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

Erythromycin and related macrolide antibiotics have recently enjoyed a resurgence of clinical interest. This is a result of activity against organisms which are becoming more prevalent, particularly in immunocompromised hosts and, in addition, better understanding of the unique tissue penetration properties and potential immunomodulating properties of macrolides. Other features of clinical interest possessed by certain of the newer macrolides include the potential for once-daily dosing, resistance to acid degradation in the stomach without enteric coating, and possibly reduced gastrointestinal side effects. The new macrolides are expected to retain the clinical indications of erythromycin, which include upper and lower respiratory tract infections, skin and skin structure infections, and genital tract infections caused by erythromycin-susceptible organisms. In addition, enhanced activity has been demonstrated in animal models and in vitro against toxoplasma, Legionella, Haemophilus, and Campylobacter spp. New macrolide derivatives also show promise to expand the antimicrobial spectrum of erythromycin to include Mycobacterium and Borrelia spp.
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PMID:New directions for macrolide antibiotics: pharmacokinetics and clinical efficacy. 268 5

Ciprofloxacin is a new fluorinated 4-quinolone with a broad spectrum of antimicrobial activity which includes both Gram-negative and Gram-positive bacteria. In this study the in vitro activity of ciprofloxacin has been determined against bacteria associated with respiratory tract infections and compared with that of other antimicrobial agents used in the therapy of such infections. Ciprofloxacin (MIC90 0.008 mg/l) was highly active against Haemophilus influenzae, including isolates producing beta-lactamase which were resistant to amoxycillin. Ciprofloxacin (MIC90 0.06 mg/l) was also highly active against Branhamella catarrhalis, again including those isolates resistant to amoxycillin as a result of beta-lactamase production. Isolates of Streptococcus pneumoniae were less susceptible to ciprofloxacin (MIC90 2 mg/l) but were highly susceptible to amoxycillin (MIC90 less than 0.12 mg/l) and erythromycin (MIC90 0.25 mg/l). Isolates of Klebsiella aerogenes were highly susceptible to ciprofloxacin (MIC90 0.06 mg/l) but much less so to amoxycillin, sulfamethoxazole, trimethoprim, oxytetracycline and erythromycin. Ciprofloxacin (MIC90 0.5 mg/l) was very active against Staphylococcus aureus, including those isolates resistant to amoxycillin and flucloxacillin, and against Mycoplasma pneumoniae. Together with rifampicin and erythromycin, ciprofloxacin was highly active against Legionella pneumophila (MIC90 0.015 mg/l). These results suggest that clinical evaluation of ciprofloxacin in the treatment of respiratory tract infections is justified.
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PMID:Comparative in vitro activity of ciprofloxacin and other unrelated antimicrobials against bacterial respiratory tract pathogens. 273 80

In a one-year prospective study of 106 adults (mean age, 60 years) who were admitted to hospital with community-acquired pneumonia, an aetiological diagnosis was made in 82 (77%) patients. Streptococcus pneumoniae was considered to be responsible for 44 (42%) and respiratory viruses for 19 (18%) infections. Other aetiological agents that were found in a smaller number of patients included Haemophilus influenzae (9% of patients), enteric Gram-negative bacilli (8% of patients), Staphylococcus aureus (3% of patients), Legionella spp. (3% of patients), Mycobacterium tuberculosis (3% of patients), Mycoplasma pneumoniae (8% of patients) and Chlamydia psittaci (5% of patients). The mortality was 10% and was related significantly to increasing age and to coexisting heart and lung disease. Antibiotic treatment that was commenced before admission to hospital and investigations were undertaken reduced significantly the isolation rate of susceptible bacterial pathogens. The Gram-stained smear of sputum was valuable in establishing a tentative diagnosis of bacterial pneumonia. The most-useful tests in making an early diagnosis proved to be those which detected pneumococcal and mycoplasmal antigens, blood cultures and culture of sputum for appropriate bacterial pathogens.
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PMID:A prospective hospital study of the aetiology of community-acquired pneumonia. 273 13

Community-acquired pneumonia accounts for about 1 p. 100 of all lower respiratory infections, i.e. 1 to 10 cases per 1,000 adults annually, depending on the country and the year. The causative organism is seldom identified since there is no simple, specific, non-invasive and cheap laboratory diagnostic method. Treatment therefore is empirical. It rests upon epidemiological and clinical data as well as upon a set of criteria concerning the acceptability of antibiotics and variations in bacterial resistance. The four principal antibiotic-sensitive microorganisms to be taken into account are pneumococci, Haemophilus influenzae, Mycoplasma pneumoniae and Legionella pneumophila. In practice, focal lung infections should initially be treated with penicillin A which is active against pneumococci and H. influenzae. In case of atypical pneumonia, preference should be given to macrolides since these drugs are active against M. pneumoniae and L. pneumophila. In initially severe or worsening pneumonia occurring in debilitated patients penicillins and macrolides should be given concomitantly from the start.
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PMID:[Community-acquired pneumonia]. 274 47

