Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “BACTEREMIA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 685 records · Page 38Linked to original sources
PubMed1996

An analysis of bacteremias during dental extractions. A double-blind, placebo-controlled study of chlorhexidine.

BACKGROUND: The literature is unclear concerning the nature and incidence of bacteremias from oral surgical procedures, the relationship of these bacteremias to dental disease, and the preventive benefit of antibacterial mouth rinses. OBJECTIVE: To determine the incidence and nature of bacteremias during single-tooth extractions in adults. METHODS: A double-blind, randomized placebo-controlled study of 70 patients in which the status of dental disease was compared with the incidence and nature of aerobic and anaerobic bacteremias following a single-tooth extraction and the antibacterial effect of rinses with chlorhexidine hydrochloride. Multiple indicators of dental disease were evaluated and recorded before the surgical procedure. Timing of the mouth rinses, the steps in the surgical procedure, and the two blood drawings were controlled for. RESULTS: Thirty-one (94%) of 34 control patients and 62 (89%) of 70 patients overall had blood cultures positive for organisms at either the 1-minute and or 3-minute mark following the initiation of surgery. The majority of cultures yielded gram-positive cocci. Cultures yielded polymicrobial organisms in 17 patients (24%). Although there was a wide range of severity of odontogenic disease, this did not correlate with results of blood cultures. However, there was a statistically significant difference in the incidence of blood cultures positive for organisms at both shorter (<3 minutes, P=.04) and longer (>6 minutes, P=.04) surgery times. There was not statistically significant difference in either the incidence of blood cultures positive for organisms or in the nature of organisms identified between the chlorhexidine and placebo groups. CONCLUSIONS: Single-tooth extraction should be expected to cause a bacteremia regardless of the status of the dentition or periodontium. Mouth rinses with chlorhexidine not significantly alter the number of positive blood cultures or the nature of the organisms at either of the two blood drawings.

Adult↗
PubMed1996

[Retrospective and comparative study of pneumococcal bacteremia in patients with chronic hepatopathy].

BACKGROUND: The chronic hepatopathy predispose to severe infections due to Streptococcus pneumoniae, including bacteremia. METHODS: We have reviewed the clinic characteristics and outcome of 34 patients without HIV infection and compared with 140 HIV-negative patients with pneumococcal bacteremia. RESULTS: From 34 patients with chronic liver diseases, 27 were male (79%) and 7 female (21%), aged from 33 to 83 years. In 16 cases the origin of hepatopathy were alcoholic. The majority of the patients had fever (85%). From 29 isolations of S. pneumoniae in which a sensibility study was available, 5 (17%) were resistant to penicillin. Among 27 (79%) cases of chronic hepatopathy, the bacteremia was associated with pneumonia; 5 (18%) cases had roentgenographic evidence of multiple-lobe involvement, and 6 (18%) had peritonitis. The independent factors associated with pneumococcal bacteremia in chronic hepatopathy patients were elevated concentrations of amino-transferases (p < 0.001), alcoholism (p < 0.001) and bacteremic peritonitis (p = 0.007). The overall case of fatality and bacteremia-related mortality rate were higher among patients with chronic hepatopathy than control group, without statistic signification (38% vs 25%; and 29% vs 24% of control group, respectively). The presence of septic shock was poor prognosis (mortality rate: 83% [10/12]; p < 0.001). The multilobar involvement was associated with high mortality rate (60%; p = 0.1). CONCLUSIONS: Pneumococcal bactermia in patients with chronic hepatopathy have a high mortality rate; however clinical outcome is similar to patients without chronic hepatopathy.

Adult↗
PubMed1996

A retrospective study of clinical characteristics of acinetobacter bacteremia.

High rates of acinetobacter bacteremia were observed in a large teaching hospital in Hong Kong. A retrospective study of 94 acinetobacter bacteremic episodes in patients in 1993-94 revealed 70 episodes of significant bacteremia. 53% of the patients were over 60 years with a male to female ratio of 1.5:1. Cases were most rare during the fourth quarter. The intensive care unit was the commonest location of acquisition of bacteremia. Most infections were hospital acquired. Intravascular catheters, urinary catheters, antibiotic therapy and respiratory tract manipulations were common risk factors. Lower respiratory tract infections and catheter-related sepsis were predominant foci of bacteremia. One-third of the patients received appropriate antibiotics within 48 hours after bacteremia onset. Mortality attributable to acinetobacter infection was 27%. Prognosis of underlying diseases, location in intensive care unit, lower respiratory tract infection as foci of infection as well as diabetes mellitus were associated with mortality.

