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

Neutrophil granulocyte function was determined in three patients with systemic staphylococcal infection, clinical manifestations of generalized allergic disease, and hyperimmunoglobulinemia E. Each of the patients had urticarial skin rashes before or at the time of development of staphylococcal suppurative lymphadenitis, pneumonia, or sepsis. Neutrophil chemotaxis, random migration, phagocytosis, and bactericidal capacity were assessed to determine if an abnormality in these functions might have contributed to the development of severe staphylococcal infections. Each of the three patients with generalized urticaria was found to have a marked defect in neutrophil chemotaxis. The mean chemotactic index of the patients was 12 +/- 4, whereas that of 20 controls was 72 +/- 11. Neutrophil random migration, phagocytosis, and bactericidal capacity were normal in each patient. The serum or plasma of the patients did not inhibit chemotaxis of control neutrophils and did not contain an increased concentration of the chemotactic-factor inactivator found in normal serum. Treatment of the neutrophils of these three patients with the competitive histamine H2 receptor blocking agent, burimamide, produced a significant increase in chemotactic responsiveness. These studies suggest the possibility of pharmacologic modification of neutrophil granulocyte function.
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PMID:Severe staphylococcal disease associated with allergic manifestations, hyperimmunoglobulinemia E, and defective neutrophil chemotaxis. 97 42

We conducted a retrospective study to analyze the impact of central venous catheters (CVCs) and antiretroviral therapy on the frequency and the patterns of bacterial infections in children infected with human immunodeficiency virus during a 3-year period. Among 204 bacterial infections other than otitis media reviewed, soft tissue infection (n = 69), bacteremia (n = 57), pneumonia (n = 27) and sinusitis (n = 27) were encountered most frequently. Catheter-related staphylococcal infection was the most common infection in children with CVCs, particularly in those who were less than 6 years old. In children without CVCs, Streptococcus pneumoniae was the most frequent organism. Younger children had more CVC-related infections whereas children with lower CD4 counts had more CVC-related and CVC-unrelated infections. A lower frequency of CVC-unrelated infections was detected in patients who received antiretroviral therapy, especially those receiving a continuous infusion of zidovudine. These data suggest that increased frequency and altered patterns of bacterial infections are associated with the use of CVCs in these patients, but antiretroviral therapy may reduce the frequency of CVC-unrelated infections.
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PMID:Bacterial infections in human immunodeficiency virus type 1-infected children: the impact of central venous catheters and antiretroviral agents. 166 Oct 3

During staphylococcal pneumonia massive destruction of lung tissue is often observed. Staphylococcal serine proteinase (SSP) inactivates alpha-1-proteinase inhibitor (alpha 1PI) a major factor which protects lungs from phagocyte proteases. We investigated the effect of SSP on elastin degradation by porcine pancreatic elastase (PE) and crude extract of human neutrophil elastase (NE) in solution and gel containing alpha 1PI. SSP having no elastase activity enhanced PE and NE-induced elastinolysis in solution when added to alpha 1PI before mixing with elastase and then with elastin. SSP added simultaneously with alpha 1PI to PE had no influence on elastin degradation. However, SSP added simultaneously, 30 min before or 30 min after PE significantly increased elastin digestion in elastin-agarose plate with alpha 1PI. Maximal increase in elastinolysis about 3-fold was for SSP added 30 min prior to PE. Since elastin is the major component of the alveolar walls it is possible that lung damage in the course of staphylococcal infection may partly depend on action of SSP.
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PMID:Serine proteinase from Staphylococcus aureus enhances elastin degradation by elastases in the presence of human alpha-1-proteinase inhibitor. 185 84

