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Sepsis and infections

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https://www.readbyqxmd.com/read/28323799/a-prospective-randomized-trial-to-assess-oral-versus-intravenous-antibiotics-for-the-treatment-of-postoperative-wound-infection-after-extremity-fractures-poviv-study
#1
William T Obremskey, Andrew H Schmidt, Robert V OʼToole, Jennifer DeSanto, Saam Morshed, Paul Tornetta, Clinton K Murray, Clifford B Jones, Daniel O Scharfstein, Tara J Taylor, Anthony R Carlini, Renan C Castillo
Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#2
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323627/effects-of-xuebijing-injection-for-patients-with-sepsis-induced-acute-kidney-injury-after-wenchuan-earthquake
#3
Qin Yuxi, Hanlai Zhang, Yu Baili, Shihua Shi
Context • Earthquakes are devastating disasters that have claimed countless lives in the past, partially owing to the danger of direct and indirect injuries to vital organs. In the deadly earthquake that occurred in Sichuan Province of China on May 12, 2008, some victims suffered from severe damage to multiple organs and tissue and developed sepsis, a systematic inflammatory reaction resulting from infection and trauma. Xuebijing injection (CCXG) could beneficial for improvement of clinical symptoms in those patients, but no research has yet examined its potential...
March 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28320052/soft-tissue-infections-from-fish-spike-wounds-normal-commensal-bacteria-are-more-common-than-marine-pathogens
#4
Hannah Collins, Kin Mun Lee, Paul T-Y Cheng, Sarah Hulme
BACKGROUND: A fish spike injury can be sustained by anyone handling fish; during fishing, meal preparation or in retail. Case reports of fish spikes inoculating victims with virulent marine-specific pathogens and causing systemic illness led us to question whether empirical treatment of these injuries with amoxicillin and clavulanic acid is adequate. METHODS: This 2-year prospective observational study was conducted at Middlemore Hospital, Auckland, New Zealand...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28315045/late-onset-chest-wall-abscess-due-to-a-biodegradable-rib-pin-infection-after-lung-transplantation
#5
Yasufumi Goda, Toyofumi F Chen-Yoshikawa, Masaaki Kusunose, Masatsugu Hamaji, Hideki Motoyama, Kyoko Hijiya, Akihiro Aoyama, Hiroshi Date
A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space...
March 17, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28314699/safety-and-tolerability-of-idelalisib-lenalidomide-and-rituximab-in-relapsed-and-refractory-lymphoma-the-alliance-for-clinical-trials-in-oncology-a051201-and-a051202-phase-1-trials
#6
Sonali M Smith, Brandelyn N Pitcher, Sin-Ho Jung, Nancy L Bartlett, Nina Wagner-Johnston, Steven I Park, Kristy L Richards, Amanda F Cashen, Anthony Jaslowski, Scott E Smith, Bruce D Cheson, Eric Hsi, John P Leonard
BACKGROUND: A new generation of biological and targeted agents might potentially replace traditional cytotoxic agents in lymphoma. Lenalidomide plus rituximab was felt to be a safe and promising backbone based on available data. Idelalisib is an oral phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor that has promising activity as a monotherapy in refractory indolent lymphomas. The primary objective of these two trials was to determine the maximum tolerated dose of lenalidomide in combination with rituximab and idelalisib in relapsed follicular and mantle cell lymphoma...
March 14, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28314653/assessment-of-risk-factors-for-candidemia-in-non-neutropenic-patients-hospitalized-in-internal-medicine-wards-a-multicenter-study
#7
M Falcone, G Tiseo, C Tascini, A Russo, E Sozio, G Raponi, C Rosin, P Pignatelli, P Carfagna, A Farcomeni, R Luzzati, F Violi, F Menichetti, M Venditti
BACKGROUND: An increasing prevalence of candidemia has been reported in Internal Medicine wards (IMWs). The aim of our study was to identify risk factors for candidemia among non-neutropenic patients hospitalized in IMWs. METHODS: A multicenter case-control study was performed in three hospitals in Italy. Patients developing candidemia (cases) were compared to patients without candidemia (controls) matched by age, time of admission and duration of hospitalization...
