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

A retrospective analysis was undertaken of the records of 107 patients with Crohn's disease of the colon or with ulcerative colitis who underwent 162 operations under steroid cover. The study revealed no correlation between steroid dosage and postoperative morbidity or mortality. The incidence of wound dehiscence and incisional hernia compared favourably with the reports of other unselected series of similar patients. Contamination did significantly influence results. Septic complications were more frequent when the operative field was contaminated and both delayed wound healing and mortality were related to this sepsis. A ;clean and dirty' technique was effective in controlling contamination during elective bowel division but preoperative bowel perforation and accidental entry into the lumen of the bowel during dissection were potentially avoidable sources of contamination. Primary healing of the perineal wound after proctocolectomy was seldom achieved in contaminated patients where a drain tube was brought out through the main perineal incision. When perineal sinuses or fistulae followed a proctocolectomy, patients with Crohn's disease had a significantly slower rate of healing than did patients with ulcerative colitis. However, there was no difference in the healing of abdominal wounds in relation to the primary pathology. Even abdominal incisions which were used on more than one occasion healed as well as those which were used for the first time. A prophylactic antibiotic regime of either ampicillin or tetracycline offered little protection against postoperative sepsis. The organisms which caused such infections were often insensitive to the two antibiotics.
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PMID:Factors which influenced postoperative complications in patients with ulcerative colitis or Crohn's disease of the colon on corticosteroids. 68 Jun 5

An increased morbidity by Streptococcus agalactiae (group B streptococci) during the perinatal period was to be found in some countries since 1961. Six cases of group B streptococcal meningitis were confirmed by the Central Streptococcus Laboratory of the GDR from July to December 1975. Therefore it is necessary to look for group B streptococcal infection in certain cases of diseases of the newborn. In a short review of literature the clinical signs (acute onset with respiratory distress, sepsis or late onset with meningitis), prevalence, source of infection and therapy (ampicillin or a combination of penicillin G and gentamicin) were summarized. The diagnosis is confirmed by isolation of group B streptococci.
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PMID:[Infections in newborn infants caused to B-streptococci]. 79 Aug 43

Hospitalized patients who received clindamycin or ampicillin were evaluated for gastrointestinal side effects for a period of up to six weeks after therapy was discontinued. Of 104 patients receiving clindamycin therapy, 31 (29.8%) developed diarrhea, and two (1.9%) developed pseudomembranous colitis (PMC). Of 138 patients receiving ampicillin, 24 (17.3%) developed diarrhea, and one (0.7%) developed PMC. Diarrhea persisting for three days or more was noted in 13 (12.5%) of the patients receiving clindamycin and in seven (5.1%) of those receiving ampicillin. The tendency to develop diarrhea was positively correlated with serious illness, abdominal or pelvic sepsis, and total dosage of clindamycin. Examination of stools from a patient with PMC that was associated with clindamycin therapy showed a decrease in the number of anaerobic bacteria from the numbers found in stool cultures of normal controls. Those patients who did not develop diarrhea also had fewer anaerobic bacteria and coliform organisms. Lymphocytes from the patient with PMC were hyporeactive to phytohemagglutinin and hyperreactive to clindamycin.
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PMID:Gastrointestinal side effects of clindamycin and ampicillin therapy. 85 84

Although disease caused by Arizona hinshawii is known to resemble the spectrum of clinical syndromes seen with Salmonella infections, little is known of their sensitivity to antimicrobials. We present three cases that are illustrative of Arizona sepsis, localized infection, or both; review the literature; and report sensitivities to 12 antimicrobials for 32 human and animal isolates of Arizona hinshawii from various geographic areas. With the exception of erythromycin and streptomycin, most strains were sensitive to many of the commonly used antibiotics. As with Salmonella infections, ampicillin or chloramphenicol appear to be the initial antimicrobial agents of choice for severe infections with A. hinshawii. Definitive antimicrobial therapy must be individualized on the basis of sensitivity testing and with regard to host factors.
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PMID:Arizona hinshawii infections. New cases, antimicrobial sensitivities, and literature review. 98 10

Although Hemophilus influenzae is a common cause of meningitis, other members of the Hemophilus genus are rarely the infecting organism. Of 56 cases of meningitis due to Hemophilus species obseved at one hospital in the period 1970-74, 53 were due to H. influenzae and 3 to H. parainfluenzae. In the cases of H. parainfluenzae meningitis the clinical picture was complicated by associated sepsis, and therapy with ampicillin was not entirely satisfactory.
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PMID:Hemophilus parainfluenzae meningitis. 107 83

Mortality from neonatal meningitis due to gram-negative microorganisms remains 50% despite use of aminoglycoside antibiotics. Blood was obtained on 238 occasions from 77 neonates with putative or documented sepsis; paired blood and cerebrospinal fluid (CSF) samples were obtained on 14 occasions from ten neonates with meningitis. Kanamycin and gentamicin were measured by a radioisotopic assay procedure. Kanamycin was administered at 15 mg/kg/day in three divided doses intravenously; serum concentrations peaked at one hour (mean, 7.77mug/ml). Gentamicin was administered at 7.5 mg/kg/day in three divided doses intravenously; serum concentrations peaked at two hours (mean, 5.34mug/ml). Both aminoglycosides generally were nondetectable within the CSF; survival of neonates with gram-negative meningitis correlated specifically with the sensitivity of their isolates to ampicillin which was administered concurrently. This study suggests that alternative approaches to the treatment of neonatal sepsis should be explored; administration of an antibiotic which crosses the blood-cerebrospinal fluid barrier more readily should be considered.
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PMID:Kanamycin and gentamicin treatment of neonatal sepsis and meningitis. 110 75

