patients died of infection. The incidence of infections, especially pneumonia and infections caused by fungi and Proteus species indicating such infections were exogenous, reduced markedly in laminar air flow rooms.
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PMID:[Infectious complications and infection prevention in patients with acute leukemia]. 386 70

The incidence of urinary tract infections (UTI) in 299 renal graft transplantations (281 patients) was analyzed. UTI episodes were demonstrated in 185 grafts (62%), most frequently in the first month after transplantation. The infectious episodes were mostly recurrent. Persistent infection, detected in 11% of grafts, was associated with urologic complications in almost all cases. No significant correlation between the primary renal disease and the UTI rate was found, and there was no significant correlation between UTI and sex. In grafts with recurrent infectious episodes, vesicoureteral reflux was more common. No significant difference was observed in the residual bladder volume, irrespective of whether infection was present or not. The urine was infected by a number of hospital strains, particularly Klebsiella, Enterobacter and indole-positive Proteus strains. An overwhelming majority of UTI episodes (96%) were asymptomatic. Antibody-coated bacteria in urinary sediment were present in only 19% of infectious episodes. Clinically severe courses were observed in infections associated with urologic complications (especially urinary fistulae); these were difficult to treat and were often a source of sepsis and a risk factor in graft loss.
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PMID:Urinary tract infection in renal transplant patients. 390 20

Laboratory and clinical studies were performed on cefminox (CMNX, MT-141), a new cephamycin antibiotic, and results were as follows. Antimicrobial activities. MICs of CMNX against various clinical isolates were determined with the inoculum size of 10(6) cells/ml. Percentages of strains susceptible to 12.5 micrograms/ml or less were 4% for S. aureus, 0% for E. faecalis, 100% for E. coli, 81% for K. pneumoniae, 3% for Enterobacter sp., 18% for S. marcescens, 90% for P. mirabilis, 88% for indole-positive Proteus sp. 100% for S. flexneri, 100% for Salmonella sp., 0% for Citrobacter sp. and 0% for P. aeruginosa. Most of those sensitive strains were inhibited by 0.39-0.78 microgram/ml. These activities were better than those of cefmetazole and cefazolin, but were not as good as those of cefoperazone. Clinical efficacy Three patients with pneumonia, 1 with pneumonia and sepsis, and 1 with urinary tract infection were treated with CMNX daily dose of 1-4 g for 7-31 days. Clinical responses were excellent in 1, good in 3, poor in 2 patients (contained a double case). Bacteriological effects were good for E. coli, K. pneumoniae and S. liquefaciens, poor for P. aeruginosa and P. mirabilis. C. freundii, A. calcoaceticus and E. faecalis were cultured after treatment. No side effect and no abnormal change of laboratory findings were seen in our cases.
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PMID:[Laboratory and clinical studies on cefminox]. 393 Jul 82

Because of increased aminoglycoside resistance of hospital bacterial isolates, aminoglycoside sensitivity patterns of isolates in a large children's hospital were assessed before and during a 33-month period of almost exclusive amikacin use. There was no significant change in overall resistance rates of gram-negative enteric bacteria to gentamicin (4.8 percent and 4.6 percent), tobramycin (2.5 percent and 3.6 percent), and amikacin (1.2 percent and 1.8 percent) from the pre-amikacin period to the amikacin usage period, respectively. No significant differences were observed for isolates of Escherichia coli, Klebsiella, Serratia, Acinetobacter, and Pseudomonas species. In contrast, significant decreases in gentamicin and tobramycin resistance rates for Enterobacter, Citrobacter, and Pseudomonas aeruginosa and in gentamicin resistance of Proteus were found. Very little change in resistance of staphylococcal isolates was seen during a shorter evaluation period. Pediatric aminoglycoside usage includes therapy of neonatal infections, cystic fibrosis, febrile neutropenic episodes in patients with cancer, abdominal surgery, bacterial endocarditis, and gram-negative central nervous system infections. Amikacin has also been used successfully as single-dose therapy of urinary tract infections, and acceptable cerebrospinal fluid levels of amikacin have been documented in hydrocephalic patients with ventriculitis. In vitro studies of 22 bacterial isolates demonstrated synergy between amikacin and penicillin or newer cephalosporins in 13, an additive effect in seven and indifference in two. No antagonism was found. In addition, in vivo synergy between imipenem and amikacin was found in neutropenic infant rats with P. aeruginosa sepsis using a strain with which no synergy was demonstrable in vitro. Amikacin is effective in pediatric infections and is well tolerated by children. Because excessive or inadequate levels are frequent with usually recommended doses, particularly in neonates and patients with compromised renal function or cystic fibrosis, serum levels should be monitored to minimize risk and to ensure therapeutic levels.
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PMID:Treatment of pediatric infections with amikacin as first-line aminoglycoside. 402 67