March 14, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28306563/antimicrobial-resistant-gram-negative-infections-in-neonates-burden-of-disease-and-challenges-in-treatment
#8
Laura Folgori, Julia Bielicki, Paul T Heath, Mike Sharland
PURPOSE OF REVIEW: This review summarizes the main challenges of antimicrobial resistance (AMR) in the neonatal population with a special focus on multidrug-resistant (MDR) Gram-negative pathogens. RECENT FINDINGS: MDR-Gram-negative bacteria are a great concern in the neonatal population, with a worldwide rise in the reported incidence and with very limited therapeutic options. Extended-spectrum β-lactamase and carbapenem-resistant Enterobacteriaceae (CRE) have been reported as responsible for neonatal ICU outbreaks...
March 16, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28304355/the-glyoxalase-system-and-methylglyoxal-derived-carbonyl-stress-in-sepsis-glycotoxic-aspects-of-sepsis-pathophysiology
#9
REVIEW
Thomas Schmoch, Florian Uhle, Benedikt H Siegler, Thomas Fleming, Jakob Morgenstern, Peter P Nawroth, Markus A Weigand, Thorsten Brenner
Sepsis remains one of the leading causes of death in intensive care units. Although sepsis is caused by a viral, fungal or bacterial infection, it is the dysregulated generalized host response that ultimately leads to severe dysfunction of multiple organs and death. The concomitant profound metabolic changes are characterized by hyperglycemia, insulin resistance, and profound transformations of the intracellular energy supply in both peripheral and immune cells. A further hallmark of the early phases of sepsis is a massive formation of reactive oxygen (ROS; e...
March 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28303104/mathematical-modeling-of-streptococcus-pneumoniae-colonization-invasive-infection-and-treatment
#10
Elisa Domínguez-Hüttinger, Neville J Boon, Thomas B Clarke, Reiko J Tanaka
Streptococcus pneumoniae (Sp) is a commensal bacterium that normally resides on the upper airway epithelium without causing infection. However, factors such as co-infection with influenza virus can impair the complex Sp-host interactions and the subsequent development of many life-threatening infectious and inflammatory diseases, including pneumonia, meningitis or even sepsis. With the increased threat of Sp infection due to the emergence of new antibiotic resistant Sp strains, there is an urgent need for better treatment strategies that effectively prevent progression of disease triggered by Sp infection, minimizing the use of antibiotics...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28302165/bilateral-adrenal-hemorrhage-in-the-background-of-escherichia-coli-sepsis-a-case-report
#11
Jahanzaib Khwaja
BACKGROUND: Sepsis is a syndrome of life-threatening organ dysfunction caused by a dysregulated host response to infection. It can have devastating consequences, including bilateral adrenal hemorrhage, particularly in patients at high thrombotic risk, such as those with antiphospholipid syndrome and those on long-term anticoagulation. CASE PRESENTATION: A 49-year-old white woman re-presented to hospital with a history suggestive of sepsis. She had a medical background of primary antiphospholipid syndrome on lifelong warfarin...
March 17, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28300896/lucio-s-phenomenon-exuberant-case-report-and-review-of-brazilian-cases
#12
Rafael Henrique Rocha, Paulo Sergio Emerich, Lucia Martins Diniz, Marcela Bahia Barretto de Oliveira, Aline Neves Freitas Cabral, Ana Cristina Vervloet do Amaral
Lucio's phenomenon is an uncommon reaction characterized by severe necrotizing cutaneous lesions that occurs in patients with Lucio's leprosy and lepromatous leprosy. It is considered by some authors as a variant of type 2 or 3 reaction. Death can occur because of blood dyscrasia or sepsis. Precipitating factors include infections, drugs and pregnancy. We report a 31-year-old female patient exhibiting both clinical and histopathological features of lepromatous leprosy and Lucio's phenomenon presenting favorable response to treatment...
