Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The available hospital records of all pediatric patients diagnosed as having periorbital, preseptal or orbital cellulitis over a five-year period were reviewed and compared to previously reported series. Only two of 39 patients had orbital cellulitis. The 37 patients with preseptal cellulitis had two characteristic clinical presentations. Twenty-two children had local trauma, abscesses, insect bites, or impetigo as the inciting event for their cellulitis. Infection was usually caused by staphylococci or streptococci. In contrast, 15 children, 12 of whom were under 36 months, had associated upper respiratory tract infections and otitis. Haemophilus influenzae was the most commonly implicated pathogen and the children were at risk of bacteremia and metastastic infection. Determination of the location of the infection in the orbit and consideration of the clinical presentation of the patient with infection in and about the orbit are of assistance in choosing appropriate therapy. Young children who have upper respiratory tract symptoms in association with preseptal cellulitis should receive antibiotic coverage for Haemophilus.
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PMID:Clinical implications of preseptal (periorbital) cellulitis in childhood. 31 May 37

In January 1983, a number of premature infants under management in the premature infants' unit of our hospital were found to have bacteremia due to Staphylococcus aureus. By the end of February of the same year, 4 of these infants, who had been treated in the same unit, developed impetigo. The S. aureus responsible for this condition was classified as type IV by a coagulase typing. In a subsequent antimicrobial susceptibility test using the disk diffusion method, this microorganism was found to be resistant to methicillin, erythromycin and lincomycin, and to be susceptible to tetracycline, chloramphenicol and cefmetazole, indicating that it was a methicillin resistant S. aureus (MRSA). Because the result from the coagulase typing agreed with the antimicrobial susceptibility pattern in all cases, we concluded that these cases represented nosocomial infection with MRSA. The source and route of the infection were investigated, and measures taken to prevent bacterial spread from carriers and to keep instruments and environments clean. Although the source of infection was not identified. Then, we tried wiping the body surface of the premature infants with an Isodine solution (10% PVP-I, 1:100 dilution) in order to prevent colonization of the microorganism on the body surface. With this application+, MRSA was no longer detected from the body surface of the premature infants, and no additional MRSA infection occurred in the premature infants' unit. Data collected for premature infants' managed at our hospital in the subsequent 6 years allows us to conclude that MRSA infection can be almost completely controlled by frequent surveys of carriers and appropriate body surface wiping with Isodine solution.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prevention and control of nosocomial infection caused by methicillin resistant Staphylococcus aureus in premature infant ward--prevention effect of "povidone iodine solution" wipe of neonatal skin]. 240 10

Ecthyma is an ulcerated form of impetigo due to Streptococcus pyogenes, seen primarily in children with poor hygiene. The authors report a homosexual man with acquired immunodeficiency syndrome (AIDS) who developed severe ecthyma and bacteremia caused by S. pyogenes. Opsonizing antibody to the M protein of S. pyogenes is important in immunity to this organism. Patients with AIDS may have defective humoral immunity as well as defective cellular immunity, and such a defect may have rendered this patient abnormally susceptible to severe infection with S. pyogenes.
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PMID:Bacteremia and ecthyma caused by Streptococcus pyogenes in a patient with acquired immunodeficiency syndrome. 327 90

Various cellular responses to skin infections in an experimental animal model were explored. Total leukocyte counts varied after group A streptococcal infections, but a depression was commonly seen after M type 12 impetigo. Staphylococcus aureus infections resulted in moderate leukocytosis. A marked neutrophilia was universal with streptococcal or staphylococcal disease. A positive nitroblue tetrazolium (NBT) response appeared 24 hr after infection, reached a peak in 48 hr, and then declined. This occurred in the absence of extensive cellulitis or bacteremia. An increase in the percentage and absolute number of NBT-positive neutrophils occurred. M type 57 streptococcus produced a more strongly positive NBT test than did M type 12. Cell-free filtrates of a broth culture of M type 57 streptococcus produced NBT responses in hamsters comparable to the responses seen after injection of live organisms. These studies indicate the usefulness of this animal model to study various parameters of the NBT test.
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PMID:Experimental infection of the skin in the hamster simulating human impetigo. IV. Cellular responses after streptococcal and staphylococcal infections. 411 85

