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Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Agrobacterium radiobacter is a gram-negative aerobic bacillus that has been reported as a cause of disease only 36 times in the literature. More than half of the patients (25) have had bacteremia. Peritonitis, urinary tract infection, endocarditis, and one case of cellulitis associated with bacteremia have also been reported. Infection is often associated with immunosuppression and the presence of a plastic foreign body, such as central venous catheters, nephrostomy tubes, intraperitoneal catheters, and prosthetic cardiac valves. We present apparently the first case of A radiobacter causing myositis after influenza virus vaccination.
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PMID:Cellulitis and myositis caused by Agrobacterium radiobacter and Haemophilus parainfluenzae after influenza virus vaccination. 922 3

Invasive pneumococcal infection (i.e., bacteremia and meningitis) and influenza are important causes of morbidity and mortality among Medicare beneficiaries aged > or = 65 years. In the United States, the estimated annual incidence of pneumococcal bacteremia among persons aged > or = 65 years is 50-83 cases per 100,000 persons, and such infections are associated with a high case-fatality rate. Older persons account for >90% of influenza-related deaths, and Medicare costs for influenza-related hospitalizations can reach $1 billion each year. The Advisory Committee on Immunization Practices (ACIP) recommends that persons aged > or = 65 years receive at least one lifetime dose of pneumococcal vaccine and annual influenza vaccination and that hospitalization should be used as an opportunity to vaccinate. This report describes an assessment of the vaccination coverage of Medicare pneumonia patients who were admitted to hospitals in 12 western states from October 1994 through September 1995 (fiscal year 1995); the findings of this assessment indicate that the opportunity to provide pneumococcal vaccine was missed for up to 80% of those hospitalized at any time during the year, and the opportunity to provide influenza vaccine was missed for 65% of those who were admitted during October-December 1994.
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PMID:Missed opportunities for pneumococcal and influenza vaccination of Medicare pneumonia inpatients--12 western states, 1995. 934 5

Pneumococcal disease and influenza impact public health considerably. S pneumoniae probably accounts for almost 14,000 deaths and more than 23,000 admissions to National Health Service hospitals per annum. Influenza epidemics occur frequently and unpredictably with the potential to inflict morbidity and mortality on a massive scale. Both diseases pose maximum risks to persons with underlying chronic illnesses. Assessing the effectiveness of pneumococcal and influenza vaccines presents complex methodological problems. However, despite these difficulties, a body of evidence has accumulated suggesting that pneumococcal vaccines offer substantial protection against both bacteremia and pneumonia among healthy low-risk adults, but only against bacteremia in those considered high-risk. There is now strong evidence that the influenza vaccine protects high-risk patients from both hospitalization and death. Although most European countries now have national guidelines for vaccination of high-risk patients, both vaccines remain underused in modern clinical practice mainly due to poor organization.
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PMID:Clinical effectiveness, policies, and practices for influenza and pneumococcal vaccines. 1039 12

Severe CAP is a life-threatening condition defined by the presence of respiratory failure or symptoms of severe sepsis or septic shock. It accounts for approximately 10% of hospitalized patients with CAP. The majority of patients with severe pneumonia have underlying comorbid illnesses, with COPD, alcoholism, chronic heart disease, and diabetes mellitus being the most frequent. S. pneumoniae, Legionella spp, GNEB (especially K. pneumoniae), H. influenzae, S. aureus/spp, Mycoplasma pneumoniae, respiratory viruses (especially influenza viruses), and P. aeruginosa represent the most important causative organisms of severe CAP. Rapid initiation of appropriate antimicrobial treatment is crucial for a favorable outcome. Initial antimicrobial treatment should be based on an epidemiological (empiric) approach. Microbial investigation may be helpful in the individual case but is probably more useful to define local antimicrobial policies based on local epidemiologic and susceptibility patterns. Mortality rates range from 21% to 54%. The most important prognostic factors include general health state of the patient, appropriateness of initial antimicrobial treatment, and the existence of bacteremia, as well as factors reflecting severe respiratory failure, severe sepsis, septic hypotension or shock, and the extent of infiltrates in chest radiograph. Initial antimicrobial treatment should consist of a second (or third) generation cephalosporin and erythromycin. Modifications of this basic regimen should be considered in the presence of distinct comorbid conditions and risk factors for distinct pathogens. Promising new approaches of nonantimicrobial treatment, including noninvasive ventilation, treatment of hypoxemia, and immunomodulation, are under investigation.
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PMID:Severe community-acquired pneumonia. 1051 5

Infectious diseases account for one third of all deaths in people 65 years and older. Early detection is more difficult in the elderly because the typical signs and symptoms, such as fever and leukocytosis, are frequently absent. A change in mental status or decline in function may be the only presenting problem in an older patient with an infection. An estimated 90 percent of deaths resulting from pneumonia occur in people 65 years and older. Mortality resulting from influenza also occurs primarily in the elderly. Urinary tract infections are the most common cause of bacteremia in older adults. Asymptomatic bacteriuria occurs frequently in the elderly; however, antibiotic treatment does not appear to be efficacious. The recent rise of antibiotic-resistant bacteria (e.g., methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus) is a particular problem in the elderly because they are exposed to infections at higher rates in hospital and institutional settings. Treatment of colonization and active infection is problematic; strict adherence to hygiene practices is necessary to prevent the spread of resistant organisms.
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PMID:Common infections in older adults. 1120 92

