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Culture-negative sepsis

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https://www.readbyqxmd.com/read/28432884/use-of-presepsin-and-procalcitonin-for-prediction-of-septifast-results-in-critically-ill-patients
#1
Dunja Mihajlovic, Snezana Brkic, Arsen Uvelin, Biljana Draskovic, Vladimir Vrsajkov
PURPOSE: There is a need for identification of marker that could lead physicians to take the right step towards laboratory techniques for documentation of infection. The aim of this study was to investigate whether presepsin and procalcitonin (PCT) levels in patients with suspected sepsis could predict blood culture (BC) and SeptiFast (SF) results. MATERIAL AND METHODS: 100 patients were included in our study. PCT, C-reactive protein (CRP), and presepsin levels were determined...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#2
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28425610/bacterial-screening-of-platelet-components-by-national-health-service-blood-and-transplant-an-effective-risk-reduction-measure
#3
Carl McDonald, Jennifer Allen, Susan Brailsford, Anjana Roy, Joanne Ball, Richard Moule, Mariza Vasconcelos, Rachael Morrison, Tyrone Pitt
BACKGROUND: Bacterial contamination of blood components remains a major cause of sepsis in transfusion medicine. Between 2006 and 2010 in the 5 years before the introduction of bacterial screening of platelet (PLT) components by National Health Service Blood and Transplant (NHSBT), seven cases of PLT component-associated transmission of bacterial infection were recorded for 10 patients, three of which were fatal. STUDY DESIGN AND METHODS: Sampling of individual PLT components was undertaken at 36 to 48 hours after donation and tested in the BacT/ALERT system with 8 mL inoculated into each of aerobic and anaerobic culture bottles...
May 2017: Transfusion
https://www.readbyqxmd.com/read/28415969/carbapenem-resistance-inappropriate-empiric-treatment-and-outcomes-among-patients-hospitalized-with-enterobacteriaceae-urinary-tract-infection-pneumonia-and-sepsis
#4
Marya D Zilberberg, Brian H Nathanson, Kate Sulham, Weihong Fan, Andrew F Shorr
BACKGROUND: Drug resistance among gram-negative pathogens is a risk factor for inappropriate empiric treatment (IET), which in turn increases the risk for mortality. We explored the impact of carbapenem-resistant Enterobacteriaceae (CRE) on the risk of IET and of IET on outcomes in patients with Enterobacteriaceae infections. METHODS: We conducted a retrospective cohort study in Premier Perspective database (2009-2013) of 175 US hospitals. We included all adult patients with community-onset culture-positive urinary tract infection (UTI), pneumonia, or sepsis as a principal diagnosis, or as a secondary diagnosis in the setting of respiratory failure, treated with antibiotics within 2 days of admission...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28409532/diagnosis-of-neonatal-sepsis-using-16s-rrna-polymerase-chain-reaction
#5
Harish Punia, Geeta Gathwala, Dhara B Dhaulakhandi, Mohammed Aamir
The gold standard for detecting bacterial sepsis is blood culture. However, the sensitivity of blood culture is low and the results take 48-72 h. Molecular assays for the detection of bacterial DNA permit early detection of a bacterial cause as the turnaround time is 6-8 h. We undertook an evaluation of the performance of universal bacterial primer (16S rRNA) polymerase chain reaction (PCR) in the diagnosis of neonatal sepsis at a tertiary care medical college teaching hospital. 16S rRNA PCR was positive in all cases of blood culture proven sepsis...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28406949/antimicrobial-resistant-infections-among-postpartum-women-at-a-ugandan-referral-hospital
#6
Lisa M Bebell, Joseph Ngonzi, Joel Bazira, Yarine Fajardo, Adeline A Boatin, Mark J Siedner, Ingrid V Bassett, Dan Nyehangane, Deborah Nanjebe, Yves Jacquemyn, Jean-Pierre van Geertruyden, Juliet Mwanga-Amumpaire, David R Bangsberg, Laura E Riley, Yap Boum
INTRODUCTION: Puerperal sepsis causes 10% of maternal deaths in Africa, but prospective studies on incidence, microbiology and antimicrobial resistance are lacking. METHODS: We performed a prospective cohort study of 4,231 Ugandan women presenting to a regional referral hospital for delivery or postpartum care, measured vital signs after delivery, performed structured physical exam, symptom questionnaire, and microbiologic evaluation of febrile and hypothermic women...
