Drug Resistance, Bacterial ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Infant, Newborn ; Microbial Sensitivity Tests ; Sepsis ; diagnosis ; drug therapy ; microbiology

No abstract available.
Aged ; Anti-Bacterial Agents/therapeutic use ; Aortic Valve/*microbiology/surgery/ultrasonography ; Cross Infection/diagnosis/*microbiology/therapy ; Diffusion Magnetic Resonance Imaging ; Endocarditis, Bacterial/diagnosis/*microbiology/therapy ; Heart Valve Prosthesis Implantation ; Humans ; Klebsiella Infections/diagnosis/*microbiology/therapy ; Klebsiella pneumoniae/drug effects/*enzymology/pathogenicity ; Male ; Microbial Sensitivity Tests ; Predictive Value of Tests ; Sepsis/diagnosis/*microbiology/therapy ; Treatment Outcome ; beta-Lactamases/*metabolism

Wound sepsis is one of the main causes of death in patients with severe burn and trauma. The high incidence of burn wound sepsis in children is attributed to their imperfect immune system function, poor resistance against infection, and the weakened skin barrier function after burn. The key to reduce the mortality of pediatric patients with burn wound sepsis is to enhance the understanding of its etiology, epidemiology, pathogenesis, and diagnostic criteria, in order to improve its early diagnosis and treatment.
Burns ; complications ; prevention & control ; therapy ; Child ; Humans ; Sepsis ; diagnosis ; etiology ; mortality ; therapy ; Skin ; microbiology ; pathology ; Survival Rate ; Wound Infection ; mortality ; prevention & control ; therapy

Selective intestinal decontamination (SID) with norfloxacin has been widely used for the prophylaxis of spontaneous bacterial peritonitis (SBP) because of a high recurrence rate and preventive effect of SID for SBP. However, it does select resistant gut flora and may lead to SBP caused by unusual pathogens such as quinolone-resistant gram-negative bacilli or gram-positive cocci. Enterococcus hirae is known to cause infections mainly in animals, but is rarely encountered in humans. We report the first case of SBP by E. hirae in a cirrhotic patient who have previously received an oral administration of norfloxacin against SBP caused by Klebsiella pneumoniae and presented in septic shock.
Administration, Oral ; Ampicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Ascitic Fluid/microbiology ; Enterococcus/*isolation & purification ; Gram-Positive Bacterial Infections/complications/drug therapy/*microbiology ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Peritonitis/*diagnosis/drug therapy/microbiology ; Sepsis/*etiology

No abstract available.
Aged ; Drug Resistance, Bacterial ; Humans ; Imipenem/pharmacology/therapeutic use ; Klebsiella Infections/diagnosis/drug therapy/*microbiology ; Klebsiella pneumoniae/drug effects/isolation & purification/*physiology ; Male ; Microbial Sensitivity Tests ; Phenotype ; Sepsis/diagnosis/drug therapy/*microbiology ; Thienamycins/pharmacology/therapeutic use

OBJECTIVE: To realize the risk factors, clinical features, and treatments of Staphylococcal scalded skin syndrome (SSSS).
 METHODS: The clinical features, laboratory findings, and treatment were retrospectively analyzed in 290 patients from Hunan Children's Hospital.
 RESULTS: Of the 290 patients, less than 3 years old children were 76.6%. One hundred and nine patients had induced factors, and 177 patients had elevated white blood cell count. There were 168 patients with SSSS accompanied with fever, 34 patients accompanied with diarrhea, and 58 patients associated with septicemia. Eighty-five patients performed the bacterial cultures of the skin secretions, 21 did the throat swab, and 13 did both of the skin secretions and throat swab. Bacterial culture results showed that 119 samples were positive for Staphylococci. All patients were cured after antimicrobial therapy. The skin lesions were improved in 3.26 d. The mean hospital stay was 6.55 d. Recovery time of the body temperature was 3.48 d in average.
 CONCLUSION SSSS predominates in infants and children under 3 years old, and has tendency to combine with multi-organ symptoms. The early diagnosis and active antimicrobial treatment are the keys of successful treatments.
Anti-Bacterial Agents ; therapeutic use ; Child, Preschool ; China ; Humans ; Infant ; Length of Stay ; Retrospective Studies ; Risk Factors ; Sepsis ; Skin ; microbiology ; Staphylococcal Scalded Skin Syndrome ; diagnosis ; drug therapy ; pathology

INTRODUCTIONSevere perianal sepsis is often difficult to manage after surgical debridement due to faecal contamination. Diversion of the faecal stream has been attempted with faecal pouches and rectal tubes, and in some cases, a diverting stoma is created. However, reversal of the stoma may be delayed due to prolonged sepsis and this is not without risks. Herein, we review the use of a flexible faecal management system in patients with severe perianal sepsis.

