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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pseudomonas cepacia is a gram negative rod, having no fermentative activity on glucose. This organism was detected in the sputum, throat swab, or throat washing of 22 inpatients treated between January, 1990, and December, 1990, at the First Department of Internal Medicine, Kagawa Medical School. The primary diseases for which these 22 patients were hospitalized were leukemia in 12, malignant lymphoma in 5, lung cancer in 2, myelodysplastic syndrome in 1, and embryonal cell carcinoma in 1. Twelve of the 22 patients had episodes of pneumonia which complied clinically with the diagnostic criteria provided to facilitate the National Nosocomial Infection Study. The complication of pneumonia occurred in 7 patients with leukemia, 2 with malignant lymphoma, 2 with lung cancer, and 1 with myelodysplastic syndrome. In 10 of these 12 patients, the organism was detected before the onset of pneumonia. All 22 patients in whom the organism was demonstrated had received antibiotics. The antibiotics which was most frequently used to treat these patients 1 month before detection of Pseudomonas cepacia were amikacin and ceftizoxime, which were used in 13 patients. Of the antibiotics in which the susceptibility to Pseudomonas cepacia was, evaluated, minocycline was effective in 100% (21/21), ceftazidime in 50% (11/22), and ofloxacin in 27.3% (6/22). Physicians should be especially aware of the possibility of colonization and nosocomial respiratory infection by Pseudomonas cepacia in patients with severe underlying diseases.
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PMID:[Nosocomial respiratory infection caused by Pseudomonas cepacia in immunocompromised hosts]. 138 85

Streptococcus pneumoniae infection was indicated serologically in 84 (19%) of 449 children hospitalized with middle or lower respiratory tract infection. Pneumococcal antigen was detected in acute serum in 28 patients, but in acute urine in only 2. An antibody response to type-specific capsular polysaccharides of S. pneumoniae was indicated in 27 patients and to a protein antigen, pneumolysin, in 25 patients, but to C-polysaccharide in only 10 patients. The observations mentioned above suggest that each serological test for pneumococcal etiology is insensitive, and to get an optimal result, a large panel of pneumococcal antigen and antibody assays must be used. Pneumococcal infection could be indicated serologically although no focus of infection, such as pneumonia or acute otitis media, or no laboratory evidence of bacterial infection as elevated values of C-reactive protein concentration, erythrocyte sedimentation rate or white blood cell count was present. Particularly antibody responses to pneumococcal pneumolysin were present in children without pneumonia or acute otitis media. Our results point out that no nonspecific parameter can be used for the selection of patients with probable pneumococcal etiology among children with respiratory tract infection. Concomitant viral infection, in most cases RSV infection, was present in a third of the children with pneumococcal infection. It is concluded that pneumococcal etiology should be actively sought for also in patients with viral respiratory infection, especially in young children with RSV infection.
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PMID:Serologically indicated pneumococcal respiratory infection in children. 141 9

We present the bacteriological findings in 329 aspirates from fiberoptic bronchoscopy. Quantitative cultures were not performed. 92 of the patients had radiologically confirmed pneumonia, 58 possibly had infectious bronchitis or pneumonia which was not verified radiologically, 154 had other pulmonary diseases and 25 had no verified pulmonary disease. 13% of aspirates contained no bacterial isolates and 33% revealed growth of multiple bacteria, classified as "normal pharyngeal flora". Among the 54% with specified bacterial findings the most frequent bacteria were viridans streptococci, staphylococci, Haemophilus influenzae, and Streptococcus pneumoniae. The differences in bacterial flora between the patient groups were only minimal. Klebsiella and Escherichia coli were the only bacteria indicating presence of pneumonia. S pneumoniae were found more frequently among patients with no signs of infection. Bronchial aspirates obtained with a fiberbronchoscope may give false positive results and are of limited value in diagnosing pneumonia. However, the presence of gram negative intestinal rods may indicate bacterial respiratory infection in hospitalized patients. Improving sampling and culture techniques can possibly improve the value of bacteriological findings.
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PMID:[Bacteriological examination of bronchial aspirates obtained via fiberoptic bronchoscopy]. 141 5

