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Culture-negative sepsis

Yuji Watanabe, Nozomi Oikawa, Maya Hariu, Ryota Fuke, Masafumi Seki
Procalcitonin (PCT) and C-reactive protein serve as biomarkers of infection in patients with sepsis/bacteremia. The present study assessed the clinical characteristics of 280 patients with suspected sepsis who were admitted to Tohoku Medical and Pharmaceutical University Hospital between January 2012 and December 2013. Among the patients, 133 and 147 were positive and negative for PCT, respectively. Patients who were PCT positive were older and more frequently male, had reduced levels of platelets and albumin, and increased levels of aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine, and C-reactive protein...
2016: International Journal of General Medicine
Yun Long, Yinxin Zhang, Yanping Gong, Ruixue Sun, Longxiang Su, Xin Lin, Ao Shen, Jiali Zhou, Zhuoma Caiji, Xinying Wang, Dongfang Li, Honglong Wu, Hongdong Tan
BACKGROUND AND AIMS: Bacteremia is a common serious manifestation of disease in the intensive care unit (ICU), which requires quick and accurate determinations of pathogens to select the appropriate antibiotic treatment. To overcome the shortcomings of traditional bacterial culture (BC), we have adapted next-generation sequencing (NGS) technology to identify pathogens from cell-free plasma DNA. METHODS: In this study, 78 plasma samples from ICU patients were analyzed by both NGS and BC methods and verified by PCR amplification/Sanger sequencing and ten plasma samples from healthy volunteers were analyzed by NGS as negative controls to define or calibrate the threshold of the NGS methodology...
July 2016: Archives of Medical Research
Gamze Ozgurhan, Oznur Vermezoglu, Didem Ocal Topcu, Adem Karbuz, Aysel Vehapoglu, Bulent Hacihamdioglu
Although rotavirus gastroenteritis is quite common in the pediatric population, secondary bacterial sepsis following rotavirus infection is a rare clinical entity. Gram-negative bacilli are the fifth most common cause of meningitis in infants but this infection rarely occurs after gastroenteritis. Here, we report a 2.5-month-old infant who developed Escherichia coli (E. coli) meningitis after acute rotavirus gastroenteritis. The 2.5-month-old male infant with fever, vomiting, and watery diarrhea that started 1 day earlier was admitted to the hospital...
2016: Case Reports in Infectious Diseases
David Carr, Elizabeth Helen Barnes, Adrienne Gordon, David Isaacs
BACKGROUND: Antibiotic resistance is a worldwide problem. We describe 25 years of responsible antibiotic use in a tertiary neonatal unit. METHODS: Data on neonatal infections and antibiotic use were collected prospectively from 1990 to 2014 at a single tertiary Sydney neonatal intensive care unit attached to a maternity unit. There are approximately 5500 deliveries and 900 nursery admissions per year. RESULTS: The mean annual rate of late-onset sepsis was 1...
October 13, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Rapeephan R Maude, Aniruddha Ghose, Rasheda Samad, Hanna K de Jong, Masako Fukushima, Lalith Wijedoru, Mahtab Uddin Hassan, Md Amir Hossain, Md Rezaul Karim, Abdullah Abu Sayeed, Stannie van den Ende, Sujat Pal, A S M Zahed, Wahid Rahman, Rifat Karnain, Rezina Islam, Dung Thi Ngoc Tran, Tuyen Thanh Ha, Anh Hong Pham, James I Campbell, H Rogier van Doorn, Richard J Maude, Tom van der Poll, W Joost Wiersinga, Nicholas P J Day, Stephen Baker, Arjen M Dondorp, Christopher M Parry, Md Abul Faiz
BACKGROUND: Fever is a common cause of hospital admission in Bangladesh but causative agents, other than malaria, are not routinely investigated. Enteric fever is thought to be common. METHODS: Adults and children admitted to Chittagong Medical College Hospital with a temperature of ≥38.0 °C were investigated using a blood smear for malaria, a blood culture, real-time PCR to detect Salmonella Typhi, S. Paratyphi A and other pathogens in blood and CSF and an NS1 antigen dengue ELISA...
October 13, 2016: BMC Infectious Diseases
Rajeev Soman, Neha Gupta, Mitesh Suthar, Jatin Kothari, Alan Almeida, Anjali Shetty, Camilla Rodrigues
BACKGROUND: Central-line-associated blood-stream infection (CLABSI) is a highly consequential nosocomial infection. The most effective management includes the removal of the infected catheter. Retention of the catheter and antibiotic lock therapy (ALT) along with systemic antibiotics may be attempted only if there are unusual extenuating circumstances. CLABSIs due to Gram-negative bacteria (GNB) is more common in our setting and the organisms are often highly resistant. Hence, there is a need to explore the use of novel antimicrobials for catheter lock solutions along with antibiofilm agents...
