Search

Introduction : La septicémie est une affection grave et fréquente dans le monde avec une mortalité élevée elle est considéré par l’OMS comme une priorité de santé publique. En outre la mortalité attribuable à la résistance est estimée plus élevée en Afrique subsaharienne occidentale soit 27,3 décès pour 100 000 infections. La présente étude visait á identifier les bactéries responsables des septicémies aux Mali de 2000-2020 et leur sensibilité aux antibiotiques. Méthodologie : Une métaanalyse a été conduite à partir des données recueillies dans les bibliothèques numériques de certaines universités d’Afrique de l’Ouest, sur Pub Med et Medline. Résultats : sept études sur les hémocultures ont été retenues. La positivité des hémocultures variait entre 7% à 38% (taux combiné = 22%). Les bactéries fréquemment isolées étaient Streptococcus pneumoniae (18%), Salmonella enterica (11,5%) et Haemophilus influenza B (10,1%). Chez les enfants, la fréquence de Salmonella enterica est passée de 14% à 0% et celle de Haemophilus influenza B de 12,8% à 3,2% entre 2008 et 2020. S. pneumoniae étaient plus sensible à l’ampicilline, la ceftriaxone et l’érythromycine. S. enterica était plus sensible à l’amikacine, la ceftazidime, la cefotaxime, à la ceftriaxone, l’acide nalidixique, la ciprofloxacine et l’Imipénème. H. influenza B était plus sensible à l’ampicilline, la ceftriaxone, chloramphénicol et la ciprofloxacine. Conclusion : les données de cette étude permettent une meilleure compréhension, une prise en charge adéquate des septicémies et des résistances aux antibiotiques au Mali

Background: Neonatal sepsis is one of the most important causes of morbidity and mortality among neonates, particularly in developing countries. This study aimed to determine the risk factors and in vitro antibiotic susceptibility patterns of bacterial pathogens associated with neonatal sepsis in Federal Medical Centre (FMC) and Turai Umaru Yar'adua Maternal and Children Hospital (TUYMCH), Katsina, Nigeria. Methodology: A total of 60 hospitalized neonates evaluated for neonatal sepsis at the special care baby units (SCBU) of the two healthcare facilities whose parents gave informed consent were enrolled for the study between July and December 2020. Blood samples were aseptically collected from the neonates and cultured on BacT/Alert automated platform (BioMérieux, Mercy-Etoile, France) machine. Bacteria were identified from all positive cultures and in vitro susceptibility test was performed on the isolates to determine their minimum inhibitory concentrations (MICs) to eight selected antibiotics using the Vitek-2 compact system. Data were analyzed by SPSS version 22.0. Results: A total of 60 neonates with clinical features suggestive of sepsis were enrolled. The mean age of the neonates is 1.35±0.48 days while the mean weight is 2.13±0.89 kg. Neonates with early onset sepsis (<3 days) constituted 65% while those with late-onset sepsis (>3 days) constituted 35%. Thirty-one (51.7%) neonates were culture positive while 29 (48.3%) were culture negative for bacterial pathogens. Gram-positive bacteria predominated, constituting 80.6% while Gram-negative bacteria constituted 19.4%. The most frequent Gram-positive bacteria were coagulasenegative staphylococci (51.6%, 16/31), with Staphylococcus haemolyticus 5 (16.1%) predominating, while the most frequent Gram-negative bacteria isolate was Escherichia coli 2 (6.5%). A high degree of antibiotic resistance (>50% rate) was exhibited by the isolates against most of the tested antibiotics including third generation cephalosporins and fluoroquinolones. Gentamicin was the only antibiotic effective, with 65.5% of all isolates sensitive to it; 68.0% Gram-positives and 50.0% Gram-negatives. Vancomycin was also effective against Gram-positive bacteria, with 68.0% of the isolates sensitive to it. Previous premature delivery (64.5%, 20/31) and baby delivery at home were respectively the only maternal and neonatal factors significantly associated with culture-positive neonatal sepsis (OR=2.975, 95% CI=1.040-8.510). There was no significant difference between culture positive and negative neonatal sepsis with respect to clinical manifestations such as refusal of feeds, fever, jaundice, fast breathing, convulsion and body temperature (p>0.05). Conclusion: Neonatal sepsis is a substantial cause of mortality and morbidity among neonates admitted at the FMC and TUYMCH, Katsina, Nigeria. There is a need for regular surveillance of the risk factors, causative organisms, and antibiotic susceptibility patterns of isolated pathogens, to inform the choice of empirical antibiotic treatment pending the results of blood cultures. [ABSTRACT FROM AUTHOR]

