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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent evidence implicates Actinobacillus actinomycetemcomitans in the etiology of localized juvenile periodontitis. This paper reviews the morphological, biochemical and serological charcteristics of A. actinomycetemcomitans, evidence incriminating it as a periodontopathogen, its importance in human nonoral infections, and virulence factors which may be involved in the pathogenesis of A. actinomycetemcomitans infections. A. actinomycetemcomitans is a non-motile, gram-negative, capnophilic, fermentative coccobacillus which closely resembles several Haemophilus species but which does not require X or V growth factors. The organism has been categorized into 10 biotypes based on the variable fermentation of dextrin, maltose, mannitol, and xylose and into 3 serotypes on the basis of heat stable, cell surface antigens. A. actinomycetemcomitans' primary human ecologic niche is the oral cavity. It is found in dental plaque, in periodontal pockets, and buccal mucosa in up to 36% of the normal population. The organism can apparently seed from these sites to cause severe infections throughout the human body such as brain abscesses and endocarditis. There is a large body of evidence which implicates A. actinomycetemcomitans as an important micro-organism in the etiology of localized juvenile periodontitis including: (1) an increased prevalence of the organism in almost all localized juvenile periodontitis patients and their families compared to other patient groups; (2) the observation that localized juvenile periodontitis patients exhibit elevated antibody levels to A. actinomycetemcomitans in serum, saliva and gingival crevicular fluid; (3) the finding that localized juvenile periodontitis can be successfully treated by eliminating A. actinomycetemcomitans from periodontal pockets; (4) histopathologic investigations showing that A. actinomycetemcomitans invades the gingival connective tissue in localized juvenile periodontitis lesions; (5) the demonstration of several pathogenic products from A. actinomycetemcomitans including factors which may: (a) facilitate its adherence to mucosal surfaces such as capsular polysaccharides; (b) inhibit host defense mechanisms including leukotoxin, a polymorphonuclear leukocyte chemotaxis inhibiting factor, and a lymphocyte suppressing factor (c) cause tissue destruction such as lipopolysaccharide endotoxin, a bone resorption-inducing toxin, acid and alkaline phosphatases, collagenase, a fibroblast inhibiting factor and an epitheliotoxin.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Actinobacillus actinomycetemcomitans in human periodontal disease. 388 66

A case of aortic infective endocarditis due to Hemophilus paraphrophilus in a patient with previous Libman-Sacks endocarditis is presented. Suggestions regarding antibiotic prophylaxis are made concerning patients with systemic lupus erythematosus.
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PMID:Clinical considerations regarding infective Libman-Sacks endocarditis. 398 75

Specific, opsonizing antibodies against Haemophilus parainfluenzae were demonstrated in serum by measuring their enhancing effect on the nitroblue tetrazolium (NBT)-reduction of normal human granulocytes, phagocytizing the homologous bacteria. Patients with septicemia and/or endocarditis and carriers of H. parainfluenzae were studied. In late phase sera of the first group such antibodies were detected in 6 of 9 cases. Opsonizing antibodies against H. parainfluenzae were not detected in any of the carrier sera. A dose-response effect was observed when a positive late phase serum was tested in serial 2-fold dilutions. The enhancement of the NBT-reduction was eliminated by absorption of serum with homologous antigen. The detection of opsonizing antibodies, essential for the immune defense against H. parainfluenzae might be helpful for evaluation of the pathogenicity of this organism, which so far is considered as a rare causative agent.
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PMID:NBT-reduction for detection of specific, opsonizing antibodies against haemophilus parainfluenzae. 404 97

