Articles: sepsis.
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Antimicrob. Agents Chemother. · Sep 1985
Comparative StudyEfficacy of cefmenoxime in experimental Escherichia coli bacteremia and meningitis.
Cefmenoxime, a new semisynthetic cephalosporin structurally similar to cefotaxime, was evaluated for its activities in vitro and in vivo against a K1 Escherichia coli strain in comparison with activities of cefotaxime and ampicillin. In vitro the MICs and MBCs of both cefmenoxime and cefotaxime were the same, 1/16th and 1/32nd those of ampicillin, respectively. ⋯ The mortality was significantly greater in rats with bacterial counts before therapy of greater than or equal to 10(6) CFU/ml of blood than in animals with lower counts. Overall, the in vivo efficacy of cefmenoxime was similar to that of cefotaxime; thus it could be useful in the therapy of neonatal E. coli infection.
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Risk factors for the development of septicemia, which are similar to those associated with any urinary tract infection, are reviewed. The "ABCs of Management" are outlined. Early recognition and effective management including selection of an effective antimicrobial agent for empiric therapy can have a direct impact on the patient's survival. ⋯ Since sepsis is a systemic infection, patients must be monitored closely for failure of vital physiologic functions. Suggestions are offered for dealing with lack of response to antibiotic and supportive measures. Rapid diagnosis and effective management can improve the prognosis for septic patients.
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Eur. J. Clin. Microbiol. · Jun 1985
Case ReportsRetrospective analysis of two hundred and twelve cases of bacteremia due to anaerobic microorganisms.
Cases of bacteremia caused by anaerobic microorganisms and occurring during a four year period in a non-selected patient group in a Spanish general hospital were analysed retrospectively. Microbiological data was collected on 212 patients and clinical data on 103 patients. Cases of anaerobic bacteremia represented 8.6% of the total number of cases of bacteremia. ⋯ The overall mortality was 32% and factors associated with poor prognosis were severe underlying disease, nosocomial acquisition, presence of shock, presence of metastatic foci of infection, and absence of adequate surgical drainage. The mortality rate of patients who received adequate antimicrobial therapy was 30% and that of patients who received inadequate treatment or none was 29%. It is concluded that anaerobic bacteremia has a significant rate of morbidity and mortality and that underlying disease and surgical debridement and/or drainage have greater prognostic significance than the use of antimicrobial agents.
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Tissue infection and systemic sepsis are common causes of morbidity and late mortality after major thoracic trauma. To seek causative mechanisms, prognostic indicators, and areas of possible improvement in therapy, we reviewed 310 consecutive adults admitted with major thoracic trauma. Of these, 56 (18%) died of massive injuries in the first 5 days; the remaining 254 were considered at risk for infectious complications. ⋯ Pulmonary infection was increased significantly following prolonged endotracheal intubation, but was virtually absent following tracheostomy. The risk of infection was increased significantly if prophylactic antibiotics were not used, but no definite correlation could be made to advanced age, pre-existent disease, nor post-traumatic malnutrition. Attention to some of these factors may decrease the risk of infection in thoracic trauma.
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The article discusses the present therapy of acute meningococcal septicemia. Besides adequate antibiotic treatment, the importance of early and aggressive shock and respiratory therapy, i.e. endotracheal intubation and mechanical ventilation, is stressed. The role of corticosteroids is discussed. The use of anticoagulants, fibrinolytic agents and inhibitors of fibrinolysis is discouraged.