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)

In patients with Influenza, the risk of death from pneumonia is closely associated with age and chronic conditions. Mortality from influenza and pneumonia in Americans age > or = 65 has been increasing since 1980. Pneumonia following influenza is usually caused by a secondary bacterial infection. Pathogens most commonly implicated are Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae. Prompt empiric therapy effective against the suspected pathogen is indicated, whether the patient is being treated as an outpatient or requires inpatient observation or hospitalization for i.v. administration. Influenza vaccination of older patients living in the community has been shown to decrease hospitalizations for influenza and pneumonia by 52% and mortality by 70% in those with chronic lung disease. Protective rates are similar for residents of long-term care facilities.
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PMID:Bacterial pneumonia. Managing a deadly complication of influenza in older adults with comorbid disease. 1189 49

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

We examined the risk factors for bacterial exacerbation, defined as the presence of pathogenic bacteria in sputum, in 90 chronic obstructive pulmonary disease (COPD) patients with an exacerbation and changes in sputum characteristics. Smoking, alcohol, lung function, body mass index, medical visits and treatments were the independent variables assessed using multivariable logistic regression modelling (OR, 95% CI). A bacterial exacerbation was diagnosed in 39 (43.3%) of 90 patients. Bacterial exacerbations were more prevalent among current smokers (OR 3.77, 95% CI 1.17-12.12), in patients with poor compliance with inhalation therapy (OR 3.25, 95% CI 1.18-8.93) and with severe lung function impairment (FEV1 OR 0.96, 95% CI 0.93-1.00). Prior use of antibiotics was a risk factor for Pseudomonas aeruginosa infection (OR 6.06, 95% CI 1.29-28.44) and influenza vaccination appeared to have a protective effect against this infection (OR 0.15, 95% CI 0.03-0.67). We conclude that severe impairment of lung function, smoking and poor compliance with therapy are risk factors for bacterial infection in COPD, and P. aeruginosa should be suspected in patients who have been treated with antibiotics and in those not vaccinated against influenza.
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PMID:Bacterial infection in exacerbated COPD with changes in sputum characteristics. 1294 81

Influenza C virus, J.J. strain, is readily propagated following intra-amniotic inoculation of embryonated eggs on the 14th day of incubation. The resulting infection is inapparent in that there is no obvious interference with normal embryonic development and no evidences of injury can be detected by the light microscope. Hemophilus influenzae, type b thrives luxuriantly in the amniotic fluid of embryonated eggs inoculated by the intra-amniotic route on the 15th day of incubation. The effects of the establishment of the bacterial infection in the embryo are noted by the occurrence of death, bacteriemia or characteristic inflammatory lesions in the form of purulent sinusitis, pharyngitis, tracheo-bronchitis and meningo-encephalitis. These lesions may occur singly or in various combinations. The incidence and severity of disease manifestations in infected embryos depends on the proportion of encapsulated and virulent bacilli in the inoculum, the number of infectious doses and the growth rate of the bacteria in the surrounding amniotic fluid. Combined viral and bacterial infection established by intra-amniotic inoculation with influenza C virus on the 14th followed by Hemophilus influenzae, type b on the 15th incubation day brings about a significant increase in the incidence and severity of disease manifestations in the embryos. Selective survival and marked acceleration of the growth rate of encapsulated and virulent elements of the bacterial population is promoted in the virus-infected embryos. The disease process appears to be entirely attributable to the bacterial component. There seems to be relatively little or no effect on influenza C virus by the accompanying proliferation of Hemophilus. The exact nature of the virus-induced influences which enhance the pathogenicity of the bacteria and favor the establishment of the infectious process under these circumstances remains to be determined.
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PMID:Experimental combined viral and bacterial infection (influenza C and hemophilus influenzae, type B) in embryonated eggs. 1337 14

Two types of pneumonia are well recognized during influenza: primary viral pneumonia and secondary bacterial pneumonia. Primary viral pneumonia occurs after a typical onset of influenza with rapid progression of dyspnea and cough leading to acute respiratory distress syndrome. Treatment consists of respiratory assistance, but mortality is high. Secondary bacterial pneumonia occurs more frequently in the elderly and in patients with chronic pulmonary diseases. Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae are the most frequently isolated bacteria. After an initial phase of clinical improvement, manifestations of bacterial infection with pulmonary consolidation occur. The outcome is favorable with antibiotics but depends on the patient's underlying conditions.
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PMID:[Influenza pneumonia]. 1455 65