Acinetobacter Infections↗
PubMed1996

[Burn bacteremia in children].

214 cases of burn children with bacteremia accounting for 6.4% of the total number of admission were treated in our hospital from 1981 through 1993, and the mortality was 29.44%. All the patients were classified according to their age, burn area, and complications such as inhalation injury and shock, agents causing the bacteremia or type of bacteria invasion, time for developing bacteremia. The inducing causes and prognosis of bacteremia were analysed, aiming at eruditing the regular pattern of bacteremia and providing means for preventive measures in treatment.

Bacteremia↗
PubMed1997

[Gram-negative enteric bacteremia in children in the Negev (1989-1994)].

During 1989-1994, there were 322 episodes of Gram-negative enteric bacteremia in 308 children. The incidence increased from 31/100,000 in children younger than 15 years of age during 1989-1991, to 50/100,000 during 1992-1994. The most common pathogens were Klebsiella, E. Coli, Salmonella and Enterobacter. 39% of episodes were nosocomial and a significant increase was recorded for each species during the last 3 years of the study. Klebsiella represented the most common pathogen causing nosocomial bacteremia, while E. coli and Salmonella were the main pathogens causing community-acquired bacteremia. In this study in southern Israel, the incidence of Gram-negative enteric bacteremia was significantly higher in Bedouin children, with the exception of bacteremia due to Salmonella, which occurred mainly in Jewish children.

Adolescent↗
PubMed1998

Capnocytophaga bacteremia: clinical features of patients and antimicrobial susceptibility of isolates.

Capnocytophaga has been recognized as an opportunistic pathogen causing systemic infections in immunocompromised individuals with granulocytopenia and oral ulceration. Treatment of Capnocytophaga infection is often empiric. We retrospectively analyzed the clinical features of all patients with Capnocytophaga bacteremia seen at the National Taiwan University Hospital between January 1981 and December 1996 and the antimicrobial susceptibility of the isolates recovered from these patients. All the patients had underlying diseases, namely neoplastic disease (9 patients), hyperthyroidism (1), and bronchiectasis and tetralogy of Fallot (1). The clinical features of these patients were primary bacteremia (10) and pneumonia (1). Nine patients had nosocomial bacteremia and 10 patients had monomicrobial bacteremia. None had septic shock. All the patients responded well to appropriate antimicrobial therapy and survived. All isolates were susceptible to amoxicillin-clavulanate, imipenem, ciprofloxacin, erythromycin, clindamycin, tetracycline, and chloramphenicol but resistant to aminoglycosides and sulfamethoxazole-trimethoprim. The susceptibilities to penicillin, ampicillin, piperacillin, cephalosporins, and aztreonam were variable. Capnocytophaga bacteremia should be included in the differential diagnosis of febrile neutropenia in immunocompromised patients, especially in the presence of oral mucositis and ulceration.

Adolescent↗
PubMed1998

Clinical and microbiologic characteristics of Ochrobactrum anthropi bacteremia.

Ochrobactrum anthropi is an oxidase-positive, nonfermenting, gram-negative bacillus that is an emerging pathogen in immunocompromised patients, particularly in those with indwelling central venous catheters. Reports of clinical manifestation of O. anthropi bacteremia are rare. Herein, we report the clinical and microbiologic characteristics of O. anthropi bacteremia in 15 patients. There were eight males and seven females, whose ages ranged from 1 month to 84 years (mean, 34 years). Ten infections were community acquired. All patients had severe underlying disease and manifested primary O. anthropi bacteremia with no obvious focus. Only three patients had central venous catheters in place at the onset of bacteremia, but none of these showed evidence of catheter-related infection. The mean duration of fever was 4 days (range 0-11) and the mean white blood cell count was 13 x 10(9)/L (range 5.5-28 x 10(9)). All O. anthropi isolates tested were resistant to ampicillin, cephalothin, cefonicid, amoxicillin/clavulanic acid, piperacillin, aztreonam, and ceftazidime, and all were susceptible to gentamicin, amikacin, imipenem, ceftriaxone, and cefoperazone. Most were also susceptible to cefotaxime and moxalactam. Monotherapy with an aminoglycoside or an appropriate beta-lactam (such as cefotaxime or ceftriaxone) yielded good clinical response. None of the 15 patients died directly from O. anthropi bacteremia. Our findings indicate that O. anthropi is often community acquired and can be pathogenic in critically ill or immunocompromised patients with or without indwelling catheters. Although O. anthropi can produce clinically significant infections, the organism seems to be of relatively low virulence.

