Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Panipenem/betamipron (PAPM/BP) is a combination drug of PAPM, a new parenteral carbapenem antibiotic and BP, an amino acid derivative at a weight ratio of 1:1. Its in vitro antibacterial activities against clinically isolated respiratory pathogenic bacteria were determined. It was superior to imipenem (IPM) in the in vitro antibacterial activities against Haemophilus influenzae, Haemophilus parainfluenzae, Branhamella catarrhalis, Staphylococcus aureus including MRSA, Klebsiella pneumoniae, Serratia marcescens and Escherichia coli. PAPM had antibacterial activities almost equal to those of IPM against Streptococcus pneumoniae and Enterococcus spp. Against Pseudomonas aeruginosa, however, its antibacterial activity was about 1/4 that of IPM. The clinical usefulness of PAPM/BP was studied by dissolving it in a solution containing lactate and administering the solution by intravenous drip infusion to 12 cases of respiratory tract infections. Out of 11 cases with respiratory tract infections excluding cytomegalovirus pneumonia, the efficacy rate was 90.9%, with 4 cases of excellent and 6 cases of good responses. In terms of its bacteriological efficacies, eradication of pathogenic bacteria including super-infection were observed in 2 out of 4 strains, but 2 strains of P. aeruginosa remained unchanged. Six strains appeared as superinfected bacteria during and after administration of this preparation substituting original pathogens. Side-effects were not observed in the 12 cases, and in laboratory tests, slight transient increases of S-GOT and S-GPT were found in 1 case. In conclusion, PAPM/BP is a very useful parenteral antibiotic against respiratory tract infections and can be one of the drugs of the first choice.
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PMID:[A study on in vitro antibacterial activity and clinical usefulness in respiratory tract infections of panipenem/betamipron, a newly synthesized carbapenem antibiotic]. 161 67

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

This study was performed to demonstrate the characteristic findings in pneumonia under neutropenic condition. The results were as follows. 1) After nebulizing Klebsiella pneumonia DT-S strains, the survival rate in the neutropenic mouse group rapidly decreased compared with that of the control group. 2) In the neutropenic state, a rapid decline of survival rate was demonstrated during the initial stage of infection. Bacteremia and endotoxemia developed earlier than in the healthy control group. 3) In neutropenic pneumonia, the neutrophil cell count in BALF was significantly lower than that in usual pneumonia. Consequently, a large number of bacteria grew in the alveolar spaces during the early period after inhalation. Neither inflammatory cell infiltration nor thickening of the alveolar wall was present; however, structural destruction of alveolar and vascular walls was found. 4) These pathological changes were also seen following intratracheal inoculation of some extracellular enzymes of Klebsiella pneumoniae DT-S into rabbit lung. However, no destruction of alveolar walls was observed after nebulizing the killed Klebsiella pneumoniae DT-S. It was suggested that the significant amount of enzymes produced by the bacteria growing in the alveoli caused tissue damage, especially in the neutropenic state. 5) Thus the typical inflammatory changes that occurred in the usual state, were not seen in neutropenic pneumonia, and a large number of bacteria grew in the alveoli. Marked tissue damage was caused by extracellular enzymes produced by bacteria. Consequently, bacteria entered the blood stream and bacteremia and endotoxemia developed. These processes observed in neutropenic pneumonia readily progressed to bacteremia of endotoxemia, which are more severe in this state.
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PMID:[Experimental study on development and lung injury in pneumonia under neutropenic condition]. 162 94

Efficacy of sulbactam, a beta-lactamase inhibitor, in combination with ampicillin, was evaluated for treatment of experimentally induced pneumonia caused by beta-lactam-resistant Klebsiella pneumoniae. Infection was experimentally induced in 18 healthy weanling foals that were randomly allocated to 3 treatment groups: sulbactam plus ampicillin (S/A, 3.3 and 6.6 mg/kg of body weight, respectively), ampicillin (6.6 mg/kg), or vehicle only. Foals were treated daily for 7 days; the observer was unaware of treatment status. Compared with ampicillin and vehicle, treatment with S/A resulted in a statistically significant (P less than 0.05) decrease in severity of pneumonia, with regard to bronchoalveolar lavage cytologic findings (decreased total cell and neutrophil numbers, and increased lymphocyte numbers) and extent of macroscopic lesions in lung tissue of the noninoculated regions. Marked trends toward improvement of S/A-treated foals were observed for quantitative results of bacteriologic culture of bronchoalveolar lavage fluid samples (P less than 0.07), macroscopic pathologic features of the whole lung (P less than 0.1), and histopathologic variables (P less than 0.07), compared with ampicillin- and vehicle-treated foals. Treatment effects were not observed for radiographic, hematologic, and blood gas abnormalities that resulted from infection. In conclusion, the combination of sulbactam plus ampicillin was found to have synergistic effects in vivo, to reduce the extent and severity of experimentally induced gram-negative lung infection in foals.
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PMID:Evaluation of sulbactam plus ampicillin for treatment of experimentally induced Klebsiella pneumoniae lung infection in foals. 162 75