Sepsis is a syndrome consisting of physiological, pathological and biochemical anomalies caused by infectious agents. It causes clinical organ dysfunction, which is identified by an acute increase in the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score of two or more points. SOFA score is a score of three components that can be easily used at the bedside to track the clinical status of a patient while on admission, and these are altered respiratory rate of ≥ 22 breaths/minute, altered mental status, and systolic blood pressure of ≤ 100 mmHg. A patient with SOFA score of ≥ 2 has an attributable 2 - 25-fold increased risk of mortality compared to a patient with SOFA score of < 2. This present review provides information on the new definition of sepsis and septic shock, aetiology, pathophysiology, biochemical, pathological and haematological changes, morbidity and mortality parameters, management, and prognostic factors in patients with sepsis. [ABSTRACT FROM AUTHOR]

Introduction : Affection potentiellement mortelle, la septicémie se caractérise par des décharges importantes et répétées dans le sang, de germes pathogènes et de leurs poisons provenant d'un foyer, créant une infection générale grave conduisant à un dysfonctionnement d'organe. Sa gravité devient maximale quand, dans certaines circonstances tenant à la nature du germe et au terrain, elle se complique d'un choc toxi-infectieux au pronostic toujours redoutable. Au Mali, il existe peu d'étude nationale sur la septicémie et sa prévalence. L'objectif de notre étude était d'étudier les aspects cliniques, paracliniques, thérapeutiques et évolutifs de la septicémie au service des urgences pédiatriques du CHU Gabriel Touré. Matériels et Méthode : Il s'agissait d'une étude rétrospective et descriptive allant du 1er Janvier 2017 au 31 Décembre 2018, soit 24 mois chez les enfants de 1 mois à 15 ans. Les données ont été recueillies sur une fiche d'enquête individuelle à partir des dossiers des malades hospitalisés et le registre des permanents du CVD (Centre de Développement des Vaccins). Résultats : Pendant la période d'étude, 5919 enfants ont été hospitalisés. La septicémie a été évoquée chez 378 dont 43 patients répondaient aux critères d'inclusion soit une fréquence de 11,38%. La tranche d'âge de 1 à 24 mois était la plus touchée avec 53,49 %. Le sex ratio était de 0,34. Tous les patients (100 %) présentaient une fièvre élevée à l'admission suivie de la détresse respiratoire (48,84 %) et de l'altération de l'état général (34,88 %). La porte d'entrée était majoritairement cutanée et ostéo-articulaire avec 41,86 % et 18,60 %. Le staphylococcus aureus a été le germe le plus isolé à l'hémoculture (25 cas sur 37 hémocultures positives) soit 67,57 %. La tri-antibiothérapie et la bi-antibiothérapie ont été les plus utilisées à proportion égale, 83,72%. Les Céphalosporines de 3ième génération ont été les plus prescrites. L'évolution a été marquée par 44,18 % de décès. Conclusion : Il y a encore de nombreux progrès à accomplir concernant le diagnostic, l'approche thérapeutique et la surveillance des patients car la mortalité reste toujours importante.

Invasive meningococcal disease (IMD) is an acute infectious illness caused by Neisseria meningitidis, with a special relevance in human pathology, being potentially fatal in 24 hours after onset, with a 10-20% medium death rate, which can increase to more than 40% in sepsis patients, but also with a high rate of permanent sequelae. According to its capsular polysaccharide, N. meningitidis was divided in 13 serogroups, 6 of them being the most frequently involved in human pathology: A, B, C, W135, X and Y. In Europe and USA, serogroups B, C, W and Y are predominant, with variations depending on age and sex, while serogroup A predominated historically, in a hiperendemic and epidemic form, in the socalled “sub-Saharan meningitis belt”. The main presentation forms of IMD are acute purulent meningitis and septicemia, the most frequently afflicted being the immunocompromised individuals from crowded areas and with close contacts. Due to its severity, diagnosing IMD as fast as possible is imperative. The isolation and identification of Neisseria meningitidis using bacterial culture and molecular methods provide the definitive diagnosis, and the treatment must be initiated before obtaining the laboratory results and right after collecting the clinical samples. Vaccination remains the most effective method for preventing IMD, especially in areas with a high prevalence. There are recombinant and conjugate meningococcal vaccines for this purpose, and many European countries introduced them in their national immunization programs. In Romania, meningococcal vaccination is optional. For those who were in contact with sick people, antimicrobial chemoprophylaxis is recommended. [ABSTRACT FROM AUTHOR]

