Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: UMLS:C0023241 (Legionella)
6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 65-kDa protein (called S1) from Spirochaeta bajacaliforniensis was identified as 'tubulin-like' because it cross-reacted with at least four different antisera raised against tubulin and was isolated, with a co-polymerizing 45-kDa protein, by warm-cold cycling procedures used to purify tubulin from mammalian brain. Furthermore, at least three genera of non-cultivable symbiotic spirochetes (Pillotina, Diplocalyx, and Hollandina) that contain conspicuous 24-nm cytoplasmic tubules displayed a strong fluorescence in situ when treated with polyclonal antisera raised against tubulin. Here we summarize results that lead to the conclusion that this 65-kDa protein has no homology to tubulin. S1 is an hsp65 stress protein homologue. Hsp65 is a highly immunogenic family of hsp60 proteins which includes the 65-kDa antigens of Mycobacterium tuberculosis (an active component of Freund's complete adjuvant), Borrelia, Treponema, Chlamydia, Legionella, and Salmonella. The hsp60s, also known as chaperonins, include E. coli GroEL, mitochondrial and chloroplast chaperonins, the pea aphid 'symbionin' and many other proteins involved in protein folding and the stress response.
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PMID:The 'tubulin-like' S1 protein of Spirochaeta is a member of the hsp65 stress protein family. 815 49

Sparfloxacin is a recently developed fluoroquinolone. The drug has shown potent antimicrobial activity against a wide range of Gram-positive and Gram-negative bacteria, glucose non-fermenters, anaerobes, Legionella spp., Mycoplasma spp., Chlamydia spp. and Mycobacterium spp. Methicillin-resistant Staphylococcus aureus is also susceptible to sparfloxacin. Plasma sparfloxacin concentrations reach a peak (Cmax) of approximately 0.7 mg/L at 3 to 5 hours after a 200mg oral dose. This is followed by a monophasic slow decrease, with an elimination half-life (t1/2) of 15 to 20 hours. The Cmax and area under the plasma concentration-time curve show dose-related increases. Food intake does not affect the absorption and pharmacokinetics of sparfloxacin. Sparfloxacin binds weakly to plasma protein (37%), and exhibits excellent tissue distribution and effective penetration into extracellular fluids. Concentrations of the drug in most tissues are similar to, or higher than, concomitant plasma concentrations. Sparfloxacin distributes slightly into cerebrospinal fluid. The drug is metabolised to a glucuronide. The urinary excretion of the unchanged drug accounts for 10 to 14% of the given dose. The ratio of Cmax values after multiple and single oral doses is 1.3 to 1.4, but other pharmacokinetic parameters of sparfloxacin are not influenced by multiple doses. Even in patients with severe renal failure, no significant prolongation of the half-life is observed after oral administration. Sparfloxacin appears unlikely to affect the pharmacokinetics of theophylline. Antacids containing aluminium hydroxide reduce the oral bioavailability of sparfloxacin by 25 to 35%. Probenecid does not affect sparfloxacin pharmacokinetics. The pharmacokinetic properties of sparfloxacin allow once-daily administration in the treatment of various infections.
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PMID:Clinical pharmacokinetics of sparfloxacin. 828 31

Familiarity with the natural history of common pneumonias is obligatory for the clinician to determine whether a specific case of pneumonia is resolving at the expected rate. To many clinicians, the term slowly resolving pneumonia conjures an association with underlying neoplasm and/or less common pathogens. In reality, host factors or common pathogens such as Streptococcus pneumoniae and Legionella pneumophila are more likely responsible for delayed resolution. Familiarity with the pattern of resolution of pneumonias caused by these organisms should allow the clinician to follow such patients and avoid premature invasive evaluation. In contrast, Mycoplasma pneumoniae and Chlamydia species rarely result in slowly resolving pneumonia. Chronic bacterial pneumonia is an infectious syndrome that may present in the absence of systemic symptoms. The presentation is varied and may mimic neoplasm, interstitial lung disease, or chronic fungal or mycobacterial infection. Bacteria most commonly associated with chronic pneumonia include Haemophilus influenzae, Staphylococcus aureus, alpha-hemolytic streptococci (not S pneumoniae), and Pseudomonas aeruginosa.
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PMID:Infectious diseases that result in slowly resolving and chronic pneumonia. 837 74

Fifty-eight consecutive patients with severe community-acquired pneumonia were studied prospectively during a three-year period. The group included 44 men and 14 women (mean age: 45.0 +/- 15.7 years). The cause of pneumonia was diagnosed in 35 (60.3 percent) cases, and the most common pathogens were Streptococcus pneumoniae (37.1 percent), Legionella pneumophila (22.8 percent) and Gram-negative bacilli (11.4 percent). The fact that Mycobacterium tuberculosis was present in four (11.4 percent) patients and Pneumocystis carinii in three (8.5 percent) is worthy of note. The overall death rate was 22.4 percent. More than 50 percent of deaths occurred within the first five days and were caused by septic shock, hemoptysis (tuberculosis) or hypoxia. However, hypoxia remains the main fatal complication and all late-occurring deaths (> 5 days) observed were due to this cause. These data could be important in planning strategies and protocols to improve prognosis.
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PMID:A three-year study of severe community-acquired pneumonia with emphasis on outcome. 841 85

