Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with inflammatory diseases are treated with a variety of biologic agents. The association between use of biologics and tuberculosis is well known. Additionally, there are numerous case reports of infections in patients receiving biologics with organisms such as Pneumocystis, Listeria, Legionella, and Salmonella. Data from the US Food and Drug Administration Adverse Event Reporting System suggest that infection with these organisms in patients receiving infliximab is at least 5 times as frequent as would be expected if there was no association between use of the drug and the infection. Each of these organisms is typically susceptible to trimethoprim-sulfamethoxazole (TMP-SMZ), and this therefore represents a potentially attractive prophylaxis to prevent these infections in patients receiving biologics. A randomized controlled trial of TMP-SMZ prophylaxis in patients receiving biologics is necessary to prove that its utility outweighs risk, but may be best preceded by a multisite case-control study to determine which patients receiving biologics are at greatest risk.
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PMID:Has the time come for routine trimethoprim-sulfamethoxazole prophylaxis in patients taking biologic therapies? 2339 96

Objective:B. contaminans was cultured from respiratory secretions and liquid docusate (Colace) in a Neurosurgical Intensive Care Unit (NICU) patient with community-acquired Legionnaire's disease but not from another bottle given to the patient. Unexpectedly, C. pelliculosa was cultured from two bottles, but not the B. contaminans bottle or respiratory secretions. Methods:B. cepacia, later identified as B. contaminans, was cultured from a bottle of liquid docusate (Colace) dispensed to a non-cystic fibrosis patient. His respiratory secretions were colonized with B. contaminans. Results: Eradication of B. contaminans colonization in the patient's respiratory secretions was attempted. With levofloxacin, B. contaminans developed multidrug resistance (MDR). Subsequent TMP-SMX therapy did not result in further MDR. Nine other ICU patients were given docusate from the same lot, but there were no other B. contaminans isolates. Conclusion:B. contaminans colonization of respiratory secretion may be difficult to eliminate. The significance of C. pelliculosa cultured from liquid docusate (Colace) remains to be elucidated. In this case, it appeared that B. contaminans may have inhibited the growth of C. pelliculosa in the same bottle. Others should be alerted to the possibility that C. pelliculosa may be present in B. contaminans-contaminated lots of liquid docusate (Colace).
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PMID:Burkholderia contaminans Colonization from Contaminated Liquid Docusate (Colace) in a Immunocompetent Adult with Legionnaire's Disease: Infection Control Implications and the Potential Role of Candida pellucosa. 2791 78