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https://www.readbyqxmd.com/read/28108390/fatal-sepsis-caused-by-multidrug-resistant-bacteroides-fragilis-harboring-a-cfia-gene-and-an-upstream-insertion-sequence-element-in-japan
#1
Itaru Nakamura, Kotaro Aoki, Yuri Miura, Tetsuo Yamaguchi, Tetsuya Matsumoto
Here, we report a case of fatal sepsis resulting from an intra-abdominal infection caused by a Bacteroides fragilis strain containing a CfiA4 metallo-β-lactamase and an upstream insertion sequence (IS) element. Meropenem was used as empiric therapy for septic shock as a result of the intra-abdominal infection, although two rounds of carbapenem treatment had been administered previously. B. fragilis was isolated from two anaerobic blood culture bottles 4 days after the onset of septic shock. Susceptibility testing revealed that the isolate was non-susceptible to all tested agents except metronidazole and tigecycline...
January 17, 2017: Anaerobe
https://www.readbyqxmd.com/read/28107491/association-of-in-hospital-mortality-and-dysglycemia-in-septic-patients
#2
Hsiao-Yun Chao, Peng-Hui Liu, Shen-Che Lin, Chun-Kuei Chen, Jih-Chang Chen, Yi-Lin Chan, Chin-Chieh Wu, Gerald N Blaney, Zhen-Ying Liu, Cho-Ju Wu, Kuan-Fu Chen
BACKGROUND: The associations between dysglycemia and mortality in septic patients with and without diabetes are yet to be confirmed. Our aim was to analyze the association of diabetes and sepsis mortality, and to examine how dysglycemia (hyperglycemia, hypoglycemia and glucose variability) affects in-hospital mortality of patients with suspected sepsis in emergency department (ED) and intensive care units. METHODS: Clinically suspected septic patients admitted to ED were included, and stratified into subgroups according to in-hospital mortality and the presence of diabetes...
2017: PloS One
https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#3
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28104273/physiologically-based-predictive-analytics-using-the-heart-rate-to-systolic-ratio-significantly-improves-the-timeliness-and-accuracy-of-sepsis-prediction-compared-to-sirs
#4
Omar K Danner, Sandra Hendren, Ethel Santiago, Brittany Nye, Prasad Abraham
BACKGROUND: Enhancing the efficiency of diagnosis and treatment of severe sepsis by using physiologically-based, predictive analytical strategies has not been fully explored. We hypothesize assessment of heart-rate-to-systolic-ratio significantly increases the timeliness and accuracy of sepsis prediction after emergency department (ED) presentation. METHODS: We evaluated the records of 53,313 ED patients from a large, urban teaching hospital between January and June 2015...
January 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28104185/causes-and-outcomes-of-sepsis-in-southeast-asia-a-multinational-multicentre-cross-sectional-study
#5
(no author information available yet)
BACKGROUND: Improved understanding of pathogens that cause sepsis would aid management and antimicrobial selection. In this study, we aimed to identify the causative pathogens of sepsis in southeast Asia. METHODS: In this multinational multicentre cross-sectional study of community-acquired sepsis and severe sepsis, we prospectively recruited children (age ≥30 days and <18 years) and adults (age ≥18 years) at 13 public hospitals in Indonesia (n=3), Thailand (n=4), and Vietnam (n=6)...