Antibiotic usage for initial empirical treatment of infections in hospitalized patients was assessed by means of a questionnaire sent to physicians in charge of surgical and medical intensive care units, departments of neurosurgery, neurology, general surgery, thoracic surgery, internal medicine and pediatrics. Analysis of a total of 82 questionnaires filled in by the various departments revealed that the most frequently used regimens for initial empirical therapy were combinations of a broad spectrum penicillin with an amino-glycoside or of a second generation cephalosporin with an aminoglycoside in intensive care. Third generation cephalosporins ranked third among combination partners with aminoglycosides. Imipenem and fluoroquinolones were used only rarely for first line treatment. Second line treatment was most frequently with third generation cephalosporins or imipenem/cilastatin for internal wards and intensive care with an extension for staphylococcal infections with vancomycin or teicoplanin as the most frequent additional antibiotics. Patterns of antibiotic usage changed with regard to infection sites with a predominance of third generation cephalosporins or broad spectrum penicillins in combination with an aminoglycoside and metronidazole in abdominal sepsis and peritonitis. In case of pneumonia a differentiation between community acquired and hospital acquired pneumonias was made. Treatment was predominantly carried out with penicillin G, ampicillin or a second generation cephalosporin with or without the addition of an aminoglycoside in case of community acquired pneumonia. The addition of clindamycin or metronidazole was considered for suspected staphylococcal infection or aspiration pneumonia. Third generation cephalosporins were preferred for pneumonia treatment in surgical patients.
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PMID:Antibiotic usage for initial empirical treatment of infections in hospitalized patients in West Germany. 188 63

The advances in the antibiotic therapy of acute bacterial infections can be shown by the decreasing frequency of complications and fatalities in children. The annual death-rate from pneumonia in children aged one month to 15 years has fallen in Schleswig-Holstein from 1.8 (1954-1958) to 0.6 per 10,000 (1969-1973). At the same time the total death-rate in the same age group has fallen from 14.5 to 9.3 per 10,000 children. The percentage of pneumonia in the total death-rate was 5.3% in 1971-1973: 1.6% in the first month of life and after the sixteenth year 2.3%. Pneumonia was in fourth place (after accident, malformation and neoplasm) as a cause of death in children more than one month old. Of 245 children operated on for congenital heart disease in 1983-1984, bacterial and fungal infections occurred in 3.6% compared to 17.8% of 469 in 1968-1972. Staphylococcal infections decreased from 3.4% to 0.8% and those caused by gram-negative bacteria from 6.9% to 0. Perioperative prophylaxis was performed with cefotaxime plus piperacillin in 1983-1984 versus oxacillin plus ampicillin in 1968-1972. Between 1984 and 1989, 944 children (premature babies and term babies) were treated in the intensive care unit of the University Children's Hospital of Kiel. The incidence of sepsis was 5% (congenital sepsis 4%, sepsis acquired after birth 1%). Early diagnosis and treatment of severe bacterial infections with cefotaxime plus piperacillin reduced the mortality rate of sepsis to 2%. Sepsis never developed under treatment with cefotaxime plus piperacillin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Progress of antibiotic therapy in pediatrics]. 200 18

In an open study, 70 in-patients and 23 out-patients aged between 1 and 14 years with sinusitis (n = 1), perforated otitis media (n = 4), pharyngotonsillitis (n = 25), tracheobronchitis (n = 30) or broncho-pneumonia (n = 33) were treated daily with a combination of 40 mg/kg amoxycillin and 10 mg/kg clavulanic acid in three equal doses for between 6 and 15 days. Purulent specimens were cultured when obtainable and pathogenic organisms identified were Staphylococcus aureus, beta-haemolytic streptococcal group A, Pseudomonas aeruginosa, Pseudococcus species and Klebsiella pneumoniae infections, of which 45.7% were beta-lactamase-producing and 54.3% were ampicillin-susceptible. After treatment, only one beta-lactamase-producing Streptococcus and one Staphylococcus infection persisted. Side-effects (vomiting, nausea, diarrhoea, maculopapular exanthema, rash) occurred in 16 patients and treatment was withdrawn in eight. It is concluded that the amoxycillin--clavulanic acid combination is a suitable first choice for the treatment of respiratory tract infections in children in whom the pathogenic organism may not have been established.
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PMID:Treatment of respiratory tract infections in children: a study of a combination of amoxycillin and clavulanic acid. 222 80

