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

The efficacy rate, minimal inhibitory concentrations (MICs), and resistance of fluoroquinolone agents against causative organisms in respiratory tract infections from January to March, 1988 were investigated. Of 333 pathogenic strains 85% consisted of 5 major causative organisms of respiratory tract infection (Haemophilus influenzae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Branhamella catarrhalis, and Staphylococcus aureus). In 61 (59 cases) of these 333 strains, including 3 cases of acute pharyngitis, 5 of acute bronchitis, 3 of pneumonia, and 48 of chronic lower respiratory tract infection fluoroquinolone agents were administered. The efficacy rate was 76.3% in all cases, and 75% in cases with chronic lower respiratory tract infection. The fluoroquinolone agents were 100% effective in H. influenzae and B. catarrhalis, though the efficacy rate was 67% in S. aureus and 40% in P. aeruginosa. The susceptibility of all strains to fluoroquinolone agents were investigated. There was no resistant strain in H. influenzae and B. catarrhalis, though resistant strains to fluoroquinolone agents have increased in S. aureus and P. aeruginosa. The efficacy rate was investigated using the MIC of administered fluoroquinolone agent against causative organisms. It is surmised that the efficacy of that agent has an MIC of 1.56-3.13 micrograms/ml.
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PMID:[The antimicrobial activity of fluoroquinolone agents against pathogenic organisms in respiratory tract infections and its clinical effect]. 217 51

The lower respiratory tract is repetitively inoculated with oropharyngeal bacteria and yet pneumonia is an infrequent event. Efficient mechanisms of antibacterial defense are present in the respiratory tract that eliminate microbes before their presence or multiplication leads to disease in the majority of instances. Resident pulmonary defenses consist of aerodynamic defenses, the mucociliary apparatus, alveolar macrophages, complement, and surfactant. These resident defenses can be augmented by the development of an inflammatory response or the development of specific immunity. Significant species variability exists in the efficiency and mechanisms of clearance for oropharyngeal organisms. Streptococci are cleared promptly, Branhamella catarrhalis is cleared slowly, whereas non-typable Haemophilus influenzae multiply before being cleared. A dual phagocytic system of alveolar macrophages and recruited polymorphonuclear leukocytes is required for clearance of most oropharyngeal microbes. Systemic immunization can significantly enhance clearance of non-typable H. influenzae, suggesting immunoprophylaxis might be possible for this organism.
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PMID:Pulmonary host defenses and oropharyngeal pathogens. 218 43

Invasive Haemophilus influenzae type b infections are a major cause of severe infections in children between 2 months and 5 years of age. Meningitis, arthritis, pneumonia, cellulitis, osteomyelitis, and epiglottitis affect approximately 25,000 patients annually and are a major cause of mortality and morbidity in children. H. influenzae type b clinical syndromes, diagnostic methods, epidemiology, immunity, and treatment are discussed in this review. Although potent antibiotics have long been available for treatment, mortality and morbidity rates have not declined substantially in the last 15 years. Prevention of disease is therefore a continuous medical challenge. Secondary cases can be prevented by identification of the high-risk groups and the application of appropriate techniques, including antimicrobial prophylaxis. Primary prevention is the major goal of current research. H. influenzae type b vaccines currently are available for protection of infants 18 months of age and older. Prevention of primary and secondary disease and future developments, including new vaccine strategies, are stressed.
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PMID:Invasive Haemophilus influenzae type B infections: a continuing challenge. 219 6

Ofloxacin is highly active against common respiratory pathogens including Haemophilus influenzae and Branhamella catarrhalis and has clinically applicable activity against Streptococcus pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa. Sputum, lung tissue and bronchial mucosal concentrations of ofloxacin equal or, in most cases significantly exceed the MICs of such pathogens. These in vitro attributes are reflected in the results of the worldwide ofloxacin clinical trial program which achieved overall response rates of 98% in lower respiratory tract infections, 83% in pneumonias and 87% to 95%, in open and comparative studies respectively, in patients with acute exacerbations of chronic bronchitis (CB). Overall bacterial eradication rates ranged from 70% for pneumococci and 84.5% for B. catarrhalis to 88.5% for H. influenzae. In lower respiratory infection ofloxacin gave equal or superior clinical results to amoxycillin or erythromycin therapy together with an overall bacterial eradication rate of 100%. Clinical results comparable with standard agents were also obtained in pneumonia, cure rates ranging from 77-89% at various dosages. Eradication rates proved greatest for H. influenzae (92%) and were satisfactory for Klebsiella spp. (80%), although less so for pneumococci (73%). Bacteriological eradication rates in acute exacerbations of chronic bronchitis ranged from 68% for pneumococcal infections, to 85% in B. catarrhalis and 94% in H. influenzae infections. Ofloxacin compared favourably with pivampicillin, co-trimoxazole and doxycycline clinically. A daily oral ofloxacin dose of 400 mg produced a good clinical response in 92% of patients or more. The available clinical data therefore substantially confirm the claim of ofloxacin to offer an effective alternative in many forms of acute bacterial respiratory infection, especially where H. influenzae and B. catarrhalis are involved.
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PMID:Overview of experience with ofloxacin in respiratory tract infection. 221 24

