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

Although gut permeability increases and bacterial translocation occurs under certain pathological conditions, it remains unknown whether gut absorptive capacity (GAC) is altered early after the onset of sepsis. The aim of the present study was to investigate this and also to determine whether diltiazem has any effect on GAC in early sepsis. Rats were lightly anesthetized and cecal ligation and puncture (CLP) was performed. A nasogastric tube was inserted, cannulation of various blood vessels was carried out, and the animals were allowed to recover from anesthesia. One hour after CLP, one group of animals received a 1-ml bolus of normal saline intravenously, and another group received diltiazem, 400 micrograms/kg body wt. Sham animals had no CLP performed. GAC was determined by the D-xylose absorption test at 2 and 4 h after CLP. One hour after the administration of D-xylose via the nasogastric tube, its concentration in portal blood was determined colorimetrically. Results show that GAC is significantly depressed at 2 and 4 h after CLP despite the maintenance of normal blood pressure, central venous pressure, and portal pressure. Administration of diltiazem restored GAC to normal levels at 4 h after CLP. Thus diltiazem is a useful adjuvant in the treatment of sepsis because it restores gut absorptive capacity to normal and allows for early enteral nutrition.
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PMID:Sepsis produces early depression of gut absorptive capacity: restoration with diltiazem treatment. 163 86

Eight-two bovine Pasteurella haemolytica strains were serotyped. The majority of the strains were isolated from calves which had died from fibrinous pneumonia and small numbers from cases of pleuritis, sepsis and abortion. A total of eight different serotypes were noticed. Serotype A1 was found to be the most prevalent 37.8 per cent, followed by serotype A2 with 20.7 per cent. Antibiotic resistance was found for sulfonamide, tetracycline and penicillin in about half of all strains. Conventional combination of biotype to serotype per strain was not confirmed by the results of arabinose and trehalose fermentation.
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PMID:[Pasteurella haemolytica serotypes in cattle]. 173 33

Recently, it has become evident that the gut plays a central role in the development of multiple organ failure in the critically ill patient after trauma-hemorrhage and sepsis. However, it remains unknown whether gut absorptive capacity (GAC) is altered under those conditions. The aim of this study, therefore, was to use a rat model for GAC measurements independent of the function of other organs and to determine whether GAC is altered after trauma. Rats (n = 79; 250-325 g) were lightly anesthetized with ether, and a 6-cm midline laparotomy was performed (i.e., trauma induced). A nasogastric tube was inserted and after cannulation of various blood vessels, the animals were allowed to recover from anesthesia. They were then divided into various groups for determinations of GAC over a period of 5 days. Control animals had GAC measurements without any surgery being performed on them. GAC was determined using the 1-h D-xylose absorption test and measuring D-xylose concentration in the portal blood. Results demonstrate that GAC 1) is significantly depressed for the first 48 h after trauma, 2) returns to normal 72 h after trauma, and 3) is further depressed by hemorrhage and resuscitation and by sepsis after trauma. Thus the model described here can be used to investigate the effects of trauma, trauma plus hemorrhage, trauma plus sepsis, hemorrhage alone, and sepsis alone on GAC, independent of the function of other organs.
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PMID:Measurement of D-xylose gut absorptive capacity in conscious rats. 195 81

Radionuclide gastroscopy conducted in patients with vast purulent wounds and sepsis disclosed reduced motor-evacuatory function of the stomach and the rate of its fractional emptying, that supports the necessity of continuous administration of nutrient mixtures by a drip method. A significant improvement of the motor evacuatory function and the rate of fractionated emptying of the stomach, 9-12 days after the commencement of the enteral (tube) nutrition, has shown the necessity of its use at the early stages of the course of severe purulent infection. The investigation of the absorptive capacity of the intestine with the use of the D-xylose test has revealed that it is insignificantly decreased in 82.6% of patients with severe purulent infection, and tube nutrition in such patients could be successfully conducted. Only in 17.4% of the patients the adsorptive capacity of the intestine was significantly decreased, and in these cases predominantly parenteral nutrition was recommended.
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PMID:[Motor evacuatory function of the stomach and the absorptive capacity of the intestines in patients with extensive suppurative wounds receiving tube feeding]. 285 77

