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

In hospitals the pathogen MRSA (methicillin-resistant Staphylococcus aureus) causes wound infections, sepsis and respiratory tract infections at an increasing number of patients. This prolongs the length of stay and results in additional high costs. Even worse is the fact that MRSA infections have been associated with a higher mortality than MSSA (methicillin-sensitive Staphylococcus aureus) infections. The steadily increasing number of patients with MRSA in German hospitals requires an objective description of the situation using reliable data. This article explains the advantages and disadvantages of different ways of expressing MRSA rates of infection and discusses which describes best the occurrence of MRSA in different situations.
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PMID:[Which rate describes the MRSA situation appropriately?]. 1758 33

The rate of infection in patients who require ventricular assist devices is estimated at more than 35%. Infections with multi-resistant organisms such as methicillin-resistant Staphylococcus aureus in ventricular assist device recipients are often difficult to treat and present a high mortality rate. Daptomycin is a new cyclic lipopeptide antibiotic, useful in gram-positive organisms resistant to standard treatment. We report a case of a 65-year-old man suffering from a dilatative cardiomyopathy and concomitant MRSA infection who received a biventricular assist device. The patient had MRSA sepsis develop resistant to conventional therapy, which was successfully treated with daptomycin.
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PMID:Daptomycin for eradication of a systemic infection with a methicillin-resistant-Staphylococcus aureus in a biventricular assist device recipient. 1758 30

We report a case of fatal necrotizing pneumonia and sepsis caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in an otherwise well, 48-year-old Canadian man with type 2 diabetes mellitus who had travelled to Texas. Despite therapy that included intravenous antibiotics, intravenous immune globulin and other supportive measures, the patient succumbed to his illness. Recently, CA-MRSA pneumonia has been reported in several countries. The virulence of this organism may in part be related to its ability to produce toxins, such as Panton-Valentine leukocidin. As rates of CA-MRSA increase worldwide, physicians should be aware of the potential for MRSA to cause life-threatening infections in patients presenting to Canadian emergency departments (EDs). Necrotizing pneumonia caused by MRSA must be considered in the differential diagnosis of acute, severe respiratory illness. Early recognition of this syndrome in the ED may help physicians initiate appropriate antibiotic therapy in a timely manner.
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PMID:Necrotizing pneumonia and septic shock: suspecting CA-MRSA in patients presenting to Canadian emergency departments. 1762 97

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has become an important pathogen in aggressive skin and soft-tissue infections in patients without risk factors for nosocomial infections. We describe a case of a previously healthy adult who developed fulminant sepsis from Fournier's gangrene caused by a strain of CA-MRSA containing the Panton-Valentine leukocidin genes.
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PMID:Community-acquired methicillin-resistant Staphylococcus aureus as a cause of Fournier's gangrene. 1841 76

Infective endocarditis is more common in heart transplant recipients than in the general population. We report a case of endomyocardial abscesses and sepsis syndrome due to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in a heart transplant recipient with a negative transesophageal echocardiogram. The suspected portal of entry for this MRSA infection was through infected herpes zoster lesions. This case demonstrates the difficulty of diagnosing endomyocardial abscesses in heart transplant patients.
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PMID:Community-acquired methicillin-resistant Staphylococcus aureus endomyocardial abscesses in a heart transplant recipient. 1881 30

We report a 12-year-old child presented with cutaneous pustular lesions. The lesions are associated with disseminated septic embolism due to Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). The mortality of CA-MRSA sepsis associated with cutaneous findings is high. In areas where CA-MRSA is endemic, empiric treatment of suspected cutaneous manifestations should include antibiotics predictably active against this pathogen.
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PMID:Cutaneous pustular manifestations associated with disseminated septic embolism due to a Panton-Valentine leukocidin-producing strain of community-acquired methicillin-resistant Staphylococcus aureus. 1893 58

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) continues to make headlines because of large outbreaks in daycare centers and among members of athletic teams. CA-MRSA infections in children commonly lead to hospitalization. Life-threatening infections, such as necrotizing pneumonitis and brain abscess, can occur. The organism has crossed into hospitals and is now a common cause of hospital-acquired sepsis. Multidrug-resistant strains of MRSA are emerging in Asia, with the resistance based on either a novel gene cassette or a transmissible plasmid. The routine use of antibiotics in livestock seems to be contributing to the emergence of resistant organisms, and some of these have already produced human infection. Fortunately, most cutaneous CA-MRSA infections present as abscesses or furunculosis, and these manifestations generally respond to drainage. The recurrence and attack rates of close contacts are high and relate to persistent colonization.
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PMID:How to handle a CA-MRSA outbreak. 1898 67

