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

A number of immunological and non-immunological techniques have been recently used to detect soluble microbial substances in body fluids of patients with acute meningitis, bacteremia, and lobar pneumonia. By the immunological methods capsular highly polymerized polisaccharide group- or type-specific antigens of the most common C. N. S. pathogens (N. meningitidis A, B, and C; Str. pneumoniae, H. influenzae type b, E. coli K1, mucoid Pseudomonas, Cryptococcus neoformans) can be detected and quantitated in spinal fluids, sera, urine and other fluids specimens from meningitic patients. Capsular type-specific antigens from pneumococcus, and likely from H. influenzae as well, can be detected in sputum from patients with lower respiratory infection. Among the various techniques, the radioimmunoassay appears as the most sensitive one, but high diagnostic sensitivity can be also achieved by using the latex agglutination, haemoagglutination inhibition and coagglutination tests. Counterimmunoelectrophoresis, however, is still the far most used technique for determining soluble microbial antigens, albeit its sensitivity is significantly less than the one of the above mentioned methods. High specificity and some advantages in serotyping the causal organisms are probably the main reasons of such preferential employment. Among the non-immunological techniques the evaluation of lactate and lactic dehydrogenase has been used by some Author for differentiating between bacterial and non bacterial meningitis, and the limulus test for detecting Gram-negative bacterial endotoxins with a high degree of sensitivity and specificity. Finally, the liquid gas chromatography has been evaluated in detection of some organic products (microbial?), such as acids, amines, neutral compounds, in spinal fluid, allowing the differential diagnosis between bacterial, tuberculous, viral, and cryptococcal meningitis. In the present review sensitivity, specificity, and other properties of each test alone and in comparison with the conventional microbiological methods (Gram and culture) are evaluated and the biological and pathogenic role and significance of the soluble microbial antigens and endotoxin are discussed.
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PMID:[Research of the soluble microbial substances in organic fluids for the rapid diagnosis of some infections and particularly of bacterial meningitis (author's transl)]. 2 97

Rapid diagnosis of Haemophilus influenzae type b meningitis is possible using immunological tests for capsular antigen (polyribophosphate, PRP), such as countercurrent immunoelectrophoresis (CIE) and latex particle agglutination (LPA). We compared two tests in monkeys with evolving, serially quantitated H. influenzae type b bacteremia (n = 23) and meningitis (n = 21). In vitro, the LPA test was sensitive to 0.5 ng of PRP/ml of saline, and the CIE test was sensitive to 1.0 ng/ml; in serum, however, CIE detected 5.0 ng of PRP/ml, whereas the sensitivity of LPA was unchanged. LPA detected PRP earlier in the course of bacteremia (mean, 12 h after onset; range, 4 to 36 h) than did CIE (mean, 45 h; range, 4 to 168 h) (P less than 0.01). A positive LPA test required greater than or equal to 100 bacteria per ml of blood, whereas CIE required greater than or equal to 1,000/ml. PRP accumulated with continuing blood stream infection, aiding detection of low-grade bacteremia. LPA detected antigen in cerebrospinal fluid (CSF) earlier in the course of meningitis and at a lower bacteria density than did CIE. Both methods detected antigen reliably with greater than or equal to 1,000 bacteria per ml of CSF. A close correlation existed between CSF concentrations of capsular antigen and bacteria (r = 0.90, P less than 0.001). We conclude that the LPA method permits earlier diagnosis of H. influenzae type b infection in part because of its greater sensitivity.
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PMID:Comparison of two antigen detection techniques in a primate model of Haemophilus influenzae type b infection. 11 34

Nonimmune rats given intravenous inoculations of 10(8) encapsulated Haemophilus influenzae type b cleared the bacteria at an exponential rate for 10 min; thereafter, the bacteremia plateaued at approximately 10(6) organisms/ml of blood. With 10(8) unencapsulated organisms, the initial clearance rate was significantly faster (P less than 0.001) and was complete by 30 min. The rate of clearance of a mutant strain of H. influenzae type b containing 0.1% as much capsular polysaccharide as the wild type was significantly faster (P less than 0.01), and H. influenzae type b from which a portion of the capsule had been removed physically had an intermediate clearance pattern. The addition of 1-1,000 mug of capsular polysaccharide to an inoculum of 10(8) organisms did not alter the clearance of the capsular polysaccharide-deficient mutant. The quantity of bacteria cleared during the 30 min after inoculation increased with the age of the animal. The initial bacterial clearance rate, corrected for animal and organ weight, also increased with age. These data are consistent with the proposal that physically integrated capsular polymer increases the virulence of H. influenzae type b by rendering it resistant to clearance from the bloodstream and that there may be an age-related increase in phagocytic activity that is reflected in increased clearance.
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PMID:The role of encapsulation and host age in the clearance of Haemophilus influenzae bacteremia. 29 66

Abnormalities in cerebrospinal fluid associated with meningitis due to Haemophilus influenzae type b were characterized in infant rats. After intranasal inoculation of bacteria, the development of intense bacteremia (greater than 10(4) colony-forming units/ml) correlated with cultures of cerebrospinal fluid positive for H. influenzae, with pleocytosis, and with hisotologic evidence of meningitis. The degree of pleocytosis was related to the age of the animal, the amount of time since inoculation, and the severity of the meningitis.
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PMID:Haemophilus influenzae meningitis in infant rats: role of bacteremia in pathogenesis of age-dependent inflammatory responses in cerebrospinal fluid. 30 94

