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

Thirteen patients with Aeromonas species septicemia were seen at Westmead Hospital between 1983 and 1987. In 10 patients (77%) septicemia was caused by A. sobria, and in 3 (23%) by A. hydrophila, A. caviae was not isolated. Chronic underlying illness was present in 10 patients (77%), hematological malignancy being the most common (46%). The average age of the patients was 65.8 years. Seven patients (54%) presented with clinical sepsis, diarrhea and abdominal pain. The biliary tract, lung and soft tissue were other primary sites of infection. Nosocomial infection occurred in 5 patients (38%). Cross-infection was not seen. Contact with fresh water or fish was observed in only 2 patients (15%). The majority of cases occurred in the warmer months of the year. The overall mortality was 46%. All isolates of Aeromonas species were resistant to ampicillin 8 mg/L. Ten isolates were resistant to tobramycin 1 mg/L, and 3 to tobramycin 4 mg/L. In contrast, 3 isolates were resistant to gentamicin 1 mg/L, and none to 4 mg/L. The isolates showed a varied pattern of resistance to other antibiotics tested, but all were susceptible to piperacillin 64 mg/L, imipenem 4 mg/L, ciprofloxacin 1 mg/L, and amikacin 16 mg/L.
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PMID:Aeromonas septicemia: relationship of species and clinical features. 281 70

Sepsis remains a significant cause of morbidity and mortality in newborn infants. From January 1983 to April 1988, 166 cases of neonatal sepsis with positive blood cultures were collected at V.G.H.--Taichung. Among them 140 newborn babies were delivered at private clinic (outborn babies), 26 cases were inborn babies. Of the inborn babies, 20 cases (76.9%) were early onset sepsis (the onset of illness within 96 hours of life) and 6 cases (23.1%) were late onset sepsis (the onset of illness beyond 96 hours of life). Off the outborn babies, 64 cases (45.7%) were early onset sepsis and 76 cases (54.3%) were late onset sepsis. The Gram positive organism (51.9%) was more common than the Gram negative organism in the inborn babies, on contrary, the Gram negative organism (59.0%) was more common in the outborn babies. The most common pathogenic organism of the inborn babies was Enterococcus (22.2%) and E. coli (22.2%), followed by Pseudomonas spp (11.1%) and Staphylococcus aureus (11.1%). The most common pathogenic organism of the outborn babies was Enterococcus (17.4%), followed by E. coli (16.1%), Staphylococcus aureus (9.9%) and Klebsiella spp (8.1%). The antibiotics sensitivity tests to the pathogens didn't show any significant difference between these two group babies. In this clinical study, we found that the first choices of antibiotics were ampicillin plus aminoglycosides. The clinical symptoms and signs were nonspecific. The most common findings were lethargy, fever, hypothermia and poor feeding. Of the inborn babies, 17 cases (65.4%) had the predisposing factor(s). Of the outborn babies, 42 cases (30%) had the predisposing factor(s).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical observation of neonatal sepsis]. 281 81

A retrospective analysis of 27 maternal deaths associated with cesarean section and occurring at Nigeria's University of Ilorin Teaching Hospital in 1982-86 was performed. The cesarean section rate for the 48,974 deliveries that took place at the hospital during the study period was 4.1%. The death rate was 18.1/1000 cesarean sections compared with 1.89/1000 vaginal deliveries. Maternal sepsis was responsible for 22 (82%) of the cesarean section-associated maternal deaths; the remaining deaths were attributed to hemorrhage (1 primary and 3 secondary) and eclampsia (1 case). Obstructed labor was the single most important indicator for cesarean section (67%) and the most significant predisposing factor to maternal sepsis (63%). Most deaths from sepsis occurred on the 2nd-4th postoperative days. The skill of the surgeon was not a significant factor in maternal deaths. The most common antibiotic used to combat sepsis was a combination of ampicillin and gentamicin--a regimen that does not cover anaerobic organisms. Some patients did not receive antibiotics until the 3rd postoperative day because they were not on stock in the hospital pharmacy. Administrative difficulties, most notably inadequate laboratory backing and funding, also played some role in the high maternal death rate in this series.
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PMID:Characteristics of maternal deaths following cesarean section in a developing country. 290 81

