Early in 1962, after an extensive review including 312 cases of bacteremia in burn patients, we were surprised to find that there was about 30% of bacteremia in the patients who had no detectable microorganisms from repeated wound cultures, but blood cultures were usually positive for gut flora. From that time on the idea of gut-origin infection emerged. In following twenty years, a series of experiments were carried on in Wistar rats with 30% TBSA full-thickness burn. The results showed that the fluorescein labeled enteric microbes (Pseudomonas aeruginosa, Bacteroid fragilis and Candida albicans) could translocate through the stress injured intestinal wall and were recovered in visceral organs. The radioisotope 125I labeled endotoxin began to ascend in concentration in portal vein since 15 minutes postburn. Radioautography of liver sections demonstrated the labeled endotoxin granules. With the creation of minute mesenteric lymph fistulas, the clearance of endotoxin and TNFalpha was found to be significantly high in lymph fluid exited from the intestine. All above evidences indicated that the gut is a potential route of endogenous infection, and it also explained how did the patients manifest sepsis early after burn injury without a definite infectious focus. Now the concepts of gut-origin infection are commonly accepted, the measures like early enteral feeding for the protection of intestinal barrier has been established.
Bacteremia ; etiology ; Bacterial Translocation ; Burns ; microbiology ; Gastrointestinal Tract ; microbiology ; Humans

Aged ; Bacteremia ; complications ; etiology ; Fatal Outcome ; Gram-Positive Bacterial Infections ; etiology ; Humans ; Male ; Streptococcaceae ; isolation & purification

Bacteremia ; etiology ; Female ; Humans ; Infant, Newborn ; Listeria monocytogenes ; isolation & purification ; Male

Aortic Aneurysm ; etiology ; Bacteremia ; complications ; Child, Preschool ; Humans ; Male ; Staphylococcal Infections ; complications

We describe a case of septic shock due to Vibrio alginolyticus presenting with fever and bilateral leg pain. Despite intensive management with antibiotics and inotropic agents, the patient died from septic shock 1 day after hospitalization. V. alginolyticus was isolated from both leg wounds and a blood culture. To the best of our knowledge, this is the first reported case of V. alginolyticus bacteremia in Korea.
Bacteremia/etiology/pathology ; Humans ; Korea ; Male ; Middle Aged ; Shock, Septic/*etiology/pathology ; Vibrio Infections/*complications/pathology ; Vibrio alginolyticus/*isolation & purification

OBJECTIVETo assess the risk factors for nosocomial blood-stream infection (BSI) in a neonatal intensive care unit (NICU).

METHODSClinical data from the neonates admitted to the NICU in the St. Louis Children's Hospital in Washington University School of Medicine between January 2005 and December 2006 were retrospectively studied.

RESULTSA total of 1 290 neonates were included. Overall, 175 nosocomial BSIs occurred. Catheter-related BSIs accounted for 62.3% (109 cases). The incidence of nosocomial BSI was 4.22 per 1 000 patient-days. Logistic regression analysis revealed that low gestational age, low Apgar scores at 5 minutes, use of central venous catheter (CVC), and longer CVC use were risk factors for the development of nosocomial BSI. In the subgroup of neonates with CVC, mechanical ventilation was an additional independent risk factor for BSI.

CONCLUSIONSCatheter-related BSI is the major source of nosocomial BSI in the NICU. Prematurity, low Apgar scores at birth and prolonged CVC use are risk factors for the development of BSI.

Bacteremia ; etiology ; Cross Infection ; etiology ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Logistic Models ; Male ; Risk Factors

BACKGROUNDCurrently, slightly more than 50% of bloodstream infections (BSIs) are hospital acquired. When these infections occur in patients in intensive care units, they are associated with a high mortality rate, additional hospital days and excess hospital costs. Because of multifactor of nosocomial BSIs, measurements of control nosocomial BSIs are wide variety and lead to some confusion in practice. The aim of this study was to explore special way in accordance with self-hospital base on common principle.