Ceftriaxone, a broad spectrum third-generation cephalosporin with a half-life of six to eight hours, was evaluated prospectively in 147 children with severe community-acquired bacterial pneumonia during the period 11/15/88-5/15/89. Thirty-nine of the children had been unsuccessfully treated with vanous oral antibiotics prior to admission [corrected]. All the patients were initially hospitalized and started on once a day intramuscular ceftriaxone. Mean duration of ceftriaxone therapy was five days. Pathogens were recovered from blood cultures of 17 (11.6%) patients and included S. pneumoniae (13 patients), H. influenzae (three, all resistant to ampicillin) and S. viridans (1) [corrected]. All isolates were sensitive to ceftriaxone. An additional patient had L. pneumophila diagnosed by serology. Cure was achieved in 142 (96.6%) patients; improvement was usually observed within 24-48 hours. After 48 hours, 121 (82.2%) children could be discharged and continued the therapy on ambulatory basis. Based on previous experience we estimated that 383 hospitalization days were saved. No serious side effects were observed. Five patients were considered therapeutic failures; two of them developed empyema and one of them required repeated drainage procedures. A third patient experienced a relapse of pneumonia shortly after completion of therapy. The other two remained febrile for more than seven days; their subsequent improvement was unrelated to the antibiotic therapy, suggesting a viral or mycoplasmal syndrome. Our data suggest that once daily intramuscular ceftriaxone can be successfully used for the outpatient treatment of most community-acquired severe bacterial pneumonias in children. In our opinion it represents the treatment of choice for patients who failed treatment with other antimicrobials and are clinically stable enough not to require hospitalization.
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PMID:Once-daily intramuscular ceftriaxone in the outpatient treatment of severe community-acquired pneumonia in children. 226 14

Latex agglutination (LA) was compared with counterimmunoelectrophoresis (CIE) for the diagnosis of pneumonia due to Streptococcus pneumoniae or Haemophilus influenzae type b in children less than 6 years old in Papua New Guinea. Neither LA nor CIE was sufficiently sensitive for the detection of pneumococcal antigens. CIE was superior to LA but had a sensitivity of only 60% (six of 10) in concentrated urine and a specificity of 90% (54 of 60). LA for the detection of H. influenzae type b had a sensitivity of 100% (eight of eight) relative to that of blood culture and a specificity of 99% (112 of 113) when urine diluted fivefold was tested, as compared with a sensitivity of 100% (nine of nine) and a specificity of 92% (56 of 61) in undiluted urine. Undiluted and concentrated urine specimens were unsuitable for LA because of the many false-positive reactions that resulted from nasal carriage of H. influenzae type b and nasal carriage of the cross-reactive S. pneumoniae type 6. CIE for the detection of H. influenzae type b had a sensitivity of only 44% (four of nine) in concentrated urine.
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PMID:Detection of Streptococcus pneumoniae and Haemophilus influenzae type b antigens in the serum and urine of patients with pneumonia in Papua New Guinea: comparison of latex agglutination and counterimmunoelectrophoresis. 227 Mar 96

Imipenem/cilastatin sodium (IPM/CS) was administered to 55 patients with respiratory tract infections (RTI). A clinical evaluation of IPM/CS was carried out in 51 patients, 28 with pneumonia, 4 with pulmonary abscess, 1 with pyothorax, 6 with bronchitis, 9 with bronchiectasis, 1 with diffuse panbronchiolitis and 2 with RTI with chronic obstructive pulmonary disease, and the clinical efficacy rate was 78.4%. Causative organisms were isolated in 23 strains out of 20 patients, such as Staphylococcus aureus 4 strains, Staphylococcus epidermidis 1 strain, Streptococcus pneumoniae 1 strain, Branhamella catarrhalis 1 strain, Haemophilus influenzae 2 strains, Klebsiella pneumoniae 4 strains, Pseudomonas aeruginosa 6 strains, Pseudomonas sp. 1 strain, Acinetobacter calcoaceticus 1 strain, Acinetobacter sp. 1 strain and glucose non-fermentative Gram-negative rod 1 strain. An eradication rate of 70.6% was obtained. An overall eradication rate of main causative organisms in RTI including S. aureus, S. pneumoniae, H. influenzae and K. pneumoniae was 75.0%. Clinical adverse effects were observed in 5 patients, and these were eruption in 2, itching in 1, vomiting in 1 and drug fever in 1. Abnormalities in laboratory test results were observed in 8 patients. These disappeared or returned to normal values after completion or discontinuation of IPM/CS administration. IPM/CS appears to be a useful antibiotic for the treatment of RTI, especially severe infections.
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PMID:[Evaluation of imipenem/cilastatin sodium in the treatment of respiratory tract infections]. 234 50

