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

The resistance to antibiotics of the 985 clinical isolates collected in Tian Tan hospital was studied. The results showed that S. aureus had a resistant rate of more than 90% to penicillin and was also highly resistant to erythromycin. Methicillin resistant Staphylococcus Aureus (MRSA) was isolated in 15.6% of all the isolates with S. aureus. The isolation rate of MRSA is lower than that in other countries or districts of West Pacific Area. K. pneumonia and other Gram negative bacilli had a resistant rate of 0.6% to amikacin and P. aeruginosa was all sensitive to Polymyxin-B.
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PMID:[Resistant rate to antibiotics in Tian Tan Hospital for 3 years]. 130 51

A strain of Methicillin-Resistant Staphylococcus aureus (MRSA) was first isolated in our hospital in March 1986. Since then, MRSA has become a difficult pathogen and a cause of sepsis, bacterial endocarditis, and pneumonia in 1988. Rigorous hospital-wide control measures have been planned. The major control measures, based on the various investigations reported, consist of the following three points; improvement of environmental control, reinforcement of handwashing practices during care and control usage of antibiotics. The frequency of isolation of MRSA among the S. aureus isolates was 43.3% in 1988 and this was further reduced to 31.7% in 1990. The total number of MRSA isolates from decubitus, bile, and blood samples have also declined. This decline resulted in a reduction of cases of severe MRSA infection. As yet, MRSA strain are still isolated on incubation. There may be a limit to complete control by measures in a single hospital. It is desired that regional measures and national consensus on nosocomial infection be established.
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PMID:[An attempt to control nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection]. 150 24

A study of the pathogenicity of the Enterococcus and Methicillin resistant S. aureus (MRSA) was made of 781 cases with gastroenterological surgery. The results obtained were summarized as follows. In this study 215 strains were isolated from clinical specimens. In these strains 13% was isolated from the postoperative mixed infection and only 7% occurred in single infection. Most of the single infections by the Enterococcus occurred in the cases with changes in host resistance, such as terminal cancer, disorder of the glucose tolerance, malnutrition and/or organ failures. Seventy-three strains were isolated from clinical specimens. In these strains 10% were the postoperative mixed infection and 40% were single infection. Incidence of the infection by the MRSA was significantly high compared with that by the Enterococcus. Single infection by the MRSA occurred even in the cases with normal host resistance. Strains producing enterotoxin C (single or plus A) were frequently isolated in MRSA enteritis or pneumonia. However, 60 percent of the patients in whom MRSA were detected in their abdominal drains had no signs of infection. These results suggest that the occurrence and severity of the MRSA infection relate with site of the infection and production of the exotoxin.
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PMID:[Study of the host factors in the occurrence of the postoperative infections--special reference to the pathogenicity of the Enterococcus and MRSA]. 194 6

A comparative study of the ecology of the burn wound bacterial flora, during Jan. 1970 to Dec. 1971 (Group I) and Jan. 1985 to Dec. 1986 (Group II) was carried out. The incidence of Gram positive cocci was 40.70% in Group I versus 45.66% in Group II. That of Gram negative bacilli was 54.92% and 48.10% respectively. The occurrence of Ps. aeruginosa was markedly reduced, in Group I it reached 35.08% versus 11.26% in Group II (P less than 0.001). The incidence of Enterobacter aerogenes was significantly increased, in Group I it was only 3.69% but it accounted for 11.14% in Group II (P less than 0.001). Before 1972, K. pneumonia and E. cloacae were seldom found on burn wounds, in Group II, however, the incidence was 3.79% and 3.06% respectively. Acinetobacter anitratum occurred more often in Group II than in Group I, being 3.30% and 1.38% respectively (P less than 0.05). A total of 79 strains of Staphylococcus aureus were isolated from burn wounds, during Dec. 1986 to Nov. 1987. Among them Methicillin resistant Staphylococcus aureus (MRSA) accounted for 58 strains (73.4%) that is notable problem. In this centre 1% silver sulphadiazine has been used routinely since 1972 and third-generation cephalosporins have been used widely since 1983, there are the principle causes of the changing pattern of bacterial flora on the burn wounds.
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PMID:[Ecological changes in burn wound bacterial flora]. 212 51

