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Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anaerobic bacteria outnumber aerobes at most oropharyngeal sites, with counts up to 10(11)/ml of fluid, and have been implicated in infections of all structures of the head and neck. They are common in chronic otitis media, chronic sinusitis, and various soft-tissue infections. These infections are initiated primarily by mucosal breaks. Bacterial factors such as adhesiveness and antileukocytic activity also may play a role. Among the complications of these infections are brain abscess, aspiration pneumonia, and anaerobic sepsis. Treatment includes surgical drainage and use of antimicrobial agents active against the mixed flora commonly found. Penicillin is currently the drug of choice, but this may change with the emergence of beta-lactamase-producing strains of anaerobes such as Bacteroides melaninogenicus.
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PMID:Anaerobes in infections of the head and neck and ear, nose, and throat. 637 19

The tolerance and efficacy of metronidazole were studied in 15 pediatric patients who had anaerobic infection. 5 had soft tissue abscess, 4 had aspiration pneumonia, 3 had intracranial abscess and 3 had chronic sinusitis. 45 bacterial isolates were recovered (3 isolates per patient). 40 were anaerobes and included 17 Bacteroides sp. (8 sp.), 16 anaerobic cocci and 6 Fusobacterium nucleatum. Metronidazole was given intravenously at the dose of 30 mg/kd/day or orally in the dose of 40-50 mg/kg/day. The length of therapy was between 14 and 52 days (average 26 days). 7 of the patients received initial parenteral therapy for 5-21 days (average 11.6 days), and subsequently received oral therapy. The minimal inhibitory concentration of 38 of the 41 anaerobic isolates (93%) was equal or less than 2 micrograms/ml. The mean peak concentration of metronidazole on the third day of therapy was 24.2 micrograms/ml range 15.2-30 micrograms/ml) and the mean trough was 7.2 micrograms/ml (range 4-11.6 micrograms/ml). No local or systemic adverse reaction as noted. A good response to therapy with a complete cure occurred in 14 of the 15 children. A fair response was achieved in 1 patient. Metronidazole appears to be effective and safe in the treatment of serious anaerobic infection in children.
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PMID:Treatment of anaerobic infections in children with metronidazole. 686 5

Anaerobic bacteria have been shown to play a role in infection of all types in humans. Certain infections are notable for the prominent role played by anaerobes; included are brain abscess, chronic sinusitis and otitis media, oral and dental infections, neck space infections, bite infections, lung abscess, aspiration pneumonia, empyema, intra-abdominal infections of all types (notably peritonitis, intra-abdominal abscess, and liver abscess), abdominal surgical wound infections, female genital tract infections of all types, various superficial and deep soft tissue infections, and osteomyelitis. In recent years, two new anaerobic infections have been appreciated-infant botulism and pseudomembranous colitis due to Clostridium difficile. Considerable progress has been made recently in delineating factors predisposing to anaerobic infections, virulence factors in anaerobes, and host defense mechanisms vs. these organisms. Taxonomic schemes for anaerobes have been improved and simplified considerably, as have techniques for growing and identifying anaerobic bacteria. Rapid procedures are coming into the picture. Finally, much has been learned about therapy of these infections. Although there has been some problem of increased resistance of anaerobes to antimicrobial agents, several promising new drugs are now available to offset this.
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PMID:The role of anaerobes in human infections. 694 63

A total of 243 strains of Fusobacteria species was recovered from 226 of 1399 (16%) specimens obtained from 213 children. The strains included 65 (27%) Fusobacterium sp., 144 (59%) Fusobacterium nucleatum, 25 (10%) Fusobacterium necrophorum, five (2%) Fusobacterium varium, three (1%) Fusobacterium mortiferum, and one (0.4%) Fusobacterium gonidiaformans. Most Fusobacteria species were recovered from patients with abscesses (100), aspiration pneumonia (24), paronychia (15), bites (14), chronic sinusitis (ten), chronic otitis media (nine), and osteomyelitis (eight). Predisposing conditions were noted in 32 (15%) of the cases. These included immunodeficiency in nine (4%), steroid therapy in eight (4%), previous surgery in six (3%), diabetes in six (3%) and malignant neoplasms in five (2%). Fusobacteria sp. was the only isolate in 16 (8%) instances while mixed infections were encountered in 197 (92%) patients. The organisms most commonly isolated with Fusobacteria sp. were anaerobic cocci (155), pigmented Prevotella sp. and Porphyromonas sp. (95), Bacteroides fragilis group (80), Escherichia coli (43) and Bacteroides sp. (39). Most strains of B. fragilis group and E. coli were recovered from intra-abdominal infections and skin and soft tissue infections proximal to the rectal area. Most pigmented Prevotella sp. and Porphyromonas sp. were recovered from oropharyngeal and pulmonary sites and from sites around the head and neck. Antimicrobial therapy was administered to all patients; surgical drainage was performed in 85 (40%). All patients, except two who died, recovered. These findings illustrate the prevalence of Fusobacteria sp. associated with infections in children.
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PMID:Fusobacterial infections in children. 803 95

