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)

As an immunomodulator, melatonin reportedly exhibits protective effects in severe sepsis/shock induced by bacterial lipopolysaccharides in animal models. The present study was conducted to evaluate the possible protective effects of melatonin against experimental Candida sepsis in rats. A total of 40 adult male Wistar rats were randomly assigned to 4 groups: control, melatonin-treated control, septic, and melatonin-treated septic. Melatonin (200 microg/kg/d, intraperitoneally) injections were begun a week prior to sepsis induction and were continued daily for 3 wk until the end of the study. Cyclophosphamide was administered to animals in all groups as an immunosuppressive agent as a single dose 4 d prior to yeast inoculation. To cause sepsis, the Candida albicans (ATCC 10259) strain was administered intravenously. Amphotericin B was given as an antimycotic therapeutic agent as a single dose to septic rats. Plasma levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), vascular cell adhesion molecule-1, and E-selectin were measured on the first and 15th days of sepsis. IL-6, TNF-alpha, vascular cell adhesion molecule-1, and E-selectin levels of septic rats were higher than those of controls. Melatonin reduced IL-6 levels and shortened time to improvement in animals with Candida sepsis. Levels of TNF-alpha and adhesion molecules in melatonin-treated septic rats were decreased compared with those in septic rats, but this difference was not statistically significant. In light of the current results, investigators conclude that melatonin may have therapeutic benefits in Candida sepsis and in classic antimycotic treatment because of its immune regulatory effects.
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PMID:Effects of melatonin on Candida sepsis in an experimental rat model. 1752 65

A first resistant strain of Enterobacter cloacae was isolated from a blood specimen in a pediatric patient with immature teratoma-developed sepsis after combination chemotherapy. The strain produced extended-spectrum beta-lactamase (ESBL), and the same ESBL-producing strains were detected in urine samples from other patients in the pediatric ward. All strains harbored genes for bla (CTX-M-3) by polymerase chain reaction (PCR) and sequencing analysis. Analysis of pulsed-field gel electrophoresis revealed that all strains were the same clonal type. These results suggest that ESBL-producing strains might be transmitted in the ward via contact among patients or medical staff.
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PMID:Outbreak of CTX-M-3-type extended-spectrum beta-lactamase-producing Enterobacter cloacae in a pediatric ward. 1772 90

CTX-M-15 beta-lactamase-producing Klebsiella pneumoniae serotype K1 was isolated from a patient with fatal upper urinary tract infection (UTI) complicated by sepsis caused by K. pneumoniae serotype K2. Transfer of a CTX-M-15 beta-lactamase plasmid from the K1 to the K2 strain was observed. However, plasmid acquisition by the K2 strain did not occur in vivo, suggesting that the K1 strain might not have contributed directly to the upper UTI. In addition, effects of K serotypes and plasmid acquisition on K. pneumoniae serum resistance were examined.
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PMID:Upper and lower urinary tract infection caused by Klebsiella pneumoniae serotype K2 and CTX-M-15 beta-lactamase-producing serotype K1: a case report and characterization of serum killing resistance. 1806 78

We describe what we believe to be the first case of neonatal sepsis caused by CTX-M-producing Escherichia coli, in a low-weight preterm infant, born to a colonized mother who had received antibiotic treatment antepartum. Increased dissemination of extended-spectrum beta-lactamase-producing E. coli in the community should be borne in mind for empirical therapy of sepsis in high-risk newborns.
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PMID:Neonatal sepsis caused by a CTX-M-32-producing Escherichia coli isolate. 1880 64

An extended-spectrum beta-lactamase (CTX-M-15 type)-producing Escherichia coli persisted in the intestinal tract for >5 months in a pediatric patient after cord blood stem-cell transplantation and caused 2 episodes of sepsis. The bla(CTX-M-15) is carried by a large plasmid of approximately 130 kb in size. The prolonged shedding of the highly resistant E. coli posed a great challenge to infection control and public health.
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PMID:Prolonged fecal shedding of CTX-M-15-producing Escherichia coli and recurrent sepsis in a patient after cord blood stem-cell transplantation. 1911 86

Since 2000, Escherichia coli producing CTX-M enzymes have emerged worldwide as important causes of community-onset urinary tract and bloodstream infections owing to extended-spectrum beta-lactamase (ESBL)-producing bacteria. Molecular epidemiological studies suggested that the sudden worldwide increase of CTX-M-15-producing E. coli was mainly due to a single clone (ST131) and that foreign travel to high-risk areas, such as the Indian subcontinent, might in part play a role in the spread of this clone across different continents. Empirical antibiotic coverage for these resistant organisms should be considered in community patients presenting with sepsis involving the urinary tract, especially if the patient recently travelled to a high-risk area. If this emerging public health threat is ignored, it is possible that the medical community may be forced, in the near future, to use carbapenems as the first choice for the empirical treatment of serious infections associated with urinary tract infections originating from the community.
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PMID:Molecular epidemiology of Escherichia coli producing CTX-M beta-lactamases: the worldwide emergence of clone ST131 O25:H4. 2006 Feb 73

