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)

Localized bacterial skin infections are frequent. In furunculosis, a local treatment is usually sufficient. In case of frequent recurrence a possible staphylococcus aureus colonization should be looked for and eliminated. Erysipela is treated by systemic antibiotics in order to avoid complications such as streptococcal gangrena or parainfectious glomerulonephritis. Anaerobic cellulitis and gas gangrena are postoperative or posttraumatic infections of the soft tissues which require a combined surgical and antibiotic treatment. Systemic infections may be recognized by characteristic skin lesions. These skin lesions are the consequence of bacterial emboli, vasculitis, intravascular coagulation or toxins, respectively. Examples for such manifestations are lesions in endocarditis, purpura fulminans, ekthyma gangrenosum, disseminated candidemia and toxic shock syndrome.
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PMID:[Localized bacterial skin infections and dermatologic manifestations of systemic infections]. 161 60

Human lactoferrin (HLf) is an iron-binding protein and a host-defence component at the mucosal surface. Recently, a specific receptor for HLf has been identified on a strain of Staphylococcus aureus associated with toxic shock syndrome. We have looked for the occurrence of 125I-HLf binding among 489 strains of S. aureus isolated from various clinical sources. HLf binding was common among S. aureus strains associated with furunculosis (94.3%), toxic shock syndrome (94.3%), endocarditis (83.3%) and septicaemia (82.8%) and other (nasal, vaginal or ocular) infections (96.1%) with a mean binding (in fmol) of 29.1, 21.9, 16.9, 22.2 and 29.2 respectively; the differences between mean HLf binding values of 29.1-29.2, 21.9-22.2 and 16.9 were significant. Furunculosis-associated (low-invasive or localised) isolates were high-to-moderate binders of HLf; 50% gave positive results at a threshold of greater than 31 fmol of 125I-HLf bound. In contrast, endocarditis-associated (high-invasive or systemic) isolates demonstrated low binding and did not bind 125I-HLf at the above threshold level. S. aureus recognised human or bovine Lf. However, bound 125I-HLf was more effectively inhibited in a dose-dependent manner by unlabelled bovine Lf than by homologous HLf. Binding of 125I-HLf to staphylococci was optimal with organisms grown in agar compared with those from broth cultures. The binding capacity of S. aureus was abolished when strains were grown on carbohydrate- and salt-rich agar media. HLf-binding ability of S. aureus did not correlate with fibronectin, fibrinogen, immunoglobulin G or laminin binding.
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PMID:Human lactoferrin binding in clinical isolates of Staphylococcus aureus. 205 16

Sixty-six cases of Gram positive infections were treated with teicoplanin in an open multicenter study, comprising 7 centers in Eastern France. There were 38 male patients and 28 females. Teicoplanin was given at a dose of 400 mg daily for a mean duration of 18.4 days. The most common infections were due to Staphylococcus aureus, found in 43 out of 56 documented cases. 69 (89.9%) of the 78 Gram + strains isolated had an MIC for teicoplanin of less than or equal to 2 mg/l. There were 44 serious infections (30 septicemia, 10 endocarditis, 1 joint and bone infection, 2 mediastinitis, 1 toxic shock syndrome) and 22 less serious infections (4 urinary infections, 14 skin and soft tissue infections, 3 lower respiratory infections, 1 hepatic abscess). In 42 cases concurrent medication was given: beta-lactamase in 11 cases, rifampicin in 10 cases, aminoglycosides in 22, phosphomycin in 3, pefloxacin in 5. The clinical cure and improvement rate was 90.10%. Adverse events were reported in 11 patients, and in only 3 cases was the therapy stopped. All were reversible on stopping therapy. Teicoplanin was found to be well tolerated and effective in the treatment of Gram positive infections in this study.
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PMID:[Teicoplanin and Gram-positive coccus infections. Results of a multicenter study on 66 cases]. 295 64