Adolescent↗
PubMed1997

[Bacteremia: a Spanish multicenter study with 5000 cases. The Hospital Infection Study Group (GEIH)].

INTRODUCTION: Bacteremia is one of the most common nosocomial infections and is still a severe condition that frequently represents a life-threatening problem for the patient. MATERIAL AND METHODS: SEPSIS DATA is a software programme developed by the SEIMC (Spanish Society of Infectious Diseases and Clinical Microbiology) nosocomial infection study group, and it has been designed to collect under common criteria bacteremia cases from Spanish hospitals. In this study, we analyse the results from the first 5,000 cases prospectively collected from 34 hospitals with the following distribution by number of beds: 8 hospitals with less than 200, 15 between 200 and 499.6 between 500 and 999 and 5 with more than 1,000 beds. RESULTS: Male patients (60%), older than 61 years (52%) are the predominant group. Bacteremia acquisition was extra-hospital in 58% of the cases. Most frequent underlying disease was neoplasm (22%) and 9% of the patients had HIV infection. Most frequent bacteremia sources were urinary tract (19.6%), primary (16%) and respiratory tract (15%). Most commonly isolated micro-organisms were E. coli (23%). S. aureus (13%), coagulase-negative Staphylococci (12%) and S. pneumoniae (8%). Microorganisms average time to grow in laboratory was 1.95 days. Origin focus of bacteremia was reported in 30% of the cases. Antibiotic therapy used was active against pathogen isolate in 96% of the cases. Adequate treatment was started empirically from the first day in 76% of the cases. Third generation cephalosporines were the antibiotic group most used (28%). Among the observed complications, 7.68% of the episodes occurred with shock and 2.68% with septic metastasis. Crude mortality until the end of episode was 16.64%.

Adult↗
PubMed1998

[Direct cost of antibiotic therapy prescribed for nosocomial bacteremia. Prospective study during 6 months at a CHU (University Hospital Center)].

A six-month prospective study of costs associated with antimicrobial therapy in nosocomial bacteremia was conducted from November 1, 1995 to April 30, 1996 in a 1837-bed teaching hospital, with the help of the hospital pharmacists and hospital hygiene unit. Only the costs due to the antimicrobials themselves were taken into account. A total of 238 cases of nosocomial bacteremia occurred during the study period. The total direct cost of antimicrobial therapy was 444,931 French francs (FF), i.e., 6.8% of total expenditures for antimicrobials. Mean cost per case was 1869 FF, and was 2.6-fold higher in the 21 patients with bacteremia due to more than one organism (P = 0.03). CAses with an identifiable portal of entry contributed 75% of the total cost. Portals of entry associated with the highest cost included central venous lines (103,928 FF) and urinary tract infections (50,810 FF). Although 20% of nosocomial bacteremias due to coagulase-negative staphylococci did not lead to antimicrobial therapy, the remaining 80% contributed 40.8% of the total cost, followed by nosocomial bacteremias due to Escherichia coli with 19.7% of the total cost. Thirty-seven patients (15.5%) did not receive specific antimicrobial therapy, for the following reasons: death before treatment initiation, transfer to another hospital, antimicrobial therapy initiated earlier for another infection elsewhere in the body due to a different organism, or other form of treatment. The results of this study highlight the need for prevention.

Anti-Bacterial Agents↗
PubMed1977

Teichoic acid antibody test: its use in patients with coagulase-positive staphylococcal bacteremia.

We have studied the occurrence and specificity of teichoic acid antibodies (TAAs), measured by double diffusion in agar, in 114 patients with bacteremia of whom 47 had coagulase-positive staphylococcal bacteremia. A total of 30% of the 47 patients with coagulase-positive staphylococcal bacteremia had a TAA titer of 1:8 or more, and an additional 30% had a titer of 1:2 or 1:4. High TAA titers were most often connected with coagulase-positive staphylococcal endocarditis, osteomyelitis, and deep wound infections. None of the six coagulase-negative patients with staphylococcal bacteremia nor any of the 92 controls had titers exceeding 1:1. A total of 10% of the other patients with bacteremia showed positive results on the TAA test at low titer levels. Compared to the antistaphylolysin value, the TAA test was about equally specific but more sensitive.

Adolescent↗
PubMed1985

Enterobacter bacteremia. An analysis of 50 episodes.

