scholarly journals Prognosis Risk of Urosepsis in Critical Care Medicine: A Prospective Observational Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Xin-Hua Qiang ◽  
Tie-Ou Yu ◽  
Yi-Nan Li ◽  
Li-Xin Zhou
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Multivariate Analysis ◽  
Critical Care ◽  
Prospective Observational Study ◽  
Organ System ◽  
The Other ◽  
Time Of Admission ◽  
Gram Positive Cocci

This study aimed to investigate the clinical features of urosepsis and to raise awareness of this problem. Of the 112 sepsis patients enrolled, 36 were identified as having urosepsis. The bacteria involved in the infection leading to urosepsis includedEscherichia coli,Proteusspecies,Enterococcusspecies,Klebsiellaspecies, other Gram-positive cocci, andPseudomonas aeruginosa. Although the organ/system dysfunction appeared earlier in the urosepsis patients than in the other sepsis patients (4.7±2.4versus7.2±4.5hours,P<0.001), the urosepsis patients presented with a better prognosis and lower 28-day mortality rate than the others (6% versus 37%). In the multivariate analysis, the type of sepsis (urosepsis, OR = 0.019, 95% CI = 0.001, 0.335,P=0.007) and SOFA score (OR = 1.896, 95% CI = 1.012, 3.554,P=0.046) remained significantly associated with the survival. The time of admission to the intensive care unit of 17 patients transferred from the Department of Urinary Surgery was significantly prolonged compared with those transferred from other departments (11.6±7.3versus7.2±4.9hours,P<0.05). In conclusion, urosepsis suggested a better prognosis, but attention needs to be paid in clinical practice, especially in urinary surgery.

scholarly journals MICROBIOLOGICAL SCREENING OF OTORRHOEA FROM PEOPLE COMING TO HOSPITAL IN MAHAJANGA

2020 ◽  
pp. 25-28
Author(s):  
Rivo RAKOTOMALALA ◽  
Patrick RANDRIANANDRAINA ◽  
Tsiriniaina RAMAVOSON ◽  
Fiacre RAMISARIMANANA ◽  
Ainamalala Catherine RAZAFINDRAKOTO ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
The Other ◽  
Coagulase Negative Staphylococcus ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Ear Infections ◽  
Corynebacterium Sp ◽  
Gram Positive Cocci

In whole, 56 patients were included. Amidst identified microorganisms were fungus (4,7%) and bacteria (95,3%) to which Gram negative bacilli represented 72,1% (n=44), Gram positive cocci 6,4% (n=10), Gram positive bacilli 8,2% (n=5) and Gram negative cocci 3,3% (n=2). Among these bacterias, Pseudomonas aeruginosa and Proteus sp were predominant, with respectively 41% (n=25), 23% (n=14). However, three cases of S. aureus reported, six with negative coagulase Staphylococcus, one with Escherichia coli, one with Klebsiella sp, one with Haemophilus sp, two cases with Neisseria sp and four cases with Corynebacterium sp. Two types of cultures were noticed, one of them monomorphic (91,1%, n=51) and the other polymorphic (8,9%, n=5) to which 3 associations of P. aeruginosa-Proteus sp, 1 association of P. aeruginosa- coagulase negative Staphylococcus and 1 association of P. aeruginosa- E. coli. No resistance to ciprofloxacin was observed with Pseudomonas, Neisseria sp, Haemophilus, and enterobacteria except for E. coli. No resistance to rifampicin was observed with S. aureus. However, the sensitivity of S. aureus to ciprofloxacin decreased (one bacterium out of three). The use of rifampicin or fluoroquinolones should be based on the type of ear infections,

scholarly journals Impact of Cefepime Therapy on Mortality among Patients with Bloodstream Infections Caused by Extended-Spectrum-β-Lactamase-Producing Klebsiella pneumoniae and Escherichia coli

