1.An understanding of burn infection.
Chinese Journal of Burns 2008;24(3):164-166
Burn infection occurs when pathogenic bacteria colonized on the burn wound surface, and they then invaded the viable tissue causing sepsis or sepsis with blood stream invasion. This infection pattern is particular to burn injury. Both in a model of pseudomonas burn wound sepsis and a clinical study of early eschar excision for bacteria quantification indicate that the bacteria not only are located on the burn wound surface but also invaded the deeper tissues. Finally, the bacteria penetrate into the neighboring viable tissue and even blood vessels. Therefore, we can say that burn infection is from local wound infection to invasive infection, and finally sepsis is developed ,and it is termed as burn wound sepsis. The cutoff count of subeschar tissue bacteria is 10(5)/g. However, the burn wound sepsis may not occur when the number of subeschar tissue bacteria reaches 10(5)/g. The criteria for the diagnosis of burn wound sepsis are mainly listed as below: (1) The number of bacteria in the subeschar reaches > or =10(5)/g. (2) Bacteria can be detected in the biopsy specimen. (3) Sepsis associated symptoms and signs. However, the sepsis associated symptoms and signs must be obvious in patients to make the clinical diagnosis of burn wound sepsis. If the sepsis associated symptoms and signs do not appear, we should not make the diagnosis of burn wound sepsis eyen with the number of bacteria in the subeschar tissue reaching 10(5)/g or bacteria can be found in the biopsy specimen. Sepsis has been defined as the body % response to bacteria and their products. The occurrence of sepsis depends primarily on immune function and stress response intensity, and it is closely related to wound infection degree such as bacteria density and invasion depth in the burn wound, or plasma endotoxin level to certain extent.
Bacterial Infections
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etiology
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Burns
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microbiology
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Humans
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Sepsis
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etiology
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Wound Infection
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etiology
2.Prospective cohort study on the relationship between pathogenic bacteria in the nasal middle meatus and acute bacterial respiratory infection in children.
Jian-Yue SUN ; Xiao-Qun JIN ; Wen-Xiu LI ; Wei-Ju LU
Chinese Journal of Contemporary Pediatrics 2006;8(6):473-475
OBJECTIVETo study the relationship between pathogenic bacteria in the nasal middle meatus and acute bacterial respiratory infection in children.
METHODSThree hundred and twenty eight children with respiratory infection (mean age 8 years) were included into the prospective cohort study. The mucosal fluid specimens from the nasal middle meatus were collected under an endoscope for bacterial culture. The patients with bacterial culture positive were defined as the Exposed group and those with bacterial culture negative as the Non-exposed group. The grouping of the patients was blinded to the patients, patients' parents and physicians. Both groups received anti-virus and symptomatic treatments, without antibiotic administration. Five days later, the patients were evaluated as to whether they had bacterial infection based on the leucocyte count and CRP results.
RESULTSOf the 328 patients, 168 had a positive nasal bacterial culture. The incidence of bacterial respiratory infection in the Exposed group [51.2% (86/168)] was significantly higher than in the Non-exposed group [13.1% (21/160)] (P < 0.01). The relative risk of bacterial respiratory infection occurrence in patients with nasal bacterial culture positive was 3.9002.
CONCLUSIONSThe children with respiratory infection who had potential pathogenic bacteria in the nasal middle meatus were more prone to develop bacterial respiratory infection.
Acute Disease ; Bacterial Infections ; etiology ; Child ; Cohort Studies ; Female ; Humans ; Male ; Nose ; microbiology ; Prospective Studies ; Respiratory Tract Infections ; etiology
4.Clinical features of ventilator-associated pneumonia caused by acinetobacter.
Acta Academiae Medicinae Sinicae 2004;26(3):285-288
OBJECTIVETo investigate the clinical features of ventilator-associated pneumonia (VAP) caused by acinetobacter.
METHODSThe clinical manifestations of 45 cases with ventilator-associated pneumonia caused by acinetobacter between 1995 and 2002 were analyzed. Bacterial susceptibility of acinetobacter strains was determined by Kerby-Bauer method.
RESULTSThe mean age of the subjects was 58 +/- 13 years with 31 patients older than 60 years. All the patients had underlying diseases, most of which were respiratory diseases (37.8%), nervous system diseases (22.2%), and trauma (22.2%). Thirteen cases (28.9%) were mixed infections with other bacteria. The main manifestations were fever, purulent secretion, and solidification in the lung. X-ray revealed inflammatory infiltration in lower lobes of both sides. The mortality was 37.8%. The in vitro activity tests of 28 antibiotics against the acinetobacter strains showed that they were multiresistant. Polymysin B, imipenem, minocycline, ofloxacin, and amikacin were relatively active.
