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

The experience with neonatal sepsis at The Johns Hopkins Hospital during 1969-1975 was reviewed. Major pathogens included Escherichia coli, group B streptococcus, other streptococci, and Klebsiella. Nineteen percent of coliform isolates were kanamycin-resistant. The frequency of recovery of E. coli was increased in early-onset sepsis, and the frequency of recovery of Klebsiella was increased in late-onset sepsis. The mortality rate was 23%. The frequency of recovery of E. coli was increased in fatal cases, and mortality was highly correlated with the presence of gastrointestinal catastrophe. Ampicillin and gentamicin are the initial antibiotics of choice for neonatal sepsis at this institution; a penicillinase-resistant penicillin should be added when Staphylococcus aureus involvement is likely, and addition of chloramphenicol or clindamycin should be considered for infants at increased risk for Bacteroides fragilis sepsis.
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PMID:Neonatal sepsis at The Johns Hopkins Hospital, 1969-1975: bacterial isolates and clinical correlates. 31 88

Fifty-nine children with congenital asplenia were reviewed for episodes of severe infection. Seven children had isolated asplenia and 52 had asplenia associated with complex congenital heart disease (asplenia syndrome). A control group of eusplenic children with comparable cardiac lesions were assembled and used for comparative statistical analysis. There were 16 instances of documented sepsis among 59 children (27%). In those less than six months of age, the invading organism was usually gram-negative (Escherichia coli or Klebsiella). In children six months of age or older, the infecting organism was usually a pneumococcus or H. influenzae. When those with asplenia syndrome were compared to the control population, the former group had a significantly greater incidence of sepsis. Children with asplenia syndrome who survived the first month of life were at greater risk of dying from sepsis than from their heart disease. It is recommended that prophylactic antibiotics be administered to children with congenital absence of the spleen, commencing at three months of age, to be continued indefinitely.
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PMID:Sepsis and congenital asplenia. 32 Feb 99

Twenty-five isolates of Staphylococcus aureus, 24 isolates of Escherichia coli, and 25 isolates of Klebsiella pneumoniae obtained from clinical material were tested in vitro for susceptibility to cefamandole, tobramycin and combinations of the two antibiotics utilizing an automated microdilution system. Synergistic or partially synergistic bactericidal effects of the combination were observed against 15 of the S. aureus isolates (60%), 23 of the E. coli isolates (96%), and 19 of the K. pneumoniae isolates (76%) tested. No antagonistic effects of the combination were noted. This study suggests that cefamandole-tobramycin combinations are capable of acting synergistically in vitro against certain gram-positive and gram-negative organisms and may have potential usefulness in clinical situations such as gram-negative rod and staphylococcal sepsis.
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PMID:In vitro synergy of cefamandole-tobramycin combinations. 33 94

The case of a kidney allograft recipient, who suffered from several episodes of Salmonella dublin sepsis following massive immunosuppressive therapy to overcome a transplant rejection crisis, is presented. The focus of sepsis was the chronic inflamed gallbladder. The Salmonella dublin strain isolated from the blood during the last episode was found to exhibit multiple resistance to antimicrobiol drugs. Because the resistance phenotype was characteristic for the gramnegative flora of the university hospital, it was suggested that transfer of a resistance plasmid, frequently found in gramnegative enterobacterial isolates, to the Salmonella strain had occurred in the patient. The comparative examination of a Klebsiella pneumoniae strain, representing the hospital flora, and Salmonella dublin revealed that both strains produced the aminoglycoside 3'-phosphotransferase type 1, the 2''-nucleotidyltransferase and the 3''-adenylyltransferase, enzymes responsible for resistance to aminoglycoside antibiotics. Furthermore, in both strains a TEM type beta-lactamase was found to render the organism resistant to penicillins and cephalosporins. Transfer experiments showed that the host ranges of the R-plasmids of both strains were identical. Furthermore, both plasmids were found to be the fi+ type. These data support the view of in vivo transfer of an R-plasmid from the enterobacterial hospital flora to a potential pathogen in a patient.
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PMID:Acquisition of multiple antibiotic resistance by Salmonella dublin from the gramnegative hospital flora, in a kidney allograft recipient. 36 85

A patient with alcoholic cirrhosis had multiple episodes of sepsis with Klebsiella pneumonia. Repeated searches for the source of infection finally revealed the organism in the root of a tooth. Evidence indicated that this site was the primary source of infection. The importance of dental infections in alcoholics and the difficulty in diagnosing those infections are emphasized by this case.
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PMID:Dental infection in a cirrhotic patient. Source of recurrent sepsis. 36 35

Because of the persistently high mortality from sepsis in cancer patients, a retrospective study was designed to identify the causative organisms and to determine the factors affecting the outcome of sepsis. A total of 84 episodes of septicemia in 61 children with cancer were studied. The more frequently isolated organisms were: Staphylococcus aureus (21.4%); Escherichia coli (18%); Klebsiella (7.1%); Pseudomonas (6%); and Bacteroides fragilis (6%). Other isolates included Proteus, Serratia, Acinetobacter, hemolytic Streptococcus, and Bacillus cereus. In 10.7% of septic episodes, mixed bacterial infections were documented. Twenty-four (28.6%) resulted in death; in 13 (54%) death occurred within 24 hours after admission. The fatality rate was high in cases associated with absolute polymorphonuclear leukocyte counts of less than 100/cu mm, in neoplastic relapse, and when infection with gram-negative, anaerobic and mixed bacterial flora occurred.
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PMID:Septicemia in children with cancer. 37 Oct