2012 ◽  
Vol 56 (7) ◽  
pp. 3936-3942 ◽  
Author(s):  
Teena Chopra ◽  
Dror Marchaim ◽  
Jennifer Veltman ◽  
Paul Johnson ◽  
Jing J. Zhao ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Empirical Therapy ◽  
Bloodstream Infections ◽  
Content Type ◽  
Time Of Admission ◽  
The Impact

ABSTRACTExtended-spectrum-β-lactamase (ESBL)-producing pathogens are associated with extensive morbidity and mortality and rising health care costs. Scant data exist on the impact of antimicrobial therapy on clinical outcomes in patients with ESBL bloodstream infections (BSI), and no large studies have examined the impact of cefepime therapy. A retrospective 3-year study was performed at the Detroit Medical Center on adult patients with BSI due to ESBL-producingKlebsiella pneumoniaeorEscherichia coli. Data were collected from the medical records of study patients at five hospitals between January 2005 and December 2007. Multivariate analysis was performed using logistic regression. One hundred forty-five patients with BSI due to ESBL-producing pathogens, includingK. pneumoniae(83%) andE. coli(16.5%), were studied. The mean age of the patients was 66 years. Fifty-one percent of the patients were female, and 79.3% were African-American. Fifty-three patients (37%) died in the hospital, and 92 survived to discharge. In bivariate analysis, the variables associated with mortality (P< 0.05) were presence of a rapidly fatal condition at the time of admission, use of gentamicin as a consolidative therapeutic agent, and presence of one or more of the following prior to culture date: mechanical ventilation, stay in the intensive care unit (ICU), and presence of a central venous catheter. In multivariate analysis, the predictors of in-hospital mortality included stay in the intensive care unit (odds ratio [OR], 2.17; 95% confidence interval [CI], 0.98 to 4.78), presence of a central-line catheter prior to positive culture (OR, 2.33; 95% CI, 0.77 to 7.03), presence of a rapidly fatal condition at the time of admission (OR, 5.13; 95% CI, 2.13 to 12.39), and recent prior hospitalization (OR, 1.92; 95% CI, 0.83 to 4.09). When carbapenems were added as empirical therapy to the predictor model, there was a trend between empirical carbapenem therapy and decreased mortality (OR, 0.61; 95% CI, 0.26 to 1.50). When added to the model, receipt of empirical cefepime alone (n= 43) was associated with increased mortality, although this association did not reach statistical significance (OR, 1.66; 95% CI, 0.71 to 3.87). The median length of hospital stay was shorter for patients receiving empirical cefepime than for those receiving empirical or consolidated carbapenem therapy. In multivariate analysis, empirical therapy with cefepime for BSI due to an ESBL-producing pathogen was associated with a trend toward an increased mortality risk and empirical carbapenem therapy was associated with a trend toward decreased mortality risk.

scholarly journals In Vitro Activity of Newer and Conventional Antimicrobial Agents, Including Fosfomycin and Colistin, against Selected Gram-Negative Bacilli in Kuwait

Pathogens ◽  
2018 ◽  
Vol 7 (3) ◽  
pp. 75 ◽  
Author(s):  
Wadha Alfouzan ◽  
Rita Dhar ◽  
David Nicolau
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Agents ◽  
The Other ◽  
In Vitro Activity ◽  
Limited Data ◽  
Gram Negative ◽  
E Coli ◽  
Microbroth Dilution