The prevalence of antibodies to Toxic Shock Syndrome Toxin (TSST-1) in a Swedish healthy control population was investigated using an enzyme-linked immunosorbent assay (ELISA). 88% of the control group above the age of 10 showed positive antibody levels as compared to 31% of those who were under 10 years old. These results indicate a very common normal exposure to TSST-1 during early life and also identify the small risk-group of potential TSS-patients. Patients with S. aureus endocarditis and septicemia showed slightly higher antibody levels as compared to the controls (p less than 0.05). The difference was in part due to 3/4 septicemia patients, infected with TSST-1 producing strains, who showed very high antibody levels. None of these 4 patients developed any signs of TSS. 5/5 menstrual associated TSS-patients were negative in the ELISA in serial serum samples as were 3/5 non-menstrual associated TSS-patients. The TSST-1 ELISA is proposed for identifying chiefly young women at risk of acquiring menstrual related Toxic Shock Syndrome.
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PMID:Serological response to toxic shock syndrome toxin in Staphylococcus aureus infected patients and healthy controls. 401 45

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

Staphylococcus aureus is a ubiquitous organism that is normally carried on the skin and body surfaces of man. The nares are sites frequently colonized, and patients and hospital personnel represent the major source of infection. The occurrence of staphylococcal infection depends on the availability of staphylococci and the host resistance to infection. Factors that influence the carrier rate of S. aureus include minimal colonizing dose, effects of antimicrobial therapy, disinfectants in the environment, coincidental respiratory infections, possible effect of immune factors, duration of hospital stay, and regular needle injections. Certain patients such as drug abusers, patients with diabetes, and patients with chronic renal failure are at high risk of S. aureus infections. although underlying immune deficiencies are present, increased carrier rate also might be related to regular needle use, as shown among allergy patients. The significance of carrier state has been defined in outbreaks in hospital nurseries, postoperative patients, and systemic infections such as endocarditis in the drug abuser, the toxic shock syndrome, and dermatologic infections.
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PMID:Skin and skin structure infections in the patient at risk: carrier state of Staphylococcus aureus. 637 66

Your recent lead article on toxic shock and tampons (November 1, p. 1161) prompts me to report a case of pelvic infection and staphylococcal septicemia 8 days after the insertion of a Lippes loop. Pelvic infection is a recognized complication of IUDs; although there have been 2 reports of endocarditis occurring in susceptible patients following the insertion of an IUD, septicemia is rare. A previously healthy 31-year old married woman had a loop inserted at a family planning clinic. 3 days later she developed sweating, vomiting, confusion, and cough and during the following 48 hours became disoriented with hallucinations. She was referred to the hospital with suspected encephalitis and on admission was febrile (38.8 degrees Celsius) and stuporose but responded to simple commands. Blood pressure was 95/60 mmHg but there were no other abnormal signs. Hemoglobin was 12.2 g/dl, white blood count 4.0x109/1 (80% neutrophils), erythrocyte sedimentation rate 70mm in the 1st hour; cerebrospinal fluid normal. Chest x-ray examination revealed patchy consolidation in the upper lobes of both lungs and an electroencephalogram showed bilateral nonspecific abnormality. 3 blood cultures taken on admission yielded penicillin-resistant Staphylococcus aureus. She was treated with high-dose intravenous cloxacillin and 24 hours after starting the antibiotic had improved markedly and the IUD was removed. Culture from the coil and also from a high vaginal swab yielded Staph aureus with a similar antibiogram to that of the organism cultured from the blood. Subsequent recovery was uneventful, although repeat chest x-ray examination showed small abscess cavities in the upper lobes of both lungs. The patient was discharged 4 weeks after admission and serial chest radiographs have confirmed complete resolution of the pneumonia and abscesses. There is little doubt that this patients' septicemia with lung abscess formation and encephalopathy originated in the genital tract. The patient was both toxic and shocked but was different from patients with the recently described toxic shock syndrome in that her blood culture was positive for Staph aureus. The case provides another example of the importance of this organism as a cause of infection associated with the insertion of foreign bodies into or through the vagina.
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PMID:Staphylococcal septicaemia after insertion of an intrauterine contraceptive device. 744 49