Cefazolin sodium was tested in vitro against 308 isolates of Enterobacteriaceae, Pseudomonas aeruginosa, Neisseria meningitidis, Haemophilus influenzae, Staphylococcus aureus, and enterococcus. Broth and agar dilution and disk diffusion techniques were used with at least two sizes of inocula of organisms. Cefazolin was also studied in the treatment of 85 hospitalized patients with a variety of serious infections. In concentations of 5 mug or less/ml, cefazolin inhibited and killed more than 90% of isolates of Enterobacteriaceae with the exception of indole-positive Proteus and Enterobacter species. No isolate of P. aeruginosa and only a few of Enterobacter and enterococci were killed by 25 mug of cefazolin/ml, a concentration readily attainable in serum with a 500-mg dose given intramuscularly. Penicillin-susceptible as well as penicillin-resistant isolates of S. aureus were killed by 1 mug or less of cefazolin per ml; however, 25 mug/ml was required to kill 100% of the strains when the inoculum size was increased 100-fold. Cefazolin treatment appeared effective in 82 of 85 patients, including four with endocarditis. Pain was minimal after intramuscular injection, and thrombophlebitis was not observed in those treated intravenously. No patient developed a positive Coombs test, and no evidence of renal toxicity was apparent in clinical studies.
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PMID:Evaluation of cefazolin, a new cephalosporin antibiotic. 479 Jun 5

Cefmenoxime was evaluated in an open trial consisting of 41 patients. Forty infections in 36 patients could be evaluated. Thirteen patients had pyelonephritis due to Escherichia coli (two bacteremic), Pseudomonas aeruginosa, Klebsiella pneumoniae, or Streptococcus faecalis; all improved and 12 of 13 were clinically cured, but one relapse (S. faecalis) occurred at two weeks. Six patients with cystitis due to E. coli, Citrobacter freundii, Serratia marcescens, P. aeruginosa, or S. faecalis all improved, but relapse or reinfection, or both, occurred in five due to P. aeruginosa, S. faecalis, C. fruendii, or E. coli. Neurogenic bladder or other complications were present in five of 13 patients with pyelonephritis and five of six with cystitis. Ten patients with pneumonia and one with tracheobronchitis due to Hemophilus influenzae, S. pneumoniae, S. agalactiae, or Neisseria meningitidis all improved and seven had resolution without relapse, but P. aeruginosa emerged in two patients, one of whom died. Eight soft tissue infections due to Staphylococcus aureus, Peptococcus prevotti, Streptococcus species, or infections of mixed origin resolved in six. Sterility of blood cultures was obtained in one patient with endocarditis due to S. anginosus, but other therapy was substituted. Clinical resolution of the toxic shock syndrome and subsequent negative endocervical cultures for S. aureus occurred in one. Granulocytopenia of unverified cause in four (with less than 1,500 mm3) and two (with less than 2,000 mm3) was reversible. Headache during treatment occurred in six patients and a possible disulfiram-like effect in three. Elevations of serum glutamic oxalacetic transaminase and alkaline phosphatase occurred in five, Coombs' positivity in two, and diarrhea in three. Clinical efficacy of cefmenoxime was significant. Possible side effects require further study.
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PMID:Cefmenoxime: clinical evaluation. 609 26

The authors report one observation of endocarditis due to Hemophilus para-influenzae associated with mitral valve prolapsus. This germ is difficult to isolate and is found late in cultures using standard techniques. The dicovery of germs resistant to ampicillin requires the search for the presence of a betalactamase. When resistant germs are found, the antibiotic of choice is chloramphenicol or cefamandole. This type of endocarditis different from the others on account of the risk major of embolism (60-85 p. 100) which justifies valve replacement when the echography reveals persistant vegetations.
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PMID:[Endocarditis due to Hemophilus para-influenzae associated with mitral valve prolapses (author's transl)]. 625 33