Methicillin-resistant Staphylococcus aureus (MRSA) are now causing severe clinical infection on a worldwide basis. Pulmonary infection due to MRSA although widely reported is poorly documented. We report the predisposing factors, underlying diseases, treatment and outcome in 4 patients with pneumonia, 3 patients with empyema thoracis, 1 patient with pneumonia and empyema thoracis, 1 patient with pneumonia plus lobectomy wound infection and 2 patients with lung abscess. Vancomycin was highly effective in treatment, a finding compatible with experience treating other severe MRSA infections.
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PMID:Pulmonary infection due to methicillin-resistant Staphylococcus aureus. 340 69

We experienced successful treatment of postoperative severe pneumonia of Methicillin-resistant Staphylococcus aureus (MRSA) with combination therapy of Arbekacin (ABK) and Fosfomycin (FOM) in three lung cancer patients. Case 1 was a advanced age of seventy-nine man who had had right upper lobectomy. Case 2 was a 61-year-old man who had had left lower lobectomy and extended bilateral mediastinal lymph-node dissection through the median sternotomy. And case 3 was a 59-year-old man who had suffered from pulmonary embolism after right pneumonectomy and partial resection of left atrium and superior vena cava. All cases were immuno-compromised patients and super-infected with Gram-negative rods, and Pseudomonas aeruginosa in case 1 and case 3. Clinical symptoms were improved after the start of administration of ABK and FOM inspite of ineffectiveness of prior treatment with other antibiotics. We added staggered chemotherapy of Sulbactam/Cefoperazone (SBT/CPZ) and Ceftazidime (CAZ) for case 1 and case 3 respectively. Thus, the combination therapy of ABK and FOM might be useful for severe pneumonia of MRSA in the immunocompromised patients, and the combined staggered chemotherapy of beta-lactum agents and above would be the first choice in the treatment for the case involving Pseudomonas aeruginosa.
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PMID:[Combination therapy with arbekacin and fosfomycin against postoperative severe mixed-pneumonia of MRSA in primary lung cancer patients]. 747 82

A double-blind randomized placebo-controlled study was carried out to evaluate the efficacy and the cost of selective digestive decontamination (SDD) to prevent nosocomial pneumonia in multiple-trauma patients. Nosocomial infections, particularly pneumonia, were more frequent in the placebo group. The most common infectious agent was Staphylococcus: Staphylococcus aureus in the placebo group and Staphylococcus epidermidis in the SDD group. Methicillin-resistant Staphylococcus epidermidis was detected more often in the SDD group. No methicillin-resistant Staphylococcus aureus was observed in this study. Fewer patients in the SDD group required antibiotherapy. SDD resulted in a saving of about 41% in drug expenditure.
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PMID:Selective digestive decontamination in multiple trauma patients: cost and efficacy. 771 73

Hospital-acquired pneumonia is one of the most important fatal respiratory diseases in the elderly. Prompt and precise empiric therapy is essential for recovery. Fourteen isolates from twelve elderly lepromatous leprosy patients (9 men, 3 women, mean age of 75.8 years) with hospital-acquired pneumonia were studied. Subsequently, empiric therapy with gentamicin and beta-lactams for nosocomial pneumonia in the elderly was examined. Fourteen types of bacteria isolated from expectorated sputum specimens consisted mainly of ten strains of gram-negative bacilli (71%) six of Klebsiella pneumoniae, one each of Citrobacter freundii, Enterobacter agglomerans, Serratia liquefaciens, and Aeromonas hydrophilia and four strains of gram-positive cocci (29%) two of Staphylococcus sp., one each of Streptococcus sp. and Streptococcus pneumoniae. Methicillin-resistant Staphylococcus aureus and Pseudomonas sp. were not detected. Resistance rates of the etiologic agents to the antibiotics showed that gentamicin was 7.7%, ceftazidime 0%, and cefmetazole 23.1%. Cephalosporins were superior to penicillins. As a result of empiric therapy, six elderly leprosy patients with nosocomial pneumonia were cured and one improved temporarily. This study shows the necessity of specific empiric therapy for hospital-acquired pneumonia in a hospital with many elderly patients. The combination of gentamicin and beta-lactams is of value as an initial antibiotic therapy for hospital-acquired pneumonia in the elderly.
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PMID:[Clinical bacteriology and empiric therapy for hospital-acquired pneumonia in the elderly at a national leprosarium]. 779 54