Although clinical studies suggest enteral, as opposed to parenteral, feeding lowers morbidity and mortality rates following severe trauma and after sepsis, it is unknown whether gut absorptive capacity (GAC) is indeed maintained under such conditions. To study this, GAC was determined in patients with blunt trauma (n = 8) and with sepsis (n = 11) by the 1-hour D-xylose absorption test. Excluded were patients with ileus, nasogastric output of more than 600 mL/24 hours, or residual gastric content of more than 25 mL after the D-xylose test. Trauma patients (ISS 8-14) and patients with intra-abdominal sepsis had an initial D-xylose test within 24 to 48 hours of admission, at 72 to 96 hours, and then weekly until D-xylose absorption had returned to normal. D-xylose (25 g in 200 mL water) was given via nasogastric tube to patients and orally to healthy volunteers (controls: n = 8). Results show that GAC was depressed at 24 to 96 hours in both groups but returned to normal by 1 to 3 weeks after trauma or resolution of sepsis. Thus (1) gut absorptive capacity was severely depressed early after trauma and after the onset of sepsis; and (2) the 1-hour D-xylose absorption test provided a simple, quantitative assessment of GAC in critically ill patients. Hence, therapeutic agents that restore gut absorptive capacity may be useful for further reducing morbidity and mortality rates following trauma or the onset of sepsis.
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PMID:Severe depression of gut absorptive capacity in patients following trauma or sepsis. 801 1

Although recent studies have shown that gut absorptive function is significantly depressed even in the early hyperdynamic phase of sepsis, the mechanism responsible for this is unknown. Tumor necrosis factor (TNF-alpha) is a potent mediator of shock resulting in a marked inflammatory response leading to mucosal erosions of the gut and multiple organ failure. Although TNF is elevated in early sepsis, it remains unknown whether TNF plays any role in the depression of gut absorptive function under these conditions. To study this, we used the 1 hr D-xylose absorption test. C3H/HeN mice (n = 12) were lightly anesthetized, and a femoral artery and the portal vein were cannulated. After recovery from anesthesia, 125 micrograms recombinant murine TNF-alpha (rMuTNF-alpha)/kg body weight was given via the tail vein to one group of animals, while another group received an equivalent volume of saline (sham). One hour later, D-xylose was given orally. The systemic blood pressure was recorded 1 hr thereafter and D-xylose concentration in a sample of portal blood was determined colorimetrically. Results show that, while the systemic pressure was elevated 2 hr after administration of rMuTNF-alpha, D-xylose absorption was severely depressed. Thus the depressed gut absorptive function seen in the early stage of sepsis may be mediated directly or indirectly by TNF-alpha.
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PMID:Tumor necrosis factor depresses gut absorptive function. 848 19

The present study includes 178 Haemophilus influenzae strains isolated in different pediatric hospitals from Havana, Cuba, during 1991-1994, associated to divers infections (meningitis, respiratory sepsis, primary bacteremia). A combination of various typing and subtyping methods was used as epidemiological markers: serotyping (slide agglutination with diagnostical serum a-f and latex agglutination), biotyping according to Killian's procedures (by determination of indole production, urease and ornithine decarboxylase activity), subtyping by fermentative profiles according to Roberts' methods (glucose, maltose, xylose and fructose) and outer membrane protein profile subtyping (vesicles extraction by a modified Barenkamp's method, analysis by lineal and gradient SDS-PAGE and assessment according to our own classification system). Serotype b was identified in 89.3%, biotype I was the most frequent (79.1%), other biotypes (II, III, IV and V) were also identified. Fermentative profile D (glucose, maltose, xylose and fructose positive) was the most frequent (52.8%) while profile G (glucose, maltose, xylose positive and fructose negative) represented 20.2%. Other known profiles were present. PA2 (33.7%) was the most frequent OMP subtype. Even though 11 different protein subtypes were found, the 77.5% of the strains were located in only three OMP electrophoretic subtypes (PA2, PC1, LA2).
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PMID:[Utilization of different microbiological markers in the study of Haemophilus influenzae]. 902 20

Vibrio vulnificus is Gram-negative bacterium that contaminates oysters, causing highly lethal sepsis after consumption of raw oysters and wound infection. We previously described two sets of V. vulnificus strains with different levels of virulence in subcutaneously inoculated iron dextran-treated mice. Both virulent, clinical strains and attenuated, environmental strains could be recovered in high numbers from skin lesions and livers; however, the attenuated environmental strains required significantly higher numbers of colony-forming units (cfu) in the inoculum to produce lethal infection. Using some of these strains and an additional clinical strain, we presently asked if the different abilities to cause infection between the clinical and environmental strains were due to differences in rates of growth or death of the bacteria in the mouse host. We therefore constructed a marker plasmid, pGTR902, that functions as a replicon only in the presence of arabinose, which is not present in significant levels in animal tissues. V. vulnificus strains containing pGTR902 were inoculated into iron dextran-treated and untreated mice. Measuring the proportion of bacteria that had maintained the marker plasmid recovered from mice enabled us to monitor the number of in vivo divisions, hence growth rate; whereas measuring the number of marker plasmid-containing bacteria recovered enabled the measurement of death of the vibrios in the mice. The numbers of bacterial divisions in vivo for all of the strains over a 12-15 h infection period were not significantly different in iron dextran-treated mice; however, the rate of death of one environmental strain was significantly higher compared with the clinical strains. Infection of non-iron dextran-treated mice with clinical strains demonstrated that the greatest effect of iron dextran-treatment was increased growth rate, while one clinical strain also experienced increased death in untreated mice. V. vulnificus inoculated into iron dextran-treated mice replicated extremely rapidly over the first 4 h of infection with doubling times of approximately 15-28 min. In contrast, one of the environmental strains exhibited a reduced early growth rate. These results demonstrate that differences in virulence among naturally occurring V. vulnificus can be explained by diverse abilities to replicate rapidly in or resist defences of the host. The marker plasmid pGTR902 should be useful for examining virulence of bacteria in terms of differentiating growth verses death in animal hosts for most Gram-negative bacteria.
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PMID:Use of a marker plasmid to examine differential rates of growth and death between clinical and environmental strains of Vibrio vulnificus in experimentally infected mice. 1685 38