This study was performed to demonstrate the early immuno-responses of lymphocytes in an experimental pneumonia with K. pneumoniae in mature mice (45 week-old) comparing with it in juvenile ones (4 week-old). Acute mice pneumonia was made by inhalation with K. pneumoniae DT-S strains into lung. Changes in lymphocytes including their subpopulation in bronchoalveolar lavage fluid (BALF), peripheral blood, hilar lymphnodes and lung tissue were observed after the inhalation. In addition, lung tissue and hilar lymphnode were examined immunohistologically. The following results were obtained: 1. Total lymphocytes in BALF were more rapidly increased in the mature group than in the juvenile one. But there was no significant change in leukocyte count in peripheral blood between both groups. 2. Such a rapid increase in lymphocytes in BALF in mature group depended on L3T4-Ly6c cells and L3T4-LFA 1 cells. These cells in juvenile group were not accumulated in BALF at initial phase of the infection. But in contrast, they were gradually increased in peripheral blood and in hilar lymphnode. There was significant time-differences in appearance of these cells in BALF between both groups. It might be, that L3T4-Ly6c cells and L3T4-LFA1 cells observed in BALF in mature animals were induced from bronchus-associated lymphoid tissue (BALT) or small lymph tissue in alveolar interstitium, but in juvenile ones were originated in hilar lymphnode. 3. Changes in Ly2-Ly6c cell and Ly2-LFA1 cell were shown the same tendency changes in L3T4-Ly6c cell and L3T4-LFA1 cell. 4. Accumulation of B220:Ly5-LFA1 cell in BALF was not observed in significant difference between the mature group and in the juvenile one. 5. L3T4 cells were markedly accumulation in subcortex area of hilar lymphnode in the juvenile group, but they were only seen scattered in the mature group. 6. It can be concluded that active T lymphocyte begins to response in situ in the early stage of respiratory infection in the mature host and this finding is a characteristic lymphocyte response, that is never seen in the juvenile group.
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PMID:[Study on lymphocyte-response in early stage of respiratory infection--a view point from experimental Klebsiella pneumoniae pneumonia]. 143 51

These guidelines deal with the evaluation of anti-infective drugs for the treatment of respiratory tract infections. Five clinical entities are described: streptococcal pharyngitis and tonsillitis, otitis media, sinusitis, bronchitis, and pneumonia. A wide variety of microorganisms are potentially pathogenetic in these diseases; these guidelines focus on the bacterial infections. Inclusion of a patient in a trial of a new drug is based on the clinical entity, with the requirement that a reasonable attempt will be made to establish a specific microbial etiology. Microbiologic evaluation of efficacy requires isolation of the pathogen and testing for in vitro susceptibility. Alternatively, surrogate markers may be used to identify the etiologic agent. The efficacy of new drugs is evaluated with reference to anticipated response rates. Establishment of the microbial etiology of respiratory tract infections is hampered by the presence of "normal flora" of the nose, mouth, and pharynx, which may include asymptomatic carriage of potential pathogens. This issue is addressed for each category of infection described. For example, it is suggested that for initial phase 2 trials of acute otitis media and acute sinusitis tympanocentesis or direct sinus puncture be used to collect exudate for culture. Acute exacerbations of chronic bronchitis also present difficulties in the establishment of microbial etiology. These guidelines suggest that clinical trials employ an active control drug but leave open the possibility of a placebo-controlled trial. For pneumonia, the guidelines suggest the identification and enrollment of patients by the clinical type of pneumonia, e.g., atypical pneumonia or acute bacterial pneumonia, rather than by etiologic organism or according to whether it was community or hospital acquired. For each respiratory infection, the clinical response is judged as cure, failure, or indeterminate. Clinical improvement is not acceptable unless quantitative response measures can be applied.
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PMID:Evaluation of new anti-infective drugs for the treatment of respiratory tract infections. Infectious Diseases Society of America and the Food and Drug Administration. 147 53