The fluoroquinolones are characterised by a broad spectrum of antibacterial activity that includes many Mycobacterium, Chlamydia, Legionella, and Mycoplasma species as well as many multiply-resistant bacterial strains, good oral bioavailability, extensive tissue penetration, low protein binding and long elimination half-lives. Numerous clinical trials have shown that these compounds are effective and well tolerated in the treatment of adult patients with various infections, including urinary tract, respiratory tract, skin and soft tissue, bone and joint, and gynaecological infections, sexually transmitted diseases, infectious diarrhoea, infections in immunocompromised patients, and in surgical prophylaxis. Thus, there is increasing pressure to use this class of drugs in paediatric patients. However, concerns regarding adverse effects, particularly cartilage toxicity, have restricted development of the fluoroquinolone compounds for use in this population. Potential indications include Pseudomonas infections (mainly exacerbations of cystic fibrosis), urinary tract, gastrointestinal and central nervous system infections, infections in immunocompromised patients, certain otorhinolaryngological infections and infections caused by multiply-resistant pathogens. To date, clinical experience gained with fluoroquinolones in paediatric infections, which has been mainly on a compassionate-use basis, indicates that well-designed formal studies should be conducted to fully assess the efficacy and tolerability of these agents in specific indications in children.
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PMID:Fluoroquinolones in paediatrics--1995. 854 23

The patient population at risk for opportunistic pulmonary infections has increased during the last decade. The spectrum of organisms causing opportunistic infections has also grown. With an ever broader list of potential diagnosis, a specific diagnosis of the cause of pulmonary disease becomes more important. Recent microbiologic advances have helped to facilitate the laboratory diagnosis of some of these agents. Immunoassays are available for the detection of antigen in nasopharyngeal secretions (respiratory syncytial virus, influenza) in serum (Cryptococcus species), and in urine (Legionella or Histoplasma species). Rapid-culture techniques are available for the culture and detection of various viruses, including cytomegalovirus. Molecular probes can now assist in the rapid identification of Mycobacterium tuberculosis and some fungi. In the near future, polymerase chain reaction-based techniques may assist in the detection of Pneumocystis carinii and Legionella, Chlamydia, Mycoplasma, and Mycobacteria species. An expeditious evaluation of pulmonary disease requires an understanding of the differential diagnosis of likely causes of pulmonary disease in specific immunosuppressed patient populations, an understanding of the most appropriate specimens to process for these diagnoses, and an understanding of the limitations (sensitivity and specificity) of these diagnostic tests. An understanding of the most appropriate specimens and tests in a given institution should allow for early, relatively specific treatment of many potentially life-threatening infections.
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PMID:The laboratory evaluation of opportunistic pulmonary infections. 859 23

Between February 1989 and June 1994 193 cases of acute community acquired pneumonia (PAC) which were of intermediate or great severity were admitted to two hospitals in the South West of France. These patients were explored using bronchofibroscopy (FB) with a protected brush (BP) and alveolar microlavage (MLBA) and quantitative cultures were performed, also there were other specimens taken in a regular fashion. The percentage of positive examinations was 60% for brushings (BP), 59% for MLBA and 21% for blood cultures and 16% for serological tests. An aetiology was determined in 137 cases (70.9%). The organisms recovered were Streptococcus pneumoniae (49.6%), gram negative bacilli (17.4%), Haemophilus influenzae (11.7%), Mycoplasma pneumoniae (4.4%), Mycobacterium tuberculosis (4.4%), Staphylococcus aureus (3.6%), Chlamydia pneumoniae (2.2%), Legionella pneumophila (0.7%), and various 5.8%. The overall mortality was 15% despite immediate antibiotics based on the likely organism in 88% of cases. The study of prognostic factors confirmed the Fine score system (determined a posteriori) which constitutes a useful and practical index determining the management of PAC. On the other hand the role of bacteriological documentation in improving the vital prognosis remains to be confirmed. If bronchofibroscopy has appeared to us as a safe and useful means of investigation, the management of these disease remains to specified. We suggest that its use is reserved for subjects with life threatening disease (a Fine score equal to or greater than 3) or for those patients who are likely to have unusual germs: failure of previous antibiotics, diabetes, malnourishment, cancer, airflow obstruction and inhalation.
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PMID:[Acute community-acquired pneumonia of moderate and grave severity investigated by bronchoscopy. Analysis of 193 cases hospitalized in a general hospital]. 871 Dec 37

