Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The bactericidal activities of human complement and human antibody directed against specific Haemophilus influenzae type b cell surface determinants were investigated. Strain Eagan, a laboratory isolate, and strain Kn, a clinical isolate, were used as the test organisms and gave qualitatively similar results. In the absence of antibody, both isolates were resistant to killing by 60% agammaglobulinemic serum (AGS) containing normal complement levels. The addition of affinity-purified immunoglobulin G anticapsular antibody was bactericidal with 15% AGS as the complement source. Bactericidal activity was also demonstrated with this antibody when the complement source was AGS-Mg-EGTA [ethylene glycol-bis(beta-aminoethyl ether)-N,N-tetraacetic acid], C2-deficient human serum (alternative complement pathway), or AGS in which factor D and properdin had been selectively inactivated (classical pathway). Immunoglobulin G fractions from a human serum pool or from serum from an adult who had recovered from H. influenzae type b (Kn) sepsis were absorbed to remove anticapsular antibody. The absorbed fractions containing noncapsular antibodies also activated complement-dependent bactericidal activity. But, in contrast to the results with anticapsular antibody, noncapsular antibodies did not elicit alternative pathway bactericidal activity. Incubation of cells of H. influenzae type b in C2-deficient serum or AGS-Mg-EGTA did not cause complement consumption (total hemolytic complement and C3). The addition of immunoglobulin G anticapsular antibody (but not noncapsular antibody) increased consumption of total complement and C3, paralleling the results of the bactericidal assays. These studies demonstrated an absolute requirement for anticapsular antibody in alternative pathway activation and killing of H. influenzae type b.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Antibody-dependent alternative pathway killing of Haemophilus influenzae type b. 660 28

Twenty-one pediatric patients with moderate or severe infections were treated with cefpiramide (CPM). The drug was given intravenously in a dose of 10 approximately 52.3 mg per kg at 8 approximately 12 hourly interval. All 7 patients with urinary tract infection, 4 with bacterial enteritis and 4 out of 7 patients with lower respiratory tract infections responded satisfactory, but 2 patients with either Serratia marcescens septicemia or H. influenzae meningitis not responded to treatment. Over all response rate was 71.4 percent. There was no change in test of liver and renal function. CPM appears to be effective and well-tolerated antibiotics for the treatment of pediatric patients with various infections.
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PMID:[Clinical results of cefpiramide therapy in infections of children]. 665 34

Cefpiramide (CPM) was given to 4 patients with respiratory tract infection (H. influenzae 3 cases, P. aeruginosa 1 case), 1 patient with enteritis (enteropathogenic E. coli) and 1 patient with sepsis (E. cloacae). Bacteriological eradication was observed in 5 cases (83.3%), and clinical effectiveness was 66.7%. Serum concentration of CPM at a dose of 15 mg/kg after intravenous drip-infusion for 30 minutes was 105 micrograms/ml at the end of infusion and 67 micrograms/ml at 1 hour. Bacteriological eradication by the administration of CPM was rapidly occurred in 3 strains of H. influenzae including 1 strain of beta-lactamase producing ABPC-resistant one, and 1 strain of P. aeruginosa in the sputum. One patient aged 2 years and 5 months with pneumonia was cured by the treatment of CPM as an outpatient. No side effects were observed except 1 case of vascular pain. It was concluded that CPM is a useful drug for the treatment of bacterial infections in children.
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PMID:[Clinical evaluation of cefpiramide in 6 cases of infection in children]. 665 37

Levels of antibodies to the capsular polysaccharides of groups A and C Neisseria meningitidis and Haemophilus influenzae type b were determined by radioimmunoassay in acute- and convalescent-phase sera of 377 patients with meningitis, septicemia, or epiglottitis. Diagnostic criteria, based on a fourfold or greater rise in antibody level and/or a high specific antibody level, correctly identified 85% of group A meningococcal diseases, 90% of group C meningococcal diseases, and 78% of H. influenzae type b diseases in children older than but only 15% in infants younger than 1.5 years of age. When levels of antibody in acute-phase sera were high, they were predominantly of the IgA class. A greater than fourfold rise in levels of antibodies to group A meningococcus was seen in 10%-32% of persons with disease caused by other bacteria, but minimal false-positive reactions occurred with group C meningococcus or H. influenzae type b.
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PMID:Antibody response to capsular polysaccharides of groups A and C neisseria meningitidis and Haemophilus influenzae type b during bacteremic disease. 678 3

