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)

Penicillin--"tolerant" Staphylococcus aureus strains are resistant to the lethal action of penicillins, but are inhibited by normal (low) concentrations. They are deficient in autolytic enzyme activity which appears to be necessary for bacteriolysis and the lethal action of penicillins. This "deficiency" is caused by a large excess of an inhibitor of autolysin. Seven such tolerant strains have been isolated from blood, bone, or sputum of patients who responded poorly to penicillin treatment of endocarditis, osteomyelitis, or staphylococcal pneumonia. These isolates were of different phage-types, and most showed cross-tolerance to the killing action of cephalosporins or vancomycin, antibiotics to which they were sensitive (inhibited). They were killed at normal rates by gentamicin, cycloserine, and rifampicin. Population analysis indicated that the proportion of tolerant organisms within a resistant strain is 7% or less; their ability to inhibit autolytic activity within their own and neighbouring cells appears to account for the net decreased autolytic activity of the entire strain; 44% of the bacteraemic strains studied showed penicillin tolerance. Tolerance is thus a common, clinically important form of penicillin resistance, that differs from previously described forms of pencillin resistance, that due to beta-lactamase, and that due to "intrinsic" (e.g., methicillin resistance) mechanisms.
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PMID:A new type of penicillin resistance of Staphylococcus aureus. 6 61

A 19-month study of group B streptococcal infection was performed to investigate the spectrum of such infections in adult males, the relation of serotypes to clinical illnesses, the effects of previous antibiotic therapy on infection and colonization, and the antibiotic susceptibility pattern of these organisms. Twenty-four patients had definite or possible infections while 41 patients were colonized with group B streptococci. The most frequent infections encountered were pneumonia (ten cases) and soft tissue infections (nine cases). Five infections (21%) were nosocomial in origin. The most frequent serotypes were Ia and II. No correlation of serotype and type of infection was observed. Patients receiving previous antibiotic therapy were significantly more likely to be colonized than infected with group B streptococci. Penicillin was the antibiotic to which these organisms were most susceptible; tetracycline and gentamicin showed the least activity.
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PMID:Group B streptococcal infections in adult males. 37 5

The use of antibiotics in viral diseases of childhood is discussed. If bacterial infection is likely, either as superinfection or as part of the differential diagnosis, then antibiotics should be given. The antibiotic of choice for each illness is considered. Respiratory infections are common. The diagnosis and treatment of streptococcal pharyngitis is compared with viral pharyngitis. Penicillin is indicated if the bacterial infection is possible. If there is difficulty in distinguishing between croup and epiglottitis, then chloramphenicol or ampicillin should be given. Otitis media and pneumonia caused by viruses are difficult to differentiate from their bacterial counterparts, and antibiotics are indicated. By contrast, antibiotics are not used in bronchiolitis or asthma. Antibiotics are contraindicated in gastroenteritis even if caused by bacteria. Prolongation of the carrier state or superinfection may then occur. Interpretation of the biochemical and bacteriological findings of the cerebrospinal fluid is important in distinguishing viral meningitis and encephalitis from bacterial meningitis. If bacterial meningitis is possible, then antibiotics should be used. The indications for antibiotics in viral diseases of the skin, eye, joints, heart and parotid are also discussed.
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PMID:Antibiotics: their true place in the treatment of viral disease. 66 65

Swaziland is a kingdom with 800,000 inhabitants bordering on Mozambique and South Africa with about 50% of the population under 15 years of age. The experience of a nurse in a small clinic in the course of several years is recounted. Swaziland ranks 3rd in the world in alcohol abuse which often leads to wounds requiring suturing. Penicillin is given prophylactically with a paracetamol preparation for analgesia. As a rule, every injured person will get a .5 ml tetanus injection for prophylaxis. The most serious conditions of polyclinic patients are hepatitis, bilharzia, diarrhea, pellagra, pneumonia, and malnutrition. A great number of patients have sexually transmitted diseases, and the rate of AIDS infection is not known. According to 1 study 60-80% of the population in reproductive age will die of AIDS in the course of a 5-year period. The majority of people are impervious to counseling about their sexual behavior in spite of educational programs on the radio, in schools, and in work places. Condoms are not popular, since they are not considered manly. Pregnant women receive iron and multivitamin tablets in the course of pregnancy. Many pregnant women are anemic, and 70% give birth at home, the rest in a hospital or clinic. During delivery they get no analgesia, and there are few complications. The average weight of the newborn is 3.5 kg, although none of the women are under 150 cm. A little after birth all children are vaccinated with bacillus Calmette-Guerin (BCG) and polio, later with diphtheria-pertussis-tetanus (DPT) and measles.
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PMID:[Nursing under a different sky. Swaziland]. 146 29