A process of adaptation of the cardiovascular system occurs during pregnancy, entailing physiologic changes. In women with congenital heart disease these changes lay a great burden on the cardiovascular system. Therefore there is an increased risk for mother and fetus, depending on the form of congenital heart disease, preceding operations and the grade of maternal hypoxemia. Overall, the maternal mortality is low, but in certain forms of congenital heart disease the mortality rate can rise to 50%. Infective endocarditis and anticoagulation therapy represent further problems for mother and fetus. It is the duty of the cardiologist, general practitioner and obstetrician to counsel the patient before conception on potential complications and risks of pregnancy, expected physical deterioration of the mother, as well as possible malformations of the child, including the recurrence risk of congenital heart disease. If pregnancy is contraindicated because of the severity of the heart disease, the patient has to be advised about reliable contraceptive methods tailored to her individual needs and their risks, including possible endocarditis, bleeding under anticoagulation therapy, thrombosis, toxic shock syndrome etc.
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PMID:[Pregnancy in patients with congenital heart defect]. 750 8

Staphylococcus aureus is a major human pathogen causing diseases which range from minor skin infection to endocarditis and toxic shock syndrome. The pathogenesis of S. aureus is due primarily to the production of toxic exoproteins, whose synthesis is controlled by a global regulatory system, agr. We show here that agr is autoinduced by a proteinaceous factor produced and secreted by the bacteria and that it is inhibited by a peptide produced by an exoprotein-deficient S. aureus mutant strain. The inhibitor, RIP, competes with the activator, RAP, and may be a mutational derivative. Our results suggest two possible approaches, independent of antibiotics, to the control of S. aureus infections. RIP may prove useful as a direct inhibitor of virulence and RAP as a vaccine against the expression of agr-induced virulence factors; either could interfere with the ability of the bacteria to establish and maintain an infection.
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PMID:Autocrine regulation of toxin synthesis by Staphylococcus aureus. 753 97

Serious staphylococcal infections remain a significant clinical problem despite advances in antibacterial therapy. Resistance to penicillin is common and methicillin-resistant staphylococci have become troublesome nosocomial pathogens in many institutions. Penicillinase-resistant penicillins (e.g. flucloxacillin, cloxacillin and oxacillin) are the preferred drugs for all methicillin-susceptible staphylococcal infections, although first generation cephalosporins, beta-lactam/beta-lactamase inhibitor combinations, clindamycin, and occasionally erythromycin and cotrimoxazole (trimethoprim/sulfamethoxazole) are alternatives. Serious infections due to methicillin-resistant staphylococci should be treated with parenteral vancomycin. Teicoplanin, where available, is a suitable alternative. Rifampicin, fusidic acid and some fluoroquinolones may be useful oral alternatives, although resistance develops rapidly if they are used as single agents. Cotrimoxazole and minocycline have also proven useful when strains are susceptible. Staphylococcal toxic shock syndrome often requires aggressive resuscitation and anti-staphylococcal therapy for generally 10 to 14 days. Staphylococcus aureus bacteraemia remains a life-threatening condition which, in all but one-third of cases, is associated with an underlying septic focus such as endocarditis, osteomyelitis or occult abscess. Differentiating between complicated and uncomplicated bacteraemia is critical to define the appropriate treatment regimen. Serious staphylococcal sepsis such as endocarditis and acute osteomyelitis generally requires prolonged (4 to 6 weeks) antibiotic treatment. Coagulase-negative staphylococci are the commonest cause of prosthetic device infection, and generally require prolonged therapy with an agent to which they have proven to be sensitive, e.g. a penicillinase-resistant penicillin or vancomycin. Removal of infected foreign or prosthetic material, and drainage of deep collections remain a critical aspect of all therapy.
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PMID:Optimum treatment of staphylococcal infections. 768 6


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