Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004623 (bacterial infection)
 15,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We prospectively studied causes of fever in patients with human immunodeficiency virus (HIV) infection that required admission to a municipal hospital. A total of 168 HIV-infected persons were admitted for 220 episodes of fever: 72% were male, 80% were nonwhite, 65% reported prior injection drug use, and 74% had a baseline CD4 lymphocyte count of < 200/mm3. Bacterial infections, principally pneumonia, accounted for > 60% of the episodes; Streptococcus pneumoniae and Staphylococcus aureus were most commonly isolated. Pneumocystis carinii pneumonia (PCP) and disseminated infection with Mycobacterium avium complex (MAC) comprised 53% of the remaining sources of fever. In comparison with episodes of fever due to nonbacterial causes, those associated with common bacterial infections were significantly more likely to involve patients with a history of injection drug use (P = .02), higher admission leukocyte count (P < .004), shorter duration of fever (P = .003), shorter hospital stays (P = .0001), and a CD4 count of > 100/mm3 (P = .002). We conclude that bacterial infection, especially pneumonia, is a common cause of fever in HIV-infected patients admitted to our hospital. Patients with bacterial infections are more likely to report a history of injection drug use and have CD4 counts of > 100/mm3, shorter duration of fever, decreased length of hospitalization, and lower mortality than patients with fever due to PCP, disseminated MAC infection, or other causes.
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PMID:Causes of fever in patients infected with human immunodeficiency virus who were admitted to Boston City Hospital. 884 71

Drosophila immunity and embryogenesis appear to be linked by an evolutionarily ancient signalling pathway, which includes the Rel-domain transcription factors Dif and dorsal, respectively, as well as a common inhibitor, cactus. Previous genetic screens have centered on maternal mutants that disrupt the dorsal pathway. In an effort to identify additional components that influence Rel-domain gene function we have conducted a search for immunodeficiency mutants in Drosophila. One such mutant, which maps near the Black cells (Bc) gene, causes a severe impairment of the normal immune response, including attenuated induction of several immunity genes. Survival assays indicate a positive correlation between the induction of these genes, particularly diptericin, and resistance to bacterial infection. These studies are consistent with the notion that insect anti-microbial peptides work synergistically by binding distinct targets within infecting pathogens. Evidence is also presented that non-specific acquired immunity results from the persistence of bacterial metabolites long after primary infection. We discuss the potential usefulness of this study with regard to the identification of conserved components of Rel signalling pathways.
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PMID:Characterization of an immunodeficiency mutant in Drosophila. 886 Nov

Recent advances in the drug therapy of localized and disseminated infection with Mycobacterium avium complex (MAC) are reviewed. MAC infection is the most commonly reported bacterial infection in patients with AIDS, and the frequency of this infection in patients negative for the human immunodeficiency virus (HIV) is increasing. The main portals of entry for MAC are the gastrointestinal and respiratory tracts. Localized MAC infection is more common in HIV-negative than HIV-infected patients. The symptoms of disseminated MAC disease are those typical of advanced HIV disease. The most reliable diagnosis is provided by blood cultures; radiometric culturing techniques are favored. The overall treatment of MAC infection has improved greatly with the introduction of new agents during the past 15 years; survival time has been extended. Clarithromycin and azithromycin have proven effective against both localized and disseminated MAC infection. Clarithromycin is the cornerstone of therapy for disseminated infection. Ciprofloxacin has been successfully used to treat disseminated infection as part of a four-drug regimen including rifampin, ethambutol, and clofazimine. Rifabutin has substantial efficacy when combined with other agents. Liposomal aminoglycosides, such as amikacin, and interferon gamma have shown some initial promise. Rifabutin is currently recommended for the prevention of MAC disease in HIV-infected patients. Clarithromycin and azithromycin have also shown efficacy for prophylaxis, and fluoroquinolones may play a preventive role as well. New drug therapies are improving the outlook for persons infected with MAC.
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PMID:New trends in the drug therapy of localized and disseminated Mycobacterium avium complex infection. 916 32