GABHS is the most common bacterial cause of tonsillopharyngitis, but this organism also produces acute otitis media; pneumonia; skin and soft-tissue infections; cardiovascular, musculoskeletal, and lymphatic infections; bacteremia; and meningitis. Most children and adolescents who develop a sore throat do not have GABHS as the cause; their infection is viral in etiology. Other bacterial pathogens produce sore throat infrequently (e.g., Chlamydia pneumoniae and Mycoplasma pneumoniae), and when they do, other concomitant clinical illness is present. Classic streptococcal tonsillopharyngitis has an acute onset; produces concurrent headache, stomach ache, and dysphagia; and upon examination is characterized by intense tonsillopharyngeal erythema, yellow exudate, and tender/enlarged anterior cervical glands. Unfortunately only about 20% to 30% of patients present with classic disease. Physicians overdiagnose streptococcal tonsillopharyngitis by a wide margin, which almost always leads to unnecessary treatment with antibiotics. Accordingly, use of throat cultures and/or rapid GABHS detection tests in the office is strongly advocated. Their use has been shown to be cost-effective and to reduce antibiotic overprescribing substantially. Penicillin currently is recommended by the American Academy of Pediatrics and American Heart Association as first-line therapy for GABHS infections; erythromycin is recommended for those allergic to penicillin. Virtually all patients improve clinically with penicillin and other antibiotics. However, penicillin treatment failures do occur, especially in tonsillopharyngitis in which 5% to 35% of patients do not experience bacteriologic eradication. Penicillin treatment failures are more common among patients who have been treated recently with the drug. Cephalosporins or azithromycin are preferred following penicillin treatment failures in selected patients as first-line therapy, based on a history of penicillin failures or lack of compliance and for impetigo. GABHS remain exquisitely sensitive to penicillin in vitro. There are several explanations for penicillin treatment failures, but the possibility of copathogen co-colonization in vivo has received the most attention. Treatment duration with penicillin should be 10 days to optimize cure in GABHS infections. A 5-day regimen is possible and approved by the United States Food and Drug Administration for cefpodoxime (a cephalosporin) and azithromycin (a macrolide). Prevention of rheumatic fever is the primary objective for antibiotic therapy of GABHS infections, but a reduction in contagion and faster clinical improvement also can be achieved. Development of streptococcal toxic shock syndrome and necrotizing fasciitis ("flesh-eating bacteria") are rising concerns. The portal of entry for these invasive GABHS strains is far more often skin and soft tissue than the tonsillopharynx.
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PMID:Group A beta-hemolytic streptococcal infections. 974 11

Group A beta-hemolytic streptococcus (GABHS) has long been recognized as a deadly pathogen with manifestations ranging from impetigo to necrotizing fasciitis. Bacteremia from streptococcal pharyngitis is a rare complication. We report a patient presenting with septic shock and diabetic ketoacidosis from streptococcal pharyngitis. The pathophysiology, classification, and treatment of invasive group A streptococcal infection is discussed.
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PMID:Severe invasive group A beta-hemolytic streptococcus infection complicating pharyngitis: a case report and discussion. 1068 Mar 23

Staphylococcus aureus is a common cause of soft tissue infection, e.g. impetigo, cellulitis, or wound infection, and causes osteomyelitis, arthritis, bacteremia with metastatic infection, and scalded skin and toxic shock syndromes. Coagulase-negative staphylococci have become increasingly important causes of nosocomial bacteremia associated with invasive monitoring, intravascular catheters and prosthetic heart valves or joints. Most staphylococci produce b-lactamase and are resistant to penicillin. An increasing proportion of S. aureus have intrinsic resistance to methicillin (MRSA) and present major problems in hospitals for the control of cross infection. The glycopeptides, teicoplanin and vancomycin, are the antibiotics of first choice for treatment of these infections. After the first report describing a Japanese clinical isolate of vancomycin-resistant S. aureus (VRSA), several papers have documented the emergence of these microorganisms. Since the development and spreading of this phenomenon which is perceived as a fearsome threat to the already difficult therapy of nosocomial infections due to the prevalence of heterogeneous vancomycin resistance, we found the incidence of MRSA exceeds 35% in our hospital. Out of 179 methicillin-resistant S. aureus isolated during 1997-1998, two strains (1.1%) gave subclones with vancomycin MICs of 8 mg/L. PFGE showed identical restriction patterns for both isolates, suggesting transfer of a single clone between two different patients.
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PMID:Evolution of antibiotic resistance in gram-positive pathogens. 1115 25