Acute respiratory infections in children aged less than 5 years in the Eastern Highlands of Papua New Guinea were investigated bacteriologically for 10 years from November 1978. Haemophilus influenzae and Streptococcus pneumoniae were responsible for 73% of all bacteria cultured from lung aspirate (83 samples), 85.5% from blood (1024 samples) and 92% from cerebrospinal fluid (155 samples). Nonencapsulated H. influenzae was carried by up to 90% of children and was the predominant haemophilus type cultured from lung tissue. Mixed infections of the lung with two types of H. influenzae (8 cases) and both H. influenzae and S. pneumoniae (18 cases), commonly together with other organisms of questionable pathogenicity, reflected the proximity of this organ to the upper respiratory tract. Serotype b accounted for 62% and 82% of H. influenzae isolated from bacteraemic pneumonia and meningitis cases, respectively. Polymicrobic bacteraemic pneumonia occurred in 16 children. Both H. influenzae and S. pneumoniae establish dense, unregulated long-term colonization in the nasopharynx during the neonatal period. Each inhibit autochthonous microflora by mechanisms that are currently unclear. Infections with two or more types occur in 30% (S. pneumoniae) and 60% (H. influenzae) of carriage-positive children. 70-75% of H. influenzae and S. pneumoniae isolates from blood concomitantly colonize the upper respiratory tract. Intense exposure of Papua New Guinean children to penicillin at all levels of health care since the 1940s has resulted in widespread relative resistance among pneumococci to this antibiotic. Resistant strains are now found in 32 serotypes, and in children penicillin resistance is present in 75% of all carriage strains and 52% and 22% of blood and cerebrospinal fluid isolates, respectively. Penicillin-susceptible and resistant pneumococcal serotypes commonly coexist in multiply populated carriage sites. Resistance to betalactam antibiotics is rare among H. influenzae strains and resistance has not been detected in either H. influenzae or S. pneumoniae to chloramphenicol, erythromycin, tetracycline or cotrimoxazole. It should not be assumed that the technology of respiratory bacteriology as it is practised in developed countries can be transferred to the third world for utilization in paediatric aetiology and carriage studies. Respiratory bacteriology strategies as they evolved in Goroka were subject to diverse influences. The type distribution of the major causative agents defied fashionable beliefs, generated the need for more precise epidemiological differentiation and, by virtue of their carriage density, cultural properties and response to commonly used antibiotics, required the introduction or development of compatible diagnostic procedures.
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PMID:The bacteriology of acute pneumonia and meningitis in children in Papua New Guinea: assumptions, facts and technical strategies. 175 Feb 63

Strictly enforced antibiotic formulary restriction in combination with formulation of agreed guidelines for antibiotic use in common infection problems such as septicemia, febrile neutropenia, urinary tract infection, biliary sepsis, liver abscess, peritonitis, nosocomial pneumonia, soft tissue infection and purulent meningitis, generated a combined savings of 307,748.5 bahts or 13.5 per cent cost reduction over a 6 month period, and improved quality of use, appropriate 54.8 vs 67.5 per cent, statistically significance (P less than 0.002). Although this saving was offset in part by increased spending of unrestricted antibiotics, such as Penicillin and Gentamicin, an overall cost saving remained. In the months during the restrictions, no significant changes occurred regarding patients response and mortality. However, after the onset of the controls, it was revealed that antibiotics were more appropriately used afterwards. This study has shown, most importantly, that savings were achieved with no negative effect on good patient care. Moreover, the antibiotic use control was operationally successful, most house-staff and attending physicians, not only antibiotic evaluating team, have accepted the program in a very positive way. Overall, this program successfully achieved its initial goal, cost saving without compromising good medical practice. We are now continuing our program and also trying to modify so that it will be useful to all departments in the hospital.
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PMID:Effect of a selective restriction policy on antibiotic expenditure and use: an institutional model. 176 42