We report the epidemiology of invasive Haemophilus influenzae type b disease requiring hospital intervention in Southern Israel, an area that contains two ethnic populations, Bedouins and Jews. The study is based on 107 blood or cerebrospinal fluid culture-positive cases during the years 1984 to 1988. The annual incidence rate among children younger than 5 years of age was 51/100,000 (48/100,000 for Jews and 58/100,000 for Bedouins). Thirty-nine percent of patients had meningitis, 32% had pneumonia and 31% had otitis media. Epiglottitis was present in only one case (less than 1%). The median age was 8 months. Twenty-six percent of the cases were 6 months old or younger, 75% were 1 year old or younger and 87% were 18 months old or younger. Ninety-five percent of all meningitis cases occurred during the first 18 months of life. A projected number of 2938 hospitalization days and 9.8 deaths/year for a population in which 100,000 births occur yearly was calculated. The major impact of invasive H. influenzae type b infections and the very young age involved justify initiation of H. influenzae vaccine studies in our region.
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PMID:Epidemiology of invasive Haemophilus influenzae type b infections in Bedouins and Jews in southern Israel. 235 16

We previously demonstrated that pneumococcal extracts contain a highly specific inhibitor of human neutrophil elastase (HNE). We now show that the active inhibitor in these extracts is a high-molecular-weight, heat-stable substance that appears to be RNA, since inhibitory activity of pneumococcal extracts is decreased by incubation with ribonuclease but not by incubation with deoxyribonuclease or proteinase K. Moreover, metabolically labeled ([3H]uridine) pneumococcal RNA, isolated by phenol extraction followed by ethanol precipitation, strongly inhibits HNE. Pneumococcal capsular polysaccharide, although polyanionic, is only weakly inhibitory toward HNE and is not a major source of elastase-inhibitory activity in pneumococcal extracts. On the other hand, the capsule of Haemophilus influenzae type b contains polyribosylribitol phosphate. This highly charged polyanion possesses HNE-inhibitory activity, but only under special circumstances to be discussed below. Pneumococci (type I, type II smooth, type II rough) and H. influenzae (type b) all release HNE-inhibitory activity into their culture medium during growth. By contrast, Klebsiella pneumoniae and Staphylococcus aureus release little (if any) stable HNE-inhibitory activity during growth. We propose that some bacterial pneumonias may spare host tissue because polyanions released by the invading microorganisms (e.g. RNA from autolysing pneumococci) inhibit elastase released from inflammatory neutrophils and thereby modulate accompanying tissue proteolysis. Pneumonias caused by microorganisms that do not release stable polyanionic inhibitors of HNE (e.g., Staphylococcus and Klebsiella) may be correspondingly more injurious to the lung.
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PMID:Inhibition of human neutrophil elastase by bacterial polyanions. 244 47

On the basis of intensified surveillance in Finland we report the epidemiology of invasive Haemophilus influenzae type b disease based on 333 consecutive culture-proved cases recorded during 1985 and 1986. The annual incidence rate among children younger than 5 years of age was 52/100,000; 46% of patients had meningitis, 29% had epiglottitis and 25% had other forms of invasive disease. The median age of patients was 27 months, with 45% younger than 2 years of age. Meningitis and epiglottitis were found more often among boys than among girls, whereas the opposite was found among patients with other types of invasive disease (P = 0.015). Among the latter 68% of children with pneumonia or septicemia were 2 years or older compared with 32% of patients with arthritis, cellulitis or pyelonephritis (P = 0.009). These background data are essential for correct interpretation and application of results from trials with H. influenzae type b conjugate vaccines that are currently ongoing in Finland.
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PMID:Epidemiology of invasive Haemophilus influenzae type b disease among children in Finland before vaccination with Haemophilus influenzae type b conjugate vaccine. 265 19


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