Ampicillin-sensitive or -resistant Staphylococcus aureus and Klebsiella strains were cultured in various nutrient media as prototypes of the agents of sepsis isolated in bacteriological routine analysis. In each case, 2 ml of defibrinated human blood containing 100 and 1000 cells, 8 gamma and 80 gamma ampicillin/1 ml blood respectively were added to 50 ml of nutrient medium. The following media were used. 1. casein soya-bean meal peptone broth (Oxoid), 2. tryptose-phosphate medium (Oxoid), 3. dextrose broth (Oxoid), 4. brain-heart-dextrose medium (Oxoid), 5. brain-heart infusion, autoclaved (Difco), 6. brain-heart infusion, after sterile filtration (Difco), 7. vacutainer culture bottles (BD) prepared medium, 8. micrognost blood culture bottles (Biotest) prepared medium. While the sensitive staphylococcus strain exhibited a slower growth than the sensitive Klebsiella strain in all nutrient media, the growth rate of the two resistant variants was approximately the same for an initial count of 100 cells per ml of blood. Among the resistant staphylococci the higher initial count of the inoculum resulted in an improved growth. After addition of 8 gamma or 80 gamma ampicillin/1 ml blood the sensitive staphylococcus strain did not show any grwoth irrespective of the inoculated number of cells while the sensitive Klebsiella strain multiplied irrespective of the initial number of cells. After 24 hours the resistant staphylococci and Klebsiella strains of which 1000 cells each had been used for inoculation exhibited growth in almost all media used.
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PMID:[Experimental studies to culture bacteria from blood specimen with an addition of ampicillin in various nutrient media (author's transl)]. 37 22

The methods of quantitative analysis of aerobe and anaerobe microbes and fungi stool specimens are described. The results of the studies in health people are compared to the results in patients undergoing surgical treatment of intestinal tract. A group of these patients received Neomycin and Bacitracin orally as short-time chemoprophylaxis to diminish possible woundinfection and/or sepsis. After oral medication germs as Bifidobacterium, Bacteroides and Clostridium (not Cl. perfringens) are reduced or lost, Veillonella, Eubacterium, Fusiformis, Peptostreptococcus and Lactobacillus were suppressed. Resistant strains of E. coli and Enterococci increased to high concentration/g faeces. After treatment the rate of gram-negative bacteria resistant to Neomycin increased. This might be of epidemiologically importance for the distribution of microbes resistant to Neomycin and other aminoglycosides as Klebsiella, Candida spec. and Torulopsis.
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PMID:[Short-term oral chemoprophylaxis before intestine surgery. Quantitative determination of bacteria and fungi in stool specimens (author's transl)]. 45 70

PC-904 was administered to 16 pediatric patients and the following basic and clinical results were obtained. (1) PC-904 was administered 20 approximately 30 mg/kg. The serum peak level of PC-904 after drip intravenous infusion over 1 hour was 66.7 microgram/ml at 1 hour and T 1/2 of PC-904 was 67.8 minutes. PC-904 was administered 25 approximately 30 mg/kg intravenous one shot injection was 49.4 microgram/ml at 1 hour and T 1/2 of PC-904 was 52.2 minutes. (2) Urinary excretion rate was about 20% up to 6 hours after drip intravenous infusion of 20 mg/kg. In a case of intravenous one shot injection of 25 approximately 30 mg/kg, the excretion rate was 11.9 approximately 19.9%. (3) PC-904 was administered 60 approximately 120 mg/kg/day for 3 approximately 48 days to 5 cases of sepsis and bacterial endocarditis, 6 of pneumonia, 2 of sss syndrome (staphylococcal scald skin syndrome) and 3 of pyelonephritis. Clinical effects were excellent in 11 cases and good in 5 cases, effective ratio being 100%. (4) Pseudomonas aeruginosa, Staphylococcus epidermidis, Streptococcus viridans, Acinetobacter anitratus and Hemophilus influenzae isolated from clinical specimens disappeared by the treatment of PC-904, and Hemophilus influenzae isolated from clinical specimens disappeared by the treatment of PC-904. Escherichia coli and Klebsiella pneumoniae reduced. (5) As to the side effect by PC-904, s-GOT and s-GPT were elevated in 2 cases. Anemia, rash and fever were observed in each 1 case out of 16 patients though the causal relation with the agent was unknown.
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PMID:[Basic and clinical studies on new semisynthetic penicillin, PC-904, in pediatric field (author's transl)]. 69 Dec 65

Twenty-five patients were treated with ticarcillin disodium, 18 of whom had anaerobic infections that included pleuropulmonary infections (seven), mandibular osteomyelitis (four), perirectal abscess (two), sepsis, primary site unknown (one), liver abscess (one), pelvic abscess (one), decubitus ulcer (one), and synergistic gangrene (one). Seven had no anaerobic infections. Three had anaerobic septicemia. Culture results included anaerobes: peptococci (ten), peptostreptococci (ten), Bacteroides fragilis (six), Bacteroides not fragilis (ten), eubacteria (three), fusobacteria (two), Clostridium (one), Veillonella (one), and acidaminococcus (one); aerobes: Proteus (three), Klebsiella (two), Escherichia coli (two), and streptococci (two). Six patients with mixed aerobic infections initially received gentamicin sulfate in addition. The serum levels were 110 +/- 20 microgram/ml one hour after intravenous infusion of 5 g of ticarcillin disodium. All anaerobic isolates were susceptible at less than or equal to 100 microgram/ml and 85% by less than or equal to 25 microgram/ml of ticarcillin. Sixteen patients responded well to ticarcillin and two failed to respond. Our study suggests that ticarcillin is useful in the treatment of anaerobic infections.
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PMID:Ticarcillin disodium in anaerobic infections. 71 11


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