The pandemic produced by COVID-19 has surprised almost all health and socio-economic systems worldwide with its high degree of infectivity and mortality. In short time we have learned many aspects of the epidemiology, pathophysiology and clinical aspects of the virus responsible, SARS-Cov-2, and the disease it induces. COVID-19 is known to produce in some patients the development of an excessive immune response and hyperinflammation, damaging various organs and sometimes causing death. There is no effective treatment available at the moment, other than life support, and for this reason different revealing therapeutic options are being tested but pending confirmation of their effectiveness and safety in well-designed clinical trials. We describe the anti-inflammatory and immunomodulatory effects of Acupuncture, as well as its preclinical and clinical effectiveness in different conditions that have some similarities to the severe forms of COVID-19. The proven biological plausibility of acupuncture, together with its acceptable level of clinical effectiveness and safety, make this medical technical procedure an option to try in this health emergency situation. We propose an adjusted classification of the clinical presentation of COVID-19 and an appropriate adjuvant Acupuncture protocol for each phase of the disease. [ABSTRACT FROM AUTHOR]

Les infections invasives à méningocoque (IIM) regroupent les méningites, septicémies et chocs septiques liés à Neisseiria meningitidis. En France, le sérogroupe B domine, suivi des sérogroupes C, Y et W. Leur létalité est de 10 %, voire 25 % si choc septique. Le diagnostic est évoqué devant une fièvre associée à des signes méningés (céphalée, fontanelle bombée, vomissements, raideur méningée) et/ou des signes de mauvaise perfusion périphérique (marbrures, temps de recoloration cutanée allongé, extrémités froides) et/ou des douleurs des membres, et secondairement une éruption (érythème morbilliforme ou purpura). L'évolution vers un choc septique (purpura fulminans) ou une méningite comateuse est à craindre si le traitement n'est pas instauré suffisamment tôt. Le traitement est urgent et repose sur une antibiothérapie par céphalosporine de troisième génération intraveineuse (dans l'heure qui suit le diagnostic présomptif, après hémoculture à l'hôpital) et sur un remplissage vasculaire rapide (20 ml/kg en 10 minutes), éventuellement renouvelé en fonction des objectifs thérapeutiques (diminution de la fréquence cardiaque, disparition des signes de choc, diminution du lactate). Si les objectifs ne sont pas atteints malgré deux remplissages, l'enfant doit être transféré dans un service de réanimation pédiatrique, les amines vasopressives débutées et l'intubation discutée. Le diagnostic positif d'IIM et du sérogroupe repose sur l'isolement du germe dans une hémoculture, dans le liquide céphalorachidien (la ponction lombaire étant contre-indiquée en cas de choc), ou par une polymerase chain reaction méningocoque positive dans le sang, le liquide céphalorachidien ou sur une biopsie d'un purpura nécrotique. Il s'agit d'une infection à déclaration obligatoire auprès de l'agence régionale de santé. Les mesures de prévention secondaires reposent sur une antibioprophylaxie des personnes en contact proche dans les dix jours précédant le diagnostic et une vaccination s'il s'agit d'un sérogroupe vaccinal (A, C, W, Y). La vaccination de tous les enfants de plus de 1 an et des jeunes adultes est recommandée. [ABSTRACT FROM AUTHOR]

Description d'une infection liée à Bacillus licheniformis. Ce germe saprophyte habituellement considéré non pathogène est isolé d'hémocultures chez une patiente prise en charge pour un cancer. La contamination des prélèvements est exclue et ce germe est incriminé dans une infection liée au cathéter. Observation of a septicemia due to bacillus licheniformis. This saprophytic and ubiquitous bacteria, usually thought to be non pathogenic, has been isolated from blood-cultures, in a patient with carcinoma. Contamination of blood cultures was excluded and the role of this saprophytic bacteria was postulated for this catheter-related sepsis [ABSTRACT FROM AUTHOR]

Tumor necrosis factor-alpha (TNF-α) is a pivotal mediator that triggers inflammatory process, oxidative stress, and multiple organ injury in sepsis. We investigated the effects of infliximab on survival, mesenteric artery blood flow (MBF), vascular reactivity, and oxidative and inflammatory injuries in cecal ligation and puncture (CLP)-induced sepsis. Wistar rats were divided into Sham, CLP, Sham+infliximab, and CLP+infliximab subgroups. Twenty-four hours before the operations, rats were injected intraperitoneally with infliximab (7 mg/kg) or vehicle (saline; 1 mL/kg). Twenty hours after the operations, MBF and phenylephrine responses of isolated aortic rings were measured. Tissue damages were examined biochemically and histopathologically. Furthermore, survival rates were monitored throughout 96 h. Infliximab improved survival, mesenteric perfusion, and aortic function after CLP. Increases of serum AST, ALT, LDH, BUN, Cr, and inflammatory cytokines (tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6) induced by CLP were blocked by infliximab. Infliximab prevented malondialdehyde elevations in septic liver, lung, spleen, and kidney tissues, as well as glutathione reductions in septic liver, spleen, and kidney tissues. Protective effects of infliximab on multiple organ damage were also observed histopathologically. Infliximab showed protective effects in sepsis due to its improvement effects on mesenteric perfusion, aortic function, and its anti-inflammatory and antioxidative effects. [ABSTRACT FROM AUTHOR]

