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

Burn wound sepsis is still a common cause of death in burn injuries. Eighty percent of this infection is with colonisation from the patient and twenty percent as a result of cross infection. Most of the mortality is due to virulent cross infection. Pseudomonas has almost disappeared and multiple resistant staphylococcus aureus is the main pathogen today. It can cause loss of skin grafts and septicaemia, particularly due to colonisation of intravenous lines. The risk increases with the time since the burn injury. Early excision and grafting is important. With a large burn it is not possible to do this in one session and so the risk is increased with a compromised patient. Maintenance of a good diet and vitamin supplements is important, preferably orally or through a naso-gastric tube. Parenteral nutrition increases the risk of infection. Clinical infection is combated by good cleaning procedures, preferably with chlorhexidine solution and the application of a good topical agent such as Silvazine. The presence of bacteria in the wound must be monitored. Strict barrier nursing and personal hygiene, particularly hand washing, are the mainstay of cross infection prevention. Antibiotics may be required, monitored by blood cultures. Documenting MRSA is a good way to monitor the unit's infection prevention programme. The main preventive measures are early referral, early excision and grafting, good nutritional support, good topical agents and barrier nursing.
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PMID:Multiple resistant Staphylococcus aureus. 129 97

We administered teicoplanin as specific antibiotic therapy for nosocomial "ICU specific" infections with methicillin-resistant Staphylococcus aureus and epidermidis (MRSA-MRSE). The above mentioned drug has been given to 20 patients (15 newborns and 5 not-newborns) admitted into intensive care unit during the years 1988, 1989, 1990 with MRSA-MRSE localized and/or systemic infection, affected by severe disease (RDS, pulmonary edema, congenital cardiac disease, cystic fibrosis) undergoing invasive procedures which presented high nosocomial infective risk (tracheal intubation, mechanical ventilation, venous and arterial cannulation, total parenteral nutrition, etc.). Complete recovery from systemic or localized infection (sepsis, low respiratory tract infection, high respiratory tract infection) occurred in 19 out of 20 patients, with a rate of success of 95%. Teicoplanin treatment lasted from a minimum of nine days to a maximum of thirty days. The dose was 5-6 mg/kg/die in one administration for the first three days, then 4 mg/kg/die. The tolerability of teicoplanin has proven satisfactory, since we had no major side effects during treatment and follow up.
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PMID:[Teicoplanin therapy in neonatal and pediatric intensive therapy]. 138 7

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

MRSA strains were first isolated in 1981 and have increased markedly from 1985 in our surgical ward. One hundred and ninety four strains of MRSA were isolated and 81 cases developed critical infections which were associated with enterocolitis, pneumonia and sepsis. There were many cases in esophageal cancer patients. Bacteriological features of the MRSA strains clearly changed in 1985 from IV to II coagulase type, accompanied with high resistance for antibiotics. Our management against nosocomial infection for MRSA started from April 1988. The number of MRSA cases decreased in 1989, increased in 1990 and decreased again in 1991. We are confident that our management is effective and we will take further efforts to choose the most adequate antibiotics after surgery in our surgical ward.
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PMID:[Postoperative MRSA infections in digestive tract surgery]. 150 33

Multiple trauma patients requiring prolonged intensive care are at high risk of MRSA infections. Surgical debridement and proper antibiotic prophylaxis combined with isolation of this compromised host from indigenous bacteria are the mainstays of initial therapy to prevent this complication. If this develops postoperatively, the sites of infection vary among the patients, such as urinary tract, surgical wounds, the abdomen, respiratory tract, vascular catheters, etc. Clinical evidence of sepsis suggests that intra-abdominal and respiratory tract infection are major contributors to mortality. In a postoperative multiple trauma patient, with pneumonia, thoracic empyema, intraabdominal abscess, wound infection and sepsis caused by MRSA, surgical drainage of the abscess with systemic infusion of vancomycin was effective and resulted in full recovery.
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PMID:[MRSA infections in multiple trauma patients]. 150 34