February 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28101156/clinical-and-microbiological-profile-of-babies-born-with-risk-of-neonatal-sepsis
#6
Bin Zhou, Xiao Liu, Jie-Bin Wu, Bao Jin, Yan-Yan Zhang
The aim of the present study was to evaluate the effects of antibiotics on the condition of babies born with risk of neonatal sepsis. From March, 2014 to February, 2015, 200 neonates born with risk factors of septicemia in the Neonatal Intensive Care Unit at Xuzhou Central Hospital, were enrolled in the present study. Venous blood samples were collected within 6 h of birth using aseptic technique. Part of the blood specimens were cultured using BACTEC PEDS PLUS/F Culture Vials. Subsequently, the subcultures were prepared from each presumptive positive vial and bacterial isolates were identified...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28100944/ostomy-in-nontraumatic-conditions-our-experience-and-review-of-the-literature
#7
Kenan Büyükaşık, Bünyamin Gürbulak, Emre Özoran, Yiğit Düzköylü, Esin Kabul Gürbulak, Aziz Arı, Hasan Bektaş
A number of nontraumatic acute abdomen can result in peritonitis leading to sepsis. In emergent conditions, various procedures like segmentary colectomy and/or subtotal colectomy with anastomosis, Hartmann's procedure, transverse colectomy, and/or expandable metallic stent (SEMS) placement can be performed, considering the status of the patient and the facilitaties of the institution. In our study, we examined the cases diagnosed as acute abdomen without the history of trauma, which had lead to a procedure requiring colostomy...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28098630/collapse-of-the-microbiome-emergence-of-the-pathobiome-and-the-immunopathology-of-sepsis
#8
John C Alverdy, Monika A Krezalek
The definition of sepsis has been recently modified to accommodate emerging knowledge in the field, while at the same time being recognized as challenging, if not impossible, to define. Here, we seek to clarify the current understanding of sepsis as one that has been typically framed as a disorder of inflammation to one in which the competing interests of the microbiota, pathobiota, and host immune cells lead to loss of resilience and nonresolving organ dysfunction. Here, we challenge the existence of the idea of noninfectious sepsis given that critically ill humans never exist in a germ-free state...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28093452/a-time-to-save
#9
Carol J Baker
Group B Streptococcus (GBS), characterized by Lancefield in 1933, was not recognized as a human pathogen until the early 1970s when it emerged and replaced Escherichia coli as the most common cause of sepsis and meningitis among neonates and young infants. This article briefly gives a personnel account of the discovery of clinical syndromes of GBS distinguished by age at onset, vertical mode of transmission for early-onset disease, meningeal tropism for GBS capsular (CPS) type III strains, and protective CPS epitopes...
January 16, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28093107/characterization-and-identification-of-microbial-communities-in-bovine-necrotic-vulvovaginitis
#10
N Y Shpigel, L Adler-Ashkenazy, S Scheinin, T Goshen, A Arazi, Z Pasternak, Y Gottlieb
Bovine necrotic vulvovaginitis (BNVV) is a severe and potentially fatal disease of post-partum cows that emerged in Israel after large dairy herds were merged. While post-partum cows are commonly affected by mild vulvovaginitis (BVV), in BNVV these benign mucosal abrasions develop into progressive deep necrotic lesions leading to sepsis and death if untreated. The etiology of BNVV is still unknown and a single pathogenic agent has not been found. We hypothesized that BNVV is a polymicrobial disease where the normally benign vaginal microbiome is remodeled and affects the local immune response...
January 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28089174/neonatal-acute-kidney-injury-severity-and-recovery-prediction-and-the-role-of-serum-and-urinary-biomarkers
#11
Deirdre U Sweetman
Neonatal acute kidney injury is common, in part due to incomplete renal maturation and also due to frequent exposure to risk factors for acute kidney injury such as perinatal asphyxia, extracorporeal-membrane-oxygenation, cardiac surgery, sepsis, prematurity and nephrotoxicity. However the current method by which acute kidney injury is diagnosed is sub-optimal and not universally accepted which impairs the accurate estimation of the true incidence of neonatal acute kidney injury. Serum Cystatin-C, urinary NGAL, KIM-1 and IL-18 are promising neonatal acute kidney injury biomarkers however the diagnosis of acute kidney injury remains serum creatinine/urine output-based in many studies...
January 11, 2017: Early Human Development
https://www.readbyqxmd.com/read/28081260/comparative-genome-sequencing-reveals-within-host-genetic-changes-in-neisseria-meningitidis-during-invasive-disease
#12
Johanna Klughammer, Marcus Dittrich, Jochen Blom, Vera Mitesser, Ulrich Vogel, Matthias Frosch, Alexander Goesmann, Tobias Müller, Christoph Schoen
Some members of the physiological human microbiome occasionally cause life-threatening disease even in immunocompetent individuals. A prime example of such a commensal pathogen is Neisseria meningitidis, which normally resides in the human nasopharynx but is also a leading cause of sepsis and epidemic meningitis. Using N. meningitidis as model organism, we tested the hypothesis that virulence of commensal pathogens is a consequence of within host evolution and selection of invasive variants due to mutations at contingency genes, a mechanism called phase variation...