Twenty trials (17 controlled and three observational cohort studies) on selective decontamination of the digestive tract (SDD) have been undertaken to date. SDD is defined as a technique which aims to eradicate carriage of disease-causing microorganisms by means of lethal oropharyngeal and faecal antimicrobial concentrations. The SDD concept and the criteria for the choice of the antimicrobials used in the SDD programme are explained. Abolition of the carrier state is thought to provide clinical, bacteriological and epidemiological benefits. Infection-specific morbidity and mortality, emergence of antibiotic resistance and outbreaks are the main endpoints evaluated in this review. Of the 15 controlled studies that considered carriage, 14 demonstrated a significant reduction of Gram-negative bacillary (GNB) carriage. Severe infections, including pneumonia and septicaemia, caused by enterobacteria and pseudomonads have been virtually eliminated in these trials. Five of the 12 centres that evaluated mortality showed a significant decrease among patients who received SDD. Two recent trials describe the control of an outbreak with a multiresistant Klebsiella by SDD. There are three indications for the use of SDD so far: (i) in trauma patients; (ii) in certain elective surgical procedures including liver transplantation and oesophageal resection; and (iii) in control of outbreaks of ICU infection. Future lines of research may include a properly designed trial with mortality as endpoint and studies on the transfer of SDD from the ICU into the ward as part of prophylaxis in major surgery.
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PMID:Selective decontamination of the digestive tract (SDD) in intensive care patients: a critical evaluation of the clinical, bacteriological and epidemiological benefits. 135 63

Bacterial attachment is believed to be an early step in gram-negative nosocomial pneumonia. The frequency of fimbria-associated adhesins among respiratory pathogens has not been studied in detail. In this study isolates belonging to the family Enterobacteriaceae, prospectively obtained from intensive care unit patients who were suspected of having nosocomial pneumonia, were examined for fimbria-associated adhesins. Type 3, P, type 1, and other fimbrial phenotypes were identified by specific hemagglutination and electron microscopy. The Klebsiella type 3 fimbrial phenotype was further characterized by using a monoclonal antibody. Also, both type 3 and Escherichia coli P fimbrial genotypes were detected by using DNA colony blot assays. The frequencies of genera or species isolated were as follows: Enterobacter (38.6%), Klebsiella (26.8%), Serratia (17.7%), E. coli (13%), and Proteus (5.2%). Isolates of Klebsiella oxytoca, K. pneumoniae, and Enterobacter cloacae most commonly possessed the type 3 fimbrial phenotype and genotype. The phenotype and genotype for E. coli P fimbriae (46.2 and 50%, respectively), a known pathogenic determinant in the urinary tract, were detected more frequently than expected. In addition, a previously unspecified hemagglutinin that was specific for porcine erythrocytes was almost uniformly expressed among isolates of Enterobacter aerogenes. Finally, the expression of the type 1 fimbrial phenotype was widely detected among the isolates tested but notably absent among K. oxytoca and Proteus mirabilis isolates. The frequency of the various fimbrial types identified suggests a role for these bacterial organelles in adherence to respiratory epithelia.
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PMID:Fimbrial types among respiratory isolates belonging to the family Enterobacteriaceae. 168 95