Four bacterial isolates were recovered from the blood cultures of four patients, two of whom were from Hong Kong and two of whom were from Canada. The two Hong Kong strains were isolated from a 48-year-old man with intestinal obstruction and secondary sepsis (strain HKU16T) and from a 39-year-old man with acute appendicitis (strain HKU17), while the two Canadian strains were isolated from a 74-year-old man with biliary sepsis (strain CA1) and from a 66-year-old woman with metastatic carcinoma and sepsis (strain CA2). While the first three patients survived, the last patient died 2 weeks after the episode of bacteremia. All four isolates are strictly anaerobic, nonsporulating, gram-positive coccobacilli that were unidentified by conventional phenotypic tests and commercial identification systems. They grow on sheep blood agar as nonhemolytic pinpoint colonies after 48 h of incubation at 37 degrees C in an anaerobic environment. All are catalase positive and motile, with flagella. They produce acid from arabinose, glucose, mannose, and xylose. They do not produce indole or reduce nitrate. They are sensitive to penicillin, vancomycin, and metronidazole but resistant to cefotaxime. 16S rRNA gene sequence analysis showed 16.0%, 16.8%, and 21.0% base differences from Clostridium propionicum, Clostridium neopropionicum, and Atopobium minutum, respectively. The G+C content of strain HKU16T is 40.2% +/- 2.2%. Based on their phylogenetic affiliation, unique G+C content, and phenotypic characteristics, we propose a new genus and species, Catabacter hongkongensis gen. nov., sp. nov., to describe the bacterium, for which HKU16 is the type strain, and suggest that it be assigned to a new family, Catabacteriaceae. The gastrointestinal tract was probably the source of the bacterium for at least three of the four patients. The isolation of a catalase-positive, motile, nonsporulating, anaerobic gram-positive bacillus in clinical laboratories should raise the possibility of C. hongkongensis. Further studies should be performed to ascertain the epidemiology and other disease associations of this bacterium.
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PMID:Catabacter hongkongensis gen. nov., sp. nov., isolated from blood cultures of patients from Hong Kong and Canada. 1712 22

Malononitrilamide 715 (FK778) is a new class of immunosuppressant, derived from the active metabolite of leflunomide A77 1726. We investigated the efficacy of two different immunosuppressive induction protocols with tacrolimus plus FK778 followed by FK778 monotherapy. In a swine model of small bowel transplantation, we observed three groups, divided by different therapy regimens: group 1 (n = 5): no immunosuppressant (control group); group 2 (n = 10): oral tacrolimus (from postoperative day [POD] 0 to 30) and FK778 (from POD 0 to 60); group 3 (n = 8): oral tacrolimus, as group 2, and FK778 (from POD 7 to POD 60). Median survival was 11, 60, and 21 days in groups 1, 2, and 3, respectively. In group 1 all animals died of acute rejection; in group 2 the causes of death were technical complication (n = 1) and sepsis (n = 1); in group 3, one animal died from obstruction, two from pneumonia, one from peritonitis, one from sepsis. Group 2 accounted for 0.5 infection episode/animal versus 0.62 in group 3 (P < .05). Acute rejection was absent or mild in 66% and 75% of group 3 and 2 biopsies, respectively (P < .05). The D-xylose absorption curves from groups 2 and 3 were similar to those of the nontransplanted healthy animals. In conclusion, FK778 monotherapy after a consistent induction period with tacrolimus combined immunosuppression is able to extend survival and preserve optimal absorptive capacity of the small bowel allograft in our pig model. The association of tacrolimus and FK778 from day 1, compared to the delayed administration of FK778 from day 7, results in a significant reduction of infections and postoperative complications.
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PMID:Prolonged survival with FK778 (malononitrilamide) monotherapy after small bowel transplantation: a large animal study. 1769 81


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