Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026918 (Mycobacterium)
 52,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent outbreaks of multidrug-resistant tuberculosis (MDR-TB) have posed challenges for the management of exposed persons. This report offers suggestions for evaluating and managing persons (i.e., contacts) who have been exposed to patients with infectious MDR-TB (TB due to strains of Mycobacterium tuberculosis resistant to both isoniazid [INH] and rifampin [RIF]), provides background information on alternative preventive therapy regimens with drugs other than INH or RIF, and presents considerations relevant to making a decision to offer one of these alternative regimens.
 ...
PMID:Management of persons exposed to multidrug-resistant tuberculosis. 164 Sep 21

Vancomycin is a safe, effective antibiotic for a variety of serious gram-positive infections. Because of emerging vancomycin-resistant enterococci and the threat of spread of vancomycin-resistant genes to other gram-positive organisms, judicious use of vancomycin should be promoted. Trimethoprim-sulfamethoxazole, a broad-spectrum synergistic combination, continues to find widespread use in gram-negative bacterial infections, especially involving the urinary tract. It has enjoyed enormous success in prophylaxis and therapy of Pneumocystis carinii pneumonia. Rifampin remains of paramount significance as a cidal agent against Mycobacterium tuberculosis; however, increasing reports of strains of MDR-tuberculosis are of great concern.
 ...
PMID:Vancomycin, trimethoprim-sulfamethoxazole, and rifampin. 749 Apr 42

Tuberculosis, a major killer in developing countries, is on the rise again in industrialized nations. AIDS, increased use of immunosuppression and the emergence of multiple drug-resistant Mycobacterium tuberculosis (MDR-TB) have further enhanced its significance. TB is projected to cause 3.5 million deaths per year by 2000. Also, other types of mycobacteria are being incriminated in human infections with increasing frequency. Thus, the enhanced risk of nosocomial and iatrogenic spread of mycobacteria is forcing a review of infection control in general and claims of mycobactericidal activity of disinfectants in particular. Mycobacteria are more resistant to disinfection than enveloped viruses and other types of vegetative bacteria, but a proper comparison with non-enveloped viruses requires more data. Flaws in currently used protocols for mycobacterial activity are: (i) a lack of proper quantitation; (ii) unrealistically long contact times at higher than ambient temperatures; (iii) absence of a suitable organic load; (iv) ineffective neutralizers; (v) unsuitable surrogates for M. tuberculosis; (vi) improper recovery media; and (vii) inappropriate types of carriers. Furthermore, we have recently found a product meant for 14 day reuse to become non-mycobactericidal after only a week under actual use in an endoscopy unit. These considerations make the available data on product efficacy unreliable, especially in view of the increasing threat from MDR-TB. Recent findings suggest that the use of Mycobacterium terrae as a surrogate, better recovery media, flat surfaces as carriers, elimination of neutralizers, proper removal of cell clumps and a required > or = 4 log10 reduction in the number of colony forming units of the test bacterium after disinfectant treatment should make mycobacteridal tests more precise and reliable, thus making product registration and selection easier. There is also an urgent need to develop standardized protocols to determine the mycobactericidal activity of disinfectants under conditions of reuse.
 ...
PMID:Mycobactericidal testing of disinfectants: an update. 756 Sep 75

Outbreaks of multidrug-resistant Mycobacterium tuberculosis (multidrug-resistant tuberculosis; MDR-TB) have recently been reported in hospitals in the United States. Rapid spread of these bacilli and a high mortality among immunocompromised patients, i.e. HIV-infected individuals and AIDS patients, were observed. Factors that play a role in these outbreaks and the prevention of MDR-TB are discussed in this article. Awareness of a possible M. tuberculosis infection and the early introduction of measures to reduce the spread of these micro-organisms are steps that can prevent a nosocomial outbreak. The use of more rapid methods for culturing mycobacteria and determining their sensitivity to antimicrobial drugs can accelerate the diagnostic process and the recognition of multiresistance. In view of the poor results of treatment of MDR-TB, prevention should be the first requirement.
 ...
PMID:Prevention of nosocomial spread of multidrug-resistant tubercle bacilli. 805 47

From January 1990 to December 1991, 16 patients with multidrug-resistant tuberculosis (MDR-TB) caused by Mycobacterium tuberculosis resistant to isoniazid, rifampin, and streptomycin were diagnosed at Elmhurst Hospital. Compared with other TB patients, MDR-TB patients were more likely to have human immunodeficiency virus (HIV) infection (14/16 vs. 21/204, P < .001) and a prior admission (10/16 vs. 3/204, P < .001). HIV-infected patients hospitalized for > 10 days within three rooms of an infectious MDR-TB patient had higher risk of acquiring MDR-TB than did HIV-infected patients with shorter hospitalizations or locations further from the MDR-TB patient(s) (6/28 vs. 2/90, P < .001). Isolates of 6 of 8 MDR-TB patients in a chain of transmission were identical by restriction fragment length polymorphism DNA typing. Ambulation on the wards of inadequately masked TB patients and lack of negative pressure in isolation rooms probably facilitated transmission. This report documents nosocomial transmission of MDR-TB and underscores the need for effective isolation practices and facilities in health care institutions.
 ...
PMID:Transmission of multidrug-resistant Mycobacterium tuberculosis among persons with human immunodeficiency virus infection in an urban hospital: epidemiologic and restriction fragment length polymorphism analysis. 810 26

