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

Haemophilus influenzae is one of the leading causes of severe bacterial infection in children of developing regions, causing 30% of the cases of culture-positive pneumonia and 20%-60% of the cases of bacterial meningitis. In infants and children, the majority of isolates from cerebrospinal fluid and blood and 16%-38% of pulmonary isolates are H. influenzae type b. The availability of several new polysaccharide-protein conjugate vaccines for the prevention of invasive disease due to H. influenzae type b prompts this review of the epidemiology of H. influenzae disease in the developing world and of the characteristics of current H. influenzae type b vaccines. To develop a strategy for use of H. influenzae type b vaccines in developing countries, the following data are needed: the age-specific attack rates of H. influenzae type b disease and the immunogenicity and efficacy of these vaccines in young infants in developing countries. Should H. influenzae type b vaccines prove to be inadequate for the prevention of H. influenzae pneumonia, the use of non-type b H. influenzae vaccines may be necessary.
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PMID:Haemophilus influenzae disease and immunization in developing countries. 186 84

During the past decade, recognition of the significance of pneumonia for childhood mortality has greatly increased. Etiologic studies have clarified the role of Streptococcus pneumoniae and H. influenzae as the pathogens most responsible for childhood pneumonia in developing countries. Case management intervention strategies using community health workers to identify cases of pneumonia by counting respiratory rate and observing chest indrawing have been shown to reduce ARI-related mortality. Although research is underway to develop more effective vaccines against Streptococcus pneumoniae and non-type b H. influenzae, effective case management will remain the most realistic method of reducing mortality in the next decade. Important gaps remain in our understanding of the pathogenesis, etiology, and epidemiology of acute respiratory infections. Our understanding is complicated by the multiplicity of viral and bacterial agents and their interrelationships, by an abundance of interacting host risk factors, and by diverse social, cultural, and environmental factors. However, sufficient knowledge is available to support the implementation of the WHO case management intervention strategies, which will save the lives of the many children now dying because of pneumonia.
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PMID:Acute respiratory infections. 186 12

Bacteriological and clinical studies on cefodizime (CDZM, THR-221), a new cephem developed by Hoechst AG and Roussel Uclaf, were carried out and the results are summarized below: 1. Against Gram-positive bacteria, Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae, antibacterial activities of CDZM were similar to those of cefotaxime (CTX), cefazolin, cefotiam and piperacillin. Against Escherichia coli, Klebsiella pneumoniae and Serratia sp., antibacterial activities of CDZM were similar to that of CTX, and superior to those of other tested antibiotics. Especially against Haemophilus influenzae and Branhamella catarrhalis, it showed an excellent antibacterial activity. 2. Although the clinical efficacy was poor in 1 patient with sepsis caused by Salmonella marcescens and in another with cervical lymphadenitis, in 5 patients with upper respiratory tract infection, 4 patients with bronchitis, 6 patients with bronchopneumonia, 18 patients with pneumonia, 5 patients with urinary tract infection and 1 patient with enteritis, the clinical efficacy was excellent or good and the efficacy rate was 95.1% (39/41) including excellent efficacies in 25 cases. 3. Bacteriologically, all identified causative bacteria were eradicated except for 1 case of Salmonella sp., thus the eradication rate was 97.4% (38/39). Especially S. pneumoniae in 10 cases, H. influenzae in 12 cases and B. catarrhalis in 3 cases were eradicated totally. 4. Adverse reactions were studied in 46 cases, and digestive symptoms were observed in 9 cases (diarrhea 5 cases, loose stools 4 cases). Eruption and vascular pain were observed in 1 case each. As digestive symptoms in 9 cases were mild, the treatment were not suspended. In laboratory test values, elevation of GOT, elevation of GPT, elevation of bilirubin, and eosinophilia were observed in 1 case each. Influences on blood coagulation parameters were studied. No change was observed between the beginning and the end of the treatment. From above results, we have concluded that CDZM is a useful and safe antibiotic in pediatrics, administered at a daily dose of 20 mg/kg divided into 3 or 4 doses and administered intravenously.
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PMID:[Bacteriological and clinical studies of cefodizime in pediatrics]. 188 Sep 19

