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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Salmonellae have demonstrated an extraordinary capacity to adapt to a wide range of ecologic niches and to the peculiarities of modern society, such as the mass production of food products. The vast majority of infections in the United States are caused by serotypes not specifically adapted to human or animal hosts, whereas the most frequent isolate in developing countries is S. typhi, which is highly adapted to human hosts. The number of isolates reported in the United States has been increasing steadily since 1975, largely a result of outbreaks associated with the mass production of food products, particularly poultry, which is frequently contaminated. Salmonella infection occurs when ingested organisms bypass gastric defenses, multiply within the intestinal lumen, penetrate the intestinal mucosa, and multiply within macrophages of the reticuloendothelial system. They may then disseminate via the systemic circulation. Several virulence factors have been identified. The wide range of pathologic and clinical manifestations are subdivided into four syndromes, each requiring a distinct diagnostic and therapeutic approach: (1) gastroenteritis, (2) enteric fever, (3) bacteremia with or without metastatic disease, and (4) asymptomatic carriage. Although any serotype can cause any of these syndromes, certain serotypes are associated with specific presentations. Serious complications of bacteremic infection include infections of the aorta, endocardium, bone, and meninges. Salmonella infection is particularly severe in patients who have AIDS, leukemia, lymphoma, immunodeficiency of other causes, inflammatory bowel disease, schistosomiasis, and macrophage dysfunction. Diagnosis is based on culture of the organism from appropriate sites. Several serologic tests have been developed that warrant further evaluation. Chloramphenicol, ampicillin, amoxicillin, and trimethoprimsulfamethoxazole have clearly established efficacy. Experience with third generation cephalosporins and quinolones is preliminary and fragmentary, but results suggest that they may prove to be efficacious in certain clinical circumstances. Antibiotic resistance has become a major problem in certain geographic areas. The three vaccines for S. typhi that are currently in use internationally provide only moderate protection for short periods of time.
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PMID:The spectrum of Salmonella infection. 307 16

A study of adult patients with gastroenteritis was carried out over an 18-month period from March 1984 until August 1985, with the aim of detecting Shigella species and studying their antibiotic resistance pattern. Two thousand four hundred and eighteen stool specimens were examined and 230 isolations of Shigella were made, a detection rate of 9.5%. Of the 230 isolates, 61.2% were found to be Sh. flexneri, and resistance to ampicillin, chloramphenicol, co-trimoxazole and tetracycline was extremely high, varying from 47% of isolates for chloramphenicol to 77% for tetracycline. Resistance to nalidixic acid was not encountered. In view of the fact that this disorder tends to be a self-limiting condition in Iran, it is advisable to be selective and cautious in the use of antibiotics for treatment.
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PMID:Antibiotic resistance among Shigella species isolated in Tehran, Iran. 307 23

While salmonellosis is often considered to affect primarily the gastrointestinal tract, infection at other sites may occur, producing characteristic clinical syndromes. We reviewed cases from our institutions and the literature on focal manifestations of salmonella infections. In the past, most extra-intestinal salmonella infections were caused by S. choleraesuis; however, we found S. typhimurium to be the predominant serotype. The mortality rate for patients in our series was considerably lower than the rate described for focal infections in other reviews. This may in part be due to lower proportion of infections due to S. choleraesuis, improved microbiologic and diagnostic techniques, increased use of ampicillin, and improved surgical techniques. Salmonella endocarditis usually occurs in patients with preexisting heart disease. Unlike other salmonella infections, S. choleraesuis is the most frequent serotype. Salmonella endocarditis is often very destructive, with a fatality rate of 70%. Nonvalvular (mural) endocarditis occurs in one-fourth of patients and survival has not been reported. While antibiotic therapy should be tried initially, if response is not prompt the clinician should look for an associated site of infection (intra- or extra-cardiac abscess), which will often require surgery. Salmonella pericarditis often presents with cardiac or pulmonary symptoms, but typical signs of pericardial disease (pulsus paradoxus, friction rub) or characteristic electrocardiographic changes (low voltage, elevated ST segments) are uncommon. Early diagnosis, before infection involves other areas of the heart, is crucial for survival. In addition to antibiotic therapy, pericardiocentesis or pericardiectomy is required. Salmonella may infect the peripheral or visceral arteries, but the abdominal aorta is the most frequent site of vascular infection. Most patients are men over age 50 with preexisting atherosclerosis of the aorta who do not have a previous history of gastroenteritis. About one-fourth of patients have associated lumbar osteomyelitis. No patients have been reported to survive with medical therapy alone. Specific guidelines for surgical removal of infected aneurysms have been proposed and these (in addition to increased use of ampicillin) may be responsible for higher survival rates in recent years. Due to the high incidence of relapses, postoperative blood cultures should be done routinely. Arterial infection should be considered in any elderly patient with salmonella bacteremia especially with prolonged fever or bacteremia after an "adequate course" of antibiotic therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Extra-intestinal manifestations of salmonella infections. 330 60