The appropriate administration method of levofloxacin in relation to symptoms was investigated by following up 2,353 patients prescribed either levofloxacin (300 mg divided into 3 doses) or 400 mg (divided into 2 doses) for the treatment of acute upper respiratory tract infection accompanied by fever (temperature (> or = 38 degrees C) of suspected bacterial infection. 1) The cure rate based on body temperature as an index was significantly higher in the group administered 400 mg/day compared with the group administered 300 mg/day. No significant difference between the two regimens was observed in patients with a temperature < or = 38.5 degrees C at the start of administration, but patients with a temperature > or = 38.6 degrees C showed a significantly higher cure rate when administered 400 mg/day compared with 300 mg/day. 2) No significant difference between the groups was observed with respect to the improvement of quality of life (QOL), assessed using a VAS. In patients with a temperature > or = 38.6 degrees C, however, significantly higher improvement rates were demonstrated on days 3, 5 and 6 of treatment at 400 mg/day compared with 300 mg/day. 3) The reconsultation rate was significantly lower in the group administered 400 mg/day compared with the group administered 300 mg/day. No significant difference between the groups was observed in patients with a temperature < or = 38.5 degrees C. However, in the patients with a temperature > or = 38.6 degrees C, treatment at 400 mg/day achieved a significantly lower reconsultation rate compared with 300 mg/day. 4) Nonsteroidal anti-inflammatory drugs (NSAIDs) were concomitantly administered to 64.3% of the patients, but no significant difference in the cure rate was observed between patients with or without concomitant use of NSAIDs. 5) Among all of the patients, 12.7% were positive for the influenza virus, and anti-influenza drugs were concomitantly administered to 41.3% of them. However, no significant difference in the cure rate was observed between the group administered levofloxacin alone and the group concomitantly administered anti-influenza drugs. 6) The incidence of adverse drug reactions was 0.84% in the group administered 400 mg/day and 0.50% in the group administered 300 mg/day. No significant difference was observed between these groups and no serious adverse drug reactions occurred. In conclusion, for treating patients with acute upper respiratory tract infection accompanied by fever (> or = 38.6 degrees C) and suspected bacterial infection, levofloxacin dosage of 400 mg/day (divided into 2 doses) was superior to 300 mg/day (divided into 3 doses) in terms of therapeutic effect, QOL, and the reconsultation rate. This was considered to be an administration method worth recommending, including its safety. In patients with a temperature of 38.0 degrees C to 38.5 degrees C, administration of levofloxacin at 300 mg/day was confirmed to demonstrate a sufficient therapeutic effect.
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PMID:[Use of the antibacterial agent levofloxacin for acute upper respiratory tract infection accompanied by fever (> or = 38 degrees C)]. 1500 81

Secondary pneumococcal pneumonia is a serious complication during and shortly after influenza infection. We established a mouse model to study postinfluenza pneumococcal pneumonia and evaluated the role of IL-10 in host defense against Streptococcus pneumoniae after recovery from influenza infection. C57BL/6 mice were intranasally inoculated with 10 median tissue culture infective doses of influenza A (A/PR/8/34) or PBS (control) on day 0. By day 14 mice had regained their normal body weight and had cleared influenza virus from the lungs, as determined by real-time quantitative PCR. On day 14 after viral infection, mice received 10(4) CFU of S. pneumoniae (serotype 3) intranasally. Mice recovered from influenza infection were highly susceptible to subsequent pneumococcal pneumonia, as reflected by a 100% lethality on day 3 after bacterial infection, whereas control mice showed 17% lethality on day 3 and 83% lethality on day 6 after pneumococcal infection. Furthermore, 1000-fold higher bacterial counts at 48 h after infection with S. pneumoniae and, particularly, 50-fold higher pulmonary levels of IL-10 were observed in influenza-recovered mice than in control mice. Treatment with an anti-IL-10 mAb 1 h before bacterial inoculation resulted in reduced bacterial outgrowth and markedly reduced lethality during secondary bacterial pneumonia compared with those in IgG1 control mice. In conclusion, mild self-limiting influenza A infection renders normal immunocompetent mice highly susceptible to pneumococcal pneumonia. This increased susceptibility to secondary bacterial pneumonia is at least in part caused by excessive IL-10 production and reduced neutrophil function in the lungs.
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PMID:IL-10 is an important mediator of the enhanced susceptibility to pneumococcal pneumonia after influenza infection. 1518 40