Isolated bacteria from respiratory infectious diseases were collected in cooperation with institutions located throughout Japan, since 1981, and Ikemoto et al. have been examining sensitivities of the isolates to various antibacterial agents and antibiotics, relationships between the isolates and the backgrounds of the patients and so forth each year. We report here the research results for the year 1988. In 18 institutions around the entire Japan from October 1988 to September 1989, 554 strains of bacteria were isolated mainly from the sputa of 439 patients with respiratory infectious diseases and assumed to be the etiologic bacteria. MICs of various antibacterial agents and antibiotics against 68 strains of Staphylococcus aureus, 102 strains of Streptococcus pneumoniae, 120 strains of Haemophilus influenzae, 86 strains of Pseudomonas aeruginosa, 65 strains of Branhamella catarrhalis, 18 strains of Klebsiella pneumoniae and so forth, were determined, and the drug sensitivities of these strains were examined except for the strains which died during transportation. The drug sensitivities of the main strains were almost the same as those determined last year for each drug. However, S. aureus strains for which MICs of methicillin were higher than 12.5 micrograms/ml (methicillin-resistant S. aureus) accounted for 38.2%, and the frequency of drug resistant bacteria increased over last year's 18.2%. Also, we examined changes in the backgrounds of patients, the infectious diseases, and the etiologic bacteria and so forth. As to patient backgrounds, there were many infectious diseases found in a high age bracket, and the patients over age 60 accounted for 57.2% of the diseases. In the distribution by disease, bacterial pneumonia and chronic bronchitis accounted for greatest numbers of cases 32.1% and 31.4%, respectively, followed by bronchiectasis and bronchial asthma. As for frequencies of etiologic bacteria by disease, S. aureus (22.5%) and S. pneumoniae (15.4%) in pneumonia, S. pneumoniae (25.7%) and H. influenzae (24.1%) in chronic bronchitis, H. influenzae (32.5%) and P. aeruginosa (23.8%) in bronchiectasis, and H. influenzae (31.4%), S. pneumoniae and B. catarrhalis (20.0%) in bronchial asthma were the most frequent. Regarding effects of administration of antibiotics and isolates obtained on each day after infection, those bacteria which were isolated before antibiotic administration and which decreased after administration included S. pneumoniae, H. influenzae, and B. catarrhalis. Frequencies of S. aureus and P. aeruginosa, however, increased after antibiotic administration. Also, when dosing continued for more than 15 days, the frequency of P. aeruginosa increased rapidly.
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PMID:[Susceptibilities of bacteria isolated from patients with respiratory infectious diseases to antibiotics (1988)]. 188 2

Cefpodoxime proxetil (RU 51807) is an enterally absorbed ester prodrug which is rapidly cleaved in vivo after oral administration, with release of the active free acid metabolite cefpodoxime. The in vitro antibacterial activity of the sodium salt of cefpodoxime (RU 51746) against approximately 800 clinical isolates was evaluated comparatively with other orally active beta-lactams. RU 51746 was found to be active against enterobacteria normally susceptible to third generation cephalosporins, with MIC50 values ranging from 0.02 mg/l (Providencia sp) to 5 mg/l (C. freundii). RU 51746 was also active against H. influenzae, including beta-lactamase producing strains (MIC50 0.04 mg/l), oxa-S S. aureus (2,5), beta-hemolytic streptococci (0.05) and S. pneumoniae (0.002). Oxa-R staphylococci and P. aeruginosa were resistant to RU 51746 (MIC50 greater than 40 mg/l for both organisms). The antibacterial activity of RU 51746 was bactericidal in nature and independent from test conditions. The molecule was stable to all the beta-lactamases studied, with the exception of cefuroximase (type Ic). RU 51746 exhibited no strong inhibitory effects on these enzymes, except with Enterobacter P99 (type Ia). A good correlation was found between in vivo activity of RU 51807 and in vitro activity of RU 51746. Cefpodoxime proxetil was found to be more effective than cefaclor in mice with experimental septicemia caused by various streptococci, with a DP50 ratio in the 10-100 range. This advantage was again evidenced for septicemias due to various enterobacteria. In contrast, cefaclor proved more effective in experimental staphylococcus infections. In mice with experimental pneumonia, cefpodoxime proxetil caused sharp falls in K. pneumoniae lung counts. Six days after induction of the infection, 60% of animals under cefpodoxime proxetil had sterile lungs, versus 25% of animals under amoxicillin.
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PMID:[RU 51807 (cefpodoxime proxetil). In vitro and in vivo antibacterial activity of a new orally administered active cephalosporin]. 190 3