L'Arcanobactérium haemolyticum (A.haemolyticum) est un bacille à Gram positif. L'homme en est le principal réservoir. C'est un pathogène opportuniste essentiellement chez l'immunodéprimé, et qui peut être responsable d'infection au niveau de la peau et du pharynx chez les sujets sains, surtout chez les enfants et les adolescents. Il peut causer des surinfections des ulcères chroniques, et occasionnellement des infections invasives. Sa détection au niveau des cultures reste toujours difficile car il simule de nombreuses bactéries auxquelles il est souvent associé dans les produits pathologiques. Et Il n'existe pas de recommandations concernant l'étude sa sensibilité aux antibiotiques. Les bactériémies à Arcanobactérium sont rares, à notre connaissance, seize cas ont été décrits dans la littérature. Nous rapportons, un autre cas de bactériémie à A.haemolyticum, secondaire à une surinfection d'escarres fessières.

Arcanobacterium hemolyticum (A.haemolyticum) is a gram-positive bacillus. Man is the primary environmental reservoir. It is essentially an opportunistic pathogen in immunocompromised patients and may be responsible for infections of the skin and pharynx in healthy subjects, especially in children and adolescents. It can cause superinfections of chronic ulcers, but occasionally it causes invasive infections. Its isolation from culture samples is always difficult because it simulates many bacteria to which it is often associated in pathological products. There are not recommendations concerning the study of its antibiotics sensitivity. Arcanobacterium Bacteremia are rare to our knowledge, only sixteen case reports have been described in the literature. We here report another case of a patient with A.haemolyticum bacteremia secondary to superinfection of gluteal eschars. [ABSTRACT FROM AUTHOR]

Copyright of Bulletin de la Société de Pathologie Exotique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Médecine Vétérinaire is the property of Ecole Nationale Veterinaire de Toulouse and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To identify the burden of severe infection within the Brazilian Network for Surveillance of Severe Maternal Morbidity and factors associated with worse maternal outcomes.Methods: This was a multicentre cross-sectional study involving 27 referral maternity hospitals in Brazil. WHO's standardised criteria for potentially life-threatening conditions and maternal near miss were used to identify cases through prospective surveillance and the main cause of morbidity was identified as infection or other causes (hypertension, haemorrhage or clinical/surgical). Complications due to infection were compared to complications due to the remaining causes of morbidity. Factors associated with a severe maternal outcome were assessed for the cases of infection.Results: A total of 502 (5.3%) cases of maternal morbidity were associated with severe infection vs. 9053 cases (94.7%) with other causes. Considering increased severity of cases, infection was responsible for one-fourth of all maternal near miss (23.6%) and nearly half (46.4%) of maternal deaths, with a maternal near miss to maternal death ratio three times (2.8:1) that of cases without infection (7.8:1) and a high mortality index (26.3%). Within cases of infection, substandard care was present in over one half of the severe maternal outcome cases. Factors independently associated with worse maternal outcomes were HIV/AIDS, hysterectomy, prolonged hospitalisation, intensive care admission and delays in medical care.Conclusions: Infection is an alarming cause of maternal morbidity and mortality and timely diagnosis and adequate management are key to improving outcomes during pregnancy. Delays should be addressed, risk factors identified, and specific protocols of surveillance and care developed for use during pregnancy. [ABSTRACT FROM AUTHOR]