METHODSIn one ward of the Intensive Care Unit, Peking Union Medical College Hospital, at first, we divided the all operation about bloodstream way into three sections used as keypoints. By surveying keypoints respectively, some operation faults of blood way were discovered. For decreasing the mobidity of nosocomial BSIs, some intervention measurements were executed. The rate of nosocomial BSIs was analyzed by chi-square test.

RESULTSAccording to the statistics from January to June, we received and cured 618 patients in total; among them, there were 13 cases of nosocomial BSI and the average occurrence was 2.3 cases/month. After intervention measurements from July to December 2011, we received and cured 639 patients in total with seven cases of nosocomial BSI, and the average occurrence was 1.2 cases/month (P < 0.05). From January to April 2012, no nosocomial BSI occurred in the investigated ward.

CONCLUSIONRemoving the operation faults of bloodstream way might decrease the nosocomial BSI rapidly and efficiently by utilizing a key point survey.

Adult ; Aged ; Bacteremia ; etiology ; prevention & control ; therapy ; Cross Infection ; etiology ; prevention & control ; therapy ; Female ; Humans ; Male ; Middle Aged

OBJECTIVE: To investigate the risk factors of oral ulcers and bloodstream infection in patients with hematopoietic stem cell transplantation. METHODS: The clinical data of 401 hematopoietic stem cell transplant patients in the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2021 were retrospective analyzed, and the risk factors of oral ulcers and bloodstream infection statistical and analyzed. RESULTS: Among the 401 patients, the incidence of oral ulcers was 61.3% (246/401), and the incidence of bloodstream infection was 9.0% (36/401). A total of 40 strains of pathogenic bacteria were isolated from 36 patients, including 26 strains of Gram negative strains (65%), 13 strains of Gram positive strains (32.5%), and 1 strain of fungi (2.5%). Single-factor analysis showed that oral hygiene was associated with the occurrence of bloodstream infection, and the Multi-factor analysis showed that age ≥14 years old, disease diagnosis of leukemia, and allogeneic hematopoietic stem cell transplantation were risk factors for oral ulcers. CONCLUSION The incidence of oral ulcers in patients with hematopoietic stem cell transplantation is high. The age ≥14 years, disease diagnosis of leukemia, and allogeneic hematopoietic stem cell transplantation were risk factors for oral ulcers in patients, and oral hygiene was associated with the occurrence of bloodstream infection.
Humans ; Adolescent ; Retrospective Studies ; Oral Ulcer/etiology* ; Bacteremia/microbiology* ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Sepsis ; Risk Factors ; Leukemia

OBJECTIVETo analyze the clinical features of inhalation injury in children, with the aim of improving its management.

METHODSThe incidence of inhalation injury in 333 cases of burned children was analyzed in terms of burn area, shock, infection and prognosis.

RESULTSThe incidences of shock and bacteremia were 41.14% and 18.92%, and those of moderate and severe inhalation injury were 58.76% and 31.96% respectively in burned children with inhalation injury. Bacteremia developed in 24.82% of the patients with shock. Among 67 patients who ultimately died, 58.21% of them were complicated with bacteremia ending in 34.33% of mortality. Early tracheostomy was beneficial in that less fluids were required for resuscitation.

CONCLUSIONBurn infection was an important factor affecting the prognosis of inhalation injury. And inhalation injury and shock were major inducers of burn infection. Early application of wide spectrum antibiotics and shock management were helpful in lowering of burn infection rate. Early tracheostomy might be beneficial to burn shock management.

Anti-Bacterial Agents ; therapeutic use ; Bacteremia ; epidemiology ; etiology ; prevention & control ; Burns ; physiopathology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Shock ; epidemiology ; etiology ; Smoke Inhalation Injury ; mortality ; physiopathology

No abstract available.
Adult ; Antineoplastic Combined Chemotherapy Protocols/*adverse effects ; Appendicitis/diagnosis/*etiology/therapy ; Bacteremia/*etiology/therapy ; Consolidation Chemotherapy/adverse effects ; Cytomegalovirus Infections/diagnosis/*etiology/therapy ; Humans ; Immunocompromised Host ; Male ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy/immunology/therapy