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

The tetracyclines are effective in the treatment of Chlamydia, Mycoplasma pneumoniae, and rickettsial infections and also can be used for gonococcal infections in patients unable to tolerate penicillin. These drugs may cause gastrointestinal irritation, diarrhea, phototoxic dermatitis, and vestibular damage, and fatal reactions due to hepatotoxicity have occurred in pregnant women. Chloramphenicol has a broad spectrum of bacteriostatic activity, but its association with suppression of the bone marrow and aplastic anemia has relegated it to a historical role. Erythromycin is the drug of choice for the treatment of infections caused by M. pneumoniae, Legionella species, group A beta-hemolytic streptococci, and Streptococcus pneumoniae. The frequency of serious adverse effects associated with the use of erythromycin is low; dose-related epigastric distress may occur. Clindamycin is bactericidal to most nonenterococcal gram-positive aerobic bacteria and many anaerobic microorganisms. Although historically it was a frequent cause of antibiotic-associated diarrhea and colitis, clindamycin is considered an excellent alternative to beta-lactam antibiotics for treatment of many staphylococcal infections, and it has therapeutic utility in anaerobic infections and in several protozoan infections in immunosuppressed patients. Metronidazole is efficacious for treating nonpulmonary anaerobic infections, various parasitic infections (trichomoniasis, amebiasis, and giardiasis), nonspecific vaginitis, and Clostridium difficile-mediated colitis. With use of metronidazole, mild side effects such as epigastric discomfort, diarrhea, reversible neutropenia, and allergic-type cutaneous reactions may occur.
Mayo Clin Proc 1991 Dec
PMID:Tetracyclines, chloramphenicol, erythromycin, clindamycin, and metronidazole. 174 96

In a setting where potable water is contaminated with Legionella pneumophila serogroup 1, we performed two case control studies. The first case control study consisted of 17 cases of nosocomial Legionnaires' disease (LD) and 33 control (the patients who were admitted to the ward where the case was admitted immediately before and after the case) subjects. Cases had a higher mortality rate 65% vs 12% (P less than 0.004); were more likely to have received assisted ventilation (P less than 0.00001); to have nasogastric tubes (P less than 0.0004) and to be receiving corticosteroids or other immunosuppressive therapy (P less than 0.0001). Based on the results of this study, sterile water was used to flush nasogastric tubes and to dilute nasogastric feeds. Only 3 cases of nosocomial LD occurred during the next year compared with 12 the previous year (P less than 0.0001). Nine cases subsequently occurred and formed the basis for the second case-control study. Eighteen control subjects were those patients admitted to the same unit where the case developed LD, immediately before and after the case. The mortality rate for the cases was 89% vs 6% for controls (P less than 0.00003). The only other significant difference was that cases were more likely to be receiving corticosteroids or other immunosuppressive therapy 89% vs 39% (less than 0.01). We hypothesized that microaspiration of contaminated potable water by immunocompromised patients was a risk factor for nosocomial Legionnaires' disease. From 17 March 1989 onwards such patients were given only sterile potable water. Only two cases of nosocomial LD occurred from June 1989 to September 1990 and both occurred on units where the sterile water policy was not in effect. We conclude that aspiration of contaminated potable water is a possible route for acquisition of nosocomial LD in our hospital and that provision of sterile potable water to high risk patients (those who are receiving corticosteroids or other immunosuppressive drugs; organ transplant recipients or hospitalized in an intensive care unit) should be mandatory.
Epidemiol Infect 1991 Dec
PMID:Control of endemic nosocomial legionnaires' disease by using sterile potable water for high risk patients. 175 8

We describe a case of culture-proven Legionnaires' disease (serogroup 1) in which a rapid diagnosis was made by detection of Legionella antigen in pleural fluid by use of the Binax radioimmunoassay for urine.
J Clin Microbiol 1991 Dec
PMID:Diagnosis of Legionnaires' disease by radioimmunoassay of Legionella antigen in pleural fluid. 175 69

In a study of the in vitro effectiveness of biocides against Legionella pneumophila, some aspects of the cooling tower environment were replicated in the laboratory, paying particular attention to water hardness and pH. Pieces of Douglas fir and polyvinyl chloride were colonized in a recirculating system and the comparative efficacy of two biocides (Bronopol and Kathon) against the sessile and planktonic populations was examined. While the biocides were relatively effective against the planktonic L. pneumophila population over a short period of time (minimum 9-12 h), substantially longer periods of time (maximum greater than 48 h) were required to reduce the number of cultivable bacteria to below detectable levels in the adherent population. The results indicate that failure to monitor the sessile population of L. pneumophila in laboratory studies of biocides may result in the use of incorrect dosages and/or contact times in field trials with apparently reduced in situ efficacy.
J Appl Bacteriol 1991 Dec
PMID:Decreased biocide susceptibility of adherent Legionella pneumophila. 177 46

The presence of a single apparently cryptic plasmid of approximately 36 MDa was demonstrated in the virulent Dodge strain of Legionella pneumophila. 'Tagging' of the plasmid with Tn5 enabled transfer to be demonstrated to other strains of Legionella (though not to Escherichia coli or Pseudomonas aeruginosa) as well as a definitive assessment to be made of its stability. Plasmid carriage confers resistance to UV light probably by means of an error-prone UV repair system. The plasmid is compatible with plasmids of the IncP and IncW incompatibility groups.
FEMS Microbiol Lett 1991 Dec 15
PMID:A plasmid from a virulent strain of Legionella pneumophila is conjugative and confers resistance to ultraviolet light. 178 81