Rapporter un cas de tétanos compliqué de septicémie chez un enfant souffrant d'une hémoglobinopathie majeure. Enfant de 9 ans drépanocytaire (SC), non vacciné contre le tétanos, a été admis au CHU YO pour raideur de la nuque, difficulté à l'ouverture de la bouche et hyperthermie. L'examen à son admission notait un syndrome infectieux avec une hyperthermie (température à 39,1C), Pouls=100/mn, Fréquence cardiaque=100batt/mn, fréquence respiratoire=30cycles/mn, poids =22Kg, un trismus, une contracture des muscles para vertébraux, des paroxysmes toniques à la palpation (stade II de Mollaret), un syndrome méningé. L'examen n'avait pas retrouvé une porte d'entrée. La ponction lombaire avait ramené un liquide céphalo rachidien clair ; l'hémogramme avait montré une hyperleucocytose à 10 200/mm3, et l'hémoculture a permis d'isoler Staphylococcus aureus. Sous antibiothérapie et sous sédatifs, l'évolution a été favorable. Les porteurs d'hémoglobinopathie majeure sont plus exposés aux infections. La physiopathologie de ces infections s'explique par l'immunodépression et les troubles de la phagocytose.Un dépistage précoce de ces hémoglobinopathies, un bon suivi et une bonne couverture vaccinale des enfants drépanocytaires sont essentiels pour prévenir le tétanos et ses complications.

We report a case of a 74-year-old female patient who was involved in a car accident. The patient suffered deep dermal and full thickness burns and the probability of survival calculated with the Abbreviated Burn Severity Index (ABSI) was extremely low. The patient showed sufficient cardiorespiratory and renal function for the entire treatment period. An epifascial necrosectomy of all four limbs was performed on day three after admission. Wound coverage was performed using the MEEK technique and split skin grafts. The patient was bedded in a FluidAir bed, which enabled the burn wounds on the back to dry and heal in large part. After four surgical procedures and four months of treatment at the burn ICU, the patient was sufficiently mobilized for transfer to a hospital in her home region. The aim of the following case report is to demonstrate that burn patients with very low chances of survival can be treated successfully. [ABSTRACT FROM AUTHOR]

Objective Group B streptococcal (GBS) colonization of pregnant women can lead to subsequent infection of the new-born and potentially fatal invasive disease. Data on GBS colonization prevalence and serotype distribution from Africa are scarce, although GBS-related infections are estimated to contribute substantially to infant mortality. In recent years, GBS vaccine candidates provided promising results in phase I and II clinical trials. We aimed to assess the prevalence and serotype distribution of GBS in Ghana since this knowledge is a prerequisite for future evaluation of vaccine trials. Methods This double-centre study was conducted in one rural and one urban hospital in central Ghana, West Africa. Women in late pregnancy (≥35 weeks of gestation) attending the antenatal care clinic ( ANC) provided recto-vaginal swabs for GBS testing. GBS isolates were analysed for serotype and antibiotic susceptibility. GBS-positive women were treated with intrapartum antibiotic prophylaxis ( IAP) according to current guidelines of the Center for Disease Control and Prevention ( CDC). Results In total, 519 women were recruited at both study sites, recto-vaginal swabs were taken from 509. The overall prevalence of GBS was 19.1% (18.1% in rural Pramso and 23.1% in urban Kumasi, restrospectively). Capsular polysaccharide serotype ( CPS) Ia accounted for the most frequent serotype beyond all isolates (28.1%), followed by serotype V (27.1%) and III (21.9%). No resistance to Penicillin was found, resistances to second line antibiotics clindamycin and erythromycin were 3.1% and 1%, respectively. Discussion Group B Streptococcus serotype distribution in Ghana is similar to that worldwide, but variations in prevalence of certain serotypes between the urban and rural study site were high. Antibiotic resistance of GBS strains was surprisingly low in this study. [ABSTRACT FROM AUTHOR]