During the terminal stages of AIDS, Mycobacterium avium complex (MAC) infection is the most common disseminated bacterial infection in rhesus macaques (Macaca mulatta) experimentally inoculated with the simian immunodeficiency virus (SIV). The source of mycobacterial infection in 15 SIV-inoculated rhesus macaques housed in a biolevel 3 containment facility was investigated using a sensitive polymerase chain reaction typing technique. Six animal isolates had banding profiles identical to that of 1 environmental isolate obtained from the facility's water distribution system. An additional 6 isolates had banding profiles differing by the addition or loss of one or two bands from this and 1 other water isolate. These findings indicate that potable water may serve as a significant source of mycobacterial infection in SIV-inoculated macaques and suggest that strategies to prevent exposure to mycobacteria within potable water should be investigated as a method to prevent mycobacteriosis in human immunodeficiency virus-infected persons.
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PMID:Simian immunodeficiency virus-inoculated macaques acquire Mycobacterium avium from potable water during AIDS. 898 17

One hundred thirty-five children born to human immunodeficiency virus (HIV)-infected mothers were selected randomly to receive immunoglobulin (Gamimune-N, Miles Pharmaceutical Co) 200 mg/kg monthly for 1 year. All patients were seropositive by ELISA and Western blot at birth. At the time of the study, 15 symptomatic (P2) and 57 asymptomatic (P1) patients with evidence of viral infection (positive HIV culture or P24 antigen) received the immunoglobulin. Sixty-three indeterminate (PO) patients with no evidence of infection served as the control. Mean age for infants in group P2 was 32 months, 26 months for group P1, and 11 months for group PO. Significant reduction in the frequency of bacterial infections (ie, otitis media, upper respiratory tract infections, urinary tract infections, and acute gastroenteritis) was seen in the symptomatic group compared with both the asymptomatic and the control groups. Growth as measured by weight and height > 50th percentile was also markedly better in the symptomatic group than either asymptomatic or control patients. There was no significant difference in head circumference in all three groups. These results indicate that monthly intravenous immunoglobulin infusion (IVIG) appears to be beneficial to both symptomatic and asymptomatic HIV patients in reducing the frequency of bacterial infection and also enhancement of the immune response. However, symptomatic patients responded much better than the asymptomatic patients.
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PMID:Intravenous immunoglobulin in symptomatic and asymptomatic children with perinatal HIV infection. 926 22

Attenuated bacteria expressing foreign antigens stimulate both systemic and mucosal immune responses to the recombinant protein. We studied the infection of rhesus macaques with an attenuated Salmonella typhimurium expressing the simian immunodeficiency virus p27 capsid protein. Juvenile rhesus macaques were inoculated by intragastric intubation with doses ranging from 3 to 9 x 10(9) viable aroA attenuated S. typhimurium. The bacterial infection was self-limiting with no overt clinical signs. Salmonella were shed in the feces of macaques for approximately five days. Salmonella were isolated from fecal material to examine the in vivo stability of both the attenuating mutation and the integrated SIVp27 expression cassette. All Salmonella isolates retained both the attenuating mutation and the recombinant expression construct. In vitro analysis showed that a minimum of 7.2 microg of p27 was delivered by a single oral dose with attenuated, recombinant S. typhimurium.
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PMID:Immunization of Macaca mulatta with aroA attenuated Salmonella typhimurium expressing the SIVp27 antigen. 927 Nov 88

