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Query: UMLS:C0043167 (
pertussis
)
19,595
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
To determine the agents associated with acute lower respiratory infection in young children, we studied 102 hospitalized children less than 5 years old using culture and serology for viruses and
Chlamydia
trachomatis, fluorescent antibody testing for
pertussis
and respiratory syncytial virus, blood cultures and counterimmunoelectrophoresis of nasopharyngeal secretions and urine for pneumococcal and Haemophilus influenzae type b antigens. At least one agent was detected in 87 children and multiple agents were found in 33. Viruses were detected 80 times; respiratory syncytial virus was most common (61 cases) and was detected as often by fluorescent antibody testing as by culture. C. trachomatis was detected in 10 children; all were less than 4 months old and 9 had mixed infections. Bacteria were detected 32 times, were usually pneumococcus (23) or H. influenzae (5) and were detected more often by counterimmunoelectrophoresis than by blood culture. Compared with children yielding only C. trachomatis or viruses, those with bacteria were significantly more likely to have fever, a band count over 2000/mm3 and radiographic consolidation. In this study acute lower respiratory infection was associated commonly with viruses, often with multiple pathogens but not with C. trachomatis after 4 months of age.
...
PMID:Pathogens associated with acute lower respiratory tract infection in young children. 670 Nov 1
The aim of the development of semisynthetic derivatives was to overcome the problem of chemical stability of erythromycin A in acid medium, with less variability in gastro-intestinal absorption and leading to renewed interest in macrolides. The new macrolides have the same antibacterial spectrum as erythromycin A including Gram-positive and Gram-negative cocci, intracellular bacteria, mycoplasma, Campylobacter sp., Helicobacter pylori, mycobacteria spp., Gram-negative bacilli including Haemophilus influenzae, Bordetella
pertussis
, Pasteurella multocida, Gram-positive bacilli including Corynebacterium diphtheriae and anaerobic species. In vitro activity against Haemophilus influenzae is still a controversial subject. Macrolides are among the best tolerated antibacterial agents. Theoretically, macrolides could be given to a large range of patients even those suffering from underlying diseases. The new macrolides, roxithromycin, azithromycin, clarithromycin, dirithromycin, rokitamycin and miokamycin, are indicated for the treatment of upper respiratory tract infections and lower respiratory tract infections due to intracellular bacteria or Mycoplasma pneumoniae. Macrolides could be used as first line therapy for non-gonococcal urethritis, especially those due to
Chlamydia
trachomatis or Ureaplasma urealyticum. In pelvic inflammatory infections in which
Chlamydia
trachomatis is involved macrolides could also be used. Other non-conventional indications under discussion are H. pylori and Lyme's disease. Macrolides in combination with other antibacterials could be an alternative for Mycobacterium avium-intracellulare infections. The antiparasite effect of erythromycin has been known since the 1950s. Extensive experimental work is currently underway to determine the potential use of these drugs in this setting. Research during the 80s in the macrolide field, led to enhanced pharmacokinetic properties. Current research is focused on expanding the antibacterial spectrum and to overcome cross-resistance among 14-membered-ring macrolides.
...
PMID:[Macrolides. New therapeutic prospects]. 783 Dec 66
The application of monoclonal antibodies and DNA probes in the clinical microbiology laboratory has resulted in an array of rapid diagnostic tests. The immunofluorescent assay or enzyme-linked immunoassay is widely used in the rapid diagnosis of bacteria eg Group A streptococcus, Legionella pneumophila, Mycoplasma pneumoniae, Bordetella
pertussis
; parasites eg
Chlamydia
tachomatis, Cryptosporidium species; and fungi eg Pneumocystis carinii. The BACTEC system was first introduced to detect bacteraemia pathogens. It has been further developed to detect Mycobacterium species in clinical specimens and this has greatly reduced turn-around time in the laboratory diagnosis of Mycobacterium species. The discovery of the polymerase chain reaction has led to hopes of using it as a potential diagnostic tool in the microbiology laboratory.
...
