Articles: sepsis.
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After gastro-intestinal operations wound infection is usually caused by the inoculation of bacteria present within the intestinal tract into the incision during the surgical procedure. In theory, wound sepsis may be minimized by the following methods: (a) avoiding intestinal contamination of the incision; (b) altering the normal flora of the intestinal tract by adding oral antimicrobials to bowel preparation; (c) using topical or systemic prophylactic antibiotic administration for certain high-risk patients. The relative importance of these methods of prophylaxis is described.
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J. Thorac. Cardiovasc. Surg. · May 1977
Case ReportsSepticemia secondary to impacted infected pacemaker wire. Successful treatment by removal with cardiopulmonary bypass.
Infection of an intravenous pacemaker electrode developed in a 78-year-old man after multiple replacements and revisions of the pulse generator and the pacemaker lead. Spread of the infective process to the endocardium was followed by septicemia with Serratia marcescens and Staphyloccus epidermids. Failure of medical treatment and external traction on the pacemaker electrode led to thoracotomy and removal of the pacemaker electrode wires with the use of extracorporeal circulation. ⋯ Cultures from the endocardium removed with the electrode rendered the same organisms as cultured preoperatively. There has been no recurrence after 2 years following the removal of the infected electrodes. Although the problem described herein is not frequently found, radical treatment becomes necessary whenever infection and septicemia develop.
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The effect of subsequent cyclic administration of oleandomycin and tetracycline on the titer of the complement, the content of lysozyme, the bactericidal properties of the serum and the presence of the antibiotic specific antibodies in the blood serum found in the Hoigne reaction were studied on rabbits. It was found that the subsequent cyclic administration of the antibiotics to both the intact animals and the animals with experimental staphylococcal sepsis was accompanied by an increase in the titer of the complement only on the 7th day of administration of oleandomycin, the first antibiotic. ⋯ Changes in the factors of non-specific resistance under the effect of the subsequent cyclic administration of oleandomycin and tetracycline on both the intact animals and the animals with experimental staphylococcal sepsis were accompanied by an appearance, progressive increase and prolonged preservation in the serum of the antibiotic specific antibodies found in the Hoigne reaction. A possibility of producing specific antibodies simultaneously to the 2 antibiotics, i. e. oleandomycin and tetracycline in their administration in subsequent 7-day cycles was shown.
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J. Thorac. Cardiovasc. Surg. · Mar 1977
Case ReportsRetention of pacemaker electrode complicated by Serratia marcescens septicemia. Removal with total cardiopulmonary bypass.
A case in which Serratia marcescens septicemia complicated the insertion of a transvernous pacemaker unit is reported. Appropriate antibiotic therapy and removal of the pacemaker electrode are two essential steps to achieve a complete cure in this stimulation. Open cardiotomy with total cardiopulmonary bypass provides a safe approach for withdrawal of an incarcerated electrode and is justified because of the lethal potential of systemic Serratia infections, particularly those superimposed on intracardiac prostheses.