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Results for “STAPHYLOCOCCAL INFECTIONS, GASTROINTESTINAL”

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PubMedDate not supplied

The management of central intravenous catheter infections.

Catheter-associated infection is a frequent complication in patients with indwelling intravenous catheters used for administration of total parenteral nutrition and/or cancer chemotherapy. Thirty-seven catheter-associated infections in 19 patients were identified in our retrospective survey conducted for the period from January 1, 1982, through December 31, 1982. Fourteen patients were receiving total parenteral nutrition for gastrointestinal disorders, and five were receiving total parenteral nutrition and chemotherapy for underlying malignancy. Coagulase-negative staphylococci were isolated from 65% of catheter-associated bacteremias, as a single species (18 cases) or as one of multiple species (6 cases). Ten of 33 coagulase-negative staphylococcal isolates (30%) were methicillin-resistant. Twenty-one infections (57%) were initially treated with antibiotics administered through the central venous catheter. There were three failures with this treatment; in two cases the catheter was removed because of continued fever and positive blood cultures despite antibiotics, and one patient developed a pyogenic granuloma. The remaining 18 (86%) catheter-associated infections were cured without catheter removal. However, a new infection occurred subsequently in two of these patients. We recommend that vancomycin and an aminoglycoside be the initial empiric therapy for suspected catheter-associated sepsis. Lack of defervescence or continued positive blood cultures for 2 to 4 days despite antibiotics are indications for catheter removal. Otherwise antibiotics should be continued for 14 to 21 days.

Anti-Bacterial Agents↗
PubMed1995

[Autobacteriographic studies on the distribution and localization of Staphylococcus aureus in mice].

Autobacteriography was proposed as a bacteriological method to follow distribution and localization of bacteria in experimentally infected animals. Infectious organisms were restricted to rifampicin-resistant strains to prevent contamination during autobacteriography. Mice were infected with Staphylococcus aureus Smith diffuse type RFPr (rifampicin-resistant) by the intravenous route and frozen at various intervals after infection. Whole body sections (40-microns thick) of the mice were transferred onto selective agar medium containing rifampicin to incubate at 37 degrees C. On day 1 after infection, dense colonies of the infecting organism on the sections were distributed in the whole body. On day 3, few organisms were detected in the liver and many were observed in the spleen, kidney and intestinal tract. On days 7, 14 and 21, the organisms in the liver and spleen disappeared, and those in the kidney and intestine remained. The remaining infectious organisms were demonstrated in the kidney and intestinal tract by autobacteriography of mice infected with S. aureus Smith compact type RFPr. By cultivation of the homogenate of the gastrointestinal tissues and their contents, the infectious organisms were detected mainly in the lower small intestines, cecum and large intestines.

Animals↗
PubMedDate not supplied

[Antibiotic resistance and putative origin of Staphylococcus aureus and Klebsiella strains isolated from the children with intestinal dysbacteriosis].

The results of the statistical treatment of data on the analyses of 766 children, the residents of Moscow, for dysbacteriosis are presented; of these children, 34 were aged up to 1 month and 732, from 1 month to 1 year. This study revealed that in the fist year of life in children with dysbacteriosis the dominating bacterial species were S. aureus, bacteria of the genus Klebsiella and fungi of the genus Candida. From the intestine of children aged up to 1 month S. aureus and Klebsiella were isolated more often than from children aged up to 1 year. The results of the study of antibioticograms demonstrated that 21.6% of S. aureus strains and 74.4% of Klebsiella strains were multiresistant to antibiotics. Taking into account the fact that multiresistance to antibiotics was characteristic of hospital strains, the suggestion was made that the isolated strains were of hospital origin and such strains could colonize the intestine of children in maternity hospitals.

Anti-Bacterial Agents↗
PubMed1987

Psoas abscess in Bristol: a 10-year review.

A consecutive series of 16 cases of psoas abscess managed over a 10-year period at the Bristol Royal Infirmary is presented. Tuberculosis accounted for 4 patients all normally resident in the United Kingdom. Intraabdominal inflammatory disorders accounted for 9 of the cases with Crohn's disease being the commonest of these with 5 cases. The remaining patients comprised 3 with primary staphylococcal abscesses, one appendicitis, one diverticulitis and 2 with colonic carcinoma. Diagnostic delay was common. Ultrasonography together with guided aspiration of pus was the most useful investigation giving the diagnosis in cases due to tuberculosis and staphylococci. The presence of gut associated organisms was indicative of gastrointestinal pathology. Four patients died and significant morbidity occurred in a further 5. We recommend effective dependent drainage together with resection of diseased gut in the cases of gastrointestinal origin.

Abscess↗
PubMed2001

Pancreatic pseudocysts complicated by splenic parenchymal involvement: results of operative and percutaneous management.