February 2016: Journal of the Association of Physicians of India
Vijaya Shivanna, S R Sunkappa, D Venkatesha
Neonatal septicemia is one of the leading causes of neonatal mortality and morbidity worldwide. Hence, the present study was undertaken to isolate the bacteria causing neonatal sepsis and determine their antibiotic susceptibility pattern. Fifty neonates suspected to have septicemia were screened for 2 months (July and August 2014). Out of 50 specimen, 15 (30%) were blood culture positive. Coagulase-negative staphylococci was the most common isolate (10, 66.6%), with 60% (6 isolates) methicillin resistance. In view of the increasing antibiotic resistance, periodic surveillance should be conducted to control the emergence and spread of antimicrobial resistance...
October 2016: Indian Journal of Pathology & Microbiology
Vanessa Poliquin, Elissa Cohen, Philippe Guillaume Poliquin, Carol Schneider, Savas Menticoglou
OBJECTIVE: We reviewed cases of group B Streptococcus (GBS) sepsis in term infants at our institution to identify areas for potential prevention. METHODS: We identified cases by searching our institution's microbiology databases for all positive GBS blood and cerebrospinal fluid cultures taken from infants between 2008 and 2013. Patients were included if the timing of the positive culture met the criteria for early-onset GBS disease (age 7 days or under). Charts that met inclusion criteria were abstracted for details related to antepartum screening, intrapartum care, and postpartum outcome...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Jasmine Chong, Chelsea Caya, Simon Lévesque, Caroline Quach
CONTEXT: NICUs in the province of Québec have seen an increase in hVICoNS, detected in the clinical laboratory. OBJECTIVE: To investigate the clinical relevance of hVICoNS on the course of infection, and to determine the prevalence of hVICoNS sepsis in the NICU. METHODS: We searched MEDLINE, EMBASE, and PubMed from 1 January 1980 to 1 July 2016. Both observational and interventional studies were considered eligible if they provided data on hVICoNS in the NICU population...
2016: PloS One
Abhishek Shukla, Nitin Shrivastava, Chirom Amit Singh, Brusabhanu Nayak
Background: Zygomycoses are uncommon, frequently fatal diseases caused by fungi of the class Zygomycetes. The majority of human cases are caused by Mucorales (genus-rhizopus, mucor, and absidia) fungi. Renal involvement is uncommon and urine microscopy, pottasium hydroxide mount, and fungal cultures are frequently negative. Case Presentation: A twenty-one-year-old young unmarried lady presented to our emergency department with bilateral flank pain, fever, nausea, and decreased urine output of one-month duration...
2016: J Endourol Case Rep
Rachele Pandolfi, Bianca Barreira, Enrique Moreno, Victor Lara-Acedo, Daniel Morales-Cano, Andrea Martínez-Ramas, Beatriz de Olaiz Navarro, Raquel Herrero, José Ángel Lorente, Ángel Cogolludo, Francisco Pérez-Vizcaíno, Laura Moreno
BACKGROUND: Pulmonary hypertension (PH) is frequently observed in patients with acute respiratory distress syndrome (ARDS) and it is associated with an increased risk of mortality. Both acid sphingomyelinase (aSMase) activity and interleukin 6 (IL-6) levels are increased in patients with sepsis and correlate with worst outcomes, but their role in pulmonary vascular dysfunction pathogenesis has not yet been elucidated. Therefore, the aim of this study was to determine the potential contribution of aSMase and IL-6 in the pulmonary vascular dysfunction induced by lipopolysaccharide (LPS)...
July 27, 2016: Thorax
Ming-Yi Wang, Jian-Li Geng, Ying-Jian Chen, Yu Song, Mei Sun, Hai-Zhu Liu, Cheng-Jin Hu
Methicillin-resistant staphylococci and ESBL-producing bacteria are the most important resistant pathogens in sepsis. In the study, a new multiplex-touchdown PCR method (MT-PCR) was developed to detect rapidly and simultaneously the presence of mecA, blaSHV , blaCTX-M , blaTEM and blaOXA genes from positive blood culture bottles. The technique showed a sensitivity of 10(3) CFU ml(-1) for mecA detection and of 10(2) CFU ml(-1) for other genes, and 100% specificity in the detection of all genes. All genes were detected in the spiked blood culture bottles artificially contaminated with reference strains...
October 4, 2016: Letters in Applied Microbiology
Dublu Lal Gupta, Sanjeev Bhoi, Teena Mohan, Sagar Galwnkar, D N Rao
INTRODUCTION: Multiple organ dysfunction syndrome (MODS) developed due to the insult of trauma is a leading cause of death. The high mortality rate in these patients with and without sepsis has been reported up to 50%, throughout the world and thus required an urgent insight to overcome this problem. OBJECTIVE: The aim of this study is to examine the differential changes in subsets of T cells, imbalance in cytokine profile, immune-paralysis (T cell anergy) in Trauma hemorrhagic shock (THS) and post traumatic sepsis patients...