Cefixime (CFIX) was evaluated clinically in pediatric respiratory tract infections, particularly those caused by Haemophilus influenzae: 1. The total number of children in this study treated with CFIX was 232, out of which 215 cases were evaluated for clinical efficacy and 224 cases were investigated for safety. A daily dosage of 3-6 mg/kg/day was given divided into 2 to 3 times daily for 3-15 days. 2. Causative organisms were identified in 146 cases, out of which 128 cases were found to be single microbial infections and 18 cases were mixed infections. In single microbial infections, clinical efficacy was 100% for those caused by H. influenzae/Haemophilus parainfluenzae, and was 95% for Streptococcus pyogenes with an overall efficacy of 96.9%. In mixed infections, the clinical efficacy was 100% for those caused by a combination of H. influenzae and Streptococcus pneumoniae, and the overall rate was 94.4%. An involvement of H. influenzae was observed in 108 cases with a clinical efficacy rate of 99.1%, and definite involvement of beta-lactamase secreting strains of H. influenzae was found in 32 cases with a clinical efficacy of 96.9%. 3. Bacteriological effect was studied for 164 strains identified in 146 cases, and eradication rates were 89.5% for H. influenzae, 100% for H. parainfluenzae and S. pyogenes, and 71.4% for S. pneumoniae. The overall eradication rate was 91.4%. Superinfection was observed in 21 cases. MICs against 78 strains of H. influenzae were in a range of less than or equal to 0.10 microgram/ml regardless of beta-lactamase production, and far superior to cefaclor and amoxicillin. MICs against S. pyogenes and S. pneumoniae were in ranges of less than or equal to 0.10 microgram/ml and 0.39 micrograms/ml, respectively. 4. Clinical efficacy was 93.0% in 215 cases (excellent: 136, good: 64, fairly good: 10, poor: 5). CFIX attained a high efficacy in the range of 89.4-95.7% in acute pharyngitis, acute tonsillitis, acute bronchitis and acute pneumonia. 5. Safety was monitored in 224 cases and there were only one case of loose stool and another of diarrhea as side effects. There were no abnormal findings in 31 cases of the laboratory test. In conclusion, it was confirmed that CFIX is excellent and safe in the treatment of the respiratory tract infections.
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PMID:[Clinical evaluation of cefixime in pediatric respiratory tract infections]. 204 Nov 46

In a prospective study aimed at determining the etiology of community-acquired pneumonia in children nasopharyngeal cultures and paired serum samples were obtained from 336 consecutive children ages 6 weeks to 15 years with pneumonia, 167 hospitalized and 169 outpatients. Results regarding Haemophilus influenzae are reported here. Blood cultures obtained from 127 of the hospitalized patients did not yield growth of H. influenzae. H. influenzae was isolated from the nasopharynx of 88 children. Seventy-three strains were noncapsulated, 2 were type b, 2 were type f and 11 were not serotyped. Paired serum samples were available from 38 children with growth of noncapsulated H. influenzae in the nasopharynx as the only potential pathogen. Sixteen of them responded with significant increases in serum antibodies against outer membrane preparations prepared from their own nasopharyngeal isolates. Thirty-eight age- and sex-matched control children with pneumonia without growth of H. influenzae in the nasopharynx served as controls. Sera from each control patient were tested for antibodies against two strains of noncapsulated H. influenzae. Of those, 4 had significant increases in antibodies against one or both outer membrane preparations. The increases in serum antibodies against the outer membrane of noncapsulated strains of H. influenzae indicate that this organism might be a cause of pneumonia in some children.
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PMID:Antibody response to outer membrane of noncapsulated Haemophilus influenzae isolated from the nasopharynx of children with pneumonia. 206 99

