Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of sulbactam/ampicillin in the treatment of mice with fatal systemic infections produced by ampicillin-resistant Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae, or Proteus vulgaris strains is well established. In this paper the demonstrations of efficacy for sulbactam/ampicillin have been extended to a number of clinically relevant models, including bacteremia and meningitis produced by H. influenzae in infant rats, experimental staphylococcal endocarditis in rabbits, localized lesions in mice, urinary tract infections in rats, and prophylaxis in a surgical wound model in mice. In these models, in which ampicillin-resistant organisms were used, sulbactam/ampicillin was either more effective than or as effective as appropriate control agents. Neither sulbactam nor ampicillin used separately displayed significant activity. The results of supportive pharmacokinetic studies, in which differential bioassays were used, demonstrated that sulbactam and ampicillin generally were delivered with equal efficiency to plasma and to extravascular fluids obtained by sampling the contents of implanted cylinders.
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PMID:Activity of sulbactam/ampicillin in screening and discriminative animal models of infection. 302 2

We studied the clinical significance of S. milleri isolated in our hospital in 68 patients during a 18-month period. In 51 patients (median age: 43 years, no underlying diseases in 29 patients), the isolates were associated with significant infections. They were beta-hemolytic in 32 cases and non-hemolytic in 19. The primary infection sites were the head and neck area (21 cases), the lungs (5 cases of pneumonia), the gastrointestinal tract (12 cases), the urogenital tract (3 cases), the soft tissues (6 cases), and the heart (2 endocarditis). Two septicemias were of unknown origin. Head and neck infections and pneumonia were most often associated with beta-hemolytic strains, and bacteremia, gastrointestinal and urogenital tract infections with alpha-hemolytic strains. S. milleri was found in pure culture in 24 cases. Polymicrobial associated flora (27 cases) was more frequent in the abdominal infections (87%) than in supra-diaphragmatic infections (42%). Severe complications were observed in 12 head and neck infections (57%) (cerebral abscesses 3, lethal mediastinitis 2, osteitis 1, meningitis 1, other suppurative lesions 5). When abscesses were present (27 cases), surgery was required in all cases. Despite the high frequency and severity of local complications, the clinical outcome was usually favorable. However, deaths directly related to S. milleri infections occurred in 2 cases of mediastinitis complicating the course of apparently harmless primary infections. Owing to the possible occurrence of life-threatening complications, S. milleri infections require early identification, treatment and surgery when indicated.
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PMID:[Clinical spectrum of a common and insidious pathogen: Streptococcus milleri]. 305 41

Most institutions are experiencing increased numbers of methicillin-resistant S. epidermidis infections. Currently, vancomycin is the only antibiotic that provides reliable bactericidal activity against this microorganism, including methicillin-resistant strains. Vancomycin is the treatment of choice for infections caused by methicillin-resistant staphylococci and for serious gram-positive infections in penicillin-allergic patients. With the emergence of more numerous and more serious gram-positive infections, this agent either alone or in combination with other antibiotics will clearly assume greater importance in the management of gram-positive infections, independent of host allergy or bacterial resistance. It is assuming a pivotal role in the treatment of gram-positive infections of central nervous system or dialysis shunts, endocarditis, meningitis, and septicemia. Except in patients with confirmed allergy to a beta-lactam antibiotic, vancomycin is not indicated for routine surgical prophylaxis. The current upsurge in methicillin-resistant staphylococcal infections as a complication of implant surgery may necessitate its use as a prophylactic agent, however.
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PMID:Therapeutic considerations for infections caused by Staphylococcus epidermidis. 307 43

Antibodies against the adherence protein of Mycoplasma pneumoniae are regularly found in patients with M. pneumoniae infection. Therefore, this 168-kilodalton (kDa) protein was used as an antigen in a dot-ELISA for serological diagnosis of M. pneumoniae disease. M. pneumoniae proteins were separated by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), gels were stained with Coomassie Blue, and the 168-kDa protein band was cut out and eluted using a special electroelution device. Isolated proteins or sonicated whole-cell antigens, respectively, were immobilized on a 96-well filtration plate with a nitrocellulose bottom (dot-ELISA). The test procedure was performed as in conventional ELISA tests, using alkaline phosphatase-labeled antihuman IgM or IgG antibodies, respectively, to detect antigen-antibody complexes. All results were confirmed by immunoblotting. The dot-ELISA using the 168-kDa antigen proved to be sensitive and specific. The specificity was tested on 53 sera of M. pneumoniae infections and on 490 serum specimens of patients with other respiratory diseases due to other pathogens, or with clinical conditions such as pancreatitis, meningitis or endocarditis. With regard to IgM antibodies, no false-positive reactions were found in non-M. pneumoniae diseases against the 168-kDa antigen, but there were such reactions against other M. pneumoniae proteins in immunoblots.
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PMID:Use of adherence protein of Mycoplasma pneumoniae as antigen for enzyme-linked immunosorbent assay (ELISA). 311 34