Chlamydia pneumoniae is emerging as a significant cause of respiratory disease, including pneumonia and bronchitis, in humans. In this recently completed study of infection due to C. pneumoniae in patients presenting with pneumonia to SUNY Health Science Center at Brooklyn, we identified two individuals for whom cultures were positive on multiple occasions over a 1-year period. To determine the frequency of persistent respiratory infection with C. pneumoniae, follow-up specimens were obtained from nine individuals with culture-documented C. pneumoniae infection. Five of these individuals had persistent infection: four had a flulike illness characterized by pharyngitis, and one had bronchitis with prominent bronchospasm. All five individuals appeared to have acute C. pneumoniae infection as determined by results of serologic tests (titers of IgM antibody for all individuals were greater than or equal to 1:16). For three patients, cultures remained positive for 11 months despite therapy with 10- to 21-day courses of tetracycline or doxycycline. These observations suggest that persistent infection with C. pneumoniae may follow acute infection and may persist for many months. Infection with C. pneumoniae may be very difficult to eradicate with use of currently available antibiotics even if there is a clinical response to therapy.
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PMID:Persistent infection with Chlamydia pneumoniae following acute respiratory illness. 157 25

Bacterial adherence to the alveolar and respiratory tract system was broadly divided into specific and non-specific adhesion, and effects such as aging were investigated. In specific adhesion, various types of lectin that specifically bind to oligosaccarids as bacterial receptors were used, and lectin specific sugers map of the alveolar and respiratory system were prepared. However, no quantitative difference in oligosaccarids distribution was noted between elderly and young subjects. Meanwhile, in nonspecific adhesion, a study on K. pneumonia infection in mice revealed a pattern of glycocalyx production by the bacteria and their adhesion to the alveolar wall. Clinically, in cases of chronic respiratory infection, a pattern of production of and assembly around glycocalices by P. aeruginosa was observed (biofilm). In vitro tests showed that bacteria in the biofilm are resistant to antibacterial drugs. In the elderly, many factors match the conditions that facilitate the production of glycocalices by bacteria, and many infections of the respiratory organs in the elderly are attributed to nonspecific bacteria adhesion. Infections are thought to become intractable once they extend into biofilm.
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PMID:[Bacterial adherence to the alveolar and respiratory tract system]. 160 53

Panipenem/betamipron (CS-976, PAPM/BP), a new carbapenem antibiotic, was administered a single dose of 500 mg or 750 mg via intravenous drip infusion twice a day for treatment of chronic respiratory infection to study its clinical efficacy, bacteriological efficacy and safety. Twenty nine cases were studied for the efficacy evaluation. Only the safety evaluation was made in 6 cases which were judged to be unsuitable, because in some of them pneumonia and other diseases were not specified as the subject diseases, of serious illness in some the conditions were too serious, and in the other cases the duration of administration was insufficient since administration had to be discontinued due to side-effects. The duration of administration was 6 to 18 days with 1 g divided into 2 doses daily or 4 to 15 days with 1.5 g in 2 divided doses daily. When clinical efficacies were classified according to different diseases, this preparation was effective in 11 cases and slightly effective in 1 case of 12 cases of chronic bronchitis with an efficacy rate of 91.7%. It was effective in 10 cases, slightly effective in 1 case and ineffective in 1 case of 12 cases of bronchiectasis with an efficacy rate of 83.3%. It was slightly effective in 2 and ineffective in 1 out of 3 cases of diffuse panbronchiolitis, and was effective in 2 cases of pulmonary emphysema with infections. PAPM/BP was given at a dose level of 1 g in 2 divided doses daily to 17 cases and that of 1.5 g in 2 divided doses daily to 10 cases. For the remaining 2 cases, changes in the dose level were made in middle course of treatment. The efficacy rate in the 1 g regimen was 76.5% and that with the 1.5 g regimen was 90%. The overall results in the 29 cases included 23 effective, 4 slightly effective and 2 ineffective cases, thus the overall efficacy rate was 79.3%. As pathogens, 11 species including 24 strains were isolated and identified from 19 cases. They were Gram-positive cocci including 2 strains each of Staphylococcus aureus and Streptococcus pneumoniae, 1 strain each of Staphylococcus epidermidis, Streptococcus sanguis, and Streptococcus viridans and a strain of Streptococcus spp., and Gram-negative rods including 9 strains of Pseudomonas aeruginosa, 4 strains of Haemophilus influenzae and 1 strain each of Klebsiella pneumoniae, Enterobacter cloacae and Pseudomonas spp.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A clinical study on panipenem/betamipron in chronic respiratory tract infections]. 161 69