During a six-year period, 147 patients had Enterobacter bacteremia (3.8% of the episodes of bacteremia), with an incidence of 1.25 per 1,000 admitted patients. We chose a random group of 50 cases for analysis. The disease was community acquired in 24% of the cases and nosocomially acquired in the remaining 76%. The bacteremia was unimicrobial in 70% and part of a polymicrobial bacteremia in 30%. The species most commonly causing bacteremia was Enterobacter cloacae. Portals of entry, in decreasing order of frequency, were unknown, surgical wound, respiratory tract, and urinary tract. The most common clinical finding was fever (92%). Shock occurred in 30% of the patients, and only two patients had evidence of disseminated intravascular coagulation. Of the Enterobacter isolates, 12% were resistant to gentamicin. Overall mortality was 42%; factors associated with a poor prognosis were inadequacy of antimicrobial chemotherapy, septic shock, type of underlying disease, clinical condition, and requirement of intensive care.

Adolescent↗
PubMed1988

Bacteremia in patients undergoing oral procedures. Study following parenteral antimicrobial prophylaxis as recommended by the American Heart Association, 1977.

The type and rate of bacteremia following dental extractions, dental cleaning, or other dental/oral surgical procedures were studied in 124 patients with valvular heart disease following parenteral antibiotic prophylaxis (penicillin G potassium with or without streptomycin sulfate, or vancomycin hydrochloride) as recommended by the American Heart Association in 1977. Generally, under penicillin G prophylaxis with or without streptomycin, detection of bacteremia in blood culture media containing no penicillinase was low (14.7% to 16.1% at five minutes and 3.1% to 9.0% at 30 minutes after the procedure). The number and types of organisms recovered from patients who received penicillin prophylaxis alone or with streptomycin were similar. Anaerobes were recovered twice as frequently as aerobes. Polymicrobial bacteremia was rare and only one patient had streptococci detected in the blood culture. Addition of penicillinase to one blood culture medium, however, and comparing it with a similar medium without penicillinase was accompanied with a sixfold greater recovery from patients of both aerobic and anaerobic bacteria, including six patients with streptococcal bacteremia. Vancomycin prophylaxis was accompanied with bacteremia in only one patient.

Anti-Bacterial Agents↗
PubMed2000

Recent experience with Pseudomonas aeruginosa bacteremia in patients with cancer: Retrospective analysis of 245 episodes.

BACKGROUND: Pseudomonas aeruginosa bacteremia is a serious and possibly fatal condition in patients with cancer. OBJECTIVES: To ascertain the frequency, demographics, and predisposing factors for P. aeruginosa bacteremia in patients with cancer and to determine the efficacy of various therapeutic regimens. SUBJECTS AND METHODS: Patient records of the Clinical Microbiology Laboratory, The University of Texas, M. D. Anderson Cancer Center, Houston, were reviewed. From January 1, 1991, through December 31, 1995, 245 eligible cases of P. aeruginosa bacteremia were identified. We examined the patient records for the underlying malignant neoplasm and its management, symptoms and signs of infection, culture results of appropriate specimens, antibiotic therapy, and outcome. We also compared our present experience with a previous analysis from this institution covering the period from January 1, 1972, to December 31, 1981. RESULTS: The incidence of P. aeruginosa bacteremia has decreased compared with the previous study (2.8 vs 4.7 cases per 1000 admissions). It was most common in patients with acute leukemia (55 of 1000 registrations), and the frequency in this disease has not changed. Half of the patients were not in the hospital when they developed their infection. The overall cure rate was 80%, which was a significant (P<.001) increase compared with the 62% cure rate in the previous study. In this study, no significant difference in the cure rates was observed between monotherapy with a beta-lactam and combination therapy overall (P = .72), and in patients with shock (P = 1.0) and those with pneumonia (P = .60). The patients' initial neutrophil counts were not of prognostic value; however, the cure rate depended on subsequent changes in neutrophil count during therapy. CONCLUSIONS: The frequency rate of P. aeruginosa bacteremia has decreased in patients with solid tumors but has remained unchanged in patients with acute leukemia. Antibiotic regimens for empirical therapy of neutropenic patients and especially patients with acute leukemia should still provide coverage against P. aeruginosa.

Acute Disease↗
PubMed1984

Gram's stains of tracheal secretions predict neonatal bacteremia.

The presence of bacteria in tracheal secretions stained by the Gram method was evaluated as a method of predicting neonatal bacteremia. The presence of bacteria had a 74% sensitivity and a 47% predictive accuracy in identifying neonates with bacteremia before 12 hours of age. The specificity in predicting newborns without bacteremia was 98%. In the same neonates, an immature neutrophil-total neutrophil ratio of 0.2 or more had a 77% sensitivity in predicting neonates with bacteremia. Neonates with bacteria in their blood and tracheal aspirates, who died shortly after birth, had pneumonia on postmortem examination. In newborns who have respiratory distress and a risk of infection at birth, Gram's stains of tracheal secretions are a practical and useful method of predicting congenital bacteremia.