Staphylococcal infection is common in Malaysian hospitals. A recent survey of 22 Malaysian hospitals revealed that staphylococci were isolated from almost 40% of positive blood cultures. A more detailed analysis of such cases in our own hospital showed that almost 70% of Staphylococcus aureus and about 16% of coagulase-negative staphylococcal isolates were associated with clinically-significant disease. Staphylococcal bacteraemia was seen mainly in neonatal sepsis, skin and soft tissue infections, pneumonia, arthritis, osteomyelitis, endocarditis and postoperative sepsis. Multiply-resistant S. aureus were encountered in all the hospitals surveyed. Resistance rates to penicillin ranged from 40% to almost 100% while methicillin resistance rates of up to 25% were reported from several hospitals.
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PMID:Staphylococcal infection in Malaysian hospitals. 289 92

Complete absence of the C1r portion of the first component of complement was found in a 2 1/2-year-old boy of Puerto Rican origin who presented with a staphylococcal liver abscess. His medical history also included two episodes of pneumonia complicated by a pneumatocele and empyema, purulent staphylococcal lymphadenitis, recurrent otitis media, and pneumococcal bacteremia. The C1s component of complement was 50% of normal, and C4 was elevated. Other immunologic tests, including nitroblue tetrazolium test, and IgE were normal. This is the tenth patient reported with C1r deficiency. The patient differs from other reported patients with C1r deficiency in that he presented with a liver abscess, an infection that has not been reported in patients with complement deficiencies, and in that he has an apparent susceptibility to staphylococcal infection.
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PMID:Recurrent infections and staphylococcal liver abscess in a child with C1r deficiency. 331 73

The effect of remantadine on the course of influenzal-staphylococcal infection was studied in white mice. When the drug was injected to the mice infected with remantadine-sensitive strain of influenza A virus and Staphylococcus the lethality decreased from 93.3% to 26.7%, the survival time increased from 3.8 to 10.1 days, the incidence of pneumonia decreased from 85.7% to 48.7%, the average intensity of pneumonia decreased from 66.4% to 9.9%, and virus titres in the lungs decreased by 3.5-4.0 lg EID50 (p less than 0.05). In the groups of mice infected with remantadine-resistant strain of influenza virus and Staphylococcus remantadine showed no significant effect on these parameters: the lethality decreased by 6.7% only, the average survival time increased only by 0.33 days, the incidence of pneumonia decreased by 9%, its intensity by 19.2%; influenza virus titres in the lung tissue did not change significantly.
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PMID:[Protective action of remantadine in experimental influenzal-staphylococcal infection]. 343 11

During the last 2 years an open lung biopsy was performed in 16 children aged from 2 to 14 years. Fourteen of these had a chemotherapeutic induced immunodeficiency and a radiological picture of diffuse pulmonary infiltrate. A definite diagnosis was established in 11 cases: 5 pneumocystis carinii pneumonitis, 2 CMV infections, 2 pneumocalcinosis, 1 neoplastic pulmonary lymphangitis and 1 staphylococcal infection. Three had a non-specific interstitial pneumonitis. In this series there was no post-operative death and the single complication was a wound infection. The tracheal tube could be removed within the hours following the intervention in 14 of the 16 children. The review of the recent literature suggests that the open lung biopsy is a safe and accurate way for the diagnosis of pulmonary infiltrates in pediatric immunocompromised patients. It is however a very invasive procedure and it is expectable that in the next year the bronchoalveolar lavage with a fiberoptic flexible bronchoscope will be systematically attempted prior to the open biopsy.
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PMID:[Surgical pulmonary biopsy in children]. 404 63


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