Because of the resurgence of tuberculosis (TB) in the United States, in 1987 the Advisory Committee for the Elimination of Tuberculosis recommended the strengthening of TB surveillance to improve monitoring and to assist in targeting groups at risk for disease. In addition, because of outbreaks of nosocomial multidrug-resistant TB (MDR-TB) in New York and Florida during 1990-1992, in 1992, the National MDR TB Task Force recommended that drug-susceptibility testing be performed on all initial and final Mycobacterium tuberculosis isolates from each TB patient and that the results be reported to CDC. In January 1993, in conjunction with state and local health departments, CDC implemented an expanded surveillance system for TB. This report summarizes final TB surveillance data for 1993, compares findings with previous years, and provides information on expanded surveillance.
 ...
PMID:Expanded tuberculosis surveillance and tuberculosis morbidity--United States, 1993. 818 27

From January 1991 through July 1992, multidrug-resistant (i.e., resistant to at least isoniazid [INH] and rifampin [RIF]) Mycobacterium tuberculosis (MDR-TB) was isolated from 43 (22%) of 198 patients with newly diagnosed TB at a New York City hospital. This report summarizes an epidemiologic investigation by the hospital infection-control, infectious diseases, and employee services staffs and presents information for the 32 patients in whom MDR-TB was diagnosed during January 1991-March 1992 (these were the only patients for whom complete information was available and analyzed).
 ...
PMID:Outbreak of multidrug-resistant tuberculosis at a hospital--New York City, 1991. 850 15

Minimal inhibitory concentrations (MICs) of 14 first and second-line antituberculous drugs against drug-susceptible and drug-resistant clinical isolates of Mycobacterium tuberculosis (including the multiple drug-resistant or MDR-TB isolates), as well as the type strain H37Rv, were determined radiometrically by the Bactec 460-TB methodols. MICs (microg/ml) of all the fourteen drugs were within an extremely narrow range in case of susceptible strains; isoniazid (0. 02-0.04), rifampin (0.2-0.4), ethambutol and streptomycin (0.5-2.0), ethionamide (0.25-0.5), D-cycloserine (25-75), capreomycin (1-2), kanamycin (2-4), amikacin (0.5-1.0), clofazimine (0.1-0.4), ofloxacin (0.5-1.0), ciprofloxacin (0.25-1.0), and sparfloxacin (0.1-0.4). The activity of second-line drugs remained unaltered against MDR-TB isolates resistant to routine first-line drugs. With peak serum level concentrations (Cmax), the intracellular killing of the virulent H37Rv strain was studied in detail in cultured human macrophages. Based on an decreasing order of bactericidal activity, our results showed the following spectrum of intracellular drug action: among the first-line drugs, rifampin > ethionamide = isoniazid > ethambutol > streptomycin > D-cycloserine; among second-line drugs, clofazimine = amikacin > kanamycin = capreomycin; among fluoroquinolones, sparfloxacin > ofloxacin > ciprofloxacin. On the other hand, contrary to atypical mycobacteria, the macrolide drug clarithromycin was inactive against both extracellular and intracellular M. tuberculosis.
 ...
PMID:In vitro activities of fourteen antimicrobial agents against drug susceptible and resistant clinical isolates of Mycobacterium tuberculosis and comparative intracellular activities against the virulent H37Rv strain in human macrophages. 867 93

Infection and disease caused by Mycobacterium tuberculosis remain a hugh global problem, and are not well controlled in several areas within the United States. Co-infection with the human immunodeficiency virus (HIV) and immigration from areas with high rates of tuberculosis contribute to the problem in the United States. Organisms resistant to the two main drugs, isoniazid and rifampin, known as multidrug-resistant M. tuberculosis or MDR-TB, present serious therapeutic challenges. Strategies for the management of such cases are presented.
 ...
PMID:Tuberculosis and multi-drug resistant tuberculosis in children. 870 Jun 14

Mycobacterium avium-intracellulare complex (MAC) is a ubiquitous environmental microorganism whose pathogenicity ranges from innocuous colonization to disease, in immunocompetent as well as immunocompromised individuals. We sought to determine the clinical significance of MAC in sputum cultures of patients with pulmonary tuberculosis (TB). A retrospective analysis between January 1994 and March 1995 at Bellevue Hospital Center revealed both Mycobacterium tuberculosis and MAC in 35 patients (11% of all patients with TB). Of 27 patients reviewed, 52% were HIV-1 infected (median CD4 + 25 cells per microliter). Radiographic manifestations in patients with TB and MAC were similar to those seen in patients with TB alone. Both mycobacteria were cultured primarily from respiratory sources. M tuberculosis was usually cultured first or concurrent with MAC, and in nearly all cases, both species were recovered within 2 months of each other. Most patients improved clinically, bacteriologically, and radiographically with standard antituberculous therapy, except those with advanced AIDS, multidrug-resistant TB (MDR-TB), or disseminated MAC. We conclude that recovery of MAC in sputum is common in patients with pulmonary TB, regardless of HIV-1 infection, MDR-TB, or other clinical, bacteriologic, or radiographic attributes. MAC cultivation in most of these patients likely represents transient colonization, and in most cases is not clinically significant.
 ...
PMID:The significance of Mycobacterium avium complex cultivation in the sputum of patients with pulmonary tuberculosis. 899 8


1 2 3 4 5 6 7 8 9 10 Next >>