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

Serious infections due to lactobacilli have been rarely cited. We report our findings in nine recent patients with lactobacillemia. In the combined literature and current experience, endocarditis and sepsis from localized suppuration were the most common clinical syndromes, most frequently arising from prior oropharyngeal infections. Lactobacillus endocarditis showed a predilection for left-sided cardiac involvement (100 per cent) and systemic arterial embolization (55 per cent). The nine clinical isolates were tested for minimal inhibitory and bactericidal concentrations (MICs and MBCs) against five drugs with broad gram-positive spectrums; of note, these organisms demonstrated a high incidence of both unachievable MBCs (64 per cent) and widely disparate (greater than 100 fold) MIC:MBC ratios (38 per cent). This is in accord with observations in Lactobacillus endocarditis of poor in vivo clinical response despite "appropriate" regimens and achievable MICs of the organisms. Bactericidal synergistic studies on two endocarditis isolates indicated that the penicillins plus aminoglycosides may be potentially useful in the treatment of deep-seated Lactobacillus infections when single antimicrobials fail to achieve a cure.
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PMID:Lactobacillemia--report of nine cases. Important clinical and therapeutic considerations. 64 45

During 1967 to 1985, three cases of listeriosis were reported in Algeria; at that time Listeria monocytogenes caused several thousand cases of meningitis and sepsis in the world. In order to determine the frequency and bacteriologic characteristics of strain isolated in Algeria, a prospective investigation was carried from 1985 to 1989 in humans and animals samples. Sensitivity tests to antibiotics (MIC) point out that all isolates strains are resistant to cephalosporins (first and third generation), but are susceptible to Ampicillin and Gentamicin which ought to constitute the treatment basis of listeriosis.
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PMID:[Prospective study of Listeria in humans and animals]. 130 33

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

Panipenem/betamipron (PAPM/BP) is a mixture of panipenem (PAPM), carbapenem antibiotic, and betamipron (BP), N-benzoyl-beta-alanine. The adverse reaction to PAPM of the kidney is reduced by the addition of BP to PAPM which inhibits the anion transport in the kidney tubules. We studied the pharmacokinetics and the clinical efficacies of PAPM/BP in children and we evaluated the antibacterial activities of PAPM by determining MIC values of PAPM in vitro against organisms isolated in our children's hospital from January to December, 1990. 1. Pharmacokinetics 10 mg/kg of PAPM/BP (10 mg PAPM/10 mg BP) was administered intravenously by drip infusion to 7 children. The mean blood concentration of PAPM was 14.8 micrograms/ml at the peak, and the mean half life was 0.9 hours in blood. PAPM was not detected in blood 3 hours after the time when the peak values were attained. 2. Clinical studies 10 mg/kg of PAPM/BP was administered intravenously 3 times a day to 18 cases including 15 of respiratory infections, 2 of otitis media and 1 of sepsis. The clinical efficacies of PAPM/BP were excellent or good in 17 out of the 18 cases. All causative organisms isolated in 5 cases, Methicillin-sensitive Staphylococcus aureus (MSSA) (1 case), Streptococcus pneumoniae (1), Haemophilus influenzae (2) and Branhamella catarrhalis (1) were eradicated in a few days upon the administrations of PAPM/BP. No adverse reactions due to PAPM/BP were observed, but a slight elevation of platelet counts in blood was observed in 1 case, which was normalized soon after the end of the treatment. 3. Antibacterial activities in vitro(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pharmacokinetics and clinical studies of panipenem/betamipron in the pediatric field]. 151 28

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

The management of severe bacterial sepsis is an integral part of intensive care medicine. Early and appropriate treatment with antimicrobials positively affects mortality and significantly reduces the time spent in both intensive care and the hospital. Drug choice is usually made on a "best guess" basis and instituted prior to receipt of appropriate blood, sputum, urine or drainage culture results. Bactericidal drugs should be given in combination, delivered by intravenous bolus and directed towards broad cover of all likely pathogens. Aminoglycoside/ureidopenicillin combinations are synergistic and widely used--often combined with metronidazole. Aminoglycoside toxicity can be reduced by giving the drug once daily (OD) rather than by traditional multiple daily dosing (MDD) and by measuring peak and trough serum levels. Efficacy is increased by attention to the peak serum level/MIC ratio which determines the response to treatment. Several newer agents have been more recently introduced. These drugs include ceftazidime, imipenem/cilastatin, the quinolones and clavulanic acid/semisynthetic penicillin combinations. Other newer drugs currently under evaluation include aztreonam, teicoplanin, the penems and carbapenems.
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PMID:Treatment of sepsis in an intensive care unit. 228 99