The majority of gastrointestinal infections due to "thermophilic" Campylobacter is self limiting and does not need antibiotic treatment. Anyhow there are some serious cases (sepsis, persistent and relapsing gastroenteritis, severe immunodeficient patients) which require appropriate therapy. The susceptibility of 15 strains of Campylobacter jejuni and of 1 strain of C. coli, isolated from patients with acute gastroenteritis, has been studied against 12 antibiotics with the broth microdilution method at two different inocula (10(3)-10(4) CFU/ml and 10(7)-10(8) CFU/ml), and with the standard agar disk diffusion test, modified to allow sensitivity testing of Campylobacter. For each antibiotic, the geometric mean of MIC and of MBC and the concentrations of the various drugs needed for inhibition and killing of 50 and 90% of the strains (MIC-MBC50 and MIC-MBC90 respectively) have been calculated. Finally the percentage of resistant strains and the percentage of tolerant strains (ratio MBC/MIC: greater than or equal to 32) at low and high inoculum was determined. Erythromycin and aminoglycosides resulted the most active antibiotics against Campylobacter, being bactericidal as well as bacteriostatic at both low and high inoculum. Among the beta-lactams, cefotaxime was the most active, followed by piperacillin and ampicillin. Ceftazidime, aztreonam and rifampin were inactive. Ciprofloxacin, cotrimoxazole and tetracyclines showed some activity against Campylobacter at low inoculum. The agar disk diffusion method cannot be used for the "routinary" assay of susceptibility of Campylobacter, because it is a "naggy" microaerophilic organism.
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PMID:[Bacteriostatic and bactericidal activity, resistance and tolerance of 16 strains of thermophilic Campylobacter to 12 antibiotic drugs]. 345 49

A previously healthy 2.5-year-old boy developed symptoms of acute pyelonephritis following an acute gastroenteritis. The patient received parenteral ampicillin and gentamicin for 72 hours and then ampicillin for an additional 11 days when the original urine and stool cultures grew Salmonella enteritidis, sensitive to ampicillin. The patient responded very well to treatment, but B-mode renal ultrasonogram revealed a left hydronephrosis and megaureter suggestive of longstanding obstruction of the ureterovesicular junction, later confirmed by other diagnostic studies and by surgical exploration and repair. Salmonella infection has been rarely documented to cause pyelonephritis in children. Obstructive uropathy appears to be a predisposing factor for this unusual complication of Salmonella enteritis.
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PMID:Salmonella enteritidis. A rare cause of pyelonephritis in children. 351 8

Starch-ampicillin agar was used to quantitatively isolate Aeromonas sp. from retail grocery store produce. All produce sampled, including parsley, spinach, celery, alfalfa sprouts, broccoli, and lettuce, contained Aeromonas sp. In most instances, the count of Aeromonas sp. increased 10- to 1,000-fold during 2 weeks of storage at 5 degrees C. Eleven (92%) of 12 kinds of produce yielded cytotoxic Aeromonas sp. Identification as Aeromonas hydrophila was the strongest indicator of cytotoxicity, and all 29 (100%) A. hydrophila isolates and 1 (6%) of 16 A. caviae isolates were cytotoxic. Twenty-seven (90%) of 30 cytotoxic Aeromonas sp. strains produced hemolysins. Strong correlations were also noted between ability to produce cytotoxin and positive Voges-Proskauer, lysine decarboxylase, and sorbitol fermentation reactions. It appears that grocery store produce is a potentially significant source of cytotoxic Aeromonas sp. and should be considered in the epidemiology of A. hydrophila gastroenteritis.
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PMID:Enumeration and characterization of Aeromonas hydrophila and Aeromonas caviae isolated from grocery store produce. 356 66