We compared hospital acquired pneumonia (HAP) with nursing home acquired pneumonia in the elderly. There were no differences in the underlying diseases, clinical signs and symptoms between HAP and nursing home acquired pneumonia, but activities of daily living were poor in HAP than nursing home acquired pneumonia. By the bacterial studies from Transtracheal aspiration (TTA), S. aureus, K. pneumoniae, P. aeruginosa and anaerobes were more isolated in HAP. On the other hand, S. pneumoniae and H. influenzae were isolated more in the nursing home acquired pneumonia. In the laboratory data, no difference was detected in inflammatory reaction between both groups, but in immunological data, especially complement C3 and tuberculin skin test were markedly reduced in HAP. The prognosis were significantly poor in HAP because the fatal rate was higher in HAP than nursing home acquired pneumonia. With regard to HAP in the elderly, severe underlying disease, poor whole body state, aspiration, bacterial resistance to drugs, superinfection and polymicrobial infection were the factors predisposing difficulty in treatment of pneumonia in the elderly. From the above results, prevention is the most necessary in HAP.
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PMID:[Clinical studies on hospital acquired pneumonia in the elderly]. 207 66

Haemophilus influenzae type b is responsible for an estimated 15,000 to 20,000 cases of meningitis per year in the United States, mainly in children 2 months to 5 years old. The mortality rate from meningitis due to H influenzae type b infections ranges from 5% to 10%. Despite antibiotic treatment, up to 35% of survivors have permanent neurologic sequelae. In addition to meningitis, H. influenzae type b is responsible for other invasive infections, including epiglottitis, septicemia, cellulitis, septic arthritis, osteomyelitis, pneumonia, pericarditis, and otitis media; approximately 30,000 cases H influenzae diseases occur annually in the United States. The diseases peak in incidence between 6 and 12 months of age, with almost one half of the cases occurring before 1 year of age. About 75% of disease caused by H influenzae type b occurs in children younger than 24 months old. The incidence of disease is higher in children of certain groups, including blacks, Hispanics, Eskimos and Native Americans, young children attending day-care facilities, patients with asplenia or antibody-deficiency syndromes, and children of lower socioeconomic status. There is considerable evidence that antibody to the capsular polysaccharide (polyribosylribitol-phosphate [PRP] of H influenzae type b is protective.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immunogenicity of a new Haemophilus influenzae type b conjugate vaccine (meningococcal protein conjugate) (PedvaxHIB). 210 17

Causative agents of respiratory infections has been changed because of increase in number of aged people and compromised host and the rapid development of new chemotherapeutic agents. Especially Branhamella catarrhalis (B. catarrhalis), which is very unique and has become a common respiratory pathogen, since 1980, in my department. Attachment ability of B. catarrhalis to oropharyngeal cells coincided with the acute exacerbation of chronic respiratory infections by this bacterium and the same phenomenon in pneumococcal infections was also established. In the hospital for aged people, two major pathogens Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) are specially seen. In these patients, the two major ones were isolated from the oropharynx. Non-typable Haemophilus influenzae (H. influenzae) is also very important in Japan like USA. Recurrent infection with this pathogen occurred due to the change of OMPs during the time period of more than one month. Complement and some amount of ceftadizim were inactivated by destroyed neutrophils in vitro. This result may explain one of the cause of intractability of P. aeruginosa infection. Monoclonal antibody against P. aeruginosa showed effectiveness in P. aeruginosa pneumonia model in mice. Intraabdominal administration of fibronectin also was effective for staphylococcal pneumonia in rat. Oropharyngeal pathogens like S. aureus, S. pneumonia, B. catarrhalis, H. influenzae and P. aeruginosa were killed by 100-500 times diluted solution of 7% povidonjod solution. Moreover the frequency of recurrence of infection by these bacteria were decreased by gargling this solution 3-4 times/day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pathogenesis of bacterial respiratory infection and new approach of the treatment]. 212 70


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