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)

The case of an HIV-seropositive man with gonorrhea, syphilis, genital warts, and chancroid is described. Multiple sexual partners, genital ulcer diseases, and lack of circumcision may have predisposed him to HIV infection. As indicated by his CD4/CD8 ratio of 0.5, his immunological status was not very compromised. Other factors were therefore probably behind these multiple sexually transmitted diseases (STD). This 30-year old man was inadequately treated for a long time for urethral discharge and genital ulcer disease, and ultimately collapsed on the job with a comprised central nervous system. Bacterial infection related to the multiple STDs could certainly have caused this collapse. The time demands of this man's work, the lack of medical facilities to diagnose and treat such conditions, his unprotected sexual behavior with multiple partners, and broader socioeconomic conditions which separate wage- earning males from their families in Africa conspire to produce multiply-afflicted cases such as these.
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PMID:Multiple sexually acquired diseases occurring concurrently in an HIV positive man: case report, diagnosis and management. 150 24

To better define the clinical and biological evolution of infants after vertical human immunodeficiency virus type 1 infection, we analyzed 94 consecutive infected patients followed up after their first clinical symptoms. The expression of clinical symptoms and biological abnormalities followed a bimodal distribution, some patients having an early and severe disease and the others having a slowly progressive one. One third of our patients suffered from early onset of opportunistic infection (OI). These patients had a significantly higher incidence of severe encephalopathy compared with patients without OI. The rate of survival at 3 years was 48% +/- 24%. In contrast, the patients without early OI or severe encephalopathy had a probability of survival at 3 years of 97% +/- 3%. This probability was not modified by the occurrence of bacterial infection or lymphoid interstitial pneumonitis. Lymphoid interstitial pneumonitis occurred at a mean age of 29 months, significantly later than OI or severe encephalopathy. Laboratory results at initial examination were correlated with clinical symptoms. Thus, when the number of CD4 lymphocytes was less than 500/mm3, children suffered more frequently from life-threatening symptoms (OI and severe encephalopathy): 15 of 22 vs 14 of 69. The same was true when the lymphocytes did not proliferate after antigenic stimulation, when anti-p18 and/or anti-p25 antibodies were absent in the serum, and when p24 antigen was detected in serum. Finally, severe encephalopathy was associated with low anti-human immunodeficiency virus cerebrospinal fluid antibody titer, whereas 88% of patients with moderate or no encephalopathy had signs of intrathecal anti-human immunodeficiency virus antibody synthesis. In conclusion, a subgroup of patients expressed very early signs of severe immunodeficiency and encephalopathy, whereas the majority of patients had a longer survival and less severe clinical symptoms during their first years of life than previously thought.
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PMID:Longitudinal study of 94 symptomatic infants with perinatally acquired human immunodeficiency virus infection. Evidence for a bimodal expression of clinical and biological symptoms. 166 56

Chaperonins are a major target of the immune response to bacteria. Infection, or immunization, with bacteria induces a strong antibody response to chaperonins, and the same proteins also provide a focus for activation of T lymphocyte subsets--including CD4, CD8 and gamma-delta T cells. The high degree of sequence conservation between prokaryotic and eukaryotic chaperonins makes them candidate antigens for models of autoimmunity based on molecular mimicry, and it is possible that the immune response to chaperonins has both protective and pathogenic potential. The interactions between chaperonins and the immune response are reviewed in this article, primarily from the perspective of intracellular bacterial infection.
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PMID:Chaperonins and the immune response. 198 68

Thirty patients who had hemophilia and were seropositive for the human immunodeficiency virus were evaluated. The preoperative CD4 lymphocyte count was decreased to an average of 336 x 10(9) per liter (range, 27 to 708 x 10(9) per liter). After twenty-six orthopaedic operations in patients who had no previous bacterial infection, a nosocomial infection (cellulitis in the forearm, at the site of an intravenous catheter) developed in only one patient, but five patients had an abnormal postoperative fever that was not accompanied by the expected increase in the white blood-cell count. The preoperative CD4 lymphocyte count was significantly reduced in the patients who had an abnormal elevation in body temperature (p less than 0.004). The functional result or outcome after operation was similar to that in hemophilic patients treated before 1982. Subsequent progression of infection with the human immunodeficiency virus, as determined by the CD4 lymphocyte count and the Walter Reed classification system, occurred in most patients. Acquired immunodeficiency syndrome was diagnosed in six patients. A more rapid progression to acquired immunodeficiency syndrome was seen in the patients who had a lower CD4 lymphocyte count preoperatively. Preoperative evaluation of the CD4 lymphocyte count and the response to intradermal skin-test antigens in patients who are at risk for infection postoperatively provides additional information concerning immunological competence. With these data, the possible risk of infection in patients who are seropositive for the human immunodeficiency virus can be estimated more accurately.
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PMID:Orthopaedic procedures and prognosis in hemophilic patients who are seropositive for human immunodeficiency virus. 229 69

