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)

From June 24 to July 5, 1996, 3 patients were admitted to the same hospital with atypical pneumonia. One of the patients, a 52-year-old man, demonstrated progressive pulmonary infiltrates and severe hypoxemia, and finally required mechanical ventilation. All 3 patients had elevated antibody titers for Legionella pneumophila serogroup 1, and had visited the same spa prior to the onset of their symptoms. On September 25, 1996 the district health department inspected the spa, and isolated Legionella pneumophila serogroup 1 from the facility's hot water tanks and outlets. Although it has been reported that many spas in Japan are contaminated with Legionellaceae, the outbreak we encountered suggests that Japanese spas, like whirlpool spas in Europe and North America, can be a source of Legionnaire's disease.
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PMID:[An outbreak of Legionnaire's disease associated with a Japanese spa]. 1049 97

The objective of this paper was to study the incidence of 6 atypical pneumonia pathogens or atypical organisms in local patients admitted for acute exacerbation of chronic bronchitis. This is a prospective observational study. Over a period of 3 years (1995 to 1997), 90 patients admitted to a large general hospital in Singapore for acute exacerbation of chronic bronchitis were tested for the following infections: Legionella, Mycoplasma, Chlamydia, influenza A, influenza B and parainfluenza viruses, using paired serological examination. The antibiotic prescribing pattern by the attending physicians in these cases were also examined. Positive serologies were found in 31 patients (34%), of whom 26 patients (28%) had viral infections. The most common organism was influenza A with 18 positive serologies (20%). Five patients were tested positive for Legionella. There was no evidence of acute infections by Mycoplasma pneumoniae or chlamydia using serological tests.
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PMID:A prospective study of infections with atypical pneumonia organisms in acute exacerbations of chronic bronchitis. 1056 56

Three monoclonal antibodies (McAb) were produced against soluble antigens of Legionella pneumophila serogroup 1 which was cultured on BCYE agar. The McAbs were all of the IgM isotype. The McAbs were used in the McAb-based ELISA for detection of circulating L. pneumophila antigens in 186 sera collected from patients with symptoms and signs suggestive of atypical pneumonia. The normal reference optical (OD) density value of each of the McAbs was determined using 44 sera collected from healthy blood donors. The antigen positivity rates for the McAbs 1C7.2B, 2B2.10F and 2B2.11E were 11.3%, 7.7% and 22.2% respectively. Antigen positivity of the McAb 2B2.10F was significantly higher in the younger age group (p < 0.05). There is no significant association between the antigen positivity with age and sex for all the McAbs. There was no cross-reaction demonstrated between the McAbs with other bacterial antigens.
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PMID:Detection of Legionella pneumophila antigens in patients' sera using monoclonal antibodies. 1087 69

"Atypical pneumonia" is a term loosely applied to lower respiratory tract infections that are not characterized by signs and symptoms of lobar consolidation. This description can apply to disease caused by a variety of bacterial, viral and even protozoan organisms. In reality, differentiation as to etiology of pneumonia cannot be distinguished on the basis of clinical presentation. This review will discuss the epidemiology, clinical manifestations, and laboratory diagnosis of Mycoplasma pneumoniae, Chlamydia sp., Legionella sp., Bordetella pertussis, and Coxiella bumetii, the most common agents associated with atypical pneumonia. Unfortunately, because many of these pathogens are intracellular, culture systems are either not available or the techniques employed are costly, time-consuming or unsafe. Until molecular techniques are standardized and widely available, diagnosis will depend upon serologic confirmation. Given the relative importance of these organisms as causes of community acquired pneumonia, current practice guidelines recommend empiric therapy with a macrolide in patients well enough to be treated as an outpatient. However, diagnostic tests should be performed in any patient requiring hospitalization.
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PMID:Laboratory diagnosis of atypical pneumonia. 1098 28

Community acquired pneumonia (CAP) is defined as pneumonia acquired outside of the hospital setting. Extensive studies of CAP in adolescents that characterize the true incidence of various etiologic pathogens are not available. However, Streptococcus pneumoniae, Mycoplasma pneumoniae, and Chlamydia pneumoniae appear to be the most frequently encountered pathogens. These organisms often cause CAP in adults as well; other infections are noted as well, including Legionella. "Atypical pneumonia" refers to pneumonia not presenting with the usual clinical picture of pneumococcal infection (which includes high fever, productive cough, chills, and other "classic" features). The term is frequently used in adolescents with CAP. However, this classification may not help in individual patients, who often show a high degree of variability in the clinical presentation of pneumonia; also it does not always predict microbial cause. There is currently a trend away from the concept of atypical pneumonia syndrome and more discussion of atypical pathogens as commonly causes of CAP. This article reviews recent literature on CAP with special emphasis on its diagnosis and management in adolescent patients.
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PMID:Community-acquired pneumonia in adolescents. 1106 May 62

This study compares the in vitro activity of novel fluoroquinolones against clinical Legionella pneumophila isolates. We determined both the MICs and intracellular efficacy of moxifloxacin, trovafloxacin, clinafloxacin and levofloxacin in the Mono Mac 6 infection model. Six legionella strains were tested and all proved highly susceptible to the fluoroquinolones. Clinafloxacin and trovafloxacin were found to have the lowest MICs (0.004 mg/L) followed by levofloxacin and moxifloxacin (0.015-0.03 mg/L). In the Mono Mac 6 infection model, inhibition of L. pneumophila was achieved at concentrations four times below the respective in vitro MICs. Concentrations as low as 0.015 mg/L of moxifloxacin and levofloxacin, 0.004 mg/L of trovafloxacin and 0.002 mg/L of clinafloxacin markedly decreased viable intracellular bacterial counts. These data strongly support further clinical evaluation of new fluoroquinolones for empirical treatment of lower respiratory tract infection including atypical pneumonia caused by L. pneumophila.
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PMID:Efficacy of moxifloxacin, trovafloxacin, clinafloxacin and levofloxacin against intracellular Legionella pneumophila. 1115 97