Bacteria↗
PubMed1988

Polymicrobial bacteremia in children. An 11-year experience.

The clinical records of all patients with blood cultures positive for a bacterial pathogen were retrospectively examined during an 11-year period to determine the rate of and clinical features associated with polymicrobial bacteremia. During this period, bacteria were isolated in 6302 blood cultures. Of these cultures, 38 instances (0.6%) of polymicrobial bacteremia occurred in 38 patients. In 37 patients (97%), an underlying condition was identified that was considered a predisposing factor for polymicrobial bacteremia--18 patients (42%) had lesions of the gastrointestinal tract, 13 patients (34%) had an indwelling central venous catheter, nine patients (24%) had a malignant neoplasm or were receiving chemotherapy, and nine patients (24%) had neutropenia. A total of 98 pathogenic organisms were isolated; 52 were gram-negative and 46 were gram-positive, and 18 patients (47%) had more than two organisms isolated. Polymicrobial bacteremia was usually clinically indistinguishable from monomicrobial septicemia. Overall mortality was 32%. Polymicrobial bacteremia continues to be a rare, but serious, infectious disease that usually affects children with underlying medical problems and is associated with a high rate of mortality.

Adolescent↗
PubMed1984

Bacteroides bacteremia. Analysis of 142 episodes from one metropolitan area.

Overall mortality for 142 patients with Bacteroides bacteremia encountered in the four hospitals of one metropolitan area between 1977 and 1982 was 41%. Only 43% of deaths of these patients, however, were attributed directly to Bacteroides infection according to the criteria used in this study. Deaths of patients with Bacteroides bacteremia, compared with deaths of patients with bacteremia due to aerobic gram-negative rods, were less likely to occur early after onset of bacteremia. Choice of antimicrobial therapy had no obvious relationship to eventual outcome. Nonobstetrical Bacteroides bacteremia identifies a group of patients at high risk of death during hospitalization. The diversity of both clinical and microbiologic features of these infections, however, makes specific recommendations regarding optimum therapy difficult to formulate.

Adolescent↗
PubMed1988

Metabolic interaction between skeletal muscle and liver during bacteremia.

To study the effects of bacteremia on skeletal muscle leucine (LEU) metabolism, mongrel dogs were infused with normal saline or Escherichia coli (10(9)/kg). After a bolus dose (3.6 microCi), L(1-carbon 14) LEU (0.3 microCi/min) was infused directly into the isolated, constant-flow, in vivo gracilis muscle. Arteriovenous differences for amino acids, labeled and unlabeled LEU and alpha-ketoisocaproic acid (KIC), and labeled carbon dioxide were measured at ten-minute intervals for one hour. Bacteremia increased the net release of amino acids and total N2 from muscle. Moreover, plasma LEU that was deaminated and released as KIC was increased, and there was also an increase in decarboxylated plasma LEU during bacteremia. Despite the marked increase in KIC release from skeletal muscle during bacteremia, arterial concentrations were not significantly different from those of controls. An unchanged arterial plasma KIC concentration associated with a marked increase in KIC released from skeletal muscle indicates an increase in LEU metabolism, most likely in the liver. Thus, the increased skeletal muscle catabolism is not a futile cycle but rather an essential event to meet the increased metabolic needs of the body during bacteremia.

Amino Acids, Branched-Chain↗
PubMed1980

Diarrhea in Streptococcus pneumoniae bacteremia.

Diarrhea with fever was a significant complaint in 26 of 280 (9.3%) of non-SS children with S. pneumoniae bacteremia and four of 30 (13%) children with sickle syndromes and S. pneumoniae bacteremia. Two additional children with sickle-cell disease and S. pneumoniae bacteremia developed diarrhea within hours of hospital admission; four of the six died. The mortality rate among 24 additional SS patients with S. pneumoniae bacteremia without diarrhea was 12.5% (3/24). Only one of 26 non-SS patients with diarrhea and S. pneumoniae bacteremia died; shs was surgically asplenic and had fulminant 9-hour course. The seasonality of the diarrhea cases was similar to our overall experience, and the serotypes associated with the diarrhea cases were also representative of our overall experience. Although predominantly seen in infants, the oldest non-SS patient was 12 years, and the oldest SS patient was nine years.

Anemia, Sickle Cell↗