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

Neisseria meningitidis is a leading cause of bacterial meningitis and sepsis in the United States. N. meningitidis is classified into serogroups based on the antigenic characteristics of its capsular polysaccharide. During 1989-1991 in the United States, serogroups B and C accounted for most (91%) of invasive meningococcal disease while serogroup Y caused < 5%; however, during 1992-1995, serogroup Y accounted for an increasing proportion of meningococcal disease. This report describes the epidemiology of serogroup Y meningococcal disease (SYMD) during 1991-1996 in Illinois and Connecticut, which conducted enhanced surveillance through active reviews of clinical records and in areas participating in active laboratory-based surveillance during 1989-1995. The findings indicate a substantial increase in the proportion of meningococcal disease caused by N. meningitidis serogroup Y since 1989.
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PMID:Serogroup Y meningococcal disease--Illinois, Connecticut, and selected areas, United States, 1989-1996. 896 99

Meropenem is a new beta-lactam carbapenem antibiotic that appears to be promising in the treatment of hospitalized infants and children with serious infections. It has broad-spectrum activity against microorganisms, including most of the major aerobic (gram-negative and gram-positive) and anaerobic pathogens that cause serious bacterial infections in neonates and children. In addition, its pharmacokinetic profile makes possible parenteral administration every 8 hours. Several studies have demonstrated that meropenem is an effective and safe treatment for infants and children with serious pediatric infections (e.g., urinary tract infections, pneumonia, sepsis, intraabdominal infections, and skin and soft-tissue infections), bacterial meningitis, and cystic fibrosis. The results of further studies of the use of meropenem in the treatment of high-risk seriously ill infants and children are awaited with interest.
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PMID:Use of meropenem in the treatment of serious infections in children: review of the current literature. 912 95

Group B streptococcus (GBS) is the leading etiologic agent of bacterial meningitis and sepsis during the neonatal period, but it is an infrequent cause of meningitis in adults. We report 12 episodes of group B streptococcal meningitis in adults and review 52 cases reported in the literature. A total of 24 men and 40 women were included in the study; the mean age (+/- SD) was 49.2 +/- 20.5 years (range, 17-89 years). All the patients had cerebrospinal fluid cultures positive for GBS. Eighty-six percent of the patients had comorbid conditions, 50% had a distant focus of infection, and blood cultures yielded GBS for 78.7%. The overall case-fatality rate was 34.4% (22 patients). Factors associated with a poor outcome were advanced mean age (+/- SD) (61.5 +/- 17.4 years vs. 42.8 +/- 19.2 years; P = .0003) and the presence of complications on admission (P = .0001). Seven percent of survivors had neurological sequelae. Group B streptococcal meningitis in adults has become increasingly frequent in recent years; it tends to occur in patients with severe underlying conditions and is associated with a high case-fatality rate. Factors associated with a poor prognosis are advanced age and the occurrence of neurological and extraneurological complications.
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PMID:Group B streptococcal meningitis in adults: report of twelve cases and review. 970 5