Since 2000, Escherichia coli producing CTX-M enzymes (especially CTX-M-15) have emerged worldwide as important causes of community-onset urinary tract infections (UTIs) and bloodstream infections due to extended-spectrum beta-lactamase (ESBL)-producing bacteria. Molecular epidemiology studies suggested that the sudden worldwide increase of CTX-M-15-producing E. coli is mostly due to a single clone named ST131 and that foreign travel to high-risk areas such as the Indian subcontinent might in part play a role in the spread of this clone across different continents. Empirical antibacterial coverage for these resistant organisms should be considered in community patients presenting with sepsis involving the urinary tract especially if a patient recently travelled to a high-risk area. Infections due to ESBL-producing Enterobacteriaceae are associated with a delay in initiation of appropriate antibacterial therapy, which consequently prolongs hospital stays and increases hospital costs. Failure to initiate appropriate antibacterial therapy from the start appears to be responsible for higher patient mortality. The carbapenems are widely regarded as the drugs of choice for the treatment of severe infections due to ESBL-producing Enterobacteriaceae, although comparative clinical trials are lacking. Agents that may be useful for the treatment of ESBL-associated UTIs include fosfomycin, nitrofurantoin and temocillin. If this emerging public health threat is ignored, it is possible that clinicians may be forced in the near future to use the carbapenems as the first choice for empirical treatment of serious infections associated with UTIs originating from the community.
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PMID:Infections with extended-spectrum beta-lactamase-producing enterobacteriaceae: changing epidemiology and drug treatment choices. 2016 68

Bacteria harboring CTX-M extended-spectrum beta-lactamases (ESBLs) have been identified worldwide, with most reports coming from regions outside North America. We have identified CTX-M enzymes in 31% of ESBL-positive Escherichia coli isolates from our hospital and more than half (53%) of the isolates from associated long-term care facilities. Approximately 3/4 of all CTX-M-bearing isolates were from urine specimens, with a predominance of CTX-M-15. A large proportion of such isolates were nonsusceptible to levofloxacin, trimethoprim/sulfamethoxazole, and all beta-lactam antimicrobials with the exception of the carbapenems, requiring carbapenem therapy for acute urinary tract infection or urinary tract-related sepsis. CTX-M beta-lactamases have emerged within our location, and detection of bacteria harboring these enzymes in the clinical microbiology laboratory remains problematic because molecular methods are needed for their identification.
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PMID:Identification of CTX-M beta-lactamases in Escherichia coli from hospitalized patients and residents of long-term care facilities. 2022 30

Systemic infection and inflammation in men are associated with bone loss. Rodent studies have elucidated the pathways mediating the effects of bacterial lipopolysaccharide (LPS), activated immune cells and hormones on bone. Here we investigate the changes in biochemical parameters of bone turnover following human endotoxemia, an experimental model of self-limiting systemic infection and inflammation. Ten healthy men received in a randomised, placebo-controlled, cross-over trial once placebo and once 2 ng/kg Escherichia coli endotoxin (LPS). During the following 6 h we monitored parathyoid hormone (PTH) and osteopontin (OPN), a multifunctional protein related to bone pathophysiology, as well as biochemical markers of bone turnover: C-terminal telopeptide of type I collagen (CTX), N-terminal propeptide of type I collagen (P1NP) and osteocalcin (OC). In LPS sessions there was a transient fall in PTH at 3 h (p=0.009) and a nearly two-fold increase in OPN levels after 6 h (LPS: 155+/-19 pg/ml; placebo: 85+/-13 pg/ml, p<0.001). LPS gradually reduced CTX levels (LPS: 0.44+/-0.4 pg/ml; placebo: 0.59+/-0.06 pg/ml, p=0.003), P1NP showed a peak at 4 h (LPS: 89.9+/-14.7 pg/ml; placebo: 75+/-9.7 pg/ml, p=0.028) and circulating OC did not change. The early human response to systemic endotoxemia boosts osteopontin levels and modifies bone biomarkers, indicating a decrease in the lytic activity of osteoclasts, accompanied by an increase in the activity of immature osteoblasts. These changes might present the acute phase response of immune and bone cells to bacterial stimuli in men.
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PMID:Changes in osteopontin and in biomarkers of bone turnover during human endotoxemia. 2042 Sep 43

Extended-spectrum beta-lactamases (ESBLs) are bacterial enzymes that confer resistance to advanced generation cephalosporins and can lead to therapeutic failures. There has been no analysis of factors associated with the risk of acquisition of ESBLs in neonates in an intensive care unit from northern India. The CTX-M ESBL enzymes impart resistance against advanced generation cephalosporins (e.g. cefotaxime) and CTX-M variants have become the most prevalent ESBLs worldwide. The CTX-M-15 enzyme in particular is increasingly being reported from Escherichia coli isolates from northern India together with TEM-1. Moreover, E. coli is the most common cause of neonatal sepsis. Accordingly, this study aimed to: (i) characterize the mode of transmission of bla(CTX-M) and bla(TEM) among ESBL-producing E. coli strains isolated from patients admitted to a neonatal intensive care unit (NICU), and (ii) identify factors associated with the acquisition of the said strains in male and female neonates. A total of 97 ESBL-producers was identified among 266 E. coli strains isolated from 238 neonates. The isolates were screened for bla(CTX-M), bla(TEM), armA, rmtA and rmtB, the last three genes being responsible for aminoglycoside resistance. PCR amplified bla(CTX-M) genes were cloned and sequenced. Five bla(CTX-M-15), two rmtB, two bla(TEM-1) and thirteen class1 integrons were detected. All the bla(CTX-M-15) positive isolates, except one, were clonally related. Both univariate and multivariate analyses of factors for the acquisition of the said strains were performed with respect to the sex of the neonates. 'Length of stay in the NICU' was found to be the single independent factor associated with ESBL acquisition. In conclusion, our data suggest that male neonates who are colonized or infected by ESBL-producing E. coli have a longer stay in the NICU compared to their female counterparts. This prolonged stay may be due to male neonates becoming colonized/infected earlier than their female counterparts. Plasmid-mediated-conjugal transfer was found to be the mechanism of transfer of the bla(CTX-M-15) resistance marker in the described setting.
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PMID:Acquisition of extended-spectrum beta-lactamase producing Escherichia coli strains in male and female infants admitted to a neonatal intensive care unit: molecular epidemiology and analysis of risk factors. 2043 Sep 3


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