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)

Hospital employees are often exposed to infectious diseases, both within and outside of the hospital. Susceptible personnel are at risk of acquiring infection and are a possible source of infection for patients, other employees and members of their households. In recent years epidemics in hospitals due to rubella, pertussis, hepatitis B and Legionnaires' disease have included infection transmitted to and from personnel. A comprehensive plan for management of hospital personnel exposed to communicable diseases should include the following: (1) protocols for the management of each of the common infectious diseases; (2) protocols for employees who are at special risk (pregnant women) and employees who work in areas of risk for certain infectious diseases (newborn nursery, clinical and pathology laboratories, hemodialysis unit); (3) assessment of infectious disease experience of new employees by history, skin test (tuberculosis) and serology (rubella, hepatitis B), and a plan for subsequent tests during employment; (4) continuous program of education of employees in infection control; and (5) coordination of policies among administration, employee health service and infection control officer and committee.
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PMID:Management of infections in hospital employees. 721 27

Recent advances in the field of molecular biology have revolutionized our understanding of the functioning of living organisms and facilitated the development of robust tools for both diagnosis and treatment of diseases. With particular reference to the field of critical care medicine, development of molecular biology techniques have aided in the following: (1) rapid and highly specific detection of pathogenic infectious agents (eg, Mycobacterium tuberculosis, Pneumocystis carinii, cytomegalovirus, Legionella); (2) development of assays for measurement of circulating cytokines such as tumor necrosis factor (TNF) and interleukin (IL)-1 that has helped our understanding of the pathogenesis of the sepsis syndrome; (3) administration of antibodies or soluble receptors to attempt to prevent untoward effects of cytokines such as TNF or IL-1; and (4) the administration of recombinant deoxyribonucleic acid (DNA) or proteins to patients in an attempt to alter the course of a disease such as antioxidant enzymes (superoxide dismutase). The rapidity of progress in this field has been staggering, which necessitates frequent updating of our knowledge for clinicians to put these molecular tools to their best use. This brief review attempts to explain the basic principles of commonly used techniques in molecular biology including recombinant DNA, polymerase chain reaction, DNA libraries, gene therapy, and protein biochemistry in a manner that is understandable to those without an in-depth knowledge of the field.
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PMID:Current techniques in cell and molecular biology. 749 50

An insertion sequence repeated multiple times in the chromosome of Mycobacterium tuberculosis was used as a target for amplification using the polymerase chain reaction (PCR) assay for detecting Mycobacterium tuberculosis in clinical specimens. The sequences of primers were 5'-CCTGCGAGCGTAGGCGTCGG-3' (primer 1) and 5'-CTCGTCCAGCGCCGCTTCGG-3' (primer 2). One cycle of amplification consisted of denaturing at 94 degrees C for 2 min, primer annealing at 68 degrees C for 2 min, and extension at 72 degrees C for 2 min. DNA (5 fg) extracted from M. tuberculosis was detected by gel electrophoresis and Southern blot hybridization after 40 cycles of amplification. The amplification products were not obtained by DNA extracted from M. kansasii, M. intracellulare, M. avium, M. fortuitum, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Legionella pneumophila and Staphylococcus aureus; only from the M. tuberculosis complex. PCR results were compared with conventional cultural, pathological and microscopic findings in the detection of M. tuberculosis in 112 clinical specimens. There were 25 specimens that were positive for M. tuberculosis by cultural or pathological examination, of which 20 (80%) were positive by PCR. PCR detected the organism in 5 (83%) of 6 smear-positive specimens and 15 (79%) of 19 smear-negative specimens in which culture or pathology revealed M. tuberculosis. In addition, 2 smear-negative specimens and 8 smear-negative and culture-negative specimens were positive by PCR. These 10 samples were collected from the patients suspected as having tuberculosis by the clinical diagnosis based on the clinical history, characteristic radiographs, a positive PPD skin test and the effectiveness of anti-tuberculous drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Detection of Mycobacterium tuberculosis in clinical specimens by polymerase chain reaction method. 774 3

Diabetes mellitus is often identified as an independent risk factor for developing lower respiratory tract infections. Pulmonary infections, such as those caused by Mycobacterum tuberculosis, mucor, Staphylococcus aureus, and gram-negative bacteria may occur with an increased frequency whereas infections due to Streptococcus pneumoniae, Legionella, and influenza may be associated with increased morbidity and mortality. The predisposition to lower respiratory tract infections may represent alterations in pulmonary host defenses at several levels. The purpose of this article is to review the spectrum of pulmonary infections encountered in the diabetic patient, focusing on predisposing defects in pulmonary host defense, highlighting characteristic clinical features, and discussing diagnostic approaches, therapeutic interventions, and prophylaxis in this patient population.
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PMID:Pulmonary complications of diabetes mellitus. Pneumonia. 776 21