One of the chemical features that distinguishes the 15-membered ring azalide azithromycin from the 14-membered ring macrolide compound erythromycin is the former's increased stability at acid pH. Azithromycin also differs pharmacokinetically from erythromycin, an important feature being azithromycin's ability to achieve high tissue concentrations, with the agent being delivered to the sites of infection by direct uptake and by targeted delivery via phagocytes. High tissue concentrations are maintained for prolonged periods because of azithromycin's long half-life, leading to once-daily dosing for 3 or 5 days. Notable microbiological features of azithromycin are in-vitro activity against many pyogenic bacteria (e.g. Neisseria gonorrhoeae and Moraxella catarrhalis), as well as organisms against which beta-lactam antibiotics are usually ineffective (e.g. Legionella and Chlamydia spp.), organisms that are resistant to benzylpenicillin and erythromycin (e.g. Haemophilus influenzae) and organisms for which satisfactory therapy is limited (e.g. Toxoplasma gondii and the Mycobacterium avium-intracellulare complex). These properties of azithromycin suggest that it might be a useful agent for the treatment of a wide range of bacterial infections.
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PMID:Azithromycin--review of key chemical, pharmacokinetic and microbiological features. 881 41

Mechanically ventilated patients have a higher incidence of pneumonia and mortality than do nonventilated patients. Ventilator-associated pneumonia (VAP) is diagnosed clinically, by bronchoscopy or "blind" bronchoalveolar lavage (BAL) or protected specimen brush (PSB), and by quantitative endobronchial aspirates (QEA). VAP is usually caused by bacteria, but Legionella pneumophila, Mycobacterium tuberculosis, viruses, and fungi are also potential pathogens. Bacteria causing nosocomial pneumonia may be part of the patient's endogenous flora, originate from other patients, hospital personnel, or environmental sources. Pseudomonas aeruginosa, Acinetobacter spp, and Staphylococcus aureus are the most common causative agents in late-onset nosocomial pneumonia, and Streptococcus pneumoniae and Hemophilus influenzae are more commonly found in early-onset pneumonia. Aspiration appears to be the major route for the entry of bacteria into the lower respiratory tract. Host factors, oropharyngeal and gastric colonization, cross-infection, and complications from the use of antibiotics and nasogastric and endotracheal tubes increases the risk of bacterial VAP. A working knowledge of the epidemiology and strategies for prevention of VAP should reduce infection rates, morbidity, and mortality in critically ill patients.
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PMID:Nosocomial pneumonia in mechanically ventilated adult patients: epidemiology and prevention in 1996. 888 61

This document updates and replaces CDC's previously published "Guideline for Prevention of Nosocomial Pneumonia" (Infect Control 1982;3:327-33, Respir Care 1983;28:221-32, and Am J Infect Control 1983;11:230-44). This revised guideline is designed to reduce the incidence of nosocomial pneumonia and is intended for use by personnel who are responsible for surveillance and control of infections in acute-care hospitals; the information may not be applicable in long-term-care facilities because of the unique characteristics of such settings. This revised guideline addresses common problems encountered by infection-control practitioners regarding the prevention and control of nosocomial pneumonia in U.S. hospitals. Sections on the prevention of bacterial pneumonia in mechanically ventilated and/or critically ill patients, care of respiratory-therapy devices, prevention of cross-contamination, and prevention of viral lower respiratory tract infections (e.g., respiratory syncytial virus [RSV] and influenza infections) have been expanded and updated. New sections on Legionnaires disease and pneumonia caused by Aspergillus sp. have been included. Lower respiratory tract infection caused by Mycobacterium tuberculosis is not addressed in this document. Part I, "An Overview of the Prevention of Nosocomial Pneumonia, 1994, provides the background information for the consensus recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC) in Part II, Recommendations for Prevention of Nosocomial Pneumonia." Pneumonia is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality. Most patients who have nosocomial pneumonia are infants, young children, and persons > 65 years of age; persons who have severe underlying disease, immunosuppression, depressed sensorium, and/or cardiopulmonary disease and persons who have had thoracoabdominal surgery. Although patients receiving mechanically assisted ventilation do not represent a major proportion of patients who have nosocomial pneumonia, they are at highest risk for acquiring the infection. Most bacterial nosocomial pneumonias occur by aspiration of bacteria colonizing the oropharynx or upper gastrointestinal tract of the patient. Because intubation and mechanical ventilation alter first-line patient defenses, they greatly increase the risk for nosocomial bacterial pneumonia. Pneumonias caused by Legionella sp., Aspergillus sp., and influenza virus are often caused by inhalation of contaminated aerosols. RSV infection usually occurs after viral inoculation of the conjunctivae or nasal mucosa by contaminated hands. Traditional preventive measures for nosocomial pneumonia include decreasing aspiration by the patient, preventing cross-contamination or colonization via hands of personnel, appropriate disinfection or sterilization of respiratory-therapy devices, use of available vaccines to protect against particular infections, and education of hospital staff and patients. New measures being investigated involve reducing oropharyngeal and gastric colonization by pathogenic microorganisms.
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PMID:Guidelines for prevention of nosocomial pneumonia. Centers for Disease Control and Prevention. 903 4


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