Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have studied cefuroxime, a new beta-lactamase resistant cephalosporin, and cefoxitin, the first cephamycin antibiotic, which is also resistant to many beta-lactamases. Both of these antibiotics have been shown to be microbiologically superior to the "first generation" cephalosporins, cefuroxime having notable activity against Haemophilus influenzae, and cefoxitin against Bacteroides fragilis. Neither antibiotic is absorbed from the gut but, following parenteral administration, serum, urine and bile concentrations are high. Clinical trials have been conducted on both cefoxitin and cefuroxime. The results of these have been satisfactory and untoward side-effects minimal. We suggest that cefoxitin will be particularly valuable in the management of abdominal sepsis and cefuroxime in infections caused by H. influenzae.
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PMID:Studies with cefuroxime and cefoxitin. 30 60

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

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

The puerperal mastitis is a staphylococcal infection of the lactating mamma cumulating during the third and fourth week after delivery. It is seen three times as often after hospital than after house delivery, and it is also more frequent with primiparae than with multiparae. The infection is caused by bacterial hospitalism. Most commonly mamilla and milkducts are infected via the child's nasopharynx. Mastitis rarely occurs in non-nursing women. Early diagnosis before the appearance of all classical inflammatory symptoms is important, to start the treatment with antibiotics before abscess formation takes place. We mentioned Fucidine, Oleandomycin and Oxacillin as staphylococcal-effective, penicillinase-resistent antibiotics. Additionally low-dose X-ray radiation may be given. In case of abscess formation local antibiotic-instillation combined with oral antibiotic treatment should be tried before incision. It is best to incise an abscess only after is complete breakdown. Complications to be looked for are maternal sepsis and staphylococcal infection of the newborn.
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PMID:[Puerperal mastitis]. 87 13

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

Two cases of serious infection following catfish spine-related injuries are presented, and the literature on this topic is reviewed. The organisms usually involved in such infections are Vibrio species, Aeromonas hydrophila, Enterobacteriaceae, Pseudomonas species, and components of the flora of the human skin. Irrigation, exploration, and culture of these wounds as well as immunization of the patient against tetanus are recommended. Patients with hepatic disease or chronic illness and immunocompromised individuals are at unusually high risk of fulminant infection due to Vibrio and Aeromonas species and should be treated with antibiotics after sustaining a water-associated wound. Patients with normal host defense mechanisms but with late wound care, punctures involving a bone or a joint, progressive inflammation hours after envenomation, fever, or signs of sepsis are at high risk for secondary infection and should receive definitive wound care and antibiotics. For moderate to severe infections, one of the following combinations constitutes a reasonable empirical regimen: (1) a tetracycline and a broad-spectrum, beta-lactamase-stable beta-lactam antibiotic, or (2) a tetracycline, a beta-lactamase-stable penicillin, and an aminoglycoside.
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PMID:Catfish-related injury and infection: report of two cases and review of the literature. 156 61

Enterococci are increasing in importance as nosocomial pathogens and causes of severe sepsis in immunocompromised patients. From September to November 1989, a survey of 898 enterococcal isolates showed that 52 had acquired high-level resistance to penicillin and ampicillin (MIC greater than 100 mg/l). These were all Enterococcus faecium, did not produce beta-lactamase and showed high-level resistance to gentamicin and streptomycin as well. The majority were urinary isolates, but a few caused bacteraemia in severely ill patients. The potential spread of these highly-resistant enterococci would limit the therapeutic options for systemic infections.
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PMID:Enterococci highly resistant to penicillin: characterizing isolates from Singapore hospitals. 178 91

Since 1980, numerous reports have been published throughout the world on the pathogenic role of Branhamella catarrhalis. Apparently, Branhamella infections have been increasing in many places. Although they can affect various organs, they are most commonly observed in the airways and eye (both in children and adults). Not infrequently, Branhamella catarrhalis causes sepsis, in particular in immunosuppressed patients. The rapid increase in beta-lactamase-forming Branhamella strains results in frequent ineffectiveness of treatment with penicillin. In patients treated with penicillin for a primary infection by other bacteria, a secondary infection due to penicillin-resistant Branhamella organisms can subsequently occur. For treatment, therefore, beta-lactamase-stable antibiotics should be preferred.
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PMID:[Branhamella catarrhalis as a disease pathogen]. 193 24

Aztreonam, the first monocyclic beta-lactam antibiotic with pure anti-Gram-negative activity, combined with flucloxacillin, a penicillinase resistant penicillin, was given as empirical treatment of 53 serious infections in very elderly people. Eighteen of the cases had positive blood cultures and 11 had a clinical picture of sepsis without positive blood cultures: Of 49 evaluable infections, 45 (92%) were cured. In 40% of the infections, antibiotic treatment could be narrowed after 72 hours to one antibiotic. Diarrhoea, mostly transitory, was the only side-effect. Aztreonam-flucloxacillin combination is a safe and effective empirical treatment regimen for serious infections in very elderly patients.
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PMID:Aztreonam-flucloxacillin double beta-lactam treatment as empirical therapy of serious infections in very elderly patients. 205 4

Gynaecological infections range from vaginitis to septic shock. Postoperative infections are common sequelae of hysterectomy. Sexually transmitted infections start as vaginitis or rather as cervicitis. During pregnancy and delivery we find septic abortion, amnionitis, endometritis, wound infections, thrombophlebitis, sepsis, mastitis and urinary tract infections. In most infections cephalosporins are drugs of first choice because of their broad spectrum, their beta-lactamase stability and their lack of toxicity, which is especially important in pregnancy.
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PMID:Infections in gynaecology and obstetrics and cefotaxime. 261 36


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