Anaerobes are generally accepted as clinically important pathogens. Although they are found on most mucocutaneous surfaces, anaerobic bacteria are especially abundant in the upper and lower respiratory tracts, gastrointestinal tract, and female genital tract. They are involved in infections such as chronic sinusitis, aspiration pneumonia, lung abscess, intra-abdominal abscess, bacterial vaginosis, decubitus ulcer, and bite wounds. Depending on the type and location of the infection, treatment may involve surgical drainage and a multiple antibiotic regimen that provides protection against both anaerobes and gram-negative aerobes. Penicillin was the drug of choice for anaerobic infections, but its inactivity against most penicillinase-producing anaerobes has made it less useful for empiric therapy. Clindamycin, with its proven activity against anaerobic infections, is the current drug of choice. Clindamycin is particularly effective against upper and lower respiratory tract infections and infections of the female genital tract.
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PMID:The role of anaerobic bacteria in human infections. 851 35

Telithromycin is a new ketolide antimicrobial with a good in vitro activity against both aerobic and anaerobic respiratory pathogens. In this study, we evaluated the antibacterial activity over time of telithromycin (800mg), azithromycin (500mg), and amoxicillin/clavulanate (875/125mg) in serum following single oral doses of these agents to 10 healthy subjects. Inhibitory and bactericidal titers were determined at 2, 6, 12, and 24h after each dose and the median titer was used to determine antibacterial activity. Against two azithromycin-resistant strains of Streptococcus pneumoniae, both telithromycin (MIC=0.25 and 0.5 microg/mL) and amoxicillin/clavulanate exhibited inhibitory and cidal activity for at least 6h. All three antibiotics provided prolonged (>or=12h) inhibitory activity against strains of Hemophilus influenzae (telithromycin MIC=4.0 microg/ml). Both telithromycin and amoxicillin/clavulanate exhibited rapid and prolonged inhibitory activity (>or=12h) against each of the anaerobes studied (Finegoldia [Peptostreptococcus] magna Peptostreptococcus micros, Prevotella bivia, and Prevotella melaninogenica). Moreover, both agents provided bactericidal activity against both Prevotella species. In this ex vivo pharmacodynamic study, we found that telithromycin provided rapid and prolonged antibacterial activity in serum against macrolide-resistant strains of S. pneumoniae, beta-lactamase-positive and -negative strains of H. influenzae, and common respiratory anaerobic pathogens. These findings suggest that telithromycin could have clinical utility in the treatment of community-acquired mixed aerobic-anaerobic respiratory tract infections, including chronic sinusitis and aspiration pneumonia.
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PMID:Human serum activity of telithromycin, azithromycin and amoxicillin/clavulanate against common aerobic and anaerobic respiratory pathogens. 1718 93

Two aspiration syndromes have been identified: Aspiration pneumonia is infectious caused by micro-aspiration of oral bacteria secondary to neurogenic dysphagia or sedation. Infectious bacteria may also be aspirated from the stomach. Aspiration pneumonitis classically follows large bolus aspiration of food, acid, or digestive enzymes and is initially noninfectious. Large bolus gastric aspiration events may have an acute/dramatic onset. This article discusses (1) prevention of recurrent aspiration events caused by 2 common motility disorders: neurogenic dysphagia and gastro esophageal reflux; (2) mechanical source control (debridement/drainage) of sites that may harbor large collections of bacteria protected from antibiotics in biofilm including dental plaque, coated tongue, and chronic sinusitis.
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PMID:Preventing aspiration in the nursing home: the role of biofilm and data from the ICU. 2012 17