Pneumonia acquired in Community (CAP) may be a primary disease occurring in healthy individuals or secondary to predisposing factors or comorbidity. Prevalence of CAP is 2.6 to 5% for all ages, in USA 12%, for over 65 years 30%. Streptococcus pneumoniae is the commonest pathogen 30-50%, H. influenzae in COPD, the atypical pneumonia Mycoplasma pn., M. catharralis, Legionella pn., Enterobacteria, anaerobics often in hospital survey. In children is different RSV, Parainfluenzae type 3, Rhinovirus in the first 2 years old. Others are S. pneumoniae, H. influenzae, Chlamydia sp., etc. Appropriate empiric antibiotic therapy choices are based in guidelines. The most common pathogen is S. pneumoniae, isolates raised resistance rates to Penicillin to 20-50%, 40% in our country and also to Macrolides, with potential clinical failure (21-40%). Specially in elderly people and with the comorbidity are recommended the 23 valent polysaccharide vaccine, effective in bacteremic pneumonia 70-80%. Is not effective in children under 2 years, for that is important conjugated vaccine Hib (toxoids T, D, CRM197, OMP Nm) to prevent carriers, otitis media and reduce exacerbation of these respiratory infections.
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PMID:[Current interest of antipneumococcal vaccination]. 1120 55

Atypical respiratory pathogens such as Mycoplasma pneumoniae and intracellular pathogens such as Legionella spp. and Chlamydia spp. form a significant proportion of the aetiological agents underlying community-acquired pneumonia (CAP). The clinical signs or radiological features of atypical pneumonia are generally insufficient to predict accurately the pathogen involved; in addition, high costs and a considerable length of time are involved in the identification of atypical pathogens. Treatment is, therefore, most often empirical, and it is important that the activity of antibacterial agents available to treat CAP is sufficiently broad to eradicate infection with both common and atypical bacterial pathogens. Telithromycin (HMR 3647) is the first of a new family of antibacterials, the ketolides, and has been designed specifically for the treatment of community-acquired respiratory tract infections (RTIs). The excellent activity of telithromycin against the respiratory tract bacterial pathogens most commonly associated with community-acquired RTIs, including resistant strains, is well established. This review examines the considerable body of evidence showing that telithromycin also has a high level of activity against atypical and intracellular respiratory tract bacterial pathogens.
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PMID:Activity of telithromycin, a new ketolide antibacterial, against atypical and intracellular respiratory tract pathogens. 1156 73

The main atypical pathogens in respiratory tract infections are classified on the basis of their ability to cause atypical pneumonia. This is not a well-defined clinical entity, and it is evident that atypical pathogens can sometimes cause 'typical' pneumonias and vice versa. This emphasizes the need for microbiological diagnosis, since it affects the selection of proper treatment, in which beta-lactam antibiotics and aminoglycosides are not effective. Moreover, mixed infections caused by atypical and typical pathogens together are common. At this moment rapid and sensitive diagnostic methods are lacking. Besides numerous viruses, the main bacterial pathogens causing atypical pneumonias are Mycoplasma pneumoniae, two chlamydial species, Chlamydia pneumoniae and C. psittaci, one rickettsia, Coxiella burnetti, and several Legionella species. The majority of these pathogens cause upper respiratory tract infections more often than overt pneumonias. An atypical agent, Chlamydia pneumoniae, has also been associated with chronic inflammatory conditions in the cardiovascular system. The most recently discovered pathogen in atypical pneumonias is a hantavirus causing hantavirus pulmonary syndrome.
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PMID:Atypical respiratory pathogens. 1186 99

Studies in community-acquired pneumonia (CAP) have compared grepafloxacin, 600 mg o.d. for 7--10 days, with amoxycillin, 500 mg t.d.s., cefaclor, 500 mg t.d.s., or clarithromycin, 250 mg b.d. Grepafloxacin appeared to be clinically as effective as the comparators. In CAP caused by Haemophilus influenzae, grepafloxacin was significantly superior to amoxycillin (p=0.005) and cefaclor (p=0.003) and equivalent to clarithromycin in eradicating the infecting organism. Bacterial eradication with grepafloxacin in CAP caused by Moraxella catarrhalis or Streptococcus pneumoniae was effective and equivalent to the comparator antibiotic. In an open study, grepafloxacin was also effective in treating atypical pneumonia caused by Mycoplasma pneumoniae and Legionella pneumophila. In acute bacterial exacerbations of chronic bronchitis (ABECB), studies have found once-daily treatment with grepafloxacin, 400 mg or 600 mg for 7--10 days, to be equivalent to amoxycillin, 500 mg t.d.s., or ciprofloxacin, 500 mg b.d. In patients with documented infections, bacteriologic eradication with grepafloxacin, 400 mg or 600 mg o.d., was superior to amoxycillin, 500 mg t.d.s. Results from clinical trials so far indicate that grepafloxacin has a broad spectrum of activity covering all important community-acquired respiratory pathogens, and may be suitable for the empirical treatment of respiratory infection.
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PMID:Clinical efficacy and tolerability of grepafloxacin in lower respiratory tract infection. 1186 47


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