Carbapenems are active beta-lactam antibiotics versus most of the gram positive and gram negative microorganisms and anaerobes although their activity is lacking in the case of Staphylococcus sp. resistant to methicillin, Enterococcus faecium and Streptococcus pneumoniae with high resistance to penicillin and some gram negative bacilli which naturally produce an methaloenzyme able to hydrolyze them such as Stenotrophomonas maltophilia. Imipenem, the first synthetized carbapenem requires administration with cilastatin to avoid inactivation by renal dehydropeptidase 1. Meropenem does not require being taken with the renal enzyme inhibitor, with its activity being similar to that of imipenem. In abdominal infection the carbapenems have shown to be the authentic monotherapy in this type of infections being as effective as the different schedules of antibiotic associations normally used. Treatment with carbapenems in bacterial meningitis should be currently limited to the cases produced by gram negative bacilli producers of wide spectrum beta-lactamases (WSBL), cases of meningitis by Pseudomonas aeruginosa or gram negative bacilli producers of inducible cephalosporinase. Meropenem is the carbapenem of choice probably in these cases because the carbapenems are often the only active antibiotics and meropenem, specifically, does not have the risk of convulsions observed with imipenem-cilastatin. The carbapenems have shown to be useful in skin and soft tissue infections as well as in obstetric and gynecologic infections as monotherapy similar to the schedules of the currently used antibiotic associations. In the case of nosocomial pneumonias, all the studies have evaluated the carbapenems in monotherapy as useful and effective, specially in the case of pneumonia by gram negative bacilli. Finally, in non filiated nosocomial sepsis and specially in the case of neutropenic patients, the use of carbapenems is particularly attractive in gram negative sepsis in intensive care units. The appearance in the last few years of strains of gram negative bacilli, producers of wide spectrum beta-lactamase or stable repressed hyperproducers of class I chromosomic cephalosporinase, as well as other multiresistant gram negative bacilli, such as Acinetobacter baumanii make the carbapenems, in many cases, the only effective antibiotic in this type of infections.
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PMID:[The role of carbapenems in the treatment of nosocomial infection]. 941 75

Haemophilus influenzae type b (Hib) causes serious invasive diseases among previously healthy children aged <5 years. Before the availability of conjugate vaccines in 1988, Hib was the most common cause of bacterial meningitis among preschool-aged children. Since 1993, the incidence of Hib invasive disease (defined as illness clinically compatible with invasive disease such as meningitis or sepsis, with isolation of the bacterium from a normally sterile site) among children aged <5 years has declined >95% in the United States. This report describes the continued decline of reported Hib invasive disease cases and underscores the need for investigation of Haemophilus influenzae (Hi) invasive disease cases.
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PMID:Progress toward eliminating Haemophilus influenzae type b disease among infants and children--United States, 1987-1997. 984 25

Bacterial meningitis is usually associated with pleocytosis of the cerebrospinal fluid due to the presence of polymorphonuclear leucocytes. However, 75 cases of bacterial meningitis without pleocytosis have been published. Normocellular bacterial meningitis accounts for 3.5% (1-42%) of all patients suffering from bacterial meningitis and is seen in all age groups: The finding can be explained by three different mechanisms including 1) lumbar puncture performed early in the course of meningitis, 2) immune deficiency, and 3) relative leucopenia due to severe sepsis. Normocellular bacterial meningitis is in general associated with a good prognosis except for cases with severe underlying diseases. A high concentration of bacteria in a normocellular cerebrospinal fluid might also indicate a poor prognosis.
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PMID:[Normocellular bacterial meningitis]. 985 Jun 14

Neisseria meningitidis, a leading cause of bacterial meningitis and sepsis in children and young adults in the United States, causes both sporadic disease and outbreaks. Preventing and controlling meningococcal disease remains a public health challenge because of the multiple serogroups and the limitations of available vaccines. Vaccination with the polysaccharide meningococcal vaccine, which protects against serogroups A, C, Y, and W135 of N. meningitidis, is recommended by the Advisory Committee on Immunization Practices (ACIP) for controlling outbreaks but routine vaccination is not recommended for control of sporadic cases. During 1998, a cluster of meningococcal disease cases occurred in Rhode Island, and although the situation did not meet ACIP criteria for an outbreak, the Rhode Island Department of Health recommended vaccination of all residents aged 2-22 years. This action stimulated controversy in Rhode Island and the rest of New England (Connecticut, Maine, Massachusetts, New Hampshire, and Vermont) and prompted a review of the epidemiology of meningococcal disease in the region. This report describes meningococcal disease data reported to the region's state health departments during 1993-1998 and discusses the situation in Rhode Island.
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PMID:Meningococcal disease--New England, 1993-1998. 1045 36