METHODSWe retrospectively evaluated 15 patients who made use of the ConvaTec Flexi-Seal® Fecal Management System (FMS) between 1 January 2007 and 31 December 2010. The demographics and comorbidities of the patients, as well as the treatment received, were recorded and reviewed.

RESULTSNone of the patients required the creation of a stoma to divert the faecal stream. Nursing requirements and wound care were found to be improved with the use of the Flexi-Seal® FMS (fewer changes were needed). No severe complications were observed in our series. Two deaths were encountered, but the cause of death was not directly due to the initial perianal sepsis. Overall, the wound healing rate was 80.0%, with one graft failure (11.1%).

CONCLUSIONThe use of the Flexi-Seal® FMS in patients with perianal sepsis following extensive debridement is feasible and can be considered before stoma creation.

Adult ; Aged ; Anti-Bacterial Agents ; Bacterial Proteins ; isolation & purification ; Catheters, Indwelling ; Debridement ; Enterococcus ; isolation & purification ; Fasciitis, Necrotizing ; microbiology ; surgery ; Feces ; Female ; Fournier Gangrene ; microbiology ; Hemolysin Proteins ; isolation & purification ; Humans ; Klebsiella ; isolation & purification ; Male ; Middle Aged ; Perineum ; microbiology ; Rectum ; microbiology ; Retrospective Studies ; Sepsis ; diagnosis ; drug therapy ; microbiology ; therapy ; Singapore ; Surgical Stomas ; Treatment Outcome ; Wound Healing

Thrombophlebitis of the portal venous system (PVS) with superimposed bacterial infection (septic pylephlebitis) is an extremely rare complication of Crohn's disease (CD), and therefore diagnosis of septic pylephlebitis is difficult without high clinical suspicion. A 16-year old male patient who was diagnosed with CD 3 months earlier was admitted with recurrent fever and abdominal pain. CD activity had been well controlled with conventional medical treatment during a follow-up period. Abdominal contrast-enhanced computed tomography showed massive thrombosis in the PVS without evidence of intra-abdominal infection, and blood cultures were positive for Streptococcus viridians. There was no evidence of deep vein thrombosis or pulmonary thromboembolism, and all laboratory tests for thrombophilia were normal. Based on these findings, the patient was diagnosed with septic pylephlebitis complicated with CD, and was successfully treated with intravenous antibiotic therapy combined with anticoagulation. This case suggests that early comprehensive evaluation is crucial for immediate diagnosis and proper treatment of septic pylephlebitis in patients with CD who present with fever and abdominal pain of unknown origin, even with stable disease activity and absence of other intra-abdominal infections.
Adolescent ; Anti-Bacterial Agents/therapeutic use ; Anticoagulants/therapeutic use ; Colonoscopy ; Crohn Disease/complications/*diagnosis ; Humans ; Male ; Phlebitis/complications/*diagnosis ; Portal Vein/radiography ; Sepsis/*diagnosis/microbiology ; Streptococcal Infections/diagnosis/drug therapy ; Thrombosis/drug therapy/radiography ; Tomography, X-Ray Computed ; Viridans Streptococci/isolation & purification

OBJECTIVETo realize the difference between China and France in the clinical manifestations, diagnosis and treatment of early-onset neonatal sepsis (EONS) and to provide basis to improve the level of our hospital in diagnosing and treating this disease.

METHODData of 146 cases of EONS were retrospectively analyzed. All data were collected from our hospital and a French hospital. Bacterial spectrum, clinical manifestations, use of antibacterial drugs, occurrence of recording and screening of perinatal risk factors were compared between the two hospitals.