In a prospective, randomized, comparative study, patients undergoing elective major colorectal surgery received four six-hour doses of either sulbactam (a beta-lactamase inhibitor) with ampicillin (1 gm with 1 gm), or cefoxitin (2 gm) commencing at induction of anesthesia. The groups were well matched for age, sex, diagnosis, and surgical procedures. Three patients in the sulbactam group (N = 44), and four in the cefoxitin group (N = 48) developed significant wound sepsis. Minor wound sepsis occurred in an additional four sulbactam patients, and in five cefoxitin patients. There was no difference between the groups in deep sepsis or anastomotic leak rates (sulbactam, four patients; cefoxitin, seven patients). No serious side effects were recorded in either group. These results suggest that sulbactam combined with ampicillin provides a safe, effective alternative to cefoxitin for prophylaxis in colorectal surgery.
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PMID:Sulbactam/ampicillin compared with cefoxitin for chemoprophylaxis in elective colorectal surgery. 300 35

Fifty-four patients were treated with intravenous ampicillin and sulbactam in an open study of intra-thoracic and intra-abdominal infection. Thirty-one were treated with 500 mg each of the combination 6-hourly while 23 patients were given 1 g of ampicillin and 500 mg of sulbactam, 6-hourly. Thirteen of fourteen (93%) patients with severe respiratory tract infection and 22/26 (85%) patients in the intra-abdominal infection group responded clinically and bacteriologically. Seven patients with clinical sepsis (but not confirmed bacteriologically) improved on therapy. 50/55 (91%) clinical isolates from this study were eliminated. An increase in MIC was found in two cases. There were minimal side effects, pain at site of injection being the commonest complaint.
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PMID:A non-comparative study of parenteral ampicillin and sulbactam in intra-thoracic and intra-abdominal infections. 300 84

The efficacy of sulbactam plus ampicillin in the treatment of various gynecologic infections was evaluated in 24 women (median age, 35 years). Ten women had pelvic cellulitis plus vaginal cuff abscess; six, pyeloperitonitis; three, vaginal cuff abscess; three, surgical wound sepsis; one, tubo-ovarian abscess; and one, endometritis. Surgical procedures preceding infection included abdominal hysterectomy, ovarian cyst removal, ectopic pregnancy, correction of cystocele, and uterine dilatation and curettage. Twenty patients received 1 g of sulbactam plus 1 g of ampicillin per dose; four received 0.5 g of sulbactam plus 1 g of ampicillin per dose. The combination was given iv every 6 hr for three to four days and then im every 8 hr for three to five days (mean treatment duration, seven days). Pus cultures yielded Enterobacteriaceae (21 cases), enterococci (two), Bacteroides fragilis (12), other Bacteroides species (five), Peptococcus species (nine), Peptostreptococcus species (seven), and other anaerobes (five). Six infections were purely anaerobic; 18 were mixed. All but two infections were cured by both clinical and bacteriologic criteria, with no adverse reactions. Parenteral sulbactam/ampicillin seems safe and effective in the treatment of gynecologic infections of moderate severity.
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PMID:Efficacy of sulbactam plus ampicillin in gynecologic infections. 302 7

Sulbactam is a beta-lactamase inhibitor that, when combined with ampicillin, gives the latter antibiotic a broad spectrum of activity, making it suitable for use as a prophylactic agent in acute appendicitis. In a single-blind, randomized trial, the efficacy of sulbactam plus ampicillin was compared with that of metronidazole plus cefotaxime. Thirty-five children undergoing appendectomy received intravenous sulbactam and ampicillin, while 38 children received metronidazole and cefotaxime. Single doses were given unless the appendix was considered gangrenous or perforated, in which case the drugs were administered for 72 hr. There were three wound infections in the group given sulbactam and ampicillin and five in the group given metronidazole and cefotaxime. The combination of sulbactam and ampicillin was well tolerated and appeared to be at least as effective as that of metronidazole and cefotaxime in the prevention of sepsis following appendectomy.
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PMID:A randomized comparative study of sulbactam plus ampicillin vs. metronidazole plus cefotaxime in the management of acute appendicitis in children. 302 17