PMID:Update of the rapid diagnosis of infectious diseases. I: Bacteria, fungi and parasites. 799 14
The authors show a scientific literary review on Ch. trachomatis pneumonia. A distinctive syndrome pneumonia has been reported in infants infected by
Chlamydia
(at 2-3 months of age) in genital-urinary infected mothers. The infection may be preceded by conjunctivitis, in apyrexia followed by attacks of coughing
pertussis
-like. Blood eosinophilia is present. Although favorable prognosis in infancy, erythromycin is the drug of choice shortening the clinical course erythromycin is also recommended in woman infected prevention.
...
PMID:[Pulmonary infections in children. III. Pneumonia due to Chlamydia trachomatis]. 809 Jan 37
Airway infections in children is a considerably broad topic. This discussion focuses on several common nonbacterial causes of lower respiratory tract infection in children, including respiratory syncytial virus, Mycoplasma pneumoniae, and
Chlamydia
pneumoniae. In addition, the occurrence of two important bacterial causes of lower respiratory illness (Bordetella
pertussis
and Mycobacterium tuberculosis) is increasing. This review focuses on current information on the prophylaxis, treatment, and diagnosis of these agents. Finally, consideration is given to infections in immunocompromised children: the effects of respiratory syncytial virus infections in immunosuppressed transplant patients, and prevention and diagnosis of opportunistic infections (including Pneumocystis carinii) in children with human immunodeficiency virus.
...
PMID:Lung infections in children. 837 45
Macrolides are antibiotics with high intracellular concentrations. They have a bacteriostatic activity but are also bactericides for concentrations five times greater than the minimal inhibitory concentration, concentrations in which they reach in the respiratory tract. They are usually active on Streptococcus, Neisseria, Moraxella catarrhalis, Listeria monocytogenes, Bordetella
pertussis
, Pasteurella multocida,
Chlamydia
, Mycoplasma pneumoniae, Legionella pneumophila and Helicobacter pylori. They have few secondary effects, some in relation with drug interactions. Their main indications are bronchopulmonary infections due to Mycoplasma pneumoniae,
Chlamydia
pneumoniae,
Chlamydia
trachomatis and Legionella pneumophila. They are also useful in whooping cough allowing the eradication of Bordetella
pertussis
in the rhinopharynx, thus limiting the dissemination of the infection in children. In amygdalitis and pharyngitis, macrolides are a good substitute in the case of allergy to penicillin. New generation of macrolides (roxithromycine, clarithromycine, dirithromycine, azithromycine) might open other interesting therapeutic perspectives.
...
PMID:[Role of macrolides in the treatment of respiratory tract infections in children]. 854
Respiratory infections, especially community-acquired forms of pneumonia (CAP), are challenging for clinicians because (1) a causative microorganism can only be found in about 50% of cases; (2) initial therapy, therefore, must be based on a probable or most likely etiology in the context of the patient's overall medical condition; and (3) new microbes or those considered previously as normal flora or less virulent forms seem responsible for some cases. It is important to be acquainted with new causes of infection which include Legionella species,
Chlamydia
pneumoniae, diphtheroids in certain instances (Corynebacterium pseudodiphtheriticum), and viruses such as the Hanta strains. Infections with Bordetella
pertussis
are increasing. However, the ever present and most common cause of CAP, Streptococcus pneumoniae, continues to present problems because of increasing antibiotic resistance, the high case fatality rate when bacteremia accompanies pneumonia, and the inability to give prophylactic immunization to all people with risk factors for this infection.
...
PMID:Respiratory infections: community-acquired pneumonia and newer microbes. 879 Dec 58
This article reviews the existing literature about acute bronchitis, a condition commonly diagnosed but poorly defined. The little epidemiologic research that has been done has failed to identify a microbiologic etiology approximately 60% to 85% of the time. The majority of cases appear to be caused by viruses, but 25% of adults with nonspecific lower respiratory symptoms may actually have
pertussis
. Mycoplasma pneumoniae and
Chlamydia
pneumoniae probably play minor roles. Although clinicians frequently prescribe antibiotics to patients they have diagnosed with acute bronchitis, there is little evidence in support. General treatment studies have failed to demonstrate benefit, and the natural history of even potentially curable pathogens is not altered by antimicrobial therapy. Some recent studies suggest that albuterol may be the best treatment choice for acute bronchitis; it can successfully ameliorate symptoms, and does not pose the same public health risk as inappropriate antibiotics do. Erythromycin may occasionally be indicated for patients in frequent contact with small infants not yet immunized against
pertussis
, but careful surveillance of the child is probably more effective than treating the contagious adult.