A simple generic peptide-based vaccine structure that targets Toll-like receptor 2-expressing dendritic cells and causes their activation is described. The vaccines are totally synthetic, serve as their own adjuvant, and are composed of (i) a single helper T cell epitope, (ii) a target epitope that is either recognized by CD8+ T cells or B cells, and (iii) a Toll-like receptor 2-targeting lipid moiety, S-[2,3-bis(palmitoyloxy)propyl]cysteine, that is situated between the peptide epitopes to form a branched configuration. The different CD8+ T cell epitopes examined were from (i) influenza virus, (ii) the intracellular bacterium Listeria monocytogenes, and (iii) ovalbumin as a model tumor antigen. Vaccines containing a B cell epitope from gastrin or luteinizing hormone-releasing hormone as a B cell epitope were also examined for their ability to elicit antibody against the parent hormones. Each of the vaccines was capable of inducing either CD8+ T cell or antibody-mediated immune responses. The lipidated vaccines, but not the nonlipidated vaccines, were able to mediate protection against viral or bacterial infection and mediate prophylactic and therapeutic anticancer activity. The two hormone-based vaccines induced high antibody titers, which in the case of luteinizing hormone-releasing hormone resulted in abrogation of reproductive function. These results highlight the utility of simple, totally synthetic, epitope-based vaccines.
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PMID:A totally synthetic vaccine of generic structure that targets Toll-like receptor 2 on dendritic cells and promotes antibody or cytotoxic T cell responses. 1548 66

The strategy of immunizing a population at risk of infectious disease has been enormously successful medically and has also proven to be cost effective. Development of effective immunogens, that induce active immunization, is a long process that requires careful monitoring and assurance of short and long term safety, induction of protective immunity and proven efficacy in preventing the disease. A successful immunization program is also dependent on delivery of the vaccine to as many susceptible individuals as possible, so as to attain herd immunity. Passive immunization with antibodies, usually used prior to the development of active vaccines has also been remarkably effective. The special circumstances of the field and crowded conditions have demanded that the Medical Corps of the Israeli army cater for the needs of our soldiers. In this issue, the past achievements and current immunization policy are outlined for the first time. Their contribution to the health of our soldiers is commendable. Close monitoring of the epidemiology of infectious disease in the special circumstances of field conditions has prompted successful programs to markedly reduce infectious hepatitis A by passive immunization with gamma globulin in the past and, nowadays, with the killed active viral vaccine. In addition, prevention of influenza by killed viral vaccine and invasive bacterial disease by Neisseria meningitidis with multivalent polysaccharide vaccines are being used. This group has also improved hygienic conditions in the field to cope with shigellosis and salmonella infections. Research in the development of effective vaccines for protection of shigellosis has also been addressed by this group. New challenges posed by the emerging infectious diseases and the possible effects of bioterrorism are certain to keep this group on their toes.
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PMID:[Vaccines for all occasions]. 1552 9

Unlike their role in bacterial infection, less is known about the role of neutrophils during pulmonary viral infection. Exposure to pollutant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, dioxin) results in excess neutrophils in the lungs of mice infected with influenza A virus. TCDD is the most potent agonist for the aryl hydrocarbon receptor (AhR), and exposure to AhR ligands has been correlated with exacerbated inflammatory lung diseases. However, knowledge of the effects of AhR agonists on neutrophils is limited. Likewise, the factors regulating neutrophil responses during respiratory viral infections are not well characterized. To address these knowledge gaps, we determined the in vivo levels of KC, MIP-1alpha, MIP-2, LIX, IL-6, and C5a in infected mouse lungs. Our data show that these neutrophil chemoattractants are generally produced transiently in the lung within 12-24 h of infection. We also report that expression of CD11a, CD11b, CD49d, CD31, and CD38 is increased on pulmonary neutrophils in response to influenza virus. Using AhR-deficient mice, we demonstrate that excess neutrophilia in the lung is mediated by activation of the AhR and that this enhanced neutrophilia correlates directly with decreased survival in TCDD-exposed mice. Although AhR activation results in more neutrophils in the lungs, we show that this is not mediated by deregulation in levels of common neutrophil chemoattractants, expression of adhesion molecules on pulmonary neutrophils, or delayed death of neutrophils. Likewise, exposure to TCDD did not enhance pulmonary neutrophil function. This study provides an important first step in elucidating the mechanisms by which AhR agonists exacerbate pulmonary inflammatory responses.
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PMID:Activation of the aryl hydrocarbon receptor increases pulmonary neutrophilia and diminishes host resistance to influenza A virus. 1579 65


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