Bacterial infections are an important cause of neonatal mortality and morbidity. The major pathogens for neonatal sepsis in the neonatal intensive care unit (NICU) vary with geographical area and time. It is therefore important to frequently audit neonatal sepsis in individual NICU, to aid in provision of adequate and appropriate preventive and therapeutic measures. We retrospectively reviewed the medical records of all infants who had positive blood cultures during a 2-year period in the NICU at a university hospital in Riyadh, Saudi Arabia. Overall the incidence of proven-bacterial-sepsis (PBS) was 10.2% of NICU admissions. The incidence of PBS in low-birth-weight (LBW), very low-birth-weight (VLBW), and extremely low-birth-weight (ELBW) infants were 19%, 41%, and 49% respectively. Multiple episodes of bacterial sepsis occurred in 21% of all infants infected. Coagulase negative Staphylococcus (CONS) (50%) was the most common infecting organism causing late onset sepsis (LOS) and Escherichia coli (29%) the most common causing early onset sepsis (EOS). Gram negative bacteria (GNB) were the infecting organisms in 50% of the EOS episodes and 29% of LOS episodes. Only 11% (14) of the PBS were EOS. Only 10 (10.4%) infants had bacterial meningitis. The overall PBS related mortality was 9%, representing 22% of all neonatal deaths.
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PMID:Pattern of proven bacterial sepsis in a neonatal intensive care unit in Riyadh-Saudi Arabia: a 2-year analysis. 1102 54

A prospective, hospital-based cerebrospinal fluid (CSF) analysis study was undertaken in 65 children who had diagnostic lumbar puncture on admission for suspected central nervous system infections. Twenty-three children were clinically diagnosed to have had sepsis and/or meningitis. CSF bacterial culture grew Haemophilus influenzae type b (Hib) in four cases and Streptococcus pneumonia (SP) was cultured in another child. Bacterial antigen was detected in 13 other CSF specimens and the pathogens were Hib (n = 9), SP (n = 3) and Group B Streptococcus (n = 1). No etiologic cause was identified to explain the abnormal CSF pleocytosis and biochemistry in the remaining five cases. In contrast, the CSF analysis was normal in 42 other children with probable viral and non-infectious neurological condition, mostly febrile convulsions. The overall frequency rate for all types of meningitis and especially for Hib meningitis were 43 and 31 cases per 100,000 children < 5 years of age, respectively. These findings support our earlier observations that Hib meningitis still remains the leading cause of childhood meningitis in our region. Also it reaffirms the observation that bacterial meningitis may often be under-reported if CSF positive culture alone is considered for the diagnosis.
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PMID:Haemophilus influenzae type b still remains a leading cause of meningitis among unvaccinated children--a prospective CSF analysis study. 1119 Nov 42

Apoptosis and necrosis in brain account for neurological sequelae in survivors of bacterial meningitis. In meningitis, several mechanisms may trigger death pathways leading to activation of transcription factors regulating caspases mRNA synthesis. Therefore, we used a multiprobe RNA protection assay (RPA) to examine the expression of 9 caspase-mRNA in the course of experimental Streptococcus pneumoniae meningitis in mouse brain. Caspase-6, -7 and -11 mRNA were elevated 6 hours after infection. 12 hours after infection caspases-1, -2, -8 and -12 mRNA rose. Caspase-14 mRNA was elevated 18 h and caspase-3 mRNA 24 h after infection. In situ hybridization detected caspases-3, -8, -11 and -12 mRNA in neurons of the hippocampal formation and neocortex. Development of sepsis was paralleled by increased transcription of caspases mRNA in the spleen. In TNFalpha-deficient mice all caspases examined were less upregulated, in TNF-receptor 1/2 knockout mice caspases-1, -2, -7, -11 and -14 mRNA were increased compared to infected control animals. In caspase-1 deficient mice, caspases-11, and -12 mRNA levels did not rise in meningitis indicating the necessity of caspase-1 activating these caspases. Hippocampal formations of newborn mice incubated with heat-inactivated S. pneumoniae R6 showed upregulation of caspase-1, -3, -11 and -12 mRNA. These observations suggest a tightly regulated caspases network at the transcriptional level in addition to the known cascade at the protein level.
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PMID:Transcriptional regulation of caspases in experimental pneumococcal meningitis. 1141 71


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