We report a 17-year-old man with destructive pulmonary embolism caused by Staphylococcus aureus bacteremia. The patient was not immunocompromised and had neither underlying diseases nor risk factors, such as concomitant influenza viral infection, which exacerbate staphylococcal infections. The rapid and extensive progression of pulmonary involvement in all lung fields make this a rare case; there have been few reports in the literature describing a similar radiographic appearance in patients with community-acquired staphylococcal bacteremia. In-vitro studies did not demonstrate the production of enterotoxins or toxic shock syndrome toxin 1 (TSST-1) by the isolated strain, but genetic analysis detected Panton-Valentine leukocidine gene from the strain. Subsequent empyema with bilateral pneumothorax was prolonged because of superinfection with both methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa. Optional surgical treatments, including thoracostomy and thoracopneumoplasty, finally improved his condition.
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PMID:Destructive pulmonary embolism in a patient with community-acquired staphylococcal bacteremia. 1195 28

A lethal synergism exists between influenza virus and pneumococcus, which likely accounts for excess mortality from secondary bacterial pneumonia during influenza epidemics. Characterization of a mouse model of synergy revealed that influenza infection preceding pneumococcal challenge primed for pneumonia and led to 100% mortality. This effect was specific for viral infection preceding bacterial infection, because reversal of the order of administration led to protection from influenza and improved survival. The hypothesis that influenza up-regulates the platelet-activating factor receptor (PAFr) and thereby potentiates pneumococcal adherence and invasion in the lung was examined in the model. Groups of mice receiving CV-6209, a competitive antagonist of PAFr, had survival rates similar to those of control mice, and lung and blood bacterial titers increased during PAFr inhibition. These data suggest that PAFr-independent pathways are operative in the model, prompting further study of receptor interactions during pneumonia and bacteremia. The model of lethal synergism will be a useful tool for exploring this and other mechanisms underlying viral-bacterial interactions.
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PMID:Lethal synergism between influenza virus and Streptococcus pneumoniae: characterization of a mouse model and the role of platelet-activating factor receptor. 2215 62

Invasive infection due to Streptococcus pneumoniae associated with rhabdomyolysis is rare. We report the case of a 31-year-old splenectomized man with pneumococcal bacteremia and paranasal sinusitis who presented with flu-like symptoms preceding a fulminant course of sepsis and rhabdomyolysis with acute renal failure and elevated creatinine phosphokinase. Although the possible mechanisms of rhabodomyolysis associated with pneumococcal infection remain unclear, this report may serve to alert clinicians of the need to prevent fulminant pneumococcal infection by vaccination and treatment with antibiotic prophylaxis in splenectomized patients.
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PMID:Rhabdomyolysis associated with Streptococcus pneumoniae bacteremia in a splenectomized patient. 1218 50

Health care-associated (nosocomial) infection is now more common in surgical patients than surgical-site or wound infection. Elderly patients and those having abdominal, neck, cardiac, or other thoracic procedures are at the highest risk. Pneumococcal pneumonia and influenza are the fifth leading cause of mortality in the elderly population. In the United States, only 54% of persons older than 65 years have received a pneumococcal vaccine, whereas approximately 67% have been immunized for influenza. In this study, interviews were conducted with 160 elderly patients seen in the preadmission testing unit of a large community hospital. Results showed immunization rates of 57% for pneumonia and 76% for influenza. Similar to findings of previous studies, minorities were less likely to be immunized than whites. Of those who were not immunized for pneumonia or could not recall their immunization status, 71% stated they had not been offered immunization. Sixty-four percent stated they would take the vaccine to prevent pneumonia if it were offered. Of those patients who were not immunized for influenza, 54% had not been offered this protection and 41% stated they would take the influenza vaccine if offered. Although vaccination rates of participants in the present study surpassed the 1998 national baseline for noninstitutionalized adults, there is much opportunity for improvement. Perianesthesia nurses have an important role in reducing surgical patients' risks of developing health care-associated pneumonia and invasive bacteremia by assessing the patient's immunization status and being proactive in helping surgical patients obtain appropriate vaccinations. Routine documentation of a vaccination history for pneumococcal pneumonia and influenza during preadmission testing and use of a standard protocol for educating and immunizing those who lack this protection are strategies that can be easily implemented by nurses practicing in perianesthesia settings such as ambulatory surgical sites and preadmission testing units. This practice would foster achievement of the Healthy People 2010 goal of 90% vaccination rates for persons at high risk for these deadly diseases.
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PMID:Incidence of adult immunization for influenza and pneumonia in a preadmission testing unit. 1238

We developed a model of sequential influenza A virus (IAV)-Neisseria meningitidis serogroup C (Nm) infection in BALB/c mice. Mice infected intranasally with a sublethal IAV dose (260 pfu) were superinfected intranasally with Nm. Fatal meningococcal pneumonia and bacteremia were observed in IAV-infected mice superinfected with Nm on day 7, but not in those superinfected on day 10. The susceptibility of mice to Nm superinfection was correlated with the peak interferon-gamma production in the lungs and decrease in IAV load. After Nm challenge, both IAV-infected and uninfected control mice produced the inflammatory cytokines interleukin (IL)-1 and IL-6. However, IL-10 was detected in susceptible mice superinfected on day 7 after IAV infection, but not in resistant mice. This model of dual IAV-Nm infection was also used to evaluate the role of bacterial virulence factors in the synthesis of the capsule. A capsule-defective mutant was cleared from the lungs, whereas a mutant inactivated for the crgA gene, negatively regulating expression of the pili and capsule, upon contact with host cells, retained invasiveness. Therefore, this model of meningococcal disease in adult mice reproduces the pathogenesis of human meningococcemia with fatal sepsis, and is useful for analyzing known or new genes identified in genomic studies.
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PMID:A model of meningococcal bacteremia after respiratory superinfection in influenza A virus-infected mice. 1275 52


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