A review of the literature reveals that glucocorticoids have: 1) a protective effect both in vitro and in vivo against bacterial endotoxins and exotoxins, and 2) a protective or therapeutic effect in sepsis/shock caused by Gram-negative microorganisms. At the Columbia Presbyterian Medical Center, the 1968-1973 mortality rate for general sepsis/shock due to Gram-negative organisms was 16.6 percent and for urologic sepsis/shock 15.3 percent. This low rate was the result of early diagnosis and early use of massive dosages of glucocorticoids (hydrocortisone, methylprednisolone, dexamethasone), beta-adrenergic isoproterenol, and bactericidal antibiotics (gentamicin, kanamycin, carbenicillin, cephalothin-cefazolin, ampicillin).
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PMID:Glucocorticoid therapy in sepsis/shock caused by gram-negative microorganisms. 117 49

The authors report a nosocomial infection outbreak by Klebsiella pneumoniae, observed in neonates at a gyneco-obstetrical hospital from Mexico City. Forty six newborns presented one or more infections due to K. pneumoniae during their stay in neonatal care units, between October 3 and November 12, 1988. Sepsis was documented in 41 cases by clinical picture and routine laboratory exams, including one positive, blood culture at least. The most frequent invasive procedures practiced in these patients were catheterization and ventilatory support. K. pneumoniae was isolated as well from several environmental sources that could have led to infection of patients. Treatment of cases was initiated with ampicillin-amikacin, however, therapeutic failure with a lethality rate of 50% (14/28) and results of antimicrobial susceptibility conducted to treatment with cefotaxime. Fifteen out of 19 patients receiving the cephalosporin survived. To prevent outbreaks like the one presented here, we concluded that appropriate measures dealing with hygiene and education of personnel plus monitoring of bacterial susceptibility to antimicrobials, should prove successful in our environment.
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PMID:Neonatal septicaemia due to K. pneumoniae. Septicaemia due to Klebsiella pneumoniae in newborn infants. Nosocomial outbreak in an intensive care unit. 134 98

The choice of antimicrobial therapy for the treatment of bacteremia is often empirical and based on the knowledge of antibiotic susceptibility profiles of the most common bacteria causing such infections. It therefore is crucial to survey the susceptibility of bacteria causing sepsis. This study examines the susceptibility profiles of 941 gram-negative bacteria, isolated from septic patients in 10 Canadian hospitals, to 28 antimicrobial agents. Among the isolates, 30 different species were represented; Escherichia coli dominated, representing 52.5% of isolates. More than 50% of all bacteria were resistant to ampicillin. Only 67% of the E. coli isolates were susceptible to ampicillin, while 30% of all strains were resistant to ticarcillin. Of the cephalosporins, ceftazidime and cefoperazone/sulbactam were the agents to which isolates were the most susceptible (90%). Only 51% of the E. coli strains were susceptible to cephalothin, while 91% were still susceptible to cefazolin. A total of 93% and 98% of the strains were susceptible to aztreonam and imipenem, respectively. Aminoglycosides were highly active against most isolates, in general in the following order: netilmicin greater than tobramycin greater than gentamicin greater than amikacin. Tobramycin was the most active against Pseudomonas aeruginosa. Nearly all isolates were susceptible to the quinolones. Tolerance (MBC/MIC ratio, greater than or equal to 32) was rarely observed. This survey of the susceptibility of gram-negative bacteria causing sepsis provides valuable information for implementing the chemotherapy for gram-negative septicemia and demonstrates that several older and newer agents, alone or in combination, can be used as adequate initial therapy for gram-negative sepsis in Canada.
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PMID:Antibiotic susceptibility profiles of 941 gram-negative bacteria isolated from septicemic patients throughout Canada. The Canadian Study Group. 142 Jun 74

To determine current opinions among experts in pediatric infectious diseases for treatment of bacterial sepsis, meningitis and acute otitis media, we polled directors of training programs in January, 1992. Responses were received from 69 centers in the United States and Canada. For initial treatment of presumed bacterial meningitis, the third generation cephalosporins alone or combined with ampicillin have become drugs of choice in all age groups. Most infectious disease programs include dexamethasone in the management of presumed bacterial meningitis for children 2 months of age and older. Third generation cephalosporins are also drugs of choice for presumed sepsis: combined with ampicillin for infants 5 weeks of age; used alone for children 5 months and 12 years of age. Amoxicillin remains the preferred drug for initial treatment of acute otitis media. The combination of amoxicillin and clavulanic acid is favored in the setting of an increased proportion of beta-lactamase-producing bacterial pathogens. Comparison of these results with polls in 1987 and 1989 indicates a shift in recommendations of therapy of presumed bacterial sepsis and meningitis from ampicillin alone or combined with an aminoglycoside or chloramphenicol to use of a third generation cephalosporin alone or combined with ampicillin.
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PMID:Therapy of bacterial sepsis, meningitis and otitis media in infants and children: 1992 poll of directors of programs in pediatric infectious diseases. 144 7


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