Staphylococcus sepsis

Staphylococcus aureus is responsible for a variety of skin infections which require therapeutic approaches different from those of streptococcal infections. Staphylococcal celluhtis is indistinguishable clinically from streptococcal cellulitis and responds to cloxacillin or flucloxacillin, but generally fails to respond to penicillin owing to penicillinase (/3-lactamase) production. Staphylococcus aureus is an important cause of superficial, localized skin sepsis which varies ftom small pustules to boils and occasionally to a more deeply invasive, suppurative skin abscess known as a carbuncle. Antibiotics are generally not indicated for these conditions. Pustules and boils settle with antiseptic soaps or creams and often discharge spontaneously, whereas carbuncles frequently require surgical drainage. Staphylococcus aureus may also cause... 

Characterization of Anti-Infective Biological Activity. Acute sepsis models utilizing either Escherichia coli or Staphylococcus aureus intraperitoneal challenge were developed to evaluate the anti-infective properties of PGG in mice. 

D8. DeJoy, S. Q., Jeyaseelan, R., Torley, L. W., Pickett, W. C., Wissner, A., Wick, M. M., Oronsky, A. L., and Kerwar, S. S., Effect of CL 184,005, a platelet-activating factor antagonist in a murine model of Staphylococcus aureus-induced gram-positive sepsis. J. Infect. Dis. 169, 150-156... 

The majority of sepsis cases, especially the more severe forms, have bacterial etiologies. Common bacterial species include Staphylococcus aureus. Streptococcus pneumoniae, Escherichia coli. Salmonella typhi (and other enterobacterial species). Pseudomonas species and haemolytic streptococci in children Haemophilus influenzae and Neisseria meningitidis are important whereas nosocomial episodes of sepsis are frequently caused by Staphylococcus epidermidis. Streptococcus faecalis (syn. enterococci), yeasts and anaerobes. 

Nakamura, T., Ushiyama, C., Suzuki, Y., Inoue, T., Shoji, H., Shimada, N., Koide, H. Combination therapy with polymyxin B-immobilized fibre haemoperfusion and teicoplanin for sepsis due to methicillin-resistant Staphylococcus aureus. J Hosp Infect 53 (2003) 58-63. 

In a rat model of neonatal sepsis, recombinant HL or talactoferrin was shown to improve survival (Venkatesh et al., 2007). In ex vivo studies, HL increased synergy of commonly used antibiotics against coagulase-negative staphylococcus and Candida (Venkatesh and Rong, 2008) and reduced biofilm of infected catheters (Venkatesh et al., 2009). 

Sunakawa K, Nonoyama M, Fuji R, Iwai N, Sakata H, Shirai M, Sato T, Kajino M, Toyonaga Y, Sano T, Naito A, Minagawa K, Niida Y, Oda T, Yokozawa M, Asanuma H, Shimura K, Fujimura M, Kitajima H, Fujinami K, Numazaki K, Fujikawa T, Kobayashi Y, Sato Y, Nishimura T, Iwata S, Tsuchihashi N, Oishi T, Matsumoto S, Motohiro T, Osawa M, Sunahara M, Shirakawa S, Nishida H, Takahashi N, Nakano R, Sai N, lyoda K, Yoshimitsu K, Ogawa K, Okazaki T, Tsukimoto I, Motoyama O, Takada Y, Kawasaki M, Sunaoshi W, Nakamura S, Ueda Y, Kamata M, Kato T, Chiba M, Ouchi K, Sato S, Horiuchi T, Suzuki K, Shimoyama T, Masaki H, Aikyo M, Kawada M, Banba M, Furukawa S, Okada T, Yamaguchi S, Hirota O, Koizumi S, Wada H, Ohta K, Uehara T, Yukitake K, Mori T, Takakuwa S, Matsuyama K. [Pharmacokinetic and clinical studies on teicoplanin for sepsis by methicillin-cephem resistant Staphylococcus aureus in the pediatric and neonate field.] Jpn J Antibiot 2002 55(5) 656-77. 

