2.Neonatal septicemia caused by Listeria monocytogenes: report of 6 cases.
Li WU ; Xian-hua ZHANG ; Hao CHEN ; Xue-lei YIN
Chinese Journal of Pediatrics 2008;46(1):22-25
OBJECTIVENeonatal listeriosis is a relatively rare but serious disease with a high mortality rate. This study was conducted to analyze the clinical features, treatment, and outcome of 6 cases with Listeria monocytogenes septicemia confirmed by positive blood cultures.
METHODSTotally 12,538 live births delivered in the hospital from January 1, 2004 to June 30, 2006 were investigated. Differences in the time of onset of the disease, clinical presentation, illness severity, laboratory data, management, and prognosis were compared between preterm and full-term infants.
RESULTSThe incidence of neonatal listeriosis was 4.8% in this study. All the cases with listeriosis were found to have early onset and the disease was transmitted from the mother to the fetus, 4 of the cases were delivered via cesarean section, 2 were born via normal spontaneous vaginal delivery. Maternal infection before parturition presented with fever in 4, diarrhea in 1; 5 had abnormal white blood cell counts and total neutrophil counts; 1 had positive result of Listeria monocytogenes in intrauterine contents culture. Three premature infants showed signs and symptoms of severe bacterial septicemia at birth, such as reduced activity, respiratory distress, poor skin color and poor peripheral perfusion; the enlarged liver was palpable 2 - 3 cm below the right costal margin and 5 cm below the xiphoid in one; congestive rashes over the body and muscular hypotonia. Abnormal results of laboratory tests included peripheral blood white cell count (21.6 - 33.8 x 10(9))/L, total neutrophil count 0.77 - 0.83; platelet count (102 - 59 x 10(9))/L; C-reactive protein (CRP) > (160 - 118) mg/L(24 - 72 h after birth). Three preterm infants who received intensive care, accompanied by pathological changes of lungs indicated by chest X ray required assisted mechanical ventilation and 2 of them survived without sequelae but the other one died at 51 h of life. The initial clinical signs of septicemia in 3 full-term infants appeared later than preterm newborn within 62 h, 63 h and 165 h, respectively after birth. They only had fever, T 38 - 39 degrees C, with lower activity in contrast to normal newborn and without other signs and symptoms of septicemia. Accurate diagnosis of listeriosis was established by positive bacterial blood cultures. Intravenous treatment of neonatal listeriosis with ampicillin or penicillins for 1 - 2 weeks was more effective, but cephalosporins were not effective.
CONCLUSIONSThere are sporadic cases with Listeria monocytogenes infection among pregnant women in this country, resulting in severe illness of their newborn infants. Early differential diagnosis, early detection of causative organisms, especially in newborn infants infected with Listeria monocytogenes, early treatment with sensitive antibiotics can decrease the mortality rate and improve neonatal outcome. It is necessary to enhance nationwide surveillance for listeriosis.
Female ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnosis ; microbiology ; Listeria monocytogenes ; isolation & purification ; Listeriosis ; microbiology ; Male ; Sepsis ; diagnosis ; microbiology
4.The clinical staging and tissue bacterial quantification in the diagnosis of burn wound sepsis.
Zhi-Qiang WANG ; Bao-Ren CAI ; Jie XIAO ; Guang-Hui HAO ; Jun-Bo WU ; Xiao-Hua ZHAO
Chinese Journal of Burns 2003;19(5):282-284
OBJECTIVETo investigate and re-evaluate the relationship between burn wound sepsis and tissue bacterial quantity.
METHODSThirty-two patients admitted during past 5 years were enrolled in the study. Bacterial isolation and quantity in burn wound tissue were carried out. Meanwhile clinical signs were evaluated for the staging of burn wound sepsis.
RESULTS1) Bacterial invasion could be identified in 123 pieces of tissue samples from 32 patients. Samples with tissue bacterial quantity > or = 10(5)/g were found in 82 subeschar tissue samples, and 41 samples with bacteria <10(5)/g. Subeschar tissue samples with bacterial quantity > or = 10(5)/g could be determined in 68 samples from 18 patients, and < 10(5)/g in 20 samples from 5 cases. In addition, samples of subeschar tissue with bacterial quantity > or = 10(5)/g could only be found in some of the samples form 9 cases. 2) Burn wound sepsis could be classified into I-IV stages according to tissue bacterial quantification and clinical signs.
CONCLUSIONBurn wound sepsis could be established by identification of bacterial invasion into living tissue with clinical symptoms of toxemia.
Adolescent ; Adult ; Burns ; complications ; diagnosis ; microbiology ; Colony Count, Microbial ; Female ; Humans ; Male ; Middle Aged ; Sepsis ; diagnosis ; etiology ; microbiology ; Young Adult
5.Standardized definitions and diagnostic criteria for infection in burn patients.