Limited data are available on susceptibilities of these organisms to some of the recently made accessible antimicrobial agents. The in vitro activities of newer antibiotics, such as, ceftolozane/tazobactam (C/T) and ceftazidime/avibactam (CZA) along with some “older” antibiotics, for example fosfomycin (FOS) and colistin (CL) were determined against selected strains (resistant to ≥ 3 antimicrobial agents) of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Minimum inhibitory concentrations (MIC) were determined by Clinical and Laboratory Standards Institute microbroth dilution. 133 isolates: 46 E. coli, 39 K. pneumoniae, and 48 P. aeruginosa were tested. Results showed that E. coli isolates with MIC50/90, 0.5/1 μ g / mL for CL; 4/32 μ g / mL for FOS; 0.25/32 μ g / mL for C/T; 0.25/8 μ g / mL for CZA, exhibited susceptibility rates of 95.7%, 97.8%, 76.1%, and 89.1%, respectively. On the other hand, K. pneumoniae strains with MIC50/90, 0.5/1 μ g / mL for CL; 256/512 μ g / mL for FOS; 2/128 μ g / mL for C/T; 0.5/128 μ g / mL for CZA showed susceptibility rates of 92.3%, 7.7%, 51.3%, and 64.1%, respectively. P. aeruginosa isolates with MIC50/90, 1/1 μ g / mL for CL; 128/128 μ g / mL for C/T; 32/64 μ g / mL for CZA presented susceptibility rates of 97.9%, 33.3%, and 39.6%, respectively. Higher MICs were demonstrated against most of the antibiotics. However, CL retained efficacy at low MICs against most of the isolates tested.

Gut Flora in Autistic Children as Biomarker for Autism in Thi-Qar Province/Iraq

2020 ◽  
pp. 73-79
Keyword(s):  
Escherichia Coli ◽  
Enterococcus Faecalis ◽  
The Other ◽  
Bacterial Isolates ◽  
Autistic Children ◽  
Gram Positive ◽  
Gram Negative ◽  
Other Hand ◽  
Significant Difference ◽  
Gram Positive Cocci

This is the first study that investigated the microbial factor as biomarker in autistic children and discuss roles of this factor in the pathogenesis of autism. The participants in current study were 145 persons, only 50 sample of stool could collected (35 autistic children and 15 healthy children). Autistic children were attended to autism unit at Disabled Hospital in Thi-Qar province, Iraq during the period from January to November 2016. The results showed males (81%) more than female (19%) with ratio 4:1 and also results explain the age group of 3-5 years recorded the highest percentage (41.05%). Distribution of autistic children according to sibling showed six were brotherly with occurrence rate 6.3%. Stool samples were subjected to examination and culture. The total aerobic count of isolated bacteria was 140 isolates. Gram-negative isolates were identified by API Enterobacteriaceae system. The results were Escherichia coli, Enterobacter cloacae, Klebsiella pneumonia, Pseudomonas aeruginosa and Proteus mirabilis with percentage 38.5%, 19.23%, 11.53%,7.69%, and 3.84% respectively. On the other hand, gram positive cocci isolates included Enterococcus faecalis, Staphylococcus aureus and Staph. epidermidis with percentage 11.53%, 4.80% and 2.88% respectively. A significant difference (P≤0.05) was recorded between bacterial isolates. Quantity and quality of isolated bacteria (colony/g *104) were done. E.coli isolates were the highest count with 261*104 colony/g while, Staphylococci epidermidis were recorded the worse colony count with 30*104 colony/g. The quality results showed Escherichia coli the most common gram negative bacterial isolates (38.46%). On the other hand, the highest gram positive cocci isolates were included Enterococcus faecalis (11.53%), with significant difference (P≤0.05) between bacterial isolates. The ability of bacterial isolates to produce histidine decarboxylase was examined on Niven medium. The positive result include colonies with purple halo around them. Only 10 isolates (25%) from all isolates were produce histidine belong to E.coli. On other hand, result of parasite examination explain no parasite in all samples. From this study can conclusion the altered gut microflora may play an essential role in the pathogenesis of autism. Despite the accurate evidence, this etiological heterogeneity is still not recognized by autism researchers, and most studies fail to take it into account.

scholarly journals The O-Antigen Gene Cluster of Escherichia coli O55:H7 and Identification of a New UDP-GlcNAc C4 Epimerase Gene