December 2016: Cytokine
Alonso Zea-Vera, Christie Gloria Turín, María Susana Rueda, Daniel Guillén-Pinto, Pilar Medina-Alva, Aldredo Tori, María Rivas, Jaime Zegarra, Anne Castañeda, Luis Cam, Theresa J Ochoa
The objective of this study was to analyze the use of lumbar punctures (LP) in the evaluation of late-onset neonatal sepsis. It is recommended to perform an LP as part of the evaluation of late-onset sepsis. We used a cohort of 414 newborns with a birth weight <2000g in three hospitals in Lima. A LP was performed in 45/214 (21.0%) of sepsis evaluations and in 13/48 (27.1%) of culture-proven sepsis. Meningitis was diagnosed in 8/214 (3.7%) of the episodes and 8/45 (17.5%) of the evaluations that included an LP...
June 2016: Revista Peruana de Medicina Experimental y Salud Pública
Jerry J Zimmerman, Erin Sullivan, Thomas D Yager, Catherine Cheng, Lester Permut, Silvia Cermelli, Leo McHugh, Dayle Sampson, Therese Seldon, Richard B Brandon, Roslyn A Brandon
OBJECTIVES: SeptiCyte Lab (Immunexpress, Seattle, WA), a molecular signature measuring the relative expression levels of four host messenger RNAs, was developed to discriminate critically ill adults with infection-positive versus infection-negative systemic inflammation. The objective was to assess the performance of Septicyte Lab in critically ill pediatric patients. DESIGN: Prospective observational study. SETTING: Pediatric and Cardiac ICUs, Seattle Children's Hospital, Seattle, WA...
September 20, 2016: Critical Care Medicine
Deepak Sharma, Ankur Patel, Priyanka Soni, Pradeep Sharma, Basudev Gupta
Empedobacter brevis is gram-negative bacilli that belongs to Flavobacteriaceae family. It was previously known with name of Flavobacterium breve. The reservoir of these bacteria is soil, plants, water, food, hospital water sources, including incubators, sinks, faucets, tap water, hemodialysis systems, saline solutions, and other pharmaceutical solutions. We report a case of term female newborn, admitted with complaint of respiratory distress developing soon after birth and developed clinical features of sepsis at age of 92 hours of postnatal life...
2016: Case Reports in Pediatrics
Dhruv Parekh, Jaimin M Patel, Aaron Scott, Sian Lax, Rachel C A Dancer, Vijay D'Souza, Hannah Greenwood, William D Fraser, Fang Gao, Elizabeth Sapey, Gavin D Perkins, David R Thickett
OBJECTIVES: Vitamin D deficiency has been implicated as a pathogenic factor in sepsis and ICU mortality but causality of these associations has not been demonstrated. To determine whether sepsis and severe sepsis are associated with vitamin D deficiency and to determine whether vitamin D deficiency influences the severity of sepsis. DESIGN, SETTING, AND PATIENTS: Sixty-one patients with sepsis and severe sepsis from two large U.K. hospitals and 20 healthy controls were recruited...
September 14, 2016: Critical Care Medicine
Shipra Gupta, Ankit Sakhuja, Gagan Kumar, Eric McGrath, Rahul S Nanchal, Kianoush B Kashani
BACKGROUND: Though 28-49% of severe sepsis hospitalizations have been described to be culture negative, there is very limited data on epidemiology and outcomes of those with culture negative severe sepsis (CNSS). The objectives of this study were to investigate the proportion and trends of CNSS, and its association with mortality. METHODS: Using Nationwide Inpatient Sample database from 2000-2010 we identified adults hospitalized with severe sepsis. Those without any specific organism codes were identified as with CNSS...
September 8, 2016: Chest
Maria Helde-Frankling, Jenny Bergqvist, Peter Bergman, Linda Björkhem-Bergman
BACKGROUND: The aim of this study was to elucidate whether palliative cancer patients benefit from antibiotic treatment in the last two weeks of life when an infection is suspected. METHOD: We reviewed medical records from 160 deceased palliative cancer patients that had been included in previous studies on vitamin D and infections. Patients treated with antibiotics during the last two weeks of life were identified and net effects of treatment (symptom relief) and possible adverse events were extracted from medical records...
September 6, 2016: Cancers
Takao Arai, Shoichi Ohta, Junya Tsurukiri, Kenichiro Kumasaka, Katsuhiro Nagata, Taihei Okita, Taishi Oomura, Akira Hoshiai, Masaharu Koyama, Tetsuo Yukioka
BACKGROUND: We examined whether the values obtained from principal component analysis (PCA) on laboratory tests can be used to predict bacterial infections and identify bacterial strains in blood culture (BC). METHOD: This study is a single-center retrospective analysis of 315 patients suspected of having sepsis. We applied PCA on procalcitonin (PCT) and laboratory test biomarkers, namely, platelet (PLT), white blood cell, and C-reactive protein (CRP) as well as BC...
August 7, 2016: American Journal of Emergency Medicine
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