A 12-month prospective study of infection was carried out in the special care baby unit (SCBU), Khoula Hospital, Muscat, Sultanate of Oman. During this period, 8720 babies were born in the hospital and 1265 were admitted to the SCBU. Altogether, 490 babies were of less than 36 weeks' gestation. A total of 190 babies (160 born in the hospital, 30 born before admission) satisfied the criteria for infection. The most common clinical presentation was pneumonia. There was one outbreak of iatrogenic infection. Infection was confirmed microbiologically in 76 of 190 symptomatic babies. Staphylococcus aureus was the most common pathogen and was isolated from 48 infected babies (25%). Beta-haemolytic streptococci were isolated from superficial sites only in eight babies. Klebsiella spp were the commonest enteric bacteria isolated, but they were rarely associated with infection. Of 46 babies who had bacteraemia, 9 also had meningitis. Nine of the 46 babies died, including 6 of the 9 who had meningitis. The mortality following Gram-negative infection was higher than that following Gram-positive infection. Fourteen per cent of infected babies born in hospital and 27% of those born before admission died. A high proportion of bacteria isolated were resistant to ampicillin and/or gentamicin. Results suggest that alternative antibiotics would be more appropriate for initial treatment. The study shows that in developing countries, unsophisticated research, using basic facilities, can be of value in identifying the problems of infection and in recognizing possible solutions to them.
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PMID:Survey of infection in babies at the Khoula Hospital, Oman. 169 43

The S. aureus 209P UF mutant dehydrogenase activity suppression method was used for detection of enterotoxin of Enterobacteriaceae opportunistic bacteria. Comparison of V. cholerae non 01, E coli and K. pneumonia toxigenic and nontoxigenic strains, neutralization test with antitoxic anticholera serum, comparative study of toxigenicities in paw edema test (according to Yu. P. Vartanyan) have shown that Escherichia and Klebsiella toxigenic strains can suppress S. aureus 209P UF mutant dehydrogenase activity, which fact permits the employment of this method for the detection of opportunistic bacteria enterotoxigenicity.
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PMID:[Determination of the enterotoxigenicity of conditionally pathogenic microorganisms using the method of suppressing the dehydrogenase activity of the UV mutant Staphylococcus aureus 209 P]. 169 48

Ethanol suppresses functions of the polymorphonuclear leukocyte (PMNL), seriously compromising normal host defenses against pneumonia. Because granulocyte colony-stimulating factor (G-CSF) augments the number and function of PMNL, the effect of G-CSF on the antibacterial defenses of the lung in normal and acutely intoxicated rats was studied. Animals received G-CSF or vehicle twice a day for 2 days, then ethanol or saline, followed by challenge with Klebsiella pneumoniae. K. pneumoniae elicited an intrapulmonary influx of PMNL in control rats that was markedly suppressed by prior ethanol administration. G-CSF augmented the recruitment of PMNL into the lungs of control rats and significantly attenuated the adverse effects of ethanol on PMNL entry into the lung. G-CSF enhanced intrapulmonary bactericidal activity against this pathogen in normal and ethanol-treated rats. All intoxicated rats pretreated with the vehicle died, while greater than 90% of rats pretreated with G-CSF survived. These findings suggest a potential role for G-CSF in mitigating the adverse effects of ethanol on PMNL delivery and pulmonary host defenses.
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PMID:Granulocyte colony-stimulating factor enhances pulmonary host defenses in normal and ethanol-treated rats. 171 3

Mortality and morbidity of nosocomial pneumonia remain high. Successful treatment of pulmonary infections depends on several factors including type of infection, offending pathogen, status of host defences, and adequate choice of antibiotic therapy. The physician's decision should aim at achieving antibiotic concentrations beyond the MIC at the site of infection. Gram-negative bacilli, notably Pseudomonos aeruginosa, Klebsiella pneumoniae and Escherichia coli, remain the most frequent agents in nosocomial pneumonia. Staphylococcus aureus and Streptococcus pneumoniae predominate among the Gram-positive cocci. Pneumocystis carinii predominates in immunocompromised patients. Protected sample bronchoscopy associated with quantitative cultures of samples, and quantification of intracellular microorganisms in cells recovered by broncho-alveolar lavage are two promising procedures which might replace previous, more aggressive methods. Penetration of antibiotics into lung tissue depends on physicochemical properties of the drug and the degree of inflammation of lung tissue. Quinolones, macrolides, tetracyclines and trimethoprim penetrate well into bronchial secretions. Penetration is moderate to low for aminoglycosides and beta-lactams. Fluoroquinolones and new beta-lactam agents, including third-generation cephalosporins imipenem, aztreonam and ticarcillin-clavulanate, showed comparative clinical efficacy in treatment of nosocomial pneumonia, with an efficacy rate close to 80%. Aminoglycosides should not be used alone. Combination therapy reduces but does not eliminate the risk of selection of Gram-negative resistant mutants. It should not be used routinely except for P. aeruginosa, Enterobacter cloacae and Serratia marcescens infections.
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PMID:Drug treatment of pneumonia in the hospital. What are the choices? 172 42


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