Otherwise infrequent, infections by non-tuberculous or atypical mycobacteria are now rising in AIDS. Infection with the Mycobacterium avium complex (MAC) is now the most frequent opportunistic bacterial infection, because of better detection of HIV positive patients. The incidence, which is probably underestimated, is now 14-33% in France. The Mycobacterium avium complex is responsible for 96% of infections by atypical mycobacteria in AIDS patients. Diagnosis of infection by MAC is bacteriological. The clinical picture is non-specific and associates high fever, profuse sweating, weight loss and asthenia, all of which make a severe alteration to the general condition. This infection persists in AIDS patients to a late phase of evolution where Immunodeficiency is profound, that is when the level of CD4 lymphocytes is low. Because of this, it is an increasing and preoccupying problem in patients, since it involves the prognosis of life. This shows the importance of prophylactic treatment for this pathology.
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PMID:[A new prophylactic agent in AIDS: Ansatipine. Disseminated Mycobacterium avium complex infection is now the most frequent of the opportunistic bacterial infections in AIDS]. 803 59

Changes in the level of CD4-bearing T-lymphocytes in injection drug users infected with the human immunodeficiency virus were evaluated in a sample of 318 subjects enrolled from a methadone program in the Bronx, New York, from 1985 through 1989. Follow-up continued through 1990. The percentage of CD4+ T-lymphocytes (CD4%) was used to maximize the stability of measurements. The rate of decline of the CD4% was determined using a random-effects assumption, and predictors of rate of decline were evaluated using an autoregressive model. The rate of CD4% decline was approximately 1.2 CD4% lost per 6 months, with a higher rate in recent seroconverters (2.2 CD4% lost). The most important predictors of decline of the CD4% in autoregressive models were current pyogenic bacterial infection (CD4% reduced by 2.75, 95% confidence interval (CI) 0.42-5.08), current report of a second constitutional symptom (CD4% reduced by 2.16, 95% CI 0.03-4.29), and history of bacterial infection (CD4% reduced by 1.49, 95% CI 0.09-2.89; proportion of prior CD4% lost increased by 0.14, 95% CI 0.01-0.27). Oral thrush was not related to an accelerated rate of CD4% decline.
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PMID:Correlates of the rate of decline of CD4+ lymphocytes among injection drug users infected with the human immunodeficiency virus. 810 Mar 95

We have studied the ability of the lupus prone MRL lpr/lpr (MRL/lpr) and (NZBxNZW)F1 (NZB/W) female mice to raise granulocyte mediated inflammatory responses. These autoimmune strains, known to exhibit severe anergy as concerns T cell dependent immune function, are not well analysed with respect to neutrophil-mediated inflammatory responses. An in vivo model of granulocyte mediated inflammation has been developed in our laboratory. A single intradermal injection of olive oil into mouse footpad induces massive infiltration of polymorphonuclear cells (PMNC) within 24 h. This extravasation of PMNC gives rise to a localized footpad swelling, which can be easily and reproducibly measured and relates to severity of the inflammatory process. T cell independence of this inflammatory model was ascertained by in vivo T cell depletion using monoclonal antibodies to CD4 and CD8 molecules. Olive oil triggered inflammation was inducible in both young and aged lupus mice. The intensity of footpad swelling upon olive oil injection was similar in lupus mice and in healthy control strains. In contrast, aged MRL/lpr and NZB/W mice showed severely depressed T cell dependent inflammatory responses as assessed by delayed type hypersensitivity reaction to sheep red blood cells. We conclude that the PMNC mediated inflammatory potential is not affected in severely diseased lupus mice. The increased numbers of circulating PMNC together with intact PMNC function may explain why severely immune deficient lupus mice seldom show clinical signs of bacterial infection.
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PMID:Neutrophil mediated inflammatory response in murine lupus. 832 62