Chinese Journal of Burns 2007;23(6):404-405
There are many criteria for the diagnosis of infection and sepsis in most patients, but the standardized definitions for infection and sepsis in burn patients are less applicable to the burn population and have never been developed. We recommend that suspicious systemic infection (sepsis) should be considered as a clinical syndrome defined by the presence of signs and symptoms of systemic infection even with negative blood microbial culture, systemic infection should be identified with positive blood microbial culture or clinical response to antimicrobials. We also expand the list of diagnostic criteria for systemic infection to reflect clinical experience in burn patients. Further refinement will be necessary when these definitions are considered for routine application in clinical practice.
Burns
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microbiology
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Cross Infection
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diagnosis
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Humans
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Reference Standards
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Sepsis
;
diagnosis
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Terminology as Topic
6.Application and Prospect of Nanopore Sequencing Technology in Etiological Diagnosis of Blood Stream Infection.
Wei GUO ; Shuai-Hua FAN ; Peng-Cheng DU ; Jun GUO
Acta Academiae Medicinae Sinicae 2023;45(2):317-321
Blood stream infection (BSI),a blood-borne disease caused by microorganisms such as bacteria,fungi,and viruses,can lead to bacteremia,sepsis,and infectious shock,posing a serious threat to human life and health.Identifying the pathogen is central to the precise treatment of BSI.Traditional blood culture is the gold standard for pathogen identification,while it has limitations in clinical practice due to the long time consumption,production of false negative results,etc.Nanopore sequencing,as a new generation of sequencing technology,can rapidly detect pathogens,drug resistance genes,and virulence genes for the optimization of clinical treatment.This paper reviews the current status of nanopore sequencing technology in the diagnosis of BSI.
Humans
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Nanopore Sequencing
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Sepsis/diagnosis*
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Bacteremia/microbiology*
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Bacteria
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Blood Culture/methods*
8.A Case of Clostridium Liver Abscess with Sepsis.
Sang Ho LEE ; Hyoung Su KIM ; Sung Jun KIM ; Woon Geon SHIN ; Kyung Ho KIM ; Myoung Kuk JANG ; Jin Heon LEE ; Hak Yang KIM
The Korean Journal of Gastroenterology 2013;61(2):103-106
Clostridial septicemia usually occurrs in patients with immunocompromised diseases such as diabetes and malignancy. Clostridial liver abscess is very rare but highly fatal. We experienced a case of Clostridial septicemia due to liver abscess in a 73-year-old man. He was presented with fever and chills. On admission, abdominal CT scan showed about 35 mm sized hypoattenuated lesion with multiple central air-bubbles. After the diagnosis of liver abscess, the patient underwent prompt empirical antimicrobial therapy and percutaneous drainage. In spite of early therapy, the patient had gone into shock and death.
Aged
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Clostridium/*isolation & purification
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Clostridium Infections/diagnosis/*microbiology
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Drainage
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Humans
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Liver/radiography
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Liver Abscess/complications/*diagnosis/microbiology
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Male
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Sepsis/complications/*diagnosis
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Tomography, X-Ray Computed
9.A Case of Sepsis and Acute Renal Failure Associated with Salmonella Enterocolitis.
Chul Han KIM ; Ki Tae SUK ; Jae Woo KIM
The Korean Journal of Gastroenterology 2008;52(2):110-114
Salmonella infection can cause an asymptomatic intestinal carrier state or clinical diseases such as enterocolitis presenting abdominal pain, fever, vomiting, or diarrhea. Salmonella usually invades Peyer's patch of terminal ileum or ascending colon. Sepsis is not common and acute renal failure secondary to rhabdomyolysis is rare. The causes of rhabdomyolysis are trauma, excessive exercise, alcohol, seizure, metabolic abnormality, and infection. Infections account for less than 5% of the reported causes of rhabdomyolysis and resulting acute renal failure. The mechanisms underlying rhabdomyolysis due to infection are direct muscle invasion, toxin production, and nonspecific effects that can occur with infections such as fever, dehydration, acidosis, and electrolyte imbalance. We report a case of sepsis and acute renal failure secondary to rhabdomyolysis associated with Salmonella infection.
Colonoscopy
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Enterocolitis/complications/*diagnosis
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Humans
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Kidney Failure, Acute/*diagnosis/etiology
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Male
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Middle Aged
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Rhabdomyolysis/diagnosis/etiology/microbiology
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Salmonella Infections/complications/*diagnosis
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Sepsis/*diagnosis/etiology
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Tomography, X-Ray Computed