Vitamin D plays an important role in modulating the immune response to infections. Deficiency of vitamin D is a common condition, affecting both the general population and patients in health care facilities. Over the last decade, an increasing body of evidence has shown an association between vitamin D deficiency and an increased risk for acquiring several infectious diseases, as well as poorer outcomes in vitamin D deficient patients with infections. This review details recent developments in understanding the role of vitamin D in immunity, the antibacterial actions of vitamin D, the association between vitamin D deficiency and common infections (like sepsis, pneumonia, influenza, methicillin-resistant Staphylococcus aureus, human immunodeficiency virus type-1 (HIV), and hepatitis C virus (HCV)), potential therapeutic implications for vitamin D replacement, and future research directions. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Physiology & Pharmacology is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives To describe the incidence and aetiology of septicaemia, and antimicrobial drug resistance in HIV-infected and uninfected individuals, and the impact of antiretroviral therapy (ART) on septicaemia. Methods Between 1996 and 2007, we followed up a rural population–based cohort of HIV-infected and uninfected participants. The aetiology and incidence of septicaemia, and antimicrobial drug resistances were determined. ART became available in 2004, and its impact on the incidence of septicaemia was examined. Results The overall septicaemia incidence (per 1000 pyrs) was 32.4 (95% CI 26.2–40.6) but was only 2.6 (95% CI 1.3–6.2) in HIV-negative patients and 67.1 (95% CI 53.4–85.4) in HIV-positive patients not on ART. Among those on ART, the overall incidence was 71.5 (95% CI 47.1–114.3), although it was 121.4 (95%CI 77.9–200.4) in the first year on ART and 37.4 (95%CI 18.9–85.2) in the subsequent period. Septicaemia incidence was significantly associated with lower CD4 counts. The commonest isolates were Streptococcus pneumoniae (SPN, n = 68) and Non-typhi salmonellae (NTS, n = 42). Most SPN isolates were susceptible to ceftriaxone and erythromycin, while resistance to cotrimoxazole and penicillin was common. All NTS isolates were susceptible to ciprofloxacin, but resistance to cotrimoxazole and chloramphenicol was common. Conclusions Septicaemia incidence was higher in HIV-infected than in HIV-uninfected participants, and it remained high for some time among those who started ART. Starting ART earlier at higher CD4 counts is likely to lead to lower septicaemia incidence. Both SPN and NTS, the commonest isolates, were resistant to most commonly available antimicrobials. Blood culture laboratory surveillance systems to monitor antibiotic susceptibility and inform treatment guidelines are needed in Africa. [ABSTRACT FROM AUTHOR]

Objective To determine the involvement of coagulation in bleeding and poor outcome in patients with severe leptospirosis. Methods In a prospective study, parameters of the coagulation system were measured on admission and during follow-up in 52 consecutive patients with severe leptospirosis. Results All patients showed coagulation disorders, such as prolonged prothrombin time (PT) and activated partial thromboplastin time, marked procoagulant activity [thrombin–antithrombin (TAT) complexes, prothrombin fragment 1+2, D-dimer], reduced levels of anticoagulant markers (protein C, antithrombin) and increased (anti-) fibrinolytic activity [plasmin–antiplasmin (PAP) complexes, plasminogen activator inhibitor-1]. These disorders were more pronounced in patients who died eventually. PT prolongation was associated with mortality (OR 1.4, 95% CI: 1.0–1.8, P = 0.04). Bleeding occurred in 31 subjects (60%). Of these, 24 had mild bleeding and seven had severe haemorrhages. Thrombocytopenia (platelets ≤100 × 109/l) was significantly associated with clinical bleeding (OR 4.6, 95% CI: 1.3–16). A subanalysis of patients with and without severe bleeding revealed a more pronounced imbalance of the coagulation system in patients with severe bleeding, as reflected by a significant association with PT (OR 1.4, 95% CI: 1.0–1.8, P = 0.05) and the TAT/PAP ratio (OR 1.3, 95% CI: 1.0–1.6, P = 0.05), which is an indicator of the balance between coagulation and fibrinolysis. Overt disseminated intravascular coagulation (DIC) was found in 10 (22%) of the 46 patients for whom the score could be calculated. There was no significant association between DIC scores, bleeding diathesis or poor outcome. Conclusion The coagulation system was strongly activated in patients with leptospirosis. This was more pronounced in the deceased and in patients with severe bleeding than in than the survivors and in those without severe bleeding. [ABSTRACT FROM AUTHOR]

The article suggests ways of reducing calf mortality at birth and during the calf's first 28 days of life. It describes several techniques which include resuscitation procedures conducted by veterinarians in cases of hypoxia to maintain oxygenation and ventilation, hydration and restoration of electrolyte and acid-base status of the calf in cases of neonatal diarrhaea and in cases of septicaemia where treatment needs to be directed against bacteraemia and toxic shock. It points out the importance of maintaining supportive care after resuscitation procedures to increase the chances of recovery through colostrum feeding, nursing and the provision of satisfactory ambient conditions.

The article details a study which determined the bacteria responsible for septicaemia in cattle from Debre Zeit and determine the corresponding antimicrobial sensitivity pattern. The study included 120 cattle that were admitted to the open air clinic of the faculty of veterinary medicine because of febrile syndrome between December 2005 and June 2006. 25 animals showed positive bacterial blood cultures of Staphylococcus aureus, Pasteurella multocida and Salmonella. Study authors found that all the identified bacterial isolates are susceptible to chloramphenicol and cirpofloxacin.