Laboratory records were reviewed to assess the clinical relevance of isolating viridans (VS) and nonhemolytic (NHS) streptococci from blood and cerebrospinal fluid (CSF) specimens in a pediatric setting. During a nine-month period, 722 of 6,569 blood cultures and 113 of 2,023 CSF cultures were positive for one or more organisms. There were 26 VS and 10 NHS blood isolates from 30 patients and five NHS isolates from the CSF of five additional patients. The patients ranged in age from five weeks to 16 years. The charts of 34 patients were reviewed for evidence of sepsis or meningitis and the physician's response to the positive cultures. Three patients had subacute bacterial endocarditis (SBE) with multiple positive blood cultures. All other patients, including six oncology patients, failed to show a positive correlation between the isolation of VS or NHS and the disease process. Speciation and MIC testing were performed on 13 isolates, including those from all SBE and four oncology patients. Because of the lack of significance of VS and NHS from blood and CSF specimens in patients other than those with SBE, the authors conclude that extensive microbiologic workup of VS and NHS is not necessary without appropriate clinical indications such as SBE or immunosuppression.
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PMID:Clinical relevance of viridans and nonhemolytic streptococci isolated from blood and cerebrospinal fluid in a pediatric population. 230 Dec 89

We evaluated standard oxacillin and methicillin disk diffusion (DD) and broth microdilution (MD)-MIC tests with and without 2% NaCl for detecting heteroresistance among 47 blood isolates of coagulase-negative staphylococci (CNS) causing catheter sepsis in pediatric patients. The 24-hr oxacillin DD test detected the greatest number (40) of apparent hetero-resistant isolates, but methicillin DD and oxacillin MD-MIC with 2% NaCl performed equally as well (38 and 37 resistant isolates, respectively). An additional 24-hr incubation did not significantly increase the number of apparent heteroresistant isolates detected by these methods. Discrepant results with the various test methods occurred most commonly among Staphylococcus epidermidis isolates with MD-MIC values near the breakpoint concentrations for interpretation of susceptible and resistant strains. For detection of heteroresistance among the CNS, we encourage use of standard oxacillin DD and MD-MIC tests but would suggest that isolates with MIC values ranging from 1-2 micrograms/ml be interpreted cautiously until clinical studies demonstrate the efficacy of treating patients with infections caused by such strains.
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PMID:Beta-lactam susceptibility of coagulase-negative staphylococci causing catheter sepsis in pediatric patients. 233 55

Two hundred obligately anaerobic bacterial isolates from human clinical sources were tested for susceptibility to ceftizoxime using a standard National Committee for Clinical Laboratory Standards microwell system. In general, the minimal inhibitory concentrations (MIC50) ranged from less than 0.125 to 32 microgram/ml; however, the MIC50 for Bacteroides fragilis averaged greater than 128 microgram/ml. This finding is inconsistent with the results of in vivo testing of ceftizoxime in an animal model of intra-abdominal sepsis (B fragilis is a major contributor to the development of intra-abdominal abscesses). Various modifications of in vitro assay parameters, including basal media (brain-heart infusion [BHI] or Wilkins-Chalgren [WC]) and methods (microwell, broth, and agar dilutions), were compared. Ten B fragilis isolates from the original clinical study were used. Results indicate that the activity of ceftizoxime decreased between two- and fourfold after storage for 48 hours at -80 degrees C, regardless of methodology or basal media. When microwell was compared with broth dilution, there was a four- to 64-fold decrease in MIC values by the latter method using BHI but little variation using WC. No differences were observed when the incubation time was varied. Preliminary data indicate that MIC values from broth dilution using BHI correspond with those of agar dilution assays. These results suggest methodologic as well as environmental discrepancies with regard to susceptibility testing of ceftizoxime. These differences may lead to misinterpretation of the true susceptibility of organisms to this agent, particularly when the results are compared with in vivo observations.
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PMID:Comparison of in vivo and in vitro efficacy of ceftizoxime. 239 Jul 72

Enterococcus faecium D399 was isolated from the blood and peritoneal abscess of a patient with intraabdominal sepsis. The patient had not been treated with vancomycin, but the strain was found to be resistant with a MIC of 1000 mg/l. Resistance was inducible and transferable (probably by conjugation) to JH2-2, and correlated with induction of synthesis of a 39 kDa protein. This mechanism appears to be identical to that previously described for E. faecalis A256, suggesting that dissemination of this form of glycopeptide resistance has already occurred. The resistance phenotype of D399, however, differed somewhat from that found in other enterococcal strains with inducible resistance.
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PMID:Inducible, transferable resistance to vancomycin in Enterococcus faecium, D399. 250 Dec 70


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