The presence of multiresistant pathogens in a hospital leads very often to a severe sepsis that threatens the patients' life. For this reason, in the interests of the patients in the Intensive Care Unite (ICU) of the Lodz Medical University Hospital No.1, a wide monitoring of the epidemiological situation and the rational antibiotic therapy, taking the resistance mechanisms of pathogens into account, have been started since 2002. Restrictive procedures of the insertion of central venous and dialysis catheters were elaborated as well as the permanent monitoring of the MRSA carrier state among the medical staff was undertaken. A procedure of the primary bacteriological examination for all new patients in the ICU was also introduced. All these actions resulted in a considerable, statistically significant (p=0.043), decrease in bloodstream infections from 14.2 infections per 100 patients in 2002 to 2.0 infections per 100 patients in 2006. A drop in the number of infections of central venous catheters was also observed: from 4.3 infections per 100 patients in 2002 to 1.9 infections per 100 patients in 2006 (p=0.025). Administration of ceftazidime and clavulanic acid, which are MRSA inductors, only in the events of guided therapy when other therapeutic options were failed as well as the reduction of the MRSA carrier state among the medical staff brought about a radical elimination of MRSA from the bloodstream infections. The obtained results show that the severe infections caused by multiresistant pathogens in hospitals can be effectively reduced due to cooperation between clinicians and microbiology laboratories.
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PMID:[Sepsis--a new life-threat or better defined old disease entity]. 1914 75

The emergence of drug-resistant pathogens such as staphylococci and enterococci in the hospital setting has long being recognized as a serious clinical problem. Staphylococcus aureus is the causative agent of many nosocomial infections from minor skin abscesses to serious, potentially life threatening diseases such as bone and soft tissue intra-surgical infections, sepsis and invasive endocarditis, while enterococci are responsible for nosocomial bacteraemia, surgical wound infections and endocarditis. The most infamous drug-resistant forms of these include MRSA (methicillin resistant S. aureus), VISA (vancomycin insensitive S. aureus), hVISA (heterogenous vancomycin insensitive S. aureus) and VRE (vancomycin resistant S. aureus). While enhanced hygiene awareness is essential to any solution, the identification of effective novel antimicrobial compounds remains a major goal in eradicating these and other infections caused by multi-drug resistant pathogens. In recent years a class of antimicrobial peptides, the Lantibiotics, have been the focus of an ever increasing level of attention. This interest has been prompted by an enhanced appreciation of the mode of action of these peptides (including, in many cases, the ability to bind lipid II) and their frequently high levels of antimicrobial activity. Here we review lantibiotic-related issues in drug discovery, outline the strategies that have been employed to identify these peptides and summarize the use of bioengineering to generate enhanced forms of these peptides as well as the application of the associated biological machinery to generate novel forms of existing pharmaceutical compounds. In so doing we highlight how some, or all, of these approaches have the potential to result in the development of clinically important drugs.
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PMID:Discovery of medically significant lantibiotics. 1927 38

Meticillin-resistant Staphylococcus aureus (MRSA) is an important cause of infection, particularly in hospitalized patients and those with significant healthcare exposure. In recent years, epidemic community-associated MRSA (CA-MRSA) infections occurring in patients without healthcare risk factors have become more frequent. The most common manifestation of CA-MRSA infection is skin and soft tissue infection, although necrotizing pneumonia, sepsis and osteoarticular infections can occur. CA-MRSA strains have become endemic in many communities and are genetically distinct from previously identified MRSA strains. CA-MRSA may be more capable colonizers of humans and more virulent than other S. aureus strains. Specific mechanisms of pathogenicity have not been elucidated, but several factors have been proposed as responsible for the virulence of CA-MRSA, including the Panton-Valentine leukocidin, phenol-soluble modulins and type I arginine catabolic mobile element. The movement of CA-MRSA strains into the nosocomial setting limits the utility of using clinical risk factors alone to designate community- or healthcare-associated status. Identification of unique genetic characteristics and genotyping are valuable tools for MRSA epidemiological studies. Although the optimum pharmacological therapy for CA-MRSA infections has not been determined, many CA-MRSA strains remain broadly susceptible to several non-beta-lactam antibacterial agents. Empirical antibacterial therapy should include an MRSA-active agent, particularly in areas where CA-MRSA is endemic.
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PMID:Community-associated meticillin-resistant Staphylococcus aureus infections: epidemiology, recognition and management. 1940 50


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