September 2016: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28296993/clinical-characteristics-and-outcomes-of-patients-with-cellulitis-requiring-intensive-care
#13
Duncan R Cranendonk, Lonneke A van Vught, Maryse A Wiewel, Olaf L Cremer, Janneke Horn, Marc J Bonten, Marcus J Schultz, Tom van der Poll, W Joost Wiersinga
Importance: Cellulitis is a commonly occurring skin and soft tissue infection and one of the most frequently seen dermatological diseases in the intensive care unit (ICU). However, clinical characteristics of patients with cellulitis requiring intensive care treatment are poorly defined. Necrotizing fasciitis is often confused for cellulitis at initial presentation and is considered to be more severe and thus has previously been described in more detail. Objective: To describe the clinical presentation and outcomes of patients with ICU-necessitating cellulitis and to compare them with patients with necrotizing fasciitis...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28296884/increased-von-willebrand-factor-decreased-adamts13-and-thrombocytopenia-in-melioidosis
#14
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 15, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28296810/activation-associated-accelerated-apoptosis-of-memory-b-cells-in-critically-ill-patients-with-sepsis
#15
Manu Shankar-Hari, David Fear, Paul Lavender, Tracey Mare, Richard Beale, Chad Swanson, Mervyn Singer, Jo Spencer
OBJECTIVE: Sepsis is life-threatening organ dysfunction due to dysregulated host responses to infection. Current knowledge of human B-cell alterations in sepsis is sparse. We tested the hypothesis that B-cell loss in sepsis involves distinct subpopulations of B cells and investigated mechanisms of B-cell depletion. DESIGN: Prospective cohort study. SETTING: Critical care units. PATIENTS: Adult sepsis patients without any documented immune comorbidity...
March 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#16
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T-cells were measured using an interferon-γ Elispot-assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28293557/sepsis-and-immunosenescence-in-the-elderly-patient-a-review
#17
REVIEW
Silvia Martín, Alba Pérez, Cesar Aldecoa
Sepsis is a prevalent, serious medical condition with substantial mortality and a significant consumption of health-care resources. Its incidence has increased around 9% annually in general population over the last years and specially in aged patients group. Several risk factors such as comorbidities, preadmission status, malnutrition, frailty, and an impared function in the immune system called immunosenescence are involved in the higher predisposition to sepsis in the elderly patients. Immunosenescence status consists in a functional impairment in both cell-mediated immunity and humoral immune responses and increases not only the risk for develop sepsis but also lead to more severe presentation of infection and may be is also related with a higher mortality...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28293548/age-appropriate-functions-and-dysfunctions-of-the-neonatal-neutrophil
#18
REVIEW
Shelley Melissa Lawrence, Ross Corriden, Victor Nizet
Neonatal and adult neutrophils are distinctly different from one another due to well-defined and documented deficiencies in neonatal cells, including impaired functions, reduced concentrations of microbicidal proteins and enzymes necessary for pathogen destruction, and variances in cell surface receptors. Neutrophil maturation is clearly demonstrated throughout pregnancy from the earliest hematopoietic precursors in the yolk sac to the well-developed myeloid progenitor cells in the bone marrow around the seventh month of gestation...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28293397/in-vitro-lymphoproliferative-response-and-cytokine-production-in-mice-with-experimental-disseminated-candidiasis
#19
Ali Reza Khosravi, Hojjatollah Shokri, Shahin Eshghi
OBJECTIVES: Systemic candidiasis is an infection of Candida albicans (C. albicans) causing disseminated disease and sepsis, invariably when host defenses are compromised. We investigated the histopathological changes as well as the lymphoproliferative responses and cytokine production of splenic cells after stimulation with Concanavalin A (Con A) and Pokeweed mitogen (PWM) in mice with disseminated candidiasis. MATERIALS AND METHODS: Lymphoproliferative responses were stimulated in vitro with Con A (1 µg/ml) and PWM (1 µg/ml) mitogens in Roswell Park Memorial Institute (RPMI) 1640 media, and the production of interferon (IFN)-γ and interleukin-4 (IL-4) in the supernatants was measured by enzyme-linked immunosorbent assay (ELISA)...
February 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28292986/arginine-is-a-critical-substrate-for-the-pathogenesis-of-pseudomonas-aeruginosa-in-burn-wound-infections
#20
Jake Everett, Keith Turner, Qiuxian Cai, Vernita Gordon, Marvin Whiteley, Kendra Rumbaugh
Environmental conditions affect bacterial behavior and can greatly influence the course of an infection. However, the environmental cues that elicit bacterial responses in specific infection sites are relatively unknown. Pseudomonas aeruginosa is ubiquitous in nature and typically innocuous. However, it is also one of the most prevalent causes of fatal sepsis in burn wound patients. The aim of this study was to determine the impact of environmental factors, specifically the availability of arginine, on the pathogenesis of P...
March 14, 2017: MBio
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