Since 1987, gram-positive organisms are the predominant pathogens in sepsis and septic shock, accounting for approximately 50% of all cases. The causes are Staphylococcus aureus, Streptococcus pneumoniae, coagulase-negative staphylococci, and enterococci. Streptococcus pyogenes and viridans streptococci are less commonly involved. ... 

Chang HR, Lian JD, Shu KH, Cheng CH, Wu MJ, Chen CH, Lau YJ, Hu BS (2000) Use of pulsed-field gel electrophoresis in the analysis of recurrent Staphylococcus aureus infections in patients on continuous ambulatory peritoneal dialysis. Am J Nephrol 20 463 67 Chaves F, Garcia-Alvarez M, Sanz F, Alba C, Otero JR (2005) Nosocomial spread of a Staphylococcus hominis subsp. novobiosepticus strain causing sepsis in a neonatal intensive care unit. J Clin Microbiol 43 4877 879... 

Ferry T, Thomas D, Genestier AL, Bes M, Lina G, Vandenesch F, Etienne J Comparative prevalence of superantigen genes in Staphylococcus aureus isolates causing sepsis with and without septic shock. Clin Infect Dis 2005 41 771-777. 

Vancomycin is the drug of choice against serious infections caused by methicihin-resistant strains of Staphylococcus aureus and coagulase-negative staphylococci [172]. It may also be used for treatment of infections by gram-positive organisms in penicillin-intolerant patients. Vancomycin has been extensively used to treat endocarditis caused by streptococci, enterococci and staphylococci. The empiric treatment of intravenous catheter sepsis and hemodialysis vascular access infection by vancomycin has led to a linear increase in its use in the last decade [173]. Oral vancomycin is efficacious in the treatment of Corynebacterium difficile-mediated diarrhea. Of major concern is the recent emergence of vancomycin-resistant enterococcus strains [174,175]. 

OB Jepsen. Postoperative wound sepsis in general surgery. VII. Staphylococcus wound sepsis. Acta Chir Scand 138 343-348, 1972. 

Briefly, Tinospora cordifolia reduced mortality associated with intra-abdominal sepsis following caecal ligation. Thus, as compared to a mortality of 66 100% on the fifth day after surgery in untreated rats, 15 days of pretreatment with Tinospora cordifolia alone reduced mortality to 33% and further to 16.6% when combined with metronidazole and gentamicin [19]. This effect was reported to be associated with improved macrophage function. Furthermore, the aqueous extract of Tinospora cordifolia was found to be devoid of in vitro antimicrobial activity against Bacillus subtilis, Bacillus cereus Staphylococcus aureus Pseudomonas aeruginosa and Escherichia coli. Sera obtained from rats (n = 10 each) orally treated with the aqueous extract of Tinospora cordifolia in doses of 100 and 200 mg/kg were also found to have no antibacterial activity [19]. These data further indicated that Tinospora cordifolia was effective in infections due to its immunostimulant effects. 

A 45-year-old woman with short-bowel syndrome, asplenia, and insulin-dependent diabetes mellitus developed catheter-related sepsis with a large skin ulcer on the left calf. A chest X-ray and a CT scan showed multiple sub-pleural pulmonary infiltrates consistent with bacterial or fungal dissemination. Blood cultures from the catheter port and the peripheral blood grew Staphylococcus haemolyticus and Fusarium oxysporum. The catheter was removed, and she was given flucloxacilhn and voriconazole. The sepsis resolved slowly. 

Infection risk The incidence rate for infection and its associated risk factors in 271 hospitalised patients on PN followed over a 6-month period. The rate of catheter-related infection (CRI) was 25/lOOOdays of TPN, with coagulase-negative Staphylococcus the most commonly isolated microorganism. Overall mortality rate was 16.9%, and this was xmrelated to the presence or absence of CRI, or use of omega-3 lipids or olive oil in the TPN [123 ]. In a report of CRI in children on PN in a hospital centre over a 21-year period, the incidence of sepsis was significantly less with patients who continued home PN after hospital discharge compared with hospital parenteral (0.94/1000 vs 2.75/lOOOdays of PN P<0.001) [12i< ]. 

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