We investigated the effect of splenectomy on the susceptibility of rats to intravenous or intranasal inoculation of Haemophilus influenzae, type b. The 50% lethal dose for asplenic rats inoculated either by intravenous (i.v.) (10(4.7)) or intranasal (i.n.) (10(4.6)) injection was similar, but significantly lower than the 50% lethal dose value in sham-operated rats (10(8.6) i.v. and 10(9.0) i.n.). Mean survival time was significantly longer for asplenic rats inoculated i.n. (49.3 h) compared to asplenic rats inoculated i.v. (24.4h). Similarly, sham-operated rats inoculated i.n. survived significantly longer after i.n. challenge (mean survival time, 171.4 h) than after i.v. challenge (34.7 h). Bacteremia was detected in 100% of asplenic rats and in 80% of sham-operated rats. The geometric mean number of bacteria in the blood of asplenic rats (10(4.90) per ml) was significantly greater than in sham-operated rats (10(3.29) per ml). Meningitis was detected in 7 of 15 randomly sacrificed asplenic rats, whereas none of 15 sham-operated rats had evidence of meningeal invasion. Thus, the asplenic rat was more susceptible to experimentally induced H. influenzae bacteremia, meningitis, and fatal sepsis and offers a biologically relevant experimental model for investigating the role of the spleen in defense against infection with encapsulated bacteria.
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PMID:Haemophilus influenzae b infection in rats: effect of splenectomy on bloodstream and meningeal invasion after intravenous and intranasal inoculations. 696 13

It has been suggested that autotransplantation of splenic tissue following trauma may result in splenic implanta that protect the human host from severe infection with encapsulated bacteria. To test this hypothesis, Sprague-Dawley rats underwent sham operation, splenectomy, or splenectomy followed by autotransplantation of splenic fragments into the peritoneal cavity. Three months later, they were inoculated intranasally with H. influenzae b. The incidence and severity of bacteremia and meningitis were determined subsequently in 15 randomly selected rats from each group. Splenosis did not appear to confer significant protection against bloodstream dissemination. However, significantly more (p = 0.005) asplenic rats (13/15) developed meningitis than did splenosed rats (6/15). None of the rats with normal splenic tissue developed CNS infection. Thus, the occurrence of meningitis was reduced in autotransplanted rats as compared to asplenic rats. Ten remaining rats from each group were followed for 3 wk after inoculation and the number of deaths was recorded. All sham-operated and autotransplanted rats survived, whereas 7 of 10 asplenic rats died (p = 0.003). These studies indicate that surgically created splenosis offers the potential for reducing the risk of life-threatening sepsis.
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PMID:Heterotropic splenic autotransplantation in the prevention of Haemophilus influenza meningitis and fatal sepsis in Sprague-Dawley rats. 696

Soft tissue inflammation is a rare manifestation of H. influenzae infection. It is known in the anglo-american literature as "cellulitis". Usually there is concomitant bacteremia or septicemia. The combination of cellulitis and meningitis is rare and not well known in German pediatric literature. Three children with facial cellulitis together with H. influenzae meningitis are described. In comparison to the literature some unusual observations were made: Early appearance of cellulitis at the age of six weeks in two infants, cellulitis of the lower extremities at the same time in one, and biphasic course with cellulitis and meningitis secondary to mastoiditis in another infant.
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PMID:[Phlegmona ("cellulitis") and Haemophilus influenzae meningitis]. 698 33

A patient with chemotherapy-treated multiple myeloma developed overwhelming sepsis and meningoencephalitis with Haemophilus influenzae type f. Typable H. influenzae other than type b has only rarely been reported as a cause of serious disease in adults. The patient's immunosuppressed status presumably predisposed her to this unusual infection.
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PMID:Lethal meningoencephalitis and septicemia caused by Haemophilus influenzae type f in an adult with multiple myeloma. 703 42