Patients referred for elective pulmonary surgery were enrolled in a prospective, randomized, double-blind study comparing the prophylactic efficacy of four-dose regimens of penicillin-G 5 million IU and cefuroxime 1.5 g. the first dose given immediately preoperatively. The treatment groups were comparable preoperatively with regard to all tested demographic factors. No significant intergroup difference was found concerning postoperative empyema, wound infection, septicaemia, pneumonia or fever of unknown origin, or any other complication or parameter tested in connection with pulmonary surgery. No side effects were observed, and no effects on the patients normal bacterial flora. Penicillin is recommended as prophylaxis in this type of surgery.
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PMID:Antibiotic prophylaxis in non-cardiac thoracic surgery. A double-blind study of penicillin vs. cefuroxime. 206 58

The attack rate for pneumonia increases with increasing age and with residence in a nursing home. The rate of hospitalization of Halifax County, Nova Scotia, Canada, residents with pneumonia was 1 in 1,000, while for nursing home residents it was 33 in 1,000. The overall mortality rate for community-acquired pneumonia requiring hospitalization was 21.9%. Mortality was age-related: Seven percent of those 30 years of age or younger died, while 38% of those in the 81 to 90 year age group died. Comorbidities increased with increasing age from 0.73 +/- 0.81 for those 30 years old or younger to 2.75 +/- 1.47 for those 71 to 80 years of age. The most common comorbidities were chronic obstructive pulmonary disease, ischemic heart disease, hypertension, diabetes mellitus, malignancy, alcoholism, and neurological disease. The acquired immunodeficiency syndrome was a significant comorbidity among those 50 years of age or younger. Age-dependent trends were observed in the use of antimicrobial therapy: Cefamandole and aminoglycosides were prescribed more frequently with increasing age, whereas after the age of 61 years, the use of erythromycin declined. Penicillin usage was not age-dependent. Resource (hemograms, chest radiographs, blood chemistry, blood gases, and sputum culture) use peaked at the 50 to 60 year age group.
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PMID:Epidemiology of community-acquired pneumonia in the elderly. 209 71

The major cause of death in sickle cell anaemia is from infection, especially infection caused by Streptococcus pneumoniae. Meningitis, pneumonia and septicaemia caused by this organism are the primary types of infection leading to death. Children under three years of age are at highest risk. We have known for over twenty years that approximately 30 per cent of the infants born with sickle cell anaemia will become infected in the first three years of life and one-third can be expected to die from the infection. These data were the reason that we conducted the Prophylactic Penicillin Study (PROPS), a trial to investigate the effectiveness of oral prophylactic penicillin in preventing severe infection due to S. pneumoniae. This investigation was a very efficient, cost effective study because of its timeliness and its conduct within the framework of an ongoing study. Moreover, the question being answered was simple and focused with up-to-date data that permitted accurate estimates of sample size and incidence.
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PMID:Sickle cell anaemia trial. 211 33

A 41-year-old homosexual man complained about weight loss of 14 kg over a period of 6 months. He developed exertional dyspnea and fever up to 39.6 degrees C. The ESR was elevated and the fraction of immature neutrophils increased. Penicillin was administered with no effect, chest X-ray showed basal pulmonary infiltrates, P. carinii was found in bronchioalveolar fluid. HIV-serology was positive. Sulfamethoxazole/trimethoprim (1600/320 mg daily) and 100 mg of prednisolone/die led to reduction of fever. Prevention of P. carinii pneumonia relapse is currently underway with bi-weekly inhalation of pentamidine-isethionate aerosol.
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PMID:[Weight loss, fever, dyspnea]. 230 43


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