[Clostridium infections after abdominal surgery].
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We report here a case of post-abortal clostridium prefringens infection in which there was severe intravascular hemolysis with black urine, but only minor abnormalities of the clotting mechanism and mild renal failure. The patient recovered following supportive therapy only.
The authors report 18 cases of Clostridium perfringens infection and discuss the main clinical and etiological aspects apart from gynecological forms and those usually requiring intensive care. Pathological foci, digestive infection and the problem of bacteremia are discussed together with appropriate treatment.
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Overwhelming Clostridium septicum infection is a rare occurrence in children. It is seen almost exclusively as a complication of acute leukemia. A high index of suspicion in the leukemic child with an acute abdomen is the key to early diagnosis and improved survival. A case in a 13-year-old girl with acute myelogenous leukemia is reported and six pediatric cases in the literature were reviewed.
Necropsy of dead and sick 5-day-old poults from a flock of 12,500 Broad-Breasted White turkeys having high early mortality (685 the first week) revealed rather large inflamed retained yolk sacs with semiliquid contents, ascites, and swollen greenish-colored livers. Cultures of livers and yolk sacs were negative by standard aerobic procedures for salmonella and any other bacterial pathogens. At the beginning of the 4th week, more poults were necropsied and found to have swollen livers with necrotic foci grossly visible, and a necrotic inflammation of the midintestinal tract extending anteriorly from attachment of the yolk stalk. Clostridium perfringens was isolated from livers and yolk remnants by anaerobic culture.
BACKGROUND: The epidemiology of Clostridium difficile-associated infection (CDI) has changed, and it is evident that susceptibility is related not only to exposures and bacterial potency, but host factors as well. Several small studies have suggested that CDI after trauma is associated with a different patient phenotype. The purpose of this study was to examine and describe the epidemiologic factors associated with C. difficile in blunt trauma patients without traumatic brain injury using the Trauma-Related Database as a part of the "Inflammation and Host Response to Injury" (Glue Grant) and the University of Florida Integrated Data Repository. METHODS: Previously recorded baseline characteristics, clinical data, and outcomes were compared between groups (67 C. difficile and 384 uncomplicated, 813 intermediate, and 761 complicated non-C. difficile patients) as defined by the Glue Grant on admission and at days seven and 14. RESULTS: The majority of CDI patients experienced complicated or intermediate clinical courses. The mean ages of all cohorts were less than 65 y and CDI patients were significantly older than uncomplicated patients without CDI. The CDI patients had increased days in the hospital and on the ventilator, as well as significantly higher new injury severity scores (NISS), and a greater percentage of patients with NISS >34 points compared with non-CDI patients. They also had greater Marshall and Denver multiple organ dysfunction scores than non-CDI uncomplicated patients, and greater creatinine, alkaline phosphatase, neutrophil count, lactic acid, and PiO2:FiO2 compared with all non-CDI cohorts on admission. In addition, the CDI patients had higher glucose concentrations and base deficit from uncomplicated patients and greater leukocytosis than complicated patients on admission. Several of these changes persisted to days seven and 14. CONCLUSION: Analysis of severe blunt trauma patients with C. difficile, as compared with non-CDI patients, reveals evidence of increased inflammation, immunosuppression, worse acute kidney injury, higher NISS, greater days in the hospital and on the ventilator, higher organ injury scores, and prolonged clinical courses. This supports reports of an increased prevalence of CDI in a younger population not believed previously to be at risk. This unique population may have specific genomic or inflammation-related risk factors that may play more important roles in disease susceptibility. Prospective analysis may allow early identification of at-risk patients, creation of novel therapeutics, and improved understanding of how and why C. difficile colonization transforms into infection after severe blunt trauma.
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Eighty-eight episodes of wound associated infection were identified among 624 consecutively admitted battlefield casualties. Ninety-one per cent of infections occurred during the administration of antibiotic therapy or prophylaxis and 65% were associated with the use of multiple antibacterial agents. Gram negative bacillary and mixed microbial infection predominated and were found to increase in relative incidence after the second day of hospitalization. Appropriate therapy, based on disc sensitivity testing, was administered in only 33% of infectious episodes. The practice of antibiotic wound prophylaxis may contribute to the incidence and nature of infection in battlefield wounds. Problems unique to the handling of battlefield wounded are discussed in comparing the present data with those of other war associated and civilian studies.
The bacteriological and histopathological changes in the ceca of young chickens after being infected with sporulated oocysts of Eimeria tenella were investigated. Lactobacilli and bifidobacteria showed remarkable decrease in number on the 5th day after infection, when shizont and gametocyate came to appear, and destruction of mucosa along with severe haemorrhaging was noticed. Other predominant bacteria like bacteroidaceae, catenabacteria and peptostreptococci showed only moderate and temporal decrease in number during the infection. Clostridium perfringens prolifereated after the 5th day post infection following the decline of lactobacilli and bifidobacteria. Proliferation of clostridia was so intense that the number was almost million times greater than that of the uninfected chicken at its peak on the 7th day after infection. Enterobacteria also showed a moderate but persistent increase in number. Most bacteria came to the normal population on the 10th day after infection. As for lactobacilli, bifidobacteria, clostridia and enterobacteria, the disturbances were still noticeable on the 17th day after injection. Antagonism between proliferated bacteria (clostridia and enterobacteria) and lactic acid bacteria (lactobacilli and bifidobacteria) whose intensity is suppose to be related to the cecal mucosa is suggested during cecal coccidiosis in chickens.
Anaerobic bacterial organisms are a frequent cause of female genital tract infections. There has been a lack of appreciation of the significant role anaerobes play in obstetric and gynecologic infections. Utilization of newer appropriate anaerobic culture techniques has shown the importance of these organisms as pathogens in serious infections of the genital tract. Many species of anaerobic bacteria appear to be part of the normal microflora of the lower genital tract in female subjects. Similar organisms are frequently isolated from pelvic infections. Bacteroides, anaerobic cocci, and Clostridia are the most commonly isolated anaerobes associated with clinical infections. The clinician must recognize the presence of anaerobic infections, utilize proper anaerobic culture methods, and institute appropriate antibiotic and/or surgical therapy.
An antibacterial agent, taurolin, formed by the combination of 2 molecules of taurine with 3 molecules of formaldehyde has been tested against anaerobes in vitro and in vivo. In vitro, taurolin is highly active against Bacteroides species and anaerobic Streptococci as measured by the minimum inhibitory concentration. In vivo, small dosages of taurolin given intraperitoneally increase the mortality in mice with Bacteroides peritonitis. However, by increasing the dosage of taurolin, survival is prolonged and mortality reduced. Intravenously administered taurolin protects rabbits from the effects of Bacteroides fragilis infection whether the organisms are given intravenously or intraperitoneally.