RESULTThe most common pathogenic bacteria in our hospital were coagulase-negative staphylococcus (69.2%) and Escherichia coli (15.4%) while in the French Hospital, group B streptococcus (33.3%) and Escherichia coli (33.3%). The most common pathogenic bacteria in gastric liquid and peripheral swabs of the French hospital were Escherichia coli (33.3%) and group B streptococcus (21.2%). Total days of antibacterial use 11.4 ± 7.2 (d), mean sorts of antibacterial drugs for single patient (3.1 ± 0.9) and proportion of patients who had antibacterial drug changes (70.2%) were greater than the French hospital 6.2 ± 2.5 (d), 2.2 ± 0.8(d), (9.9%). Both hospitals were inclined to combine 2 antibacterial drugs for the first dose (second-generation cephalosporins + semi-synthetic penicillin in our hospital vs. amoxicillin + amikacin in the French hospital). The common second and third line antibacterial drugs in our hospital are carbapenems and vancomycin vs. third-generation cephalosporins and vancomycin in the French hospital. The rates of occurrence of recording and screening perinatal risk factors (chorioamnionitis, maternal fever, prolonged rupture of membranes, screening results of vaginal swabs or urinary infection, amniotic fluid contamination, prenatal antibacterial prophylaxis, anamnesis of EONS) in our hospital was all lower than those of the French hospital. There was no significant difference in positive rate of perinatal risk factors between the two hospitals. For newborns hospitalized for immediate abnormalities after birth, the most common symptom was respiratory distress (96.5% vs. 88.2%). For those admitted after a period of time after birth, the proportion of abnormalities was different: in our hospital, the most common reasons were respiratory distress (44.4%) and lethargy (22.2%) while in the French hospital there were rise of C reactive proteins (78.2%) and fever (5.5%). The false negative rate of C reactive proteins in diagnosing EONS was not significantly different between the two hospitals.

CONCLUSIONThere was significant difference in diagnosing and treating EONS in the two hospitals. Emphasis on screening and recording perinatal risk factors, as well as strengthened surveillance on neonates in obstetric department could improve the accuracy of early diagnosis of EONS of our hospital. Positive attitude to gastric liquid and peripheral swabs culture, with drug susceptibility test may help pediatricians better select antibacterial drugs and reduce unnecessary changes and the total time of antibiotic use.

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; C-Reactive Protein ; analysis ; China ; Drug Resistance, Microbial ; Escherichia coli ; drug effects ; isolation & purification ; Female ; France ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnosis ; drug therapy ; microbiology ; Male ; Microbial Sensitivity Tests ; Neonatal Screening ; methods ; Pregnancy ; Pregnancy Complications ; diagnosis ; Prenatal Diagnosis ; methods ; Retrospective Studies ; Risk Factors ; Sepsis ; diagnosis ; drug therapy ; microbiology ; Staphylococcus ; drug effects ; isolation & purification ; Streptococcus agalactiae ; drug effects ; isolation & purification

Portal vein thrombosis is an uncommon but an important cause of portal hypertension. The most common etiological factors of portal vein thrombosis are liver cirrhosis and malignancy. Albeit rare, portal vein thrombosis can also occur in the presence of local infection and inflammation such as pancreatitis or cholecystitis. A 52-year-old male was admitted because of general weakness and poor oral intake. He had an operation for colon cancer 18 months ago. However, colonic stent had to be inserted afterwards because stricture developed at anastomosis site. Computed tomography taken at admission revealed portal vein thrombosis and inflammation at colonic stent insertion site. Blood culture was positive for Escherichia coli. After antibiotic therapy, portal vein thrombosis resolved. Herein, we report a case of portal vein thrombosis with sepsis caused by inflammation at colonic stent insertion site which was successfully treated with antibiotics.
Anti-Bacterial Agents/therapeutic use ; Cholecystitis/etiology ; Colonic Neoplasms/pathology/therapy ; Escherichia coli/isolation & purification ; Escherichia coli Infections/drug therapy/etiology ; Humans ; Inflammation/*etiology ; Liver/diagnostic imaging ; Male ; Middle Aged ; Pancreatitis/etiology ; Portal Vein ; Sepsis/*diagnosis/drug therapy/microbiology ; Sigmoidoscopy ; Stents/*adverse effects ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*diagnosis