The most common pathogens involved in disseminated bacterial infection in people with acquired immunodeficiency syndrome (AIDS) are organisms of the Mycobacterium avium-intracellulare complex (MAC). Azithromycin and clarithromycin, a new azalide and macrolide, respectively, are among the most potent monotherapies for MAC bacteraemia, Although many bloodstream isolates demonstrate increased minimum inhibitory concentrations after 4 months of treatment. Current recommended prophylaxis, based on the results of two randomized, double-blind, prospective studies, is rifabutin 300 mg daily for people with AIDS with < 100 CD4 lymphocytes/mm3. In the beige mouse model, we have shown that both azithromycin and clarithromycin prevent MAC bacteraemia following repetitive oral challenge. Clinical trails are now underway to confirm these effects in man; comparative treatments include placebo, rifabutin and an azalide/macrolide plus rifabutin. While combinations might be more effective and reduce the emergence of resistance, the spectre of cytochrome P-450 drug interactions necessitates careful study before combination prophylactic approaches are accepted. Such interactions are associated with rifabutin and some macrolides, although azithromycin may be less problematic in this respect as it appears to have little potential to interact with other antimicrobial agents.
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PMID:Treatment and prophylaxis of Mycobacterium avium complex. 865 24

Microbial heat shock proteins (HSP) are dominant antigens for the host immune response. Because of the high sequence homology between mammalian and microbial HSP, their value as component of a subunit vaccine has been the subject of controversy. Previous work from this laboratory, however, demonstrated for the first time that the adoptive transfer of HSP60-reactive CD4+ alphabeta T-cell clones confers protection against bacterial infection in mice but does not induce autoimmunity. In the present study, we have therefore evaluated the potential role of Yersinia HSP60 (Y-HSP60) as a vaccine in the Yersinia enterocolitica mouse infection model. For this purpose, immunostimulating complexes (ISCOM) which included Y-HSP60 were constructed. Parenteral administration of this vaccine induced high Y-HSP60-specific serum antibody responses as well as T-cell responses. This reaction was parallelled by immunity against a lethal challenge with Y. enterocolitica. In contrast, mucosal application of Y-HSP60-ISCOM failed to induce systemic Y-HSP60-specific T-cell responses and thus failed to induce immunity against yersiniae. Likewise, vaccination with purified recombinant Y-HSP60 induced antibody responses but only weak T-cell responses. Therefore, this vaccination protocol was not protective. However, when interleukin-12 was used as an adjuvant, purified Y-HSP60 induced significant Y-HSP60-specific T-cell responses and thus induced protection against subsequent challenge with yersiniae. These studies suggest that (i) microbial HSP might be promising candidates for the design of subunit vaccines and (ii) interleukin-12 is an efficient alternative adjuvant to ISCOM particles for induction of protective CD4 Th1-cell-dependent immune responses against bacterial pathogens.
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PMID:Immunity against Yersinia enterocolitica by vaccination with Yersinia HSP60 immunostimulating complexes or Yersinia HSP60 plus interleukin-12. 875 20

Cytomegalovirus (CMV) is one of the most frequent opportunistic agents that affects HIV positive subjects. The prophylaxis and treatment of cytomegalovirus infection in HIV positive subjects represent difficult and controversial problems. In this study we evaluated efficacy of anti-CMV immunoglobulins (derived from plasma with a high titer of CMV anti-bodies) in primary and in secondary prophylaxis for CMV disease in adults with severe immunodeficiency caused by HIV infection. For primary prophylaxis, in 22 patients with CD4 < 200/mmc enrolled to receive a monthly infusion of intravenous immunoglobulins (IVIG) at 200 mg/kg we observed prophylactic effect for the prevention of CMV and bacterial infections. Concerning secondary prophylaxis, 7 patients with CMV manifestation treated after remission with anti-CMV IVIG at 200 mg/kg every two weeks, had a low frequency of relapse and a good clinical outcome. Because their tolerability, anti-CMV immunoglobulins are an interesting option particularly for the prevention of CMV and bacterial infection in HIV-positive adults in advanced stages of disease.
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PMID:[The use of hyperimmune anti-cytomegalovirus immunoglobulins in HIV infection]. 876 51


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