During 1982-83 there was a substantial increase in the number of S. ohio infections at the University Hospital of the West Indies, which coincided with the appearance of strains resistant to chloramphenicol, cotrimoxazole, ampicillin, neomycin and carbenicillin. Multiresistant strains of S. ohio accounted for 19.3% of all salmonella isolates during this period and all of 40 strains tested were able to transfer resistance determinants to E. coli K12 J 53-2. S. ohio was cultured from stool (60), blood (5), wounds and abscesses (4) and postmortem material (2). Eighty-six per cent of S. ohio infections occurred in children of 3 years old or less. There was a high incidence of gastroenteritis in malnourished children, a 14% incidence of localizing infections and a 7% incidence of septicaemia. Two infants with severe gastroenteritis and bronchopneumonia died. There were a number of unusual infections including two cases of septicaemia in children receiving chloramphenicol for Haemophilus influenzae meningitis, a scrotal abscess secondary to extravasation of urine and infected scabies in a child with marasmic kwashiorkor.
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PMID:Multiresistant Salmonella ohio infections at the University Hospital of the West Indies. 377 19

Antibacterial sensitivity tests were done for 513 salmonellae and 133 shigellae. Salmonella strains were divided into three groups: 336 Salmonella typhi, 134 salmonellae isolated from cases of gastroenteritis and 43 salmonellae isolated from non-human sources. All salmonellae and shigellae were sensitive to chloramphenicol. All salmonellae were sensitive to co-trimoxazole, while shigellae showed 18% of resistance. Salmonella resistance to ampicillin was low compared with a high resistance in shigellae. No resistance to from non-human sources. In analysing the resistance pattern in the 4-year period 1979-1982, it was found that there was a rising resistance to ampicillin and sulphonamides in salmonellae. In contrast there was no significant increase in resistance to tetracycline. Tetracycline resistance was high in cases of salmonellae isolated from gastroenteritis. A comparatively low resistance to streptomycin was detected in Salmonella isolated from non-human sources.
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PMID:Sensitivity of Salmonella and Shigella to antibiotics and chemotherapeutic agents in Sudan. 385 91

A retrospective study was done in children in whom salmonellosis was confirmed by laboratory findings with the aim of reviewing etiology, epidemiology, clinical manifestations and therapy. The 15 serotypes most frequently isolated from stool, and in exceptional cases from urine, are discussed. If patients with typhoid fever are excluded, only one patient (who subsequently died) had a blood culture positive for Salmonella, specifically S. enteritidis.No seasonal or other peaks of incidence were noted. Age appeared to be important; of 81 patients with gastroenteritis, 30 were less than 6 months old.Two children in the older age group developed complications; one with appendicitis required surgery.Ten strains of Salmonella out of 23 tested by the disc method showed in vitro resistance to ampicillin on primary isolation.Acquired in vitro resistance to one or more antibiotics appeared to develop with six Salmonella strains reisolated from patients after or during antibiotic treatment.In several children the stool cultures remained positive after clinical signs had disappeared. These findings strongly suggest that, even though antibiotic therapy may improve the symptoms of Salmonella infection, it does not decrease the number of carriers during the convalescent period.
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PMID:[Salmonellosis in children: study of 95 cases in the Hospital Ste-Justine, Montreal, in 1963-1964]. 517 43

Forty-six clinical isolates of enteropathogenic Escherichia coli (EPEC) collected in Addis Ababa, Ethiopia, 1977--1978, were tested for susceptibility to 12 different antibiotics and beta-lactamase-production. Special reference was made to mecillinam and trimethoprim-sulfamethoxazole (TMP-SMZ) that were recently shown to be effective in the treatment of severe gastroenteritis caused by EPEC. Twenty-nine of the strains were of serotype 0111:B4. Thirty of the strains were resistant to 4 antibiotics or more, most of these strains belonging to serotype 0111:B4. For mecillinam, 19 strains had minimal inhibitory concentration (MIC) less than or equal to 0.2 microgram/ml, 27 strains had MIC 0.8--3.2 microgram/ml. Regarding TMP-SMZ, 41 strains had MIC less than or equal to 1 microgram/ml, 5 strains had 2--4 microgram/ml. No strain was resistant to gentamicin or nalidixic acid. Increased production of beta-lactamase was correlated to ampicillin resistance.
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PMID:Antibiotic sensitivity of enteropathogenic Escherichia coli to mecillinam, trimethoprim-sulfamethoxazole and other antibiotics. 625 83


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