Endotoxin(lipopolysaccharide = LPS), cell wall component of gram-negative bacteria, activates monocytes and macrophages to release cytokines, reactive nitrogen intermediates (RNI), and to generate tissue factor(TF) which initiate coagulation. We have purified 7kDa and 18kDa cationic antibacterial proteins (CAP-7 and CAP-18) with LPS-binding and LPS-neutralizing activities from rabbit granulocytes using as an assay the agglutination of erythrocytes coated with Re-LPS. From protein sequencing, CAP-7 was identified as the C-terminal 37 amino acid fragment of CAP-18. Synthetic peptide #197 (identical sequence to CAP-7, Gly1-Try37) and #36-1 (a truncation of CAP consisting of 32 amino acid residues, Gly1-Ala32) showed LPS-binding activity. Each peptide inhibited LPS-induced tissue factor(TF) generation by murine peritoneal macrophages, even added 1-3 hours after stimulation of cells with LPS. C57BL/6 mice treated with #197 were significantly protected from lethal LPS challenge. Peptide #36 also blocked the LPS-induced lethality. These peptides had antibacterial activity to gram-negative bacteria, such as E.coli, S.typhimurium, K.pneumonia, Ps.aeruginosa and also to gram-positive S.aureus (Methicillin sensitive and resistant strains). Both peptides inhibited TF- and Xa-induced plasma clotting. Using synthetic chromotogenic substrates, both CAP7 peptides blocked the coagulation cascade at two sites, activation of factor X to Xa and conversion of Factor II (prothrombin) to factor IIa (thrombin). In vivo treatment of peptide #197 prevented acute lethality in mice injected with tissue factor (rabbit brain thromboplastin). Two other peptides, #32(Gly1-Phe9) and #50(Ile13-Typ37) failed to demonstrate LPS-binding, LPS-neutralizing, antibacterial and anticoagulant activities. The active peptides but not the inactive peptide maintain a putative heparin binding domain at their N-termini. This heparin binding domain is participate in the LPS-binding, LPS neutralizing, antibacterial and anticoagulant activities of CAP7. These active peptides may have a therapeutic potential for treatment for DIC due to sepsis and endotoxin shock.
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PMID:Endotoxin-binding synthetic peptides with endotoxin-neutralizing, antibacterial and anticoagulant activities. 783 55

Methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as a nosocomial pathogen in Europe and North America for 3 decades. More recently it has emerged as a problem in long-term care facilities. It is less frequently considered a pathogen in nonfacility, community-acquired infections, where it is most often seen in intravenous drug users. There are no studies in the literature specifically describing the clinical features of MRSA pneumonia. Presumably its presentation and outcome are similar to that of pneumonia caused by susceptible strains. Staphylococcus aureus pneumonia is more often nosocomial- or nursing home-acquired, has a variable association with influenza, has clinical and laboratory features similar to other types of community-acquired pneumonia and carries a relatively high mortality of 20% to 84%. MRSA should be considered resistant to all classes of beta-lactam (beta) antibiotics. In addition, these isolates are frequently resistant to a number of other antibiotics, with vancomycin and only antibiotic to have consistently shown activity against MRSA. Therefore, vancomycin remains the treatment of choice for infections caused by MRSA, although treatment failures have been reported. The use of alternative antibiotics should be based on results of susceptibility testing of the strain isolated from the patient.
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PMID:Methicillin-resistant Staphylococcus aureus as a cause of community-acquired pneumonia--a critical review. 783 42


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