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Dercum''s disease or adiposis dolorasa is unusual and unknown. Four symptoms are typical. It is characterized by painful subcutaneous fatty tumors in postmenopausal woman. We present this disease through the study of an uncommon clinical case: a sceptic choc following the “steato-cutaneous-necrosis” of a fatty tumor. The disease remains rare. The etiology is to this day unknown and different hypothesis (endocrinous, metabolic, genetics) are put forward. Multiple complications can occur but severe septicemia is rare. The treatment can be medical (loss of weight, corticoids, intravenous lidocaine) or surgical (surgical excision or liposuction). [Copyright &y& Elsevier]

The authors report a post-appendectomy septicemia due to Streptococcus milleri group occurring with metronidazole antibiotherapy diagnosis delay is possible with diarrhoea observed in childhood complicated appendicitis Streptococcus milleri group can develop postoperative sepsis despite antibiotherapy. They recommend associative and synergetic antibiotherapy in childhood gangrenous appendicitis to prevent a possible septicaemia due to Streptococcus milleri group. [Copyright &y& Elsevier]

Introduction. – Acquired haemophilia is a rare bleeding diathesis caused by auto-immune depletion of factor VIII. It is characterised by spontaneous haemorrhagic syndrome, which can be fatal sometimes.Exegesis. – A 71 year-old man presents in a dysimmunitary context (rheumatoid arthritis complicates by an acquired haemophilia) a septicemia with a methicillin resistant staphylococcus aureus. At the time of the hospitalization, the patient is febrile (39 °C). The activated partial thromboplastin time is very much increased, the level of factor VIII is lowered by 7% and the title of the inhibitor to factor VIII amounts to 140 Bethesda unities. An haematoma of the right root thigh is also noted. In that case, the concomitant presence of septicemia makes difficult the use of immunosuppressive therapy usually recommended to decrease auto-antibody’s level. For the management of the septicemia, an adapted antibiotherapy (vancomycin then teicoplanin) is organized to J1. To control haemorrhagic risk, immunoglobulins are prescribed from d12 to d16, without immediate results. Then prednisone is introduced. We observe a very fast decrease of the anticoagulant circulating title with a neat improvement of the clinical state, allowing so to realize a draining puncture of the psoas. This invasive investigation required the use of prothrombinic complex concentrates ((Feiba ®) in the dose of 80 UI/kg two to three times a day). Biopsy does not show infection source.Conclusion. – The infection delayed the prescription of immunosuppressive therapy and the surgery. Use of corticoids, following 5 days of intravenous polyvalent immunoglobulin, was the good choice. After 7 weeks of hospitalization the patient has recovered a normal haemostasis results, and a good general state. [Copyright &y& Elsevier]

Un foyer de bursite infectieuse (IBD) est apparu en même temps qu'une colibacillose septicémique aiguë chez des poulettes âgées de 15 semaines. La septicémie a été précédée par une IBD subclinique. Dans ce foyer, la mortalité a commencé par des cas de septicémie et Escherichia coli a été isolé du sang du cœur des oiseaux. Après traitement antibiotique, les mortalités se sont poursuivies en augmen-tant, puis, après un pic, ont décliné et enfin ont cessé. L'IBD a été confirmée par des lésions des bourses caractérisées par une lymphocytose importante et une dégénération cystique des follicules lymphoïdes. Sur les 253 volailles, 42 (16,60 %) sont mortes dans une période de huit jours. Les éléments liés à ce foyer laissent à penser que l'absence de vaccination de rappel contre IBD a favorisé l'établissement d'IBD subclinique, diminuant fortement l'immunité et prédisposant les volailles à la septicémie colibacillaire.

L'infection expérimentale de trois races de mouton du Nigéria, les moutons Djallonké, Yankasa et Oudah, provoqua la maladie mortelle causée par la souche Zinga du virus de la fièvre de la Vallée du Rift. Cette infection caractérisée par une hyperactivité, des écoulements nasaux séro-muqueux, une diarrhée sanglante et très liquide, une hémorragie externe et des manifestations cliniques de troubles nerveux. La virémie fut suivie d'un faible taux de développement des anticorps chez tous les moutons infectés. Les transformations hématologiques comportèrent une forte baisse de l'hématocrite, de la concentration d'hémoglobine et du taux des globules rouges pendant l'évolution de la maladie. Les transformations dans les composants biochimiques du sérum comportèrent une forte augmentation progressive du niveau de l'alanine aminotransférase et de l'aspartate aminotransférase. Les taux de sodium baissèrent graduellement, mais ceux de potassium, bien que stables au début, augmentèrent par la suite jusqu'à la mort des animaux infectés. Il y eut une augmentation importante de l'azote uréique à partir du 3ème jour p.i. qui se poursuivit jusqu'à la mort des animaux infectés. L'examen macroscopique et microscopique des carcasses a montré des lésions importantes dans beaucoup d'organes, y compris des coagulations intravasculaires disséminées.