We experienced a case of a 68-year-old female with beta-lactam antibiotics including penicillin G (PCG) resistant pneumococcal pneumonia, leading to death during the treatment with ceftizoxime (CZX). We reported the clinical course and the mechanism of resistance of isolated bacteria. The present case is the first in Japan. Minimum inhibitory concentration (MIC) against Streptococcus pneumoniae 88031 isolated from the present case was 1.56 micrograms/ml in PCG and 6.25 micrograms/ml in CZX, showing PCG resistance. The isolate was no beta-lactamase production and serotype 23. The drug susceptibility in 34 strains of S. pneumoniae which were isolated as causative organism of respiratory infection in our department in 1988 was studied. PCG high resistant strain (PCG MIC greater than 1.56 micrograms/ml) was only observed in the isolated strain in the present case and PCG low sensitive strains (PCG MIC = 0.1-1.0 micrograms/ml) were observed in 3 strains (8.8%). The CZX resistance was observed only in the present case. The detection of penicillin-binding protein (PBP) and binding affinity of beta-lactam antibiotics were studied using PCG sensitive strain, S. pneumoniae type I (preserved strain PCG MIC = 0.05 micrograms/ml, CZX MIC = 0.1 micrograms/ml, CMX MIC = 0.025 micrograms/ml) and PCG resistant strain, S. pneumoniae 88031. The result obtained showed that PBP1a, detected in sensitive strain type I, was not detected in resistant strain 88031 and PBP1b was increased. The binding of 14C-PCG of PCG resistant strain to PBP1b showed lower affinity for CZX and CMX than PCG sensitive strain.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of penicillin-resistant pneumococcal pneumonia and penicillin-binding proteins of the clinical isolates]. 162 45

Branhamella catarrhalis is an aerobic Gram-negative diplococcus. It has been traditionally regarded as an oropharyngeal commensal and until recently was only identified as a pathogen in cases of bronchopulmonary infections. The aim of this study was to analyse the characteristics of the respiratory infections caused by B. catarrhalis and to know the antibiotic susceptibility of this microorganism. We retrospectively studied 32 lower respiratory tract infections, caused by B. catarrhalis (20 cases of bronchial infection and 12 cases of pneumonia), diagnosed between 1988-1989 in our hospital. All patients had an underlying disease; chronic obstructive pulmonary disease (COPD) and chronic heart disease being the most frequent. The aetiological diagnostic procedures were: sputum culture in 28 cases (15 in pure culture and 13 mixed), protected specimen brush (PSB) in three cases and transthoracic needle aspiration (TNA) in one case. Twenty B. catarrhalis isolates were penicillin and ampicillin-resistant, 11 in the pneumonia group and 9 in the bronchial infection group. All isolates were sensitive to amoxycillin-clavulanic acid and second generation cephalosporin. In our group four patients died. We conclude that B. catarrhalis is a not infrequent cause of respiratory infection, particularly in COPD patients, and that the high incidence of antibiotic resistance to penicillin and ampicillin should be taken into account before considering an empirical antibiotic treatment.
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PMID:Branhamella catarrhalis respiratory infections. 162 25


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