Enterococci isolated from different body sites were tested for high-level gentamicin resistance. A total of 259 enterococcal isolates were screened for resistance (MIC, greater than 2,000 micrograms/ml) by a broth-tube method. Thirty-nine (15.1%) were found to exhibit resistance and were confirmed by agar screening (1,000 micrograms/ml) and agar dilution MIC determinations. The majority of isolates also showed high-level resistance to kanamycin and streptomycin. The remaining isolates showed high-level resistance to gentamicin and kanamycin but not streptomycin. Synergy testing of several isolates confirmed the correlation between lack of synergy and high-level resistance. A retrospective clinical review was performed. Most patients had a source of definite or likely infection (79%). Serious infections such as endocarditis or meningitis were not observed during the course of this study. Retrospective clinical data suggest that in cases not involving endocarditis or meningitis, neither infection refractory to therapy nor relapse of infection is a common sequela of infection with gentamicin-resistant enterococci in hospitalized patients.
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PMID:Multiply high-level-aminoglycoside-resistant enterococci isolated from patients in a university hospital. 313 46

This is a case of bacterial endocarditis and dissecting aneurysm of the ascending aorta secondary to group B streptococcal (GBS) septicemia in a one-mouth-old infant girl who presented with meningitis. A large aortic vegetation and a large dissecting aneurysm of the root of the aorta were detected by two-dimensional (2D) echocardiography. Apparently the infant did not have any preexisting cardiac anomaly. She received intravenous ampicillin for six weeks. She also underwent successful surgery for the replacement of the ascending aorta with an aortic homograft. This occurrence reemphasizes the value of 2D echocardiography in detecting vegetations for endocarditis.
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PMID:Group B streptococcal endocarditis in a neonate. 327 8

Discriminative animal models of infection are important in helping to define the role of new antibacterial drugs in the treatment of human diseases. Several animal models have been used to compare the efficacies of quinolones with those of standard therapies against selected bacterial pathogens. In animal models of endocarditis, pefloxacin, enoxacin, and ciprofloxacin have been shown to be equivalent to standard therapies against methicillin-sensitive Staphylococcus aureus and as effective as vancomycin against methicillin-resistant strains. Difloxacillin has been shown to be equivalent to vancomycin in a model of osteomyelitis due to S. aureus. Ciprofloxacin is as effective as the combination of ceftazidime and tobramycin in a model of pseudomonal meningitis, although the levels of ciprofloxacin (6 mg/L) in serum required to produce a bactericidal effect in the cerebrospinal fluid are higher than those usually obtained in humans. Ciprofloxacin and other quinolones are also effective therapy for pseudomonal infections in neutropenic animals with pneumonia, peritonitis, osteomyelitis, and endocarditis. Data obtained from these animal studies suggest that the quinolones may have an important role in the treatment of endocarditis, meningitis, osteomyelitis, and other serious infections in humans caused by S. aureus and Pseudomonas aeruginosa.
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PMID:Use of animal models in evaluation of the quinolones. 327 87

After a pathogen has been identified and the antibiotic susceptibility determined, parenteral antibiotic administration can be replaced by the oral route for certain patients with meningitis, brain abscess, endocarditis, and skeletal infections. Antibiotics should be administered with the stomach empty and accompanied by 3 ml/kg of water. Direct instillation into the lumen of the small intestine may be advantageous with selected patients. Documenting adequate antibiotic absorption and ensuring compliance are essential to efficacious therapy.
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PMID:Oral antibiotic therapy for serious infections. 328 69

Unusual infections associated with colorectal tumors may, in some instances, be the sole clue to the presence of a malignancy. The infections are either related to invasion of tissues or organs in close proximity to the tumor or secondary to distant seeding by transient bacteremia arising from necrotic tumors. Seven patients seen at one hospital over a 5-year period illustrate the clinical presentations of such infections. The infections identified in these seven patients include endocarditis, meningitis, nontraumatic gas gangrene, empyema, hepatic abscesses, retroperitoneal abscess, clostridial sepsis, and colovesical fistulae with urosepsis. A computer-assisted search of the English-language literature and cross-checks from other review articles identified other infections associated with colon cancer, which include nontraumatic crepitant cellulitis, suppurative thyroiditis, pericarditis, appendicitis, pulmonary microabscesses, septic arthritis, and fever of unknown origin. The clinical importance of these infections and their correlation with colorectal malignancies are reviewed.
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PMID:Unusual infections associated with colorectal cancer. 328 64

Haemophilus parainfluenzae, although a human commensal, is infrequently reported to be pathogenic. A child with a hepatic abscess caused by this organism was studied, and 54 other significant pediatric infections associated with H. parainfluenzae, as reported in the English-language literature, were reviewed. Meningitis and endocarditis were the most frequently reported infections and affected dissimilar populations of patients. Localized abscesses of the brain, skin, joints, and liver also occurred. Risk factors and antecedent illnesses were occasionally identified. The overall mortality rate was 11%, and the combined rates of morbidity and mortality totaled 38%. Difficulty in identifying H. parainfluenzae may have resulted in misdiagnosis of infections caused by this organism in the past. Antibiotic-resistant strains have emerged. Because H. parainfluenzae is ubiquitous and can cause serious disease in otherwise normal patients, it should be considered a pathogen, and its potential for causing pediatric illness should be more fully appreciated.
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PMID:Haemophilus parainfluenzae infections in children, with the report of a unique case. 328 63


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