2017: PloS One
https://www.readbyqxmd.com/read/28079790/ecthyma-gangrenosum-a-skin-manifestation-of-pseudomonas-aeruginosa-sepsis-in-a-previously-healthy-child-a-case-report
#13
Stephanie Biscaye, Diane Demonchy, Mickael Afanetti, Audrey Dupont, Herve Haas, Antoine Tran
RATIONALE: Ecthyma gangrenosum (Eg) is a necrotic lesion that is mostly seen in immunocompromised patients. It reflects a severe sepsis, possibly caused by Pseudomonas aeruginosa (Pa). PATIENT CONCERNS: A healthy 3-year-old girl admitted to the Pediatric Emergency Department presented a sepsis-associated purpura with neurological and respiratory distress. INTERVENTIONS: An empiric antibiotherapy (anti-meningococcal) was prescribed. DIAGNOSES: Forty-eight hours after admission, blood and wound cultures were positive for Pa...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#14
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#15
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28068970/quadriplegia-caused-by-an-epidural-abscess-occurring-at-the-same-level-of-cervical-destructive-spondyloarthropathy-a-case-report
#16
Jun-Seok Lee, Ji-Hyun Ryu, Jong-Tae Park, Ki-Won Kim
BACKGROUND: Destructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA. CASE PRESENTATION: A 49-year-old woman was transferred to our emergency department with 5 days of sepsis, drowsy mental status, and quadriplegia below the C5 level...
January 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28068437/association-between-early-lactate-levels-and-30-day-mortality-in-clinically-suspected-sepsis-in-children
#17
Halden F Scott, Lina Brou, Sara J Deakyne, Allison Kempe, Diane L Fairclough, Lalit Bajaj
Importance: Improving emergency care of pediatric sepsis is a public health priority, but optimal early diagnostic approaches are unclear. Measurement of lactate levels is associated with improved outcomes in adult septic shock, but pediatric guidelines do not endorse its use, in part because the association between early lactate levels and mortality is unknown in pediatric sepsis. Objective: To determine whether the initial serum lactate level is associated with 30-day mortality in children with suspected sepsis...
January 9, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28062417/pulmonary-tuberculosis-presenting-as-post-operative-fever-of-unknown-origin
#18
Patrick Bogue, Mhairi Bolland, Peter How, Harrison Benziger
Post-operative fever is common following emergency surgery. Investigation and management of post-operative fever can be challenging when a clear source of sepsis is not evident or the underlying source of infection is not recognised. We herein report a case of secondary pulmonary tuberculosis presenting as post-operative fever following emergency laparotomy for a perforated duodenal ulcer. This case of tuberculosis was diagnosed on day 41 post-operatively and prior inconclusive results meant that we relied mainly on re-visiting history and examination in order to identify 3 targeted investigations: plain chest X-ray, sputum sample and blood test...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28062114/effect-of-immediate-administration-of-antibiotics-in-patients-with-sepsis-in-tertiary-care-a-systematic-review-and-meta-analysis
#19
REVIEW
Amy N B Johnston, Joon Park, Suhail A Doi, Vicki Sharman, Justin Clark, Jemma Robinson, Julia Crilly
PURPOSE: The goal of this review was to synthesize existing evidence regarding outcomes (mortality) for patients who present to the emergency department, are administered antibiotics immediately (within 1 hour) or later (>1 hour), and are diagnosed with sepsis. METHODS: A search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL, using the MeSH descriptors "sepsis," "systemic inflammatory response syndrome," "mortality," "emergency," and "antibiotics," was performed to identify studies reporting time to antibiotic administration and mortality outcome in patients with sepsis...
January 3, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28058551/modified-frailty-index-predicts-morbidity-and-mortality-after-pancreaticoduodenectomy
#20
Harveshp Mogal, Sarah A Vermilion, Rebecca Dodson, Fang-Chi Hsu, Russell Howerton, Perry Shen, Clancy J Clark
BACKGROUND: Pancreatic cancer is a disease of older adults, who may present with limited physiologic reserve. The authors hypothesized that a frailty index can predict postoperative outcomes after pancreaticoduodenectomy (PD). METHODS: All patients who underwent PD were identified in the 2005-2012 NSQIP Participant Use File. Patients undergoing emergency procedures, those with an American Society of Anesthesiologists (ASA) classification of five, and those with a diagnosis of preoperative sepsis were excluded from the study...
January 5, 2017: Annals of Surgical Oncology
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