deoxycholic-acid and Shock--Septic

The urinary tract is a common source for life-threatening infections. Most patients with sepsis or septic shock from a urinary source have complicated urinary tract infection. This article explains the epidemiology, risk factors, and treatment. Effective management, appropriate collection of microbiology specimens, prompt initiation of antimicrobial therapy, source control, and supportive therapy are described.

Topics: Acute Disease; Aminoglycosides; Amphotericin B; Anti-Infective Agents; Antifungal Agents; Catheters, Indwelling; Community-Acquired Infections; Cross Infection; Deoxycholic Acid; Drug Combinations; Female; Fluconazole; Humans; Male; Prognosis; Risk Factors; Shock, Septic; Urinary Tract; Urinary Tract Infections

Freeze-thaw lysates prepared from strains of Escherichia coli belonging to serogroups O138, O139, and O141 contained a principle (edema disease principle) which induced edema disease in swine. All freeze-thaw lysates contained endotoxic activity that tended to obscure the edema disease syndrome and methods were developed to reduce such activity. Freeze-thaw lysates prepared from E. coli O139 induced the most characteristic edema disease syndrome. Partially purified edema disease principle prepared from O139 freeze-thaw lysates by sequential precipitation with ammonium sulphate and streptomycin sulphate had increased specific activity with markedly reduced endotoxic activity. This material was insoluble at acidic pH but readily soluble at alkaline pH. The effective molecular weight of edema disease principle, based on retention and filtration properties of diaflo membranes, appeared to be greater than 50,000 and less than 100,000. The biological activity of edema disease principle was thermolabile. Sodium deoxycholate treatment of edema disease principle further reduced endotoxic activity. A thermolabile, ammonium sulphate precipitable material was prepared from E. coli O139 that induced a predictable syndrome which resembled edema disease clinically and pathologically following intravenous inoculation in pigs.

Topics: Ammonium Sulfate; Animals; Chemical Precipitation; Culture Media; Deoxycholic Acid; Edema Disease of Swine; Endotoxins; Escherichia coli; Escherichia coli Infections; Female; Injections, Intravenous; Male; Molecular Weight; Shock, Septic; Streptomycin; Swine; Swine Diseases; Ultrafiltration

Topics: Acetates; Agar; Alkanes; Animals; Autoradiography; Benzalkonium Compounds; Bile; Cattle; Chromium Radioisotopes; Deoxycholic Acid; Detergents; Electrophoresis; Endotoxins; Escherichia coli; Female; Lead; Lethal Dose 50; Polyethylene Glycols; Polysorbates; Quaternary Ammonium Compounds; Rats; Shock, Septic; Sodium Dodecyl Sulfate; Swine