Staphylococcus aureus is a common cause of soft tissue infection, e.g. impetigo, cellulitis, or wound infection, and causes osteomyelitis, arthritis, bacteremia with metastatic infection, and scalded skin and toxic shock syndromes. Coagulase-negative staphylococci have become increasingly important causes of nosocomial bacteremia associated with invasive monitoring, intravascular catheters and prosthetic heart valves or joints. Most staphylococci produce blactamase and are resistant to penicillin. An increasing proportion of S. aureus have intrinsic resistance to methicillin (MRSA) and present major problems in hospitals for the control of cross infection. The glycopeptides, teicoplanin and vancomycin, are the antibiotics of first choice for treatment of these infections. After the first report describing a Japanese clinical isolate of vancomycin-resistant S. aureus (VRSA), several papers have documented the emergence of these microorganisms. Since the development and spreading of this phenomenon which is perceived as a fearsome threat to the already difficult therapy of nosocomial infections due to the prevalence of heterogeneous vancomycin resistance, we found the incidence of MRSA exceeds 35% in our hospital. Out of 179 methicillin-resistant S. aureus isolated during 1997-1998, two strains (1.1%) gave subclones with vancomycin MICs of 8 mg/L. PFGE showed identical restriction patterns for both isolates, suggesting transfer of a single clone between two different patients.
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PMID:[Emergence of drug-resistant gram-positive pathogenic bacteria]. 1142 95

The population structure of Staphylococcus aureus carried by healthy humans was determined using a large strain collection of nonclinical origin (n = 829). High-throughput amplified fragment length polymorphism (AFLP) analysis revealed 3 major and 2 minor genetic clusters of S. aureus, which were corroborated by multilocus sequence typing. Major AFLP cluster I comprised 44.4% of the carriage isolates and showed additional heterogeneity whereas major AFLP groups II and III presented 2 homogeneous clusters, including 47.3% of all carriage isolates. Coanalysis of invasive S. aureus strains and epidemic methicillin-resistant S. aureus (MRSA) revealed that all major clusters contained invasive and multiresistant isolates. However, clusters and subclusters with overrepresentation of invasive isolates were also identified. Bacteremia in elderly adults, for instance, was caused by a IVa cluster-derived strain significantly more often than by strains from other AFLP clusters. Furthermore, expansion of multiresistant clones or clones associated with skin disease (impetigo) was detected, which suggests that epidemic potential is present in pathogenic strains of S. aureus. In addition, the virulence gene encoding Panton-Valentine leukocidin was significantly enriched in S. aureus strains causing abscesses and arthritis in comparison with the carriage group. We provide evidence that essentially any S. aureus genotype carried by humans can transform into a life-threatening human pathogen but that certain clones are more virulent than others.
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PMID:Natural population dynamics and expansion of pathogenic clones of Staphylococcus aureus. 1559 92

Pediatric outpatients and healthy children in the community were examined for nasal methicillin-resistant Staphylococcus aureus (MRSA) in Japan. MRSA isolation frequencies were 0.7% (3/426) and 3.7% (5/136), respectively, in pediatric outpatients and healthy children in the community (overall frequency, 1.4%). The frequency of MRSA isolation was higher in children 5-9 years of age compared with the other age groups. All eight MRSA strains isolated were Panton-Valentine leukocidin-negative. Of these, three with the genotype multilocus sequence type (ST) 8/spa606/SCCmecIV (2 cases) and ST88/spa999/SCCmecIV/exfoliative toxin A gene (eta) were identical or similar to MRSA from bullous impetigo, determined by pulsed-field gel electrophoresis. One strain with ST764 (ST5 variant)/spa2/SCCmecII/staphylococcal enterotoxin B gene seb2 (seb variant) was similar to MRSA from bacteremia, and one with ST5/spa2/SCCmecII was the Pandemic New York/Japan clone. The remaining three strains, with ST22/spa998/SCCmecI, ST380/spa799/SCCmecIV, and ST857/spa416/SCCmecII, have not been identified. All MRSA strains were resistant to one or more non-beta-lactam antibiotics, and the ST5 and ST764 strains were multidrug-resistant. Family analysis demonstrated parent-to-child transmission (for ST8 and ST764), as well as acquisition from outside the family (for ST8 and ST380). The data suggest that young school-age children have a higher carriage rate of nasal MRSA than children of other ages, and that not only community-acquired MRSA strains but also MRSA strains with characteristics of hospital-acquired MRSA are spreading in the community.
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PMID:Genotypes, intrafamilial transmission, and virulence potential of nasal methicillin-resistant Staphylococcus aureus from children in the community. 1939 17


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