CONCLUSIONThe patients with VAP caused by acinetobacter usually had underlying diseases without unique features and high mortality, and the isolated strains were often mutiresistant. It is necessary to make early diagnosis, select the appropriate agents, and improve the disinfection of the breath loop in the ventilator.
Acinetobacter ; isolation & purification ; Acinetobacter Infections ; microbiology ; Aged ; Cross Infection ; etiology ; Drug Resistance, Bacterial ; Female ; Humans ; Male ; Middle Aged ; Pneumonia, Bacterial ; microbiology ; Ventilators, Mechanical ; microbiology
5.Relationship between Intrauterine Bacterial Infection and Early Embryonic Developmental Arrest.
Shao-Fei YAN ; Xin-Yan LIU ; Yun-Fei CHENG ; Zhi-Yi LI ; Jie OU ; Wei WANG ; Feng-Qin LI
Chinese Medical Journal 2016;129(12):1455-1458
BACKGROUNDEarly embryonic developmental arrest is the most commonly understudied adverse outcome of pregnancy. The relevance of intrauterine infection to spontaneous embryonic death is rarely studied and remains unclear. This study aimed to investigate the relationship between intrauterine bacterial infection and early embryonic developmental arrest.
METHODSEmbryonic chorion tissue and uterine swabs for bacterial detection were obtained from 33 patients who underwent artificial abortion (control group) and from 45 patients who displayed early embryonic developmental arrest (trial group).
RESULTSIntrauterine bacterial infection was discovered in both groups. The infection rate was 24.44% (11/45) in the early embryonic developmental arrest group and 9.09% (3/33) in the artificial abortion group. Classification analysis revealed that the highest detection rate for Micrococcus luteus in the early embryonic developmental arrest group was 13.33% (6/45), and none was detected in the artificial abortion group. M. luteus infection was significantly different between the groups (P < 0.05 as shown by Fisher's exact test). In addition, no correlation was found between intrauterine bacterial infection and history of early embryonic developmental arrest.
CONCLUSIONSM. luteus infection is related to early embryonic developmental arrest and might be one of its causative factors.
Abortion, Induced ; statistics & numerical data ; Abortion, Spontaneous ; etiology ; microbiology ; Bacterial Infections ; complications ; Female ; Humans ; Micrococcus luteus ; pathogenicity ; Pregnancy ; Uterus ; microbiology
6.Early-stage bacterial infection following orthotopic liver transplantation in patients over 60 years old.
Ji-Xiao ZENG ; Xiao-Shun HE ; Xiao-Feng ZHU ; Jie-Fu HUANG
Chinese Journal of Surgery 2008;46(13):988-991
OBJECTIVETo summarize the pathogenic characteristics of bacterial infection and analyze the risk factors after orthotopic liver transplantation (OLT) in patients over 60 years of age.
METHODSA retrospective study of 69 patients that were over 60 years of age and underwent OLT was carried out. Descriptive statistics and risk factor analysis were performed with SPSS 11.0.
RESULTSThirty-eight patients developed bacterial infection (55.1%) after OLT, and thirty recipients suffered from mixed bacterial infection (79.0%). Multi-location infection was most commonly seen (68.4%). Nine patients died of bacterial infection. The primary pathogenic germs included enterococcus, methicillin-resistant coagulase negative staphylococcus, c maltophilia. The risk factors related to bacterial infection included preoperative malnutrition, long anhepatic phase, use of ventilator and duration of ICU stay.
CONCLUSIONSThe old patients that have undergone OLT are susceptible to bacterial infection. Bacterial infections are associated with high rate of mortality and multidrug resistance. Eliminating various risk factors can reduce the incidence of bacterial infection.
Aged ; Bacterial Infections ; etiology ; microbiology ; prevention & control ; Drug Resistance, Bacterial ; Female ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Postoperative Complications ; etiology ; microbiology ; prevention & control ; Retrospective Studies ; Risk Factors
7.A preliminary study of the postburn intestinal biological barrier injury in severely burned rats.
Jun CHEN ; Yaping ZHANG ; Guangxia XIAO
Chinese Journal of Burns 2002;18(4):216-219
OBJECTIVETo investigate the postburn change in the intestinal biological barrier in severely burned rats.