2017: PloS One
https://www.readbyqxmd.com/read/28399544/intrawound-tobramycin-powder-eradicates-surgical-wound-contamination-an-in-vivo-rabbit-study
#7
Joseph L Laratta, Jamal N Shillingford, Nathan Hardy, Joseph M Lombardi, Comron Saifi, Alexander Romanov, Lawrence G Lenke, Ronald A Lehman, K Daniel Riew
STUDY DESIGN: Therapeutic anti-infective trial in rabbitsOBJECTIVE.: The purpose of the present study was to assess the efficacy of intrawound tobramycin powder in terms of eradicating a known bacterial contamination in an Escherichia coli infected rabbit spinal implantation model. SUMMARY OF BACKGROUND DATA: Implant-associated surgical site infections (SSI) remain a dreaded complication of spinal surgery. Currently, over 30% of all spine SSIs are secondary to gram-negative bacteria...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28387901/endocarditis-sustained-by-streptococcus-viridans-with-normal-levels-of-procalcitonin-an-unexpected-finding
#8
G Merra, D Marsiliani, S Di Giambenedetto, F Franceschi
OBJECTIVE: Procalcytonin is a useful marker of bacterial infections. Several studies have reported elevated serum levels of PCT in patients with infective endocarditis (IE) and/or other infections sustained by cocci. We report a rare case of IE attributed to Streptococcus viridans in whom levels of PCT were normal. CASE REPORT: A 67 years-old male was admitted to the Emergency Department for a 25-day history of recurring night fever. Upon admission, patient underwent blood test, including PCT, showing normal levels, except for a slight increased creatinine concentration (1...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28375806/microbiomic-analysis-of-intra-abdominal-infections-by-using-denaturing-high-performance-liquid-chromatography-a-prospective-observational-study
#9
Christian Koch, Anca L Amati, Andreas Hecker, Marcel Höxter, Marcus Hirschburger, Reginald Matejec, Winfried Padberg, Marcus A Weigand, Christoph Lichtenstern, Eugen Domann
BACKGROUND: Intra-abdominal infections represent a subgroup of septic syndromes with high death rates and the need for prompt and appropriate antimicrobial therapy. Conventional culture-based microbial identification has notable shortcomings in the diagnostics of polymicrobial infections. Modern culture-independent molecular methods may represent a new diagnostic approach. The current study aimed to compare the results obtained from the denaturing high-performance liquid chromatography WAVE(®) system as a culture-independent diagnostic tool with those obtained from standard culture-based microbiologic testing in the clinical setting of severe intra-abdominal sepsis...
April 4, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28363639/increased-expression-of-ctla4-by-t-cells-induced-by-b7-in-sera-reduces-adaptive-immunity-in-patients-with-acute-liver-failure
#10
Wafa Khamri, Robin D Abeles, Tie Zheng Hou, Amy E Anderson, Ahmed El-Masry, Evangelos Triantafyllou, Christine Bernsmeier, Fin S Larsen, Arjuna Singanayagam, Nobuaki Kudo, Lucia A Possamai, Fanny Lebosse, Georg Auzinger, William Bernal, Christopher Willars, Christopher J Weston, Giovanna Lombardi, Julia Wendon, Mark Thursz, Charalambos G Antoniades
BACKGROUND & AIMS: Patients with acute liver failure (ALF) have defects in innate immune responses to microbes (immuneparesis) and are susceptible to sepsis. Cytotoxic T-lymphocyte associated protein 4 (CTLA4), which interacts with the membrane receptor B7 (also called CD80 and CD86), is a negative regulator of T-cell activation. We collected T cells from patients with ALF and investigated whether inhibitory signals downregulate adaptive immune responses in patients with ALF. METHODS: We collected peripheral blood mononuclear cells from patients with ALF and controls from September 2013 through September 2015 (45 patients with ALF, 20 patients with acute-on-chronic liver failure, 15 patients with cirrhosis with no evidence of acute decompensation, 20 patients with septic shock but no cirrhosis or liver disease, and 20 healthy individuals)...