2002 ◽  
Vol 184 (10) ◽  
pp. 2620-2625 ◽  
Author(s):  
Lei Wang ◽  
Sandy Huskic ◽  
Adam Cisterne ◽  
Deborah Rothemund ◽  
Peter R. Reeves
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Gene Cluster ◽  
Gene Clusters ◽  
The Other ◽  
Recombination Site ◽  
E Coli ◽  
Antigen Gene ◽  
O Antigen ◽  
Usual Location

ABSTRACT Escherichia coli O55 is an important antigen which is often associated with enteropathogenic E. coli clones. We sequenced the genes responsible for its synthesis and identified genes for O-antigen polymerase, O-antigen flippase, four enzymes involved in GDP-colitose synthesis, and three glycosyltransferases, all by comparison with known genes. Upstream of the normal O-antigen region there is a gne gene, which encodes a UDP-GlcNAc epimerase for converting UDP-GlcNAc to UDP-GalNAc and is essential for O55 antigen synthesis. The O55 gne product has only 20 and 26% identity to the gne genes of Pseudomonas aeruginosa and E. coli O113, respectively. We also found evidence for the O55 gene cluster's having evolved from another gene cluster by gain and loss of genes. Only three of the GDP-colitose pathway genes are in the usual location, the other two being separated, although nearby. It is thought that the E. coli O157:H7 clone evolved from the O55:H7 clone in part by transfer of the O157 gene cluster into an O55 lineage. Comparison of genes flanking the O-antigen gene clusters of the O55:H7 and O157:H7 clones revealed one recombination site within the galF gene and located the other between the hisG and amn genes. Genes outside the recombination sites are 99.6 to 100% identical in the two clones, while most genes thought to have transferred with the O157 gene cluster are 95 to 98% identical.

scholarly journals Postantibiotic Effect of Trovafloxacin against Gram-Positive and -Negative Organisms

1998 ◽  
Vol 42 (6) ◽  
pp. 1503-1505 ◽  
Author(s):  
G. A. Pankuch ◽  
M. R. Jacobs ◽  
P. C. Appelbaum
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Bactericidal Activity ◽  
The Other ◽  
Postantibiotic Effect ◽  
Gram Positive ◽  
E Coli

ABSTRACT Trovafloxacin pneumococcal and staphylococcal postantibiotic effects (PAEs) were 0.7 to 1.8 and 0.7 to 2.4 h, respectively. ForEscherichia coli and Pseudomonas aeruginosa, PAEs were 2.4 to 4.4 h. Pneumococcal and staphylococcal postantibiotic sub-MIC effects (PA-SMEs) (0.4 times the MIC) were 2.3 to 3.7 and 2.4 to >9.2 h, respectively, and E. coliPA-SMEs (0.3 times the MIC) were 6.8 to >12.0 h. For one P. aeruginosa strain, the PA-SME (0.4 times the MIC) was >10 h; in the other, rapid bactericidal activity precluded measurement.

scholarly journals DYSNATREMIAS;

2017 ◽  
Vol 24 (07) ◽  
pp. 1076-1080
Author(s):  
Riffat Omer ◽  
Muhammad Khalid Masood ◽  
Saima Asghar ◽  
Muhammad Jawad ◽  
Amir Afzal ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Serum Sodium ◽  
Prospective Observational Study ◽  
Pediatric Intensive Care ◽  
Pediatric Critical Care ◽  
Life Threatening ◽  
Study Setting ◽  
Critical Care Patients

Dysnatremias (hyponatremia and hypernatremia) are common electrolytedisorders encountered in pediatric critical care patients. The spectrum of both hypo- andhypernatremia varies from mild to severe, being life threatening occasionally. We carried outa study to determine the etiology, epidemiology and effect of dysnatremias on outcomes ofpediatric critical care patients. Objectives: To determine the etiology, epidemiology and effectof dysnatremias on outcomes of pediatric critical care patients. Study Design: Prospective,observational study. Setting: Paediatric Intensive Care Unit (PICU) Services Hospital Lahore.Period: October 2014 to March 2015. Results: 185 patients were included. 19 (10.3%) patientshad hyponatremia and 22 (11.9%) patients had hypernatremia. A weak but significant inverserelationship between presentation serum sodium and mortality was observed (r = - 0.39,n=185, p= <0.001, two-tailed). Conclusions: Presentation serum sodium may influence theoutcomes of the patients admitted to the pediatric intensive care unit.