In burn patients, MRSA was detected in the wound from the early stage to the wound closure stage. It is after the middle stage that sepsis by MRSA occurs. In comparison with Gram-negative bacilli, MRSA caused fewer sudden deaths, except for complications of toxic shock syndrome (TSS); MRSA was not considered to have a significant effect. The presence of a path of invasion into the blood other than the wound was suspected. Investigation of 35 Staphylococcus aureus sepsis patients (25 infected with MRSA) revealed that diagnosis is difficult when severe TSS occurs as a complication in sepsis. No correlation was found between toxic shock syndrome toxin-1 production by the bacterium detected and the onset of TSS. These findings suggest strong dependency upon the action of another toxin or endotoxin produced by Staphylococcus aureus and upon the immune condition of the host.
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PMID:[MRSA infection and toxic shock syndrome in burn patients]. 150 35

During the 12 year period from 1978 to 1990, 112 mature newborn and premature infants were diagnosed as sepsis in our nursery. The first case of MRSA sepsis was found in 1985. Since then, cases abruptly increased in number and 31 cases were found in total. Seven cases died and 24 were cured. Antibiotics such as AMK, MINO, IPM were effective. As the sensitivity of these drugs has been gradually dropping, we believe that VCM will be selected as the first choice. Early diagnosis and therapy are most important. Daily measurement of low level CRP (0.1 to 1.0 mg/dl) is useful and careful management is necessary in the course of significant PDA.
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PMID:[MRSA sepsis of premature infants]. 150 36

During the 12-month period ending December 1990, urological infections due to MRSA were found 18 patients (14 hospitalized and 4 outpatients) and clinical features of these cases were reviewed. Ten patients with MRSA in the urine were asymptomatic, but MRSA sepsis due to severe pyelonephritis occurred in one patient and extensive treatment was required. Factors contributing to MRSA infections were mainly indwelling catheterization, preceding antimicrobial therapy (new quinolones and new cephems), and obstructive disease. Strict management of indwelling catheters and drainage of wounds is especially important, because MRSA infections are considered to be nosocomial.
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PMID:[MRSA infection in urological field]. 150 41

Cellular antigens extracted from the cells of four Staphylococcus aureus strains from different kinds of infections (sepsis, osteomyelitis, furunculosis) were analysed by the western blotting technique. Antibiotic sensitivity pattern of the strains was compared. One isolate was found to be MRSA strain. Sera samples from patients of whom strains were isolated and four sera from blood donors (as a control) were used in the investigation. IgG levels for purified staphylococcal antigens (lipase, alpha-toxin and teichoic acid) were estimated. Interaction between extracted bacterial antigens and serum antibodies of IgG class were analysed in homologous and heterologous systems. The most strong immunological reaction of the investigated sera with staphylococcal antigens was observed in the case of homologous system. Serum from sepsis patient was found to be the most reactive serum with all staphylococcal antigens mixtures.
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PMID:[Humoral response to Staphylococcus aureus antigens evaluated by the western blotting method]. 178 33

While most authorities agree that methicillin-resistant Staphylococcus aureus (MRSA) are as pathogenic as methicillin-sensitive strains (MSSA), some believe that MRSA are relatively avirulent opportunists, and that their importance has been exaggerated. We present evidence that Hong Kong strains of MRSA and MSSA are equally pathogenic: they have similar virulence in animal models; they are isolated in similar proportions from both deep and superficial clinical sites including blood; in patients with hospital-acquired bacteraemias mortality rates are similar when adjusted for clinical factors; and in both animals and patients with systemic MRSA infection, mortality rates are significantly reduced by vancomycin therapy. Efforts to control the spread of MRSA are justified, and in invasive sepsis early treatment with vancomycin may be life-saving.
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PMID:Hong Kong strains of methicillin-resistant and methicillin-sensitive Staphylococcus aureus have similar virulence. 196 33


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