...
PMID:Acute bronchitis in adults: commonly diagnosed but poorly defined. 900 13
Clinical laboratories are increasingly receiving requests to perform nucleic acid amplification tests for the detection of a wide variety of infectious agents. In this paper, the efficiency of nucleic acid amplification techniques for the diagnosis of respiratory tract infections is reviewed. In general, these techniques should be applied only for the detection of microorganisms for which available diagnostic techniques are markedly insensitive or nonexistent or when turnaround times for existing tests (e.g., viral culture) are much longer than those expected with amplification. This is the case for rhinoviruses, coronaviruses, and hantaviruses causing a pulmonary syndrome, Bordetella
pertussis
,
Chlamydia
pneumoniae, Mycoplasma pneumoniae, and Coxiella burnetii. For Legionella spp. and fungi, contamination originating from the environment is a limiting factor in interpretation of results, as is the difficulty in differentiating colonization and infection. Detection of these agents in urine or blood by amplification techniques remains to be evaluated. In the clinical setting, there is no need for molecular diagnostic tests for the diagnosis of Pneumocystis carinii. At present, amplification methods for Mycobacterium tuberculosis cannot replace the classical diagnostic techniques, due to their lack of sensitivity and the absence of specific internal controls for the detection of inhibitors of the reaction. Also, the results of interlaboratory comparisons are unsatisfactory. Furthermore, isolates are needed for susceptibility studies. Additional work remains to be done on sample preparation methods, comparison between different amplification methods, and analysis of results. The techniques can be useful for the rapid identification of M. tuberculosis in particular circumstances, as well as the rapid detection of most rifampin-resistant isolates. The introduction of diagnostic amplification techniques into a clinical laboratory implies a level of proficiency for excluding false-positive and false-negative results.
...
PMID:Relevance of nucleic acid amplification techniques for diagnosis of respiratory tract infections in the clinical laboratory. 910 53
Erythromycin, the prototypical macrolide, has been widely used since the 1950s in the management of pediatric infections. Erythromycin is the drug of choice for infants and children with Legionnaire's disease,
pertussis
, diphtheria, lower respiratory tract infections caused by Mycoplasma pneumoniae,
Chlamydia
pneumoniae and
Chlamydia
trachomatis and enteritis caused by Campylobacter jejuni. It is also indicated for treatment of syphilis; for streptococcal, staphylococcal and pneumococcal infections; genital infections caused by Ureaplasma urealyticum; and for the prevention of rheumatic fever and endocarditis in patients who are allergic to beta-lactam antibiotics. The new macrolides azithromycin and clarithromycin are also active against Borrelia burgdorferi, Helicobacter pylori, Mycobacterium avium-intracellulare complex, Cryptosporidium spp. and Toxoplasma gondii. Erythromycin is associated with a low risk of serious side effects, although gastric distress occurs in a significant proportion of patients. Drug interactions with theophylline, carbamazepine, warfarin, cyclosporine, terfenadine and digoxin limit erythromycin use. The newer macrolides azithromycin and clarithromycin are more stable, better absorbed and better tolerated than erythromycin. Azithromycin is more active than erythromycin against Haemophilus influenzae. Excellent tissue and intracellular penetration may contribute to their clinical efficacy. In children both azithromycin and clarithromycin are indicated for acute otitis media caused by Streptococcus pneumoniae, H. influenzae and Moraxella catarrhalis and for pharyngitis/tonsillitis caused by Streptococcus pyogenes. (As of December, 1996, azithromycin for oral suspension was approved for community-acquired pneumonia in children caused by C. pneumoniae, H. influenzae, M. pneumoniae and S. pneumoniae.) Claritromycin is also indicated for acute maxillary sinusitis, uncomplicated skin and skin structure infections, pneumonia and disseminated mycobacterial infections. Azithromycin and clarithromycin are associated with a lower incidence of gastrointestinal side effects, a low rate of drug discontinuation caused by side effects and a low potential for interaction with other drugs.
...
PMID:History of macrolide use in pediatrics. 910 54
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