March 28, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28353453/a-change-for-the-antibacterial-treatment-policy-to-decrease-carbapenem-consumption-at-a-haematopoietic-stem-cell-transplantation-centre
#11
Gõkhan Metan, Leylagül Kaynar, Nuran Yozgat, Ferhan Elmali, Cemile Altay Kürkçüoglu, Emine Alp, Mustafa Çetin
After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28348778/veb-1-extended-spectrum-%C3%AE-lactamase-producing-multidrug-resistant-proteus-mirabilis-sepsis-outbreak-in-a-neonatal-intensive-care-unit-in-india-clinical-and-diagnostic-implications
#12
Sarika Jain, Rajni Gaind, Charu Kothari, Rachna Sehgal, A Shamweel, S S Thukral, Harish K Chellani
INTRODUCTION: Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, multidrug-resistant (MDR) pathogens, are increasingly implicated in nosocomial outbreaksworldwide, particularly in neonatal intensive care units (NICUs). Proteus mirabilis is an uncommon nosocomial pathogen causing sepsis in neonates. CASE PRESENTATION: We report an outbreak of ESBL-positive MDR P. mirabilis sepsis involving five babies within 10 days in a NICU, which was promptly detected and managed...
August 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28343091/rapid-detection-and-ruling-out-of-neonatal-sepsis-by-pcr-coupled-with-electrospray-ionization-mass-spectrometry-pcr-esi-ms
#13
Cristina Delcò, Oliver Karam, Riccardo Pfister, Alain Gervaix, Gesuele Renzi, Stéphane Emonet, Jacques Schrenzel, Klara M Posfay-Barbe
BACKGROUND: Sepsis is an important cause of morbidity and mortality in neonates and clinicians are typically required to administer empiric antibiotics while waiting for blood culture results. However, prolonged and inappropriate use of antibiotics is associated with various complications and adverse events. Better tools to rapidly rule out bacterial infections are therefore needed. AIMS: We aimed to assess the negative predictive value of PCR coupled with Electrospray Ionization Mass Spectrometry (PCR/ESI-MS) compared to conventional blood cultures in neonatal sepsis...
March 23, 2017: Early Human Development
https://www.readbyqxmd.com/read/28331866/clinical-response-and-outcome-in-patients-with-multidrug-resistant-gram-negative-infections
#14
Masoume Malekolkottab, Lida Shojaei, Hossein Khalili, Mahsa Doomanlou
OBJECTIVE: In this study, frequency and antimicrobial sensitivity pattern of multidrug resistant (MDR) microorganisms were evaluated in a referral teaching hospital in Iran. METHODS: Patients with MDR Gram-negative pathogens were followed during the course of hospitalization. Demographic data, baseline diseases, type of biological sample, isolated microorganism, type of infection, antibiotic regimen before the availability of the culture result and change in the antibiotic regimen following receiving the antibiogram results, response to the treatment regimen, and duration of hospitalization and patient's outcome were considered variables for each recruited patient...
January 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28301503/cerebral-ultrasound-abnormalities-in-preterm-infants-caused-by-late-onset-sepsis
#15
L C Claessens, I A Zonnenberg, F A M van den Dungen, R J Vermeulen, M M van Weissenbruch
INTRODUCTION: This study describes cerebral ultrasound abnormalities caused by late-onset sepsis (LOS) in very preterm infants with a gestational age of < 32 weeks and/or birthweight < 1500 grams. METHODS: The prospective study ("INFANT study") included 117 preterm infants with suspected LOS. Proven LOS was defined as a positive blood culture after 72 hours of life. In case of coagulase-negative staphylococci an elevated C-reactive protein was additionally required to establish proven LOS...
2017: PloS One
https://www.readbyqxmd.com/read/28296884/increased-von-willebrand-factor-decreased-adamts13-and-thrombocytopenia-in-melioidosis
#16
Emma Birnie, Gavin C K W Koh, Ester C Löwenberg, Joost C M Meijers, Rapeephan R Maude, Nicholas P J Day, Sharon J Peacock, Tom van der Poll, W Joost Wiersinga
BACKGROUND: Melioidosis, caused by bioterror treat agent Burkholderia pseudomallei, is an important cause of community-acquired Gram-negative sepsis in Southeast Asia and Northern Australia. New insights into the pathogenesis of melioidosis may help improve treatment and decrease mortality rates from this dreadful disease. We hypothesized that changes in Von Willebrand factor (VWF) function should occur in melioidosis, based on the presence of endothelial stimulation by endotoxin, pro-inflammatory cytokines and thrombin in melioidosis, and investigated whether this impacted on outcome...