The aetiology, pathogenesis, diagnosis and therapy of sepsis are dealt with in this paper. These problems are discussed on the basis of 151 patients treated for sepsis. The cases with monoinfection are 73.6% and those with polyinfection are 24.4%. Monoinfection is caused mainly by Staphylococci -65,3%, followed by E. coli - 15.2%, Proteus - 13% and Klebsiella - 3.3%. For the cases of polyinfection the gram-negative bacteria are 3:1 in respect to the gram-positive bacteria. The bacteriological finding from the haemoculture (92.8% mono- and 7.2% polyinfection) is not equal to this from the input source. Here also the cases of monoinfection are mainly caused by Staphylococci - 70.9%, followed by Proteus - 7.7%, E. coli - 6%, Klebsiella aerogenes - 5.1% and Streptococcus 2.6%. The gram-negative bacteria prevail in the cases of polyinfection. The virulent aggressive infection, bacteria resistant to antibiotics, the aggressive local infection, hypoproteinemia, anaemia, diabetes, a prolonged corticosteroid treatment and unsuitable antibiotic treatment are discussed as main factors predisposing to sepsis. All the 151 patients were treated with the complex therapy, recommended in this paper. It includes a surgical cleaning-up of the initial nidus, intensive reasonable antibiotic treatment against the gram-positive and gram-negative aerobes and anaerobes. Additionally, substitution of infusion therapy, parenteral nutrition, regulation of the pathophysiological deviations and stimulating therapy are carried out. 74.2% from the patients were cured, 25.8% died. 16.6% of the patients who died had sepsis caused by gram-positive bacteria, and 46.1% had sepsis caused by gram-negative bacteria. 17% of the patients who died had septicaemia and 22% had septicopyaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical problems of surgical infection. The Pirogov Institute for Emergency Medicine, Sofia]. 615 Jun 8

Mixed polyclonal cryoglobulinaemia was evidenced in a 49-year-old woman admitted to our hospital because of Proteus mirabilis sepsis associated with polyarthralgia and purpuric manifestations on the lower limbs. Cryoglobulins and circulating immune complexes decreased during the second week of illness and disappeared after recovery. CH50, C3 and properdin factor B, which were low during the early phase of the illness, returned to normal; C4 was normal throughout. The rapid clearance of cryoglobulins and immune complexes and the restoration of a normal complement profile might all be explained by the gradual elimination of P. mirabilis due to chemotherapeutic treatment.
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PMID:Cryoglobulinaemia in a patient with Proteus mirabilis sepsis. 621 95

Systemic bacterial infections due to Escherichia coli MB 2884, Proteus mirabilis MB 3125 and Klebsiella pneumoniae MB 4005 were well controlled by treatment with norfloxacin both in normal and streptozotocin-induced diabetic mice. similar observations were made when trimethoprim-sulfamethoxazole was used against susceptible pathogens. Systemic infection due to Pseudomonas aeruginosa MB 4700 was well controlled by norfloxacin and gentamicin in normal mice; this infection was more refractory to treatment by both drugs in diabetic animals. These observations suggest that norfloxacin may be an effective drug in the treatment of bacterial infections which may occur under diabetic conditions, and further investigation is warranted.
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PMID:Antibacterial efficacy of norfloxacin, trimethoprim-sulfamethoxazole, and gentamicin in experimentally-infected normal and streptozotocin-induced diabetic mice. 624 48

The mouse model of intraperitoneal sepsis with Proteus rettgeri was used to evaluate the anti-endotoxic effect of polymyxin B sulfate. An unexpected reversal of the usual protective effect of polymyxin in experimental enterobacterial sepsis was observed in which the lethality of the infection was enhanced.
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PMID:Lethal effect of polymyxin B sulfate in experimental Proteus rettgeri infection in mice. 625 Jun 90


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