Thirty-two infants and children ranging in age from 3 to 151 months (mean, 26 months) were treated with parenteral cefoxitin (150 mg/kg per day). Ten patients with isolates of Haemophilus influenzae (six with cellulitis, two with arthritis, and two with mastoiditis), four with Staphylococcus aureus (one with lymphadenitis, one with septicemia, and two with abscess), and three patients with Streptococcus pneumoniae (one each with cellulitis, abscess, and arthritis), were clinically and bacteriologically cured by therapy. Two additional patients with septic arthritis and facial cellulitis developed meningitis with H. influenzae type b and S. pneumoniae, respectively. Minimal inhibitory and bactericidal concentrations were </=5 mug/ml for 15 isolates. Minimal bactericidal concentrations were >20 mug/ml for one strain of S. aureus and one of H. influenzae type b. The mean peak serum levels were 81.9 and 68.5 mug/ml 15 min after intravenous or intramuscular doses, respectively. The mean elimination half-lives were 42.4 and 40.1 min after intravenous or intramuscular doses, respectively. The mean volumes of distribution were 5,540 and 4,760 ml after intravenous and intramuscular doses, respectively. Mean plasma clearance was 242 and 257 ml/min per m(2) after intravenous and intramuscular doses, respectively. Therapy was discontinued in one patient because of neutropenia, which resolved after cefoxitin was stopped. Eosinophilia and transiently elevated liver function tests occurred in eight and six patients, respectively. These data indicate that cefoxitin may be an effective treatment for infections due to susceptible bacteria in the dosage tested, but its use may be limited because of the occurrence of meningitis during therapy in some patients.
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PMID:Clinical and pharmacokinetic evaluation of parental cefoxitin in infants and children. 739 56

The penicillins are a large group of bicyclic ring compounds which contain a 4-membered beta-lactam ring (penams) fused to a 5-membered thiazolidine ring. Benzylpenicillin (penicillin G) was the first natural penicillin with potent activity against all Gram-positive pathogens, Gram-negative cocci and some spirochaetes and actinomycetes. For the last 50 years benzylpenicillin has been the mainstay of therapy for serious pneumococcal, streptococcal, meningococcal and gonococcal infections. However, the past decade has seen the emergence of resistance in certain parts of the world, initially among the gonococci, and more recently among the pneumococci and meningococci. Discovery of the 6-aminopenicillinamic acid nucleus has led to considerable manipulation of the basic ring structure, resulting initially in the synthesis of ampicillin, and subsequently the other aminopenicillins, analogues, esters and prodrugs. These drugs have the advantages of improved oral bioavailability and superior activity against Haemophilus influenzae, certain Gram-negative bacilli, salmonellae, enterococci and Listeria monocytogenes, making these agents popular in the treatment of upper and lower respiratory tract infections and urinary tract infections. The increasing spread of bacterial resistance, particularly among Enterobacteriaceae and H. influenzae, has curtailed the usefulness of these drugs in these clinical settings. To counteract this problem, a number of agents combining a penicillin and a beta-lactamase inhibitor (e.g. clavulanic acid, tazobactam and sulbactam) have been developed. These inhibitors have no intrinsic antibacterial activity, but combining them with a penicillin (e.g. amoxicillin/clavulanic acid) confers greater stability to beta-lactamases and hence a broader spectrum of activity. The emergence of penicillinase-producing staphylococci that rendered benzylpenicillin ineffective also stimulated the search for penicillinase-resistant penicillins--methicillin and nafcillin, followed by the acid-stable isoxazolyl penicillins. These agents are now the principle antistaphylococcal treatment. Methicillin-resistant coagulase-negative staphylococci are currently a major cause of hospital sepsis, and are resistant to these latter agents. Enteric Gram-negative bacilli have been the predominant cause of serious hospital infections during the last 30 years. Further manipulation of the penicillin structure has resulted in compounds with broader activity against Gram-negative bacilli, particularly Pseudomonas aeruginosa, while retaining activity against Gram-positive pathogens. The carboxypenicillins were the first step in this direction, but have been largely superseded by the ureidopenicillins. These agents have better activity against P. aeruginosa, and are still effective against Gram-negative and Gram-positive bacteria, including enterococci and anaerobic organisms.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Penicillins. A current review of their clinical pharmacology and therapeutic use. 769 96


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