METHODSWistar rats inflicted by 30% TBSA III degree scalding on the back were employed as the model. The samples were harvested at 24, 48, 72 and 96 postburn hours (PBHs), respectively with the employment of microorganism analysis, biochemical and radio-immune methods for the study. The membranous flora in cecum, the mucin and sIgA in intestinal content, the intestinal endotoxin and bacterial translocation rate and quantification analysis and the endotoxin content in cava vein were observed.
RESULTSThe total intestinal membranous flora amount decreased, especially and obviously did the anaerobic bacteria such as bifidobacteria. But aerobic ones increased. In addition, The fungus and enterobacteria exhibited rapid overgrowth. This lead to evident imbalance between anaerobic and aerobic bacteria and to the destruction of intestinal biological barrier and the decrease of colonization resistance. As a result, the intestinal bacterial translocation rate increased markedly. The endotoxin content in the cava and intestinal containing increased, while the mucin and sIgA contents decreased.
CONCLUSIONIntestinal biological barrier could be severely damaged after major burn, which might be one of the causes of postburn intestinal infection.
Animals ; Bacterial Infections ; etiology ; Burns ; complications ; Cell Membrane ; microbiology ; Female ; Intestinal Diseases ; etiology ; microbiology ; Intestinal Mucosa ; microbiology ; Male ; Rats ; Rats, Wistar
8.Investigation of intestinal bacterial translocation in 78 patients with cirrhosis after liver transplantation.
Zhong-Wen WU ; Kai-Jin XU ; Lan-Juan LI ; Jian ZUO ; Ji-Fang SHENG ; Shu-Sen ZHENG ; Ting-Bo LIANG ; Yan SHEN ; Wei-Lin WANG ; Min ZHANG
Chinese Journal of Surgery 2006;44(21):1456-1459
OBJECTIVETo investigate the prevalence and associated risk factors of bacterial translocation (BT) in patients with cirrhosis after liver transplantation and analyze the effect of BT on bacterial infection after the surgery.
METHODSMesenteric lymph nodes (MLN), portal vein blood, and peripheral blood were collected during the liver transplantation for microbiological culture from 78 patients with cirrhosis. And meanwhile, all related clinical data were analyzed to investigate the risk factors of BT and its relationship with post-liver transplantation infections.
RESULTSBT was occurred in 8 of 78 cirrhotic patients (10.3%) and positive-rate of MLN culture was 5/8. Gram-negative aerobic bacillus was the main causative bacterium of BT (5/9), followed by Gram-positive aerobic enterococcus (22.2%, 2/9). Total bilirubin level in patients with BT was significantly higher than that in patients without BT.
CONCLUSIONSIt suggests that hyperbilirubinemia is the only risk factor for BT, and BT is associated with an increased infectious rate after liver transplantation.
Adult ; Bacterial Infections ; blood ; etiology ; Bacterial Translocation ; Female ; Humans ; Intestines ; microbiology ; Liver Cirrhosis ; microbiology ; surgery ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Peritonitis ; etiology ; Postoperative Complications ; etiology ; microbiology ; Risk Factors
9.Vibrio Fetus Human Infection: Isolation from a Subacute Bacterial Endocarditis Case.
Yonsei Medical Journal 1970;11(2):126-130
Vibrio fetus was isolated from blood specimens of a subacute bacterial endocarditis patient. The 38 year old male patient was admitted to Severance Hospital in January 1970 for 11 days and again in July 1970 for 13 days. Subacute bacterial endocarditis was the major condtion. Aortic insufficiency and cholestatic hepatitis were the accessory diagnosis. The organism was isolated during the second admission. V. fetus human infection is known to be very rare, and the present case appears to be the first case in Korea. V. fetus grows very slowly with increased carbon dioxide tension which favours the growth. It is a slightly curved, S-shaped and spiral gram-negative organism. Many antibiotics, effective to gram negative organisms, inhibit the growth of the organism. V. fetus is an animal pathogen causing disease in ruminants. The patient enjoyed raw beef dishes. He could be infected with the organism by eating raw beef.
Adult
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Campylobacter fetus/isolation & purification
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Endocarditis, Subacute Bacterial/etiology
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Endocarditis, Subacute Bacterial/microbiology*
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Human
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Male
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Vibrio/isolation & purification*
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Vibrio Infections/microbiology*