Distribution of Legionella spp. were surveyed two different times in Kinki District, Japan. The first time, eighty six building cooling tower waters were collected from Osaka, Hyogo and Nara Prefecture between April and December, 1987. The second time, thirty five waters were studied from Nishinomiya City in Hyogo Prefecture on July, 1989. BMPA alpha agar plate was used as the isolation medium for the first eighty six samples and MWY agar plate for the second thirty five samples. Legionella were isolated from forty two samples (48.8%) of the first eighty six samples. Three different species of Legionella were isolated simultaneously from one sample and two species from eight samples. L. pneumophila serogroup 1 was the most predominant species. Twenty three samples (65.7%) were positive in culture from the second thirty five samples. Three different species of Legionella were isolated simultaneously from three samples and two species from eleven samples. Legionella anisa was more predominant than L. pneumophila serogroup 1 in this study.
Kansenshogaku Zasshi 1991 Dec
PMID:[Isolation of Legionella spp. from cooling tower water in Kinki District, Japan]. 178 9

The influence of the preparations of interferon on morphological changes in L. pneumophila on the ultrastructural level has been studied. Disturbances in the ultrastructure of L. pneumophila result from the direct bactericidal action of interferons without any interference of immune mechanisms. These disturbances are manifested by damages in the cell wall, plasma membrane, nuclear and ribosomal apparatuses of microbial cells. Leukinferon exhibits pronounced anti-Legionella activity, both in vitro in a liquid culture medium and in ovo, than reaferon.
Zh Mikrobiol Epidemiol Immunobiol 1991 Dec
PMID:[The effect of interferon preparations on the ultrastructural organization of Legionella pneumophila]. 178 42

Indole-3-propionic acid (IPA), a phytohormone derivative, is a potent inhibitor of growth of Legionella pneumophila cultivated extracellularly in a chemically defined hypotonic medium and intracellularly in human monocytes. The inhibitory activity turns into bactericidal activity with increasing concentrations. The susceptibility of the microorganism to IPA was more evident in "fast-growing" cultures (under conditions of vigorous shaking) than in static cultures growing under an atmosphere of 5% CO2-95% air, which resulted in a decreased growth rate. The MIC, after incubation with the drug for 48 h and as determined by counting of the CFU, was 1.58 microM for fast-growing cultures and 2.64 microM for those grown under static conditions. The MBCs were 5.28 and 26.43 microM, respectively. Tryptophan (Trp) at 150 microM prevented the inhibition caused by 2.64 microM IPA, increased the MIC about 3-fold, and increased the MBC by 10-fold. The effect of Trp was less remarkable in "slow-growing" cultures. The susceptibility of L. pneumophila proliferating in human monocytes was markedly lower than that when it was cultivated extracellularly in the chemically defined hypotonic medium. The MIC after incubation for 48 h was 5.28 microM, and a decrease in viable count was achieved with 105.70 microM. The lower susceptibility was apparently due (at least partially) to the presence of Trp (24.50 microM) in the RPMI 1640 medium that was used for the monocyte cultures. The effect of IPA was time dependent, and prolonged exposure enhanced the bactericidal activity and turned the inhibitory dose into a bactericidal dose. The present data demonstrate that IPA is a potent anti-L. pneumophila factor, although it has a markedly lower activity against bacteria growing intracellularly compared with its activity against extracellularly proliferating microorganisms.
Antimicrob Agents Chemother 1991 Dec
PMID:Susceptibility of Legionella pneumophila grown extracellularly and in human monocytes to indole-3-propionic acid. 181 Jan 85

Clarithromycin, a new macrolide antibiotic, is at least four times more active in vitro than erythromycin against Legionella pneumophila. In this study the safety and efficacy of orally administered clarithromycin (500 to 1,000 mg bid) in the treatment of Legionella pneumonia were evaluated. Forty-six patients were enrolled in the study, 15 of whom had not responded to previous routine anti-Legionella therapy (erythromycin, ofloxacin, rifampin [rifampicin], or tetracycline). Twelve patients prematurely discontinued the study (nine by the patient's request while feeling well; one because of cancer diagnosis; and two because of adverse events). The response rates after treatment were as follows: clinical cure rate, 98 percent (43/44); clinical success (cure or improved), 100 percent (44/44); radiographic success (cure and improved), 93 percent (28/30); direct antigen fluorescence resolution, 100 percent (40/40); and bacteriologic cure, 100 percent (13/13). Ten patients reported 13 adverse events (seven mild, four moderate, and two severe). Clarithromycin is a safe effective treatment for patients with severe chest infections due to Legionella pneumophila.
Chest 1991 Dec
PMID:The safety and efficacy of clarithromycin in patients with Legionella pneumonia. 183 89

The effect of human urinary colony-stimulating factor (CSF-HU) on in-vitro phagocytosis of Legionella pneumophila, superoxide anion production and intracellular killing of Legion, pneumophila by guinea pig alveolar macrophages was studied. Alveolar macrophages when incubated with CSF-HU demonstrated enhanced phagocytic activity and superoxide production. The bactericidal activity of treated cells was enhanced when they were afterwards incubated with a low concentration of bacteria, but these cells failed to inhibit bacterial multiplication when they were incubated with bacteria in a 1:10 ratio. In vivo, an increase in the total peripheral leucocyte count in guinea pigs after intraperitoneal injection of CSF-HU occurred and this was accompanied by an increase in granulocyte and monocyte counts. A comparison of treatment of experimental Legion, pneumophila pneumonia with CSF-HU alone, ceftazidime alone and a combination revealed lower mortality rates in the group receiving combination therapy. These data suggest a possible function for CSF-HU of enhancing antibiotic therapy in Legionnaires' disease.
J Antimicrob Chemother 1990 Dec
PMID:Effect of human urinary colony-stimulating factor on experimental Legionella pneumophila infection in guinea pigs. 196 49


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