Rapid detection of sepsis using cesda: the caenorhabditis elegans sepsis detection assay

Abstract INTRODUCTION The nematode Caenorhabditis elegans was used as a biological sensor to detect the urine of sepsis patients (CESDA assay). METHODS C. elegans was aliquoted onto the center of assay plates and allowed to migrate towards sepsis (T) or control (C) urine samples spotted on the same plate. The number of worms found in either (T) or (C) was scored at 10-minute intervals over a 60-minute period. RESULTS The worms were able to identify the urine (<48 hours) of sepsis patients rapidly within 20 minutes (AUROC=0.67, p=0.012) and infection within 40 minutes (AUROC=0.80, p=0.016). CONCLUSIONS CESDA could be further explored for sepsis diagnosis.

Tratamiento antibiótico empírico de elección en pacientes con urosepsis secundaria a litiasis ureteral: reporte de sensibilidad local / Antimicrobial susceptibility of bacteria causing urosepsis

Background: Early inappropriate antibiotic therapy for the management of urosepsis is associated with higher mortality. Therefore, to establish an adequate empirical therapy is crucial. Aim: To determine an optimal antibiotic treatment, adjusted according local bacterial resistance in patients diagnosed with urosepsis secondary to ureteral lithiasis. Material and Methods: Urine cultures and blood cultures from a prospective cohort of patients with ureteral lithiasis admitted for urosepsis in our center between November 2013 and May 2016, were reviewed. Patients who presented two or more criteria of systemic inflammatory response syndrome (SIRS) and positive blood or urine cultures were admitted. Antimicrobial sensitivity patters derived from cultures were analyzed to describe bacterial susceptibility to commonly used antibiotics. Results: Data from 31 patients were analyzed. Seventeen blood cultures (55%) and 29 urine cultures (94%) were positive. The most commonly isolated pathogens were Escherichia coli in 65% of the cultures, followed by Klebsiella pneumoniae, Proteus mirabilis and Enterococcus faecalis. After performing an analysis of sensitivity and resistance for all bacteria in both blood and urine cultures, amikacin showed the highest sensitivity (100%), followed by 2nd and 3rd generation cephalosporins. Conclusions: Amikacin demonstrated higher antibiotic sensitivity in comparison to other antibiotics for empirical management of patients with urosepsis secondary to ureteral lithiasis.

Etiología de la Sepsis Neonatal

De los 100 pacientes incluidos en el estudio, se documentó la sepsis en 74 niños, en 48 de estos pacientes se aislaron microorganismos en sangre (66.2 por ciento). En los hemocultivos los gérmenes aislados con mayor frecuencia fueron Enterobacter aerogens (31.2 por ciento), Klebsiella sp. (27 por ciento) y Staphylococcus epidermidis (22.9 por ciento). En cultiv os de L.C.R. se aislaron 2 Klebsiellas sp; 2 Escherichia coli y 1 Staphylococcus epidermis, todos estos gérmenes coincidieron con el aislado en el hemocultivo respectivo, excepto 1 Escherichia coli, que en el hemocultivo fue negativo. De los pacientes en los cuales se hizo aislamiento de microorganismos (49) se pudo hacer punción lumbar y procesar el L.C.R. en 32 de ellos, comprobáandose la miningitis en el 15.6 por ciento. La V.S.G., la proteína C reactiva y la haptoglobina furon las pruebas coadyuvantes que más aportaron al diagnóstico de sepsis neonatal. Los gérmenes aislados mostraron baja sensibilidad a la ampicilina, droga considerada tradicionalmente como de primera elección en el inicio del manejo de la sepsis. La misma observación en relación a la sensibilidad se obtuvo en el caso del Staphylococcus epidermidis frente a la oxaciclina. La ampicilina debe dejar de utilizarse durante algún tiempo en los hospitales en los cuales se hizo el estudio, debido a la baja sensibilidad de los gérmenes