March 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28283553/genome-wide-association-study-of-sepsis-in-extremely-premature-infants
#17
Lakshmi Srinivasan, Grier Page, Haresh Kirpalani, Jeffrey C Murray, Abhik Das, Rosemary D Higgins, Waldemar A Carlo, Edward F Bell, Ronald N Goldberg, Kurt Schibler, Beena G Sood, David K Stevenson, Barbara J Stoll, Krisa P Van Meurs, Karen J Johnson, Joshua Levy, Scott A McDonald, Kristin M Zaterka-Baxter, Kathleen A Kennedy, Pablo J Sánchez, Shahnaz Duara, Michele C Walsh, Seetha Shankaran, James L Wynn, C Michael Cotten
OBJECTIVE: To identify genetic variants associated with sepsis (early-onset and late-onset) using a genome-wide association (GWA) analysis in a cohort of extremely premature infants. STUDY DESIGN: Previously generated GWA data from the Neonatal Research Network's anonymised genomic database biorepository of extremely premature infants were used for this study. Sepsis was defined as culture-positive early-onset or late-onset sepsis or culture-proven meningitis. Genomic and whole-genome-amplified DNA was genotyped for 1...
March 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28283014/-fungemia-and-septic-arthritis-caused-by-saprochaete-capitata-in-a-patient-with-fanconi-aplastic-anemia-a-case-report
#18
Ömür Mustafa Parkan, Mustafa Altay Atalay, Ayşe Nedret Koç, Çiğdem Pala, Gonca Aydemir, Leylagül Kaynar
Saprochaete capitata (formerly known as Blastoschizomyces capitatus, Trichosporon capitatum, Geotrichum capitatum) is a rare but emerging yeast-like fungus. It is commonly found in environmental sources and can be isolated from skin, gastrointestinal system and respiratory tract of healthy individuals as well. It mainly infects patients with hematological malignancies such as acute myeloid leukemia (AML), especially in the presence of neutropenia; and mortality rates are high in those patients. Although the data about the in vitro antifungal susceptibility are limited, it is being reported that amphotericin B and voriconazole are more effective on S...
January 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28272077/changing-trend-in-bacterial-etiology-and-antibiotic-resistance-in-sepsis-of-intramural-neonates-at-a-tertiary-care-hospital
#19
M P Roy, M Bhatt, V Maurya, S Arya, R Gaind, H K Chellani
BACKGROUND: Septicemia is an important cause of neonatal morbidity and mortality. However, organized data on causative organisms and their resistant pattern are scanty from developing countries. The changing trend in causative organisms and their antibiotic resistance is yet to be documented in India. The present study examines the trends in bacterial profile and antibiotic resistance of the organisms causing sepsis in hospitalized neonates. MATERIALS AND METHODS: A retrospective laboratory-based analysis of blood cultures obtained from Neonatal Intensive Care Unit of a tertiary care hospital in New Delhi was done for the period of 1999-2014, divided into five phases...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28271546/factors-associated-with-survival-in-97-horses-with-septic-pleuropneumonia
#20
M G Arroyo, N M Slovis, G E Moore, S D Taylor
BACKGROUND: Septic pleuropneumonia is a common cause of morbidity and mortality in horses, but there is limited data available regarding factors associated with survival. HYPOTHESIS/OBJECTIVES: To identify factors predictive of survival in horses with septic pleuropneumonia. ANIMALS: A total of 97 horses with septic pleuropneumonia at 2 referral institutions. METHODS: A retrospective study was performed. A diagnosis of septic pleuropneumonia was based on the presence of sepsis, pleural effusion, and positive bacterial culture from tracheal aspiration (TA) or pleural fluid (PF)...
March 8, 2017: Journal of Veterinary Internal Medicine
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