The age-related acquisition of serum anticapsular and bactericidal antibodies to Haemophilus influenzae type b observed in rats was similar to that of humans. The antigenic source for this "natural" immunity was not identified since neither pharyngeal infection with H. influenzae b nor enteric colonization by cross-reacting bacteria was detected. Infant rats surviving H. influenzae b bacteremia failed to respond immunologically to the capsular polysaccharide. However, surviving rats demonstrated no impairment of immune responsiveness to this antigen after subsequent immunization with live bacteria in adulthood. In passive protection experiments, antibodies directed against the type b capsular polysaccharide represented the major protective specificity. However, a small protective effect of antibodies to noncapsular antigens also appeared to have been demonstrated.
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PMID:Immunology of the infant rat experimental model of Haemophilus influenzae type b meningitis. 30 6

The kinetics of bacteremia and capsular antigenemia in infant rats infected with Haemophilus influenzae type b were measured by quantitative bacterial counts in blood and counterimmunoelectrophoresis of plasma. After intraperitoneal inoculation with 10(4) colony-forming units (cfu) of H. influenzae type b, bacteremia was detected in 100% of animals at 12 hr after inoculation (mean, 16,500 cfu/ml) and by two days exceeded 10(5) cfu/ml in most animals. Despite these high levels of bacteremia, capsular antigen was detected infrequently during the early phase of experimental infection; it was present in 20% of animals at 12 hr and in 50% at one day. Peak levels of antigen in blood occurred two to three days after inoculation and coincided with the histologic appearance of meningitis. Thereafter, the frequency of antigenemia declined and paralleled the decline in quantitative bacterial counts in blood. Since detection of antigen was dependent on the occurrence of prolonged infection, counterimmunoelectrophoresis proved to be an insensitive method for early diagnosis.
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PMID:Circulating capsular antigen in infant rats infected with Haemophilus influenzae type b. 30 89

Described herein are three patients over the age of 50 years who had cellulitis of the neck and the upper portion of the chest, associated with Hemophilus influenzae type B bacteremia and respiratory tract infection--particularly that of the upper airway. Only one of the patients with cellulitis had the classic bluish-purple hue commonly seen in children affected with this syndrome. In the other two, the H. influenzae type B cellulitis could not be distinguished clinically from the more common group A streptococcal or staphylococcal cellulitis. Since the antibiotics employed in treating patients with infection due to the latter two organisms differ significantly from those used to treat patients with H. influenzae type B infection, the possibility of disease due to H. influenzae type B must be considered in any adult or child in whom cellulitis of the neck, chest and possibly face is associated with a respiratory tract infection, especially of the upper airway.
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PMID:Bacteremic hemophilus influenzae type B cellulitis in the adult. 30 44

Intraperitoneal injections of 250 mg of ampicillin per kg every 6 h for 30 h sterilized the blood and cerebrospinal fluid of infant rats infected with either a beta-lactamase-containing strain of Haemophilus influenzae type b or a strain lacking the enzyme. However, a single injection of 100 mg/kg sterilized the blood and cerebrospinal fluid of significantly fewer of those rats infected with the beta-lactamase-producing strain. The results suggest that resistance of beta-lactamase-containing strains of H. influenzae in vivo may be inoculum dependent, as demonstrated previously in vitro. The infant rat model appears suited for the quantitative delineation of the effect of beta-lactamase on the treatment of H. influenzae bacteremia and meningitis with beta-lactamase antibiotics.
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PMID:Beta-lactamase effect on ampicillin treatment of Haemophilus influenzae B bacteremia and meningitis in infant rats. 30 97

Hemophilus influenzae pneumonia was diagnosed in 41 adult patients based on cultures of blood, pleural fluid or transtracheal aspirate. Bacteremia occurred in all age groups, but was most frequent in patients over the age of 50 years with severe underlying pulmonary disease. Chest films usually demonstrated multisegmental or multilobar infiltrates without evidence of cavitation. Pleural involvement was evident in half of the patients, although empyema occurred infrequently. Mortality was almost always associated with serious underlying diseases and bacteremia. Encapsulated strains of H. influenzae (usually type B) were identified in 18 of 22 (82 per cent) patients. The use of transtracheal aspirations and the adoption of routine subculturing of blood cultures on chocolate agar appear to be important factors in our increased recognition of this disease.
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PMID:Hemophilus influenzae pneumonia in adults. 30 71

Fifty-three infants and children, aged three months to 15 years, were treated with an average daily dose of 100 mg of cefamandole/kg intravenously. Of these patients, 47 had soft tissue cellulitis and six had pneumonia. Primary pathogens, including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae, were isolated from 43 of the 53 patients. Bacteremia was documented in six of the 53 patients. A satisfactory clinical and bacteriologic response to cefamandole was achieved in all cases except on (98%). The only treatment failure occurred in an infant with both periorbital cellulitis and bacteremia due to H. influenzae who developed meningitis while receiving cefamandole; no extravasation of the drug across the blood-brain barrier could be detected in spite of inflamed meninges. In general, the only aberrant effects of cefamandole were the appearance of eosinophilia in 28% of patients and a positive indirect Cooms' test without hemolysis in one patient. Cefamandole showed excellent in vitro activity against 87 ampicillin-resistant strains of H. influenzae. Because it has greater activity than any of the other cephalosporins against this important pediatric pathogen, cefamandole may have particular pertinence in the treatment of infections in infants and young children.
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PMID:Clinical and laboratory evaluation of cefamandole in infants and children. 30 2


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