In a prospective, randomized trial involving 100 patients with severe intra-abdominal sepsis, the value of single agent antibiotic therapy with cefotetan was compared with that of combination therapy of ampicillin, gentamicin and metronidazole (AGM). All patients underwent exploratory laparotomy. The mortality rate was 3 per cent, all deaths occurring within 48 h of operation. Two-thirds of patients were considered severely ill on admission, and one-third were moderately ill. Six patients had positive blood cultures on entry into the study. The mean age was 31 years and concurrent disease was present in 14 per cent of the patients. A satisfactory response was achieved in 82 per cent of patients receiving cefotetan and in 65 per cent of those receiving AGM, whereas the response was unsatisfactory in 18 per cent of cefotetan patients and 35 per cent of those receiving AGM (P = 0.075 n.s.). Significant changes in laboratory values during the study occurred in 51 per cent of patients, and 7 per cent required vitamin K administration for hypoprothrombinaemia. The results of this study suggest that antibiotic therapy with single agent cefotetan is as safe and effective as a combination of ampicillin, gentamicin and metronidazole in patients with severe intra-abdominal sepsis requiring operative management.
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PMID:Management of severe intra-abdominal sepsis: single agent antibiotic therapy with cefotetan versus combination therapy with ampicillin, gentamicin and metronidazole. 272 Mar 62

An increased incidence of neonatal sepsis caused by Group D streptococci, specifically enterococci (GDE), during a recent 6-month period prompted a 5-year review of enterococcal sepsis in our neonatal intensive care unit. Sixteen episodes occurred in 14 babies. GDE accounted for 8 of 19 (42%) episodes of neonatal bacteremia during the epidemic period vs. only 8 of 159 (5%) episodes during the remaining 4.5 years (endemic period) (P less than 0.001). Blood isolates were all identified as Streptococcus faecalis. A combination of three strain-typing methods successfully distinguished the epidemic organisms from endemic nursery strains of GDE and from "background" GDE flora in the hospital. Nursery isolates were all susceptible to ampicillin, intermediate or resistant to the aminoglycosides and variably resistant to the newer cephalosporins. There were no differences in antibiotic susceptibilities of the GDE or in characteristics of the patients that were unique to the epidemic. Neonates with GDE sepsis had a mean birth weight of 913 g, a mean gestational age of 27 weeks and a mean age of onset of sepsis of 8.5 weeks. Twenty-five controls, matched for birth weight and admission date, were identified. Significant differences (P less than 0.05) between cases and controls included: use of a nonumbilical central line (71 vs. 32%); days central line in place (26.5 vs. 6.5 days); and bowel resection (29 vs. 4%). This is the first reported outbreak of S. faecalis sepsis in neonates. GDE are important nosocomial pathogens that must be considered in late onset neonatal sepsis.
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PMID:Neonatal enterococcal sepsis: case-control study and description of an outbreak. 312 58

A randomized trial of intrapartum versus postpartum antibiotic treatment of women with intra-amniotic infection was conducted. Intra-amniotic infection was treated with ampicillin and gentamicin during labor (at the time of diagnosis) in 26 women and immediately after umbilical cord clamping in 19 women. Intrapartum treatment led to a lower incidence of neonatal sepsis (0 versus 21%; P = .03) and a shorter neonatal hospital stay (3.8 versus 5.7 days; P = .02) when compared with postpartum treatment. There were no significant differences in the microbiologic results, the gestational age, or the birth weight between the groups. Intrapartum-treated mothers had a shorter mean postpartum stay, a lower mean number of febrile days, and a lower mean peak postpartum temperature than did postpartum-treated mothers; these differences were all statistically significant (P = .05). The treatment of clinical intra-amniotic infection during labor results in improved outcome.
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PMID:A randomized trial of intrapartum versus immediate postpartum treatment of women with intra-amniotic infection. 318 87


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