Cefonicid is a new second-generation cephalosporin with a broad antimicrobial spectrum of activity and a prolonged serum elimination half-life. It has good in vitro activity against methicillin-sensitive Staphylococcus aureus, nonenterococcal streptococci, Hemophilus influenzae, Neisseria gonorrhoeae, Neisseria meningitidis and many of the commonly isolated Enterobacteriaceae. Organisms usually resistant to cefonicid include species of Pseudomonas, Serratia, Acinetobacter and Providencia, and Bacteroides fragilis. The drug is 98% protein bound in human serum, which probably contributes to its significant reduction of antimicrobial activity measured in serum. Limited clinical trials have demonstrated it to be effective for surgical prophylaxis and for treating infections of the urinary tract, lower respiratory tract and bone. Failures have been reported in treatment of soft tissue infections and endocarditis caused by S. aureus. A potential cost reduction may be achieved by administering a single daily dose of cefonicid for established infections or a single preoperative dose for effective surgical prophylaxis instead of multiple-dose regimens of other, similar agents.
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PMID:Cefonicid: a long-acting, second-generation cephalosporin. Antimicrobial activity, pharmacokinetics, clinical efficacy and adverse effects. 639 74

Despite the availability of numerous beta-lactam antibiotics, benzylpenicillin remains the most important beta-lactam antibiotic in the treatment of bacterial endocarditis. Penicillin alone and in combination with an aminoglycoside is effective in the treatment of endocarditis due to all streptococci, Streptococcus pneumoniae, penicillin-susceptible Staphylococcus aureus, Haemophilus aprophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Listeria monocytogenes. Oral phenoxymethylpenicillin in combination with streptomycin is effective in treating endocarditis due to viridans streptococci. Ampicillin is effective in endocarditis due to Haemophilus influenzae, H. parainfluenzae, H. paraphrophilus, Listeria monocytogenes and Escherichia coli. Oral amoxicillin with gentamicin has been used to treat enterococcal endocarditis. The penicillinase-resistant penicillins are effective in treating S. aureus endocarditis. Carbenicillin or ticarcillin in combination with tobramycin or gentamicin are used to treat endocarditis due to Serratia marcescens and Pseudomonas aeruginosa. The use of piperacillin in combination with tobramycin against P. aeruginosa endocarditis has been associated with failure and increased resistance. The cephalosporins have been used to treat endocarditis caused by susceptible organisms. There have been few data on the efficacy of the newer cephalosporins in treating endocarditis. They have been used to treat septicaemia due to susceptible organisms with good results.
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PMID:The use of beta-lactam antibiotics in the treatment of septicaemia and endocarditis. 644 9

A kinetic killing-curve method, designed to mimic several aspects of clinical therapy in endocarditis, was used to test 10 strains of Haemophilus parainfluenzae against 28 antibiotic regimens. In an effort to simulate changing in vivo levels of antibiotic in serum, concentrations of three penicillins, three cephalosporins, gentamicin, and chloramphenicol were sequentially adjusted over a 12-hr period. Against six beta-lactamase-negative strains, gentamicin in combination with penicillin or cephalosporin invariably resulted in an additive or synergistic effect. Chloramphenicol and a penicillin or cephalosporin usually displayed an indifferent effect, but chloramphenicol was often antagonistic when combined with gentamicin. With four beta-lactamase-positive strains, variable responses were noted to penicillin-aminoglycoside combinations; cephalosporin-aminoglycoside combinations were usually synergistic. This dynamic approach to killing-curve studies may be more appropriate than a static system for in vitro examination of the effect of antimicrobial combinations against selected organisms.
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PMID:Antimicrobial susceptibility testing of Haemophilus parainfluenzae by a kinetic killing-curve method. 644 77

Ninety-six clinical isolates of Pasteurella, Actinobacillus and related organisms were submitted to our reference laboratory for identification. The procedures for detecting the 11 identified species, Pasteurella multocida, Pasteurella haemolytica, Pasteurella ureae, Pasteurella pneumotropica, Actinobacillus lignieresii, Actinobacillus equuli, Actinobacillus actinomycetemcomitans, Haemophilus aphrophilus, Cardiobacterium hominis, and two unnamed species of CDC groups, HB-5 and EF-4, are described and their clinical importance is discussed. These organisms have been increasingly isolated in Japan and are most often associated with respiratory infections and endocarditis.
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PMID:Increased frequency of isolation of Pasteurella and Actinobacillus species and related organisms. 646 68


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