Lomefloxacin is a new difluoro-quinolone. In this study, we have determined the in vitro activity of lomefloxacin against a wide range of clinical bacterial isolates and compared it with that of other fluoro-quinolones and some unrelated antimicrobials. Lomefloxacin was very active against Enterobacteriaceae (MIC90, 0.5 micrograms/ml) with activity comparable to that of ofloxacin (MIC90, 0.25 micrograms/ml). Lomefloxacin was moderately active against isolates of Pseudomonas aeruginosa (MIC90, 4 micrograms/ml), and again the activity was comparable to ofloxacin (MIC90, 4 micrograms/ml) but was eightfold less than ciprofloxacin (MIC90, 0.5 micrograms/ml). Lomefloxacin was also active against isolates of Staphylococcus aureus (MIC90, 1 micrograms/ml), irrespective of methicillin susceptibility, and this activity was most comparable to ofloxacin (MIC90, 0.5 micrograms/ml) and ciprofloxacin (MIC90, 0.5 micrograms/ml). Lomefloxacin was fourfold less active than either ofloxacin or ciprofloxacin against isolates of Enterococcus faecalis (MIC90, 8 micrograms/ml) and Streptococcus pneumoniae (MIC90, 8 micrograms/ml). In common with ofloxacin and ciprofloxacin, lomefloxacin was very active against isolates of Neisseria spp. (MIC90, less than or equal to 0.06 micrograms/ml), Haemophilus spp. (MIC90, less than or equal to 0.06 micrograms/ml), Legionella spp. (MIC90, less than or equal to 0.06 micrograms/ml), Vibrio spp. (MIC90, less than or equal to 0.06 micrograms/ml), and Campylobacter jejuni (MIC90, 1 microgram/ml). Lomefloxacin showed poor activity against isolates of Bacteroides spp. (MIC90, 16 micrograms/ml) or Clostridium difficile MIC90, 32 micrograms/ml) and was only moderately active against isolates of Clostridium perfringens (MIC90, 2 micrograms/ml), Peptostreptococcus spp. (MIC90, 4 micrograms/ml), Chlamydia trachomatis (MIC90, 4 micrograms/ml), Mycoplasma hominis (MIC90, 2 micrograms/ml), and Urea-plasma urealyticum (MIC90, 8 micrograms/ml). Lomefloxacin was found to be bactericidal at concentrations generally close to the MIC with greater than 3 log10 reduction in viability of exponentially dividing cultures of Escherichia coli and S. aureus within 5 hr of exposure to concentrations at eight times the MIC. These results indicate a potential clinical role for lomefloxacin in the treatment of genitourinary tract infections caused by Gram-positive and Gram-negative bacteria, respiratory tract infections caused by susceptible organisms, and soft tissue infections caused by S. aureus.
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PMID:Comparative in vitro activity of lomefloxacin, a difluoro-quinolone. 279

AT-4140, 5-amino-1-cyclopropyl-6,8-difluoro-1,4-dihydro-7-(cis-3,5- dimethyl-1-piperazinyl)-4-oxoquinoline-3-carboxylic acid, showed broad and potent antibacterial activity. Its MICs for 90% of the strains tested were 0.1 to 0.78 micrograms/ml against gram-positive organisms, such as members of the genera Staphylococcus, Streptococcus, and Enterococcus, and 0.0125 to 1.56 micrograms/ml against gram-negative organisms, such as members of the family Enterobacteriaceae and the genera Pseudomonas, Branhamella, Campylobacter, Haemophilus, and Neisseria. Its MICs were 0.025 to 0.78 micrograms/ml against glucose nonfermenters, such as members of the genera Xanthomonas, Acinetobacter, Alcaligenes, Moraxella, Flavobacterium, and Brucella; 0.2 to 0.78 micrograms/ml against anaerobes, such as Clostridium perfringens and Bacteroides fragilis; 0.0125 to 0.05 micrograms/ml against Legionella spp.; 0.0125 to 0.2 micrograms/ml against Mycoplasma spp.; 0.031 to 0.063 micrograms/ml against Chlamydia spp.; and 0.1 to 0.3 micrograms/ml against Mycobacterium spp. The potencies of AT-4140 against gram-negative organisms were comparable to those of ciprofloxacin and higher than those of ofloxacin, enoxacin, and norfloxacin. The potencies of AT-4140 against gram-positive organisms, glucose nonfermenters, anaerobes, Mycoplasma spp., Chlamydia spp., and Mycobacterium spp. were generally higher than those of the quinolones with which AT-4140 was compared. AT-4140 showed good oral efficacy against systemic infections with Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Escherichia coli, and Pseudomonas aeruginosa in mice. Its efficacy was better when a daily dose was given once than when it was given in two doses. Good efficacies of the orally administered drug were also observed in pulmonary, dermal, and urinary tract infection models in mice. The in vivo efficacies of AT-4140 were equal to or better than those of ciprofloxacin, ofloxacin, enoxacin, and norfloxacin.
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PMID:In vitro and in vivo antibacterial activities of AT-4140, a new broad-spectrum quinolone. 280 44