scholarly journals Predictors of Mortality in Patients of COVID-19 Pneumonia in Intensive Care Unit: An Observational Study in a Tertiary Care Hospital, Lucknow, India

2021 ◽  
Author(s):  
Hemant Kumar ◽  
Preeti Gupta ◽  
Shobhit Shakya ◽  
Sumeet Dixit ◽  
Manoj Kumar Pandey ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Intensive Care ◽  
Observational Study ◽  
Acute Phase ◽  
Biochemical Parameters ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Time Of Admission

Introduction: Coronavirus Disease-2019 (COVID-19) is caused by the Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) which is an enveloped positive-sense single-stranded RNA virus. Initial steps of the infection involve binding of the spike protein (S) of the virus to Angiotensin Converting Enzyme-2 (ACE-2) receptor on the mucosal surfaces of various organs like lungs, kidney, heart, intestine. Pathogenesis of complications are still poorly understood. Aim: This study was designed to find out the baseline biochemical parameters at the time of admission which may predict outcome in COVID-19 patients. Materials and Methods: This observational study was conducted in a dedicated COVID-19 hospital, Dr. Ram Manohar Lohia Institute of Medical Sciences (Dr. RMLIMS), Lucknow, Uttar Pradesh, India, from 1st July, 2020 to 30th November, 2020. A total of 109 moderate to severe COVID-19 pneumonia patients who required Intensive Care Unit (ICU) admission, were enrolled. Based on their outcome, patients were divided into two groups: “Survived” and “Expired”. Biochemical characteristics of patients were compared among the two groups using univariate and multivariate analysis. Results: On Univariate analysis Coagulation profile, Prothrombin Time (PT), International Normalised Ratio (INR), Activated Partial Thromboplastin Time (APTT) and D-Dimer values were raised significantly in the expired group. Among other acute phase reactants Lactate Dehydrogenase (LDH), C-Reactive Protein (CRP), Interleukin-6 (IL-6), and Creatinine Phosphokinase-MB (CPKMB) were raised in expired group and this difference was significant statistically too. On Multivariate analysis among all acute phase reactant only IL-6 was increased significantly. All other variables were found to be non significantly associated with mortality, statistically (p-value <0.05). Conclusion: Baseline biochemical parameters have prognostic values in COVID-19 patients. Raised IL-6 levels can be viewed as an independent predictor of mortality among COVID-19 patients at the time of admission in ICU.

scholarly journals The inhibition of class C β-lactamases by boronic acids

1983 ◽  
Vol 209 (1) ◽  
pp. 229-233 ◽  
Author(s):  
T Beesley ◽  
N Gascoyne ◽  
V Knott-Hunziker ◽  
S Petursson ◽  
S G Waley ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Hydroxy Group ◽  
Phenylboronic Acid ◽  
Boronic Acids ◽  
The Other ◽  
Serine Residue ◽  
Reversible Inhibitors ◽  
Beta Lactamases ◽  
Class C

Aromatic boronic acids are reversible inhibitors of the recently classified class C beta-lactamases. The boronic acids studied include ortho-, meta- and para-methyl-, -hydroxymethyl- and -formyl-phenylboronic acid. The beta-lactamases were chromosomally-encoded enzymes, one from Pseudomonas aeruginosa, and the other specified by the ampC gene of Escherichia coli. The inhibition may be correlated with our finding that these beta-lactamases are serine enzymes, i.e. their function entails the hydroxy group of a serine residue acting as a nucleophile.

Sign in / Sign up

Export Citation Format

Share Document