Sepsis often leads to systemic multiple organ dysfunction, with the majority of deaths attributable to acute myocardial injury (AMI). In this study, we aimed to explore the functional role of miR-365a-3p in sepsis-induced AMI. The sepsis myocardial injury model was constructed using lipopolysaccharide (LPS) both in vitro and in vivo with selective regulation of miR-365a-3p expression. Real-time PCR or Western blot was employed to detect the expressions of miR-365a-3p, inflammatory cytokines (tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and IL-6), and inflammation-related proteins (nuclear factor-κB (NF-κB), I-κB, myeloid differentiation factor 88 (MyD88)) in myocardial tissues and cells. Also, cell counting kit-8 (CCK8) and flow cytometry assays were used to measure cardiomyocyte proliferation and apoptosis, respectively. Furthermore, the targeting relationship between miR-365a-3p and MyD88 was verified with the dual luciferase activity assay. miR-365a-3p was downregulated in LPS-induced myocardial injury model. miR-365a-3p overexpression attenuated cardiomyocyte apoptosis and suppressed the expressions of inflammatory cytokines and proteins. Inhibiting miR-365a-3p, however, produced the opposite effects. Mechanistically, miR-365a-3p targeted the 3'-untranslated region of MyD88, thereby inactivating MyD88-mediated NF-κB pathway. miR-365a-3p overexpression mitigated sepsis-mediated myocardial injury by inhibiting MyD88-mediated NF-κB activation.

No abstract available. See PDF file for full text.

Abstract: We report a case of a Pseudomonas aeruginosa septicemia complicated by a septic shock after chemotherapy for pulmonary cancer. Bilateral legs necrotic purpura corresponding to echtyma gangrenosum lesions (erythematous inflammatory halo, positive bacteriologic cutaneous biopsy) was noted 48h previous to the shock. Echtyma gangrenosum manifestation should alert physician to P. aeruginosa septicemia risk and can be useful to guide probabilist antibiotherapy. [Copyright &y& Elsevier]

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objective: Members of the genus Bacillus are Gram-positive bacilli, ubiquitous in the environment. When isolated in clinical practice, it is frequently considered as due to environmental contamination. Bacillus cereus is the most frequent species isolated in clinical practice, nevertheless other Bacillus spp. are sometimes isolated. Bacillus bacteremia is uncommon, the affected patients are severely ill and frequently immunocompromised with hematological malignancies. Study design: Two cases of bloodstream infection due to Bacillus species rarely described before are described, one due to Bacillus macerans and the other to Bacillus pumilus. Both patients presented with severe bacteremia and were immunodepressed after recent chemotherapy. They died a few days after admission to our ICU. Conclusion: The initial report of Bacillus spp. isolated in blood culture in oncohematological patients indicates a potentially severe infection. [Copyright &y& Elsevier]

Résumé: Propionibacterium avidum est un bacille à Gram positif non sporulant, anaérobie préférentiel, de faible virulence et rarement pathogène. Ce germe est commensal ubiquitaire de la peau (glandes sébacées et follicules pileux) et parfois responsable d’acné vulgaire. Il peut exceptionnellement être responsable d’infections systémiques au décours de gestes invasifs, notamment dans un contexte d’immunodépression. Deux cas de sacro-iliites ont été décrits. Nous rapportons l’observation d’une patiente de 78 ans qui, dans les suites d’une infiltration de hanche, a développé une coxite infectieuse avec sepsis sévère àP. avidum. Aucun cas de coxite àP. avidum n’a, à notre connaissance, été décrit. [Copyright &y& Elsevier]

Abstract: Introduction: We report a new case of pneumonia and bacteremia due to Yersinia enterocolitica (YE) in a diabetic patient with HLA-B27 positive spondylarthritis. Observation: A 75-year-old man was admitted for a pneumonia. He was suffering from HLA-B27 positive spondylarthritis and stable diabetes mellitus. Amoxicillin with clavulanic acid was ineffective. Two blood and stool cultures were positive for YE. There was no evidence of septic metastases, immunodepression and iron overload. Outcome was uneventful after 21 days of ofloxacin. Conclusion: YE pneumonia is rare. In this patient, diabetes mellitus and spondylarthritis with HLA-B27 may have played a role in the infection but their imputability remain questionable. [Copyright &y& Elsevier]

Abstract: We report a fatal case of Chromobacterium violaceum septicemia in a 42-year-old farm worker living in the French West Indies. The bacteria found in the muddy soil and the stagnant water of tropical and subtropical regions is rarely a source of human infection. [Copyright &y& Elsevier]