The in vitro activity of azithromycin (CP 62,993 or XZ-450) against Haemophilus influenzae was greater than that of three other macrolides. However, azithromycin was four- to eightfold less active than erythromycin against the gram-positive cocci and against Listeria monocytogenes. Erythromycin and azithromycin were similar in their activity against Legionella pneumophila, Neisseria gonorrhoeae, Neisseria meningitidis, and Branhamella catarrhalis.
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PMID:In vitro activities of azithromycin (CP 62,993), clarithromycin (A-56268; TE-031), erythromycin, roxithromycin, and clindamycin. 284 16

Pneumonia is an important cause of morbidity and mortality. A variety of conditions that damage the airways and weaken host defense mechanisms increase the susceptibility of the individual to bacterial colonization of the pulmonary tree. Because the clinician frequently cannot determine the etiologic agent, pneumonia is often treated empirically. Cefonicid, a long-acting cephalosporin, is a useful and cost-effective antibiotic that is active against many of the common pathogens that cause community-acquired pneumonia, such as Streptococcus pneumoniae and Haemophilus influenzae. It is also active against less common community-acquired pathogens, such as Klebsiella pneumoniae, Escherichia coli, and some anaerobic mouth flora. Erythromycin is useful when Mycoplasma or Legionella species are suspected. Cefonicid's demonstrated safety and efficacy, its low cost, and its long half-life, permitting once-daily dosing, make this antibiotic an ideal parenteral choice for empiric therapy of community-acquired pneumonia.
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PMID:Community-acquired pneumonia: etiology, diagnosis, and treatment. 285 99

A prospective one-year study of community pneumonia was conducted in Nottingham. 236 of 251 episodes of pneumonia (defined as an acute lower respiratory tract infection, for which antibiotics were prescribed, associated with new focal signs on examination of the chest) were investigated. Acute radiographic changes were present in 93 (39%). A pathogen was identified in 129 (55%) episodes, with Streptococcus pneumoniae, Haemophilus influenzae, and influenza viruses those most frequently identified. Mycoplasma pneumoniae was uncommon and infection with Legionella pneumophila was found in only 1 episode. Hospital admission was required in 52 (22%) episodes. 7 patients died (3%), all but one of the deaths occurring in patients who had been admitted to hospital. Pneumonia in the community is common but few people die of it. Initial antibiotic therapy should always cover S pneumoniae and H influenzae.
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PMID:Prospective study of the aetiology and outcome of pneumonia in the community. 288 91

Hybrid cell lines producing monoclonal antibodies against Bordetella pertussis lipopolysaccharide (LPS) were established. The specificity of the antibodies was ascertained by enzyme-linked immunosorbent assay (ELISA) and ELISA-inhibition experiments with LPS and delipidated polysaccharide fragments (PS-1 and PS-2) prepared from B. pertussis LPS. Monoclonal antibody 9-1-H5 reacted with B. pertussis LPS only, whereas monoclonal antibodies 6-4-H6 and 9-2-A8 reacted with PS-1 and PS-2 as well as B. pertussis LPS. The antibodies did not react with LPS prepared from B. parapertussis and B. bronchiseptica in an LPS-specific ELISA. A monoclonal antibody-based sandwich ELISA was developed for detection of B. pertussis LPS. This assay had a detection limit of B. pertussis LPS in concentrations ranging from 0.16 to 0.32 microgram/ml. The assay was also shown to be specific for the detection of whole B. pertussis bacteria. No cross-reactions were observed with strains of Branhamella catarrhalis, Neisseria meningitidis, Streptococcus miteor, Haemophilus influenzae, or Legionella pneumophila. The monoclonal antibodies might be useful for the detection of soluble antigens and whole bacteria in clinical samples and for studies of the immunochemical structure of B. pertussis LPS.
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PMID:Production and characterization of monoclonal antibodies directed against Bordetella pertussis lipopolysaccharide. 289 6


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