UNLABELLED: Pancreatic pseudocysts are a common finding in acute and chronic pancreatitis, but most are small and uncomplicated, and do not require treatment. Pseudocysts with splenic parenchymal involvement are uncommon but have the potential for massive hemorrhage. Data on the clinical presentation and optimal treatment of this unusual complication of pseudocysts are lacking. The purpose of this review was to identify the clinical features of pancreatic pseudocysts complicated by splenic parenchymal involvement and to determine the outcome with nonoperative and operative therapy. METHODS: A retrospective review of the medical records of all patients with pancreatic pseudocysts from December 1984 to January 1999 revealed 238 patients, of whom 14 (6%) had splenic parenchymal involvement. These medical records were reviewed in detail and all pertinent radiographs were reviewed by the authors to confirm splenic parenchymal involvement by a pancreatic pseudocyst. RESULTS: Initial treatment included observation (n = 2), percutaneous drainage (n = 8), and surgery (n = 4). Of the eight patients treated by percutaneous drainage, one died, three required repeated percutaneous drainage, and three required surgical intervention. None of the patients treated primarily by surgery required additional therapy for the pseudocyst. Overall, 11 patients had complications of the primary therapy, and 25% of patients treated by surgery had significant hemorrhage. Complications included infection (n = 5), pseudocyst persistence (n = 4), bleeding (n = 2), multisystem organ failure (n = 2), gastric outlet obstruction (n = 1), and splenic rupture (n = 2). CONCLUSIONS: Pancreatic pseudocysts complicated by splenic parenchymal involvement may have life-threatening clinical presentations and respond poorly to percutaneous drainage. Distal pancreatectomy and splenectomy are effective, but the complication rate is high.

Adult↗
PubMed1955

Acute infections of the gastrointestinal tract.

Even though "shot-gun" treatment often proves effective in acute enteric infections, attempt to establish accurate diagnosis is still worthwhile. In most cases acute enteric infection is self limited and responds well to symptomatic treatment. Postantibiotic diarrhea is relatively common and is often severe. Usually the organism is staphylococcus and at present, at least, erythromycin seems to be the drug of choice in treatment. Antibiotics should be used only when definitely indicated. Indiscriminate "specific" treatment for acute diarrheas may mask acute infections with organisms which are suppressed-not conquered. These infections present a potential public health problem. Cases of acute gastroenteritis that are apparently of staphylococcic or viral origin should be managed symptomatically at first. If satisfactory response is not obtained quickly, accurate bacteriological diagnosis should be sought.

Acute Disease↗
PubMed1999

Prospective assessment of the risk of bacteremia in cirrhotic patients undergoing lower intestinal endoscopy.

BACKGROUND: Patients who have prosthetic heart valves, previous history of endocarditis, and surgically constructed systemic-pulmonary shunts or conduits should receive prophylactic antibiotics before colonoscopy. The usefulness of this approach in cirrhotic patients remains unknown. The present study prospectively assesses the incidence of bacteremia in these patients. METHODS: Lower intestinal endoscopy was performed in 58 cirrhotic patients. Two blood samples were obtained from every patient (just before endoscopy and within 5 minutes of withdrawal of the endoscope) and were incubated for 7 days and examined daily for growth of bacteria. Patients were closely monitored for 72 hours after endoscopy to detect the development of infectious complications. RESULTS: Only 6 cultures from 6 patients were positive. Four were obtained post-endoscopy and the remaining 2 before colonoscopy but the corresponding post-endoscopy samples were negative. All organisms recovered were normal skin flora. All patients, including those with positive cultures, remained asymptomatic during the 72 hours after the procedure. CONCLUSIONS: Our findings indicate that lower intestinal endoscopy does not induce bacteremia in cirrhotic patients with or without ascites in the absence of gastrointestinal bleeding and do not support the routine use of prophylactic antibiotics in these patients.

Bacteremia↗
PubMed1995

The order of ward rounds influences nosocomial infection. A 2-year study in gastroenterologic surgery patients.

We studied the effect of the order of ward rounds on nosocomial infection in gastroenterologic surgery patients. The subjects were patients with gastrointestinal diseases admitted between September 1992 and August 1994. During the 1st year, the round proceeded indiscriminately among recovery rooms and rooms with stable patients and isolated patients with methicillin-resistant Staphylococcus aureus (MRSA). In the subsequent year, the round started in the recovery rooms and moved into the general rooms with stable patients and finally into the isolation rooms. Against the time course, piecewise linear regression analyses were made with the number of culture-positive patients and the quantities of antibiotics and disinfectants used. Of a total of 1894 strains from 264 patients, isolates of MRSA (n = 200) decreased from 150 in the 1st year to 50 in the 2nd year. The number of MRSA-positive patients showed the point of inflexion in the analysis at the change of round order, with a later decrease. The trend was similar for Candida (n = 99) and Enterococcal (n = 225) species. The amount of antibiotics was unchanged while the amount of disinfectants used decreased in the 2nd year. Thus, the round re-ordering appeared to help prevent nosocomial infection. Ward rounds for patients who have had gastroenterologic surgery should proceed from compromised hosts to stable patients, and then isolated patients.

Anti-Infective Agents, Local↗
PubMed2003

Psoriasiform-lichenoid-like dermatosis in three dogs treated with microemulsified cyclosporine A.

Cyclosporine has been reported to be effective for the treatment of various cutaneous autoimmune disorders in dogs. Adverse reactions have generally been limited to gastrointestinal tract disturbances and cutaneous eruptions. The article describes antimicrobial-responsive cutaneous reactions in 3 dogs being treated with microemulsified cyclosporine A because of various dermatologic conditions. Cutaneous reactions in these dogs were similar to psoriasiform-lichenoid dermatitis and may represent an atypical staphylococcal infection.

Animals↗