We have used the cryosection immunogold technique to study the composition of the Mycobacterium tuberculosis phagosome. We have used quantitative immunogold staining to determine the distribution of several known markers of the endosomal-lysosomal pathway in human monocytes after ingestion of either M. tuberculosis, Legionella pneumophila, or polystyrene beads. Compared with the other phagocytic particles studied, the M. tuberculosis phagosome exhibits delayed clearance of major histocompatibility complex (MHC) class I molecules, relatively intense staining for MHC class II molecules and the endosomal marker transferrin receptor, and relatively weak staining for the lysosomal membrane glycoproteins, CD63, LAMP-1, and LAMP-2 and the lysosomal acid protease, cathepsin D. In contrast to M. tuberculosis, the L. pneumophila phagosome rapidly clears MHC class I molecules and excludes all endosomal-lysosomal markers studied. In contrast to both live M. tuberculosis and L. pneumophila phagosomes, phagosomes containing either polystyrene beads or heat-killed M. tuberculosis stain intensely for lysosomal membrane glycoproteins and cathepsin D. These findings suggest that (a) M. tuberculosis retards the maturation of its phagosome along the endosomal-lysosomal pathway and resides in a compartment with endosomal, as opposed to lysosomal, characteristics; and (b) the intraphagosomal pathway, i.e., the pathway followed by several intracellular parasites that inhibit phagosome-lysosome fusion, is heterogeneous.
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PMID:Characterization of the Mycobacterium tuberculosis phagosome and evidence that phagosomal maturation is inhibited. 780 6

Approximately 5% to 10% of patients hospitalized with community-acquired pneumonia (CAP) require treatment in an intensive care unit (ICU) because of severe disease. The case fatality rates in these patients are high, between 20% and 50% in most series. Streptococcus pneumoniae, Legionella spp, Haemophilus influenzae, Staphylococcus aureus, and gram-negative enteric bacteria are the most common causes of severe CAP. However, because the spectrum of pathogens encountered in these patients is unlimited, including viruses, tuberculosis, and opportunistic pathogens, it is crucial to obtain an etiologic diagnosis. A complete diagnostic arsenal should be used, including, if possible, invasive diagnostic procedures before antibiotics are given. The initial empirical therapy must cover the most common pathogens, and in most patients this can be accomplished with a combination of a cephalosporin and a macrolide.
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PMID:Initial investigation and treatment of the patient with severe community-acquired pneumonia. 783 38

The new macrolide derivatives, such as roxithromycin, clarithromycin or azithromycin, respectively, extend the spectrum of activity in antimicrobial chemotherapy. Their direct antibacterial activities are more or less similar to that of erythromycin, i.e., besides gram-positive cocci and rods the gram-negative cocci are likewise susceptible to these drugs. This holds true for aerobes as well as anaerobes. Especially the cell wall deficient bacteria, such as chlamydias, rickettsias, mycoplasmas, are generally rather susceptible. Among the gram-negative aerobic rods some genera are susceptible, for example Bordetella, Haemophilus or Legionella, whereas the Enterobacteriaceae are practically resistant, because their cell wall is rather impermeable. In a few examples, i.e. mycobacteria other than tuberculosis and certain protozoa, such as Toxoplasma, the new macrolides exert a definite greater activity than erythromycin. In particular, the property of the new derivatives to be highly accumulated within host cells, especially within phagocytes, renders these drugs extremely effective against intracellular pathogens, such as Mycobacteria, Legionella, Chlamydia, Listeria, Toxoplasma. Consequently, these new derivatives definitely improve and extend the indications for macrolide antibiotics.
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PMID:[Macrolides, a group of antibiotics with a broad spectrum of activity]. 795 64

Bacterial heat shock proteins (hsp) have been shown to be important immunogens stimulating both T cells and B cells. However, little is known concerning the direct interactions between hsp and macrophages. In this study, we demonstrated that treatment of macrophage cultures with purified bacterial hsp, including Legionella pneumophila hsp60, Escherichia coli GroEL, Mycobacterium tuberculosis hsp70, Mycobacterium leprae hsp65, and Mycobacterium bovis BCG hsp65, increased the steady-state levels of cytokine mRNA for interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-6, tumor necrosis factor alpha, and granulocyte-macrophage colony-stimulating factor as well as supernatant IL-1 secretion. This effect was shown not to be due to contamination of the hsp preparations with bacterial lipopolysaccharide. However, not all hsp induced cytokines; M. tuberculosis hsp10 showed minimal activity in our study. These results suggest that bacterial hsp might modulate immunity by rapidly and directly increasing cytokine production in macrophages.
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PMID:Bacterial heat shock proteins directly induce cytokine mRNA and interleukin-1 secretion in macrophage cultures. 796 Jan 55

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

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


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