It is well recognised that although nutritionally breast milk is the optimal food for babies, there are a number of caveats to this, based on the consequences of the modern lifestyle. Here we have considered ways in which the young breast fed child may be exposed to various environmental and medical contaminants which might cause adverse reactions and to which he/she may not otherwise be exposed. These substances are divided into four different areas: (i) medication taken by the mother; (ii) exposure to possibly addictive drugs taken by the mother; (iii) exposure to pollutants mainly from the maternal diet or as the result of her occupation; (iv) viruses. The infant who consumes breast milk may be exposed to a variety of chemicals which may have untoward effects on his/her immediate health and temperament and future development. Potentially hazardous substances ingested by the breast fed infant include medicaments (or their metabolites) that may have been ingested by the mother, potentially addictive common neurotoxicants such as nicotine, caffeine and alcohol, illicit drugs such as heroin and cocaine, and pollutants such as polychlorinated biphenyls and dichlorodiphenyltrichloroethane (DDT). There is a paucity of good information on which to base reliable estimates of the harm that this may cause the child. Although breast feeding is known to protect against bacterial infection, a number of viruses are excreted in the breast milk which may infect the child asymptomatically (e.g. cytomegalovirus, Epstein-Barr virus) and which are not known to be harmful, as well as human immunodeficiency virus (HIV) excretion which, in contrast, does appear to increase the risk of the child becoming infected. Balancing the risk of infection to the child born to an HIV infected mother, results in the proposition that known HIV positive women in developing countries (where the risk of gastrointestinal infection is high) should continue to breast feed but those in the developed world (where the risk of gastrointestinal infection is lower) are better advised to bottle feed.
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PMID:Unnatural constituents of breast milk--medication, lifestyle, pollutants, viruses. 936 16

Neonatal sepsis is a major cause of morbidity and mortality in newborn infants. Hematopoiesis and host defense in the neonate is developmentally immature compared with the adult. Defects in both the quantitative and qualitative aspects of the phagocytic system contribute significantly to a relative state of immunodeficiency in the neonate. Dysregulation of neonatal hematopoiesis and the immune response is a significant contributing factor to the increased susceptibility of the neonate to infection. A relatively small set of pluripotent stem cells gives rise to large numbers of functionally diverse mature effector cells. Cell proliferation and differentiation are regulated and controlled by highly specific protein factors, affecting single and multiple lineage hematopoiesis. Reduced neonatal rat myeloid progenitor pools, accelerated myeloid progenitor proliferative rates and decreased total body neutrophil storage pools predispose the newborn rat to depletion of mature effector neutrophils and a tendency to develop neutropenia during states of increased demand such as overwhelming bacterial infection. We review here the multifactorial complex biological process involved in the regulation of hematopoietic growth factors. We also review the biological effects of various non-lineage-committed and lineage-committed growth factors as reported in in vitro investigations and in vivo neonatal animal experiments. We also review our results of phase I/II clinical studies utilizing rhuG-CSF in neonates with presumed sepsis, and of rhuGM-CSF in very low birth weight neonates.
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PMID:The role of cytokines in modulating neonatal myelopoiesis and host defense. 938 73

Patients with severe form of common variable immunodeficiency require chronic immunoglobulin substitution. However, intravenous Ig administration may not be possible in some of them because of serious anaphylactoid reactions. It has been suggested that such patients may tolerate well Ig administration by subcutaneous infusion. A case is described (originally with IgG level of 53 mg/dl) who reacted with anaphylactic shock to intravenous immunoglobulin and now for more than 7 months at 1-2 week intervals receives immunoglobulin by subcutaneous infusion without any adverse reactions and maintaining IgG level above 400 mg/dl. In contrast to the period proceeding immunoglobulin substitution, the patient remains free of bacterial infection during last 7 months.
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PMID:[Subcutaneous immunoglobulin infusion in antibody deficiency substitution of a patient sensitized to intravenous immunoglobulins. Case report]. 941 13

The fluoroquinolones have secured an important place in the management of bacterial infection, they are well absorbed orally, are found in respiratory secretions in higher concentrations than in serum and are concentrated inside macrophages. The agents are well tolerated and have an excellent safety record in long-term therapy. No new antituberculosis agents have been developed since the introduction of rifampicin into clinical use, so fluoroquinolones have been investigated for potential efficacy in tuberculosis. In vitro studies have shown that they are active against Mycobacterium tuberculosis at achievable concentrations. Treatment studies in mice have demonstrated efficacy. Few clinical studies have been performed in humans, but ciprofloxacin has demonstrated significant early bactericidal activity. Regimens including a fluoroquinolone have been comparable to other standard regimens, although the outcome in human immunodeficiency virus (HIV) seropositive patients was significantly poorer. There is still insufficient clinical data to use fluoroquinolones in first-line treatment of tuberculosis, but they may find a role in the management of multidrug-resistant infections or in patients with adverse reactions to other agents.
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PMID:Fluoroquinolones: a new treatment for tuberculosis? 1109 27


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