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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper summarizes the first study on clinical, etiologic, and epidemiologic features of acute lower respiratory tract infection (ALRI) in children in Argentina. A total of 1,003 children less than 5 years of age (805 inpatients and 198 outpatients) presenting with ALRI were studied during a 40-month period. Nasopharyngeal aspirate (NPA), blood, urine, and throat-swab samples were collected when each child was first seen for care. Virologic studies were performed on the NPA by means of indirect immunofluorescence and isolation of virus in cell culture. Bacteriologic studies primarily were done by means of culture of blood or pleural fluid (when available); Bordetella pertussis and Mycoplasma pneumoniae, however, were searched for by the use of immunofluorescence and complement-fixation testing, respectively, in paired sera. Respiratory syncytial virus was the most commonly isolated virus, followed by adenovirus, parainfluenza virus, and influenza virus. Streptococcus pneumoniae was the most frequently isolated bacterium, followed by B. pertussis and Haemophilus influenzae type b. Overall, the patient fatality rate was 3.8% among inpatients with pneumonia or bronchiolitis.
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PMID:Etiologic and clinical evaluation of acute lower respiratory tract infections in young Argentinian children: an overview. 227 Apr 11

Macrolides are active against Streptococcus pneumoniae, Legionella spp. and Mycoplasma pneumoniae, the main causes of community-acquired pneumonia They may therefore be used for the empirical treatment of community-acquired pneumonia, although emergent resistance in Str. pneumoniae limits their use in some parts of the world. In patients with bronchitis the use of macrolides reduces the severity and duration of symptoms. Macrolides have also been used successfully in the treatment of otitis media and sinusitis; combination with sulphonamides may be desirable. They may be effective in eradicating the carrier state of Str. pyogenes, Bordetella pertussis, Corynebacterium diptheriae, and Neisseria meningitidis. Macrolides provide alternative therapy for the prophylaxis of recurrent acute rheumatic fever and of infective endocarditis after dental treatment. The cure rate with macrolides of streptococcal skin infections and of minor staphylococcal infections is equal to that achieved with penicillins. In diarrhoea due to Campylobacter jejuni, the administration of macrolides shortens the duration of the faecal excretion of organisms and may give clinical improvement in severe disease. Macrolides are the drugs of choice for infections due to Chlamydia trachomatis in pregnancy and for Haemophilus ducreyi infections. They are effective alternative therapy to benzylpenicillin for the treatment of N. gonorrhoeae and Treponema pallidum infections.
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PMID:The clinical use of macrolides. 305 68

The large surface area provided by the respiratory tract epithelium of humans for exposure to microbial agents and toxic substances in the environment makes this organ system very vulnerable but a good early indicator of adverse health effects. However, the complexity of pulmonary defense mechanisms complicates definition of the interactive effects of pollutants and infectious agents. Tracheal organ culture has been utilized to maintain organized, differentiated respiratory epithelium in vitro. This model system permits the exposure of respiratory epithelium to injurious agents in an easily visualized and controlled environment. Effects of individual toxin and/or infectious agents may be examined without the involvement of most host defenses and unwanted secondary microbial invaders which hamper interpretation of in vivo model studies. Further, elements of host immune response, pharmacologic agents and the like may be added selectively if desired. A body of information is being developed on specialized respiratory cell injury by various common pathogenic agents--including respiratory syncytial virus, parainfluenza virus type 3, Bordetella pertussis and Mycoplasma pneumoniae--through studies in tracheal organ cultures. These agents injure specialized epithelial cells in different ways, providing a spectrum of changes against which the added effects of toxic substances could be evaluated at the cellular and subcellular levels. Information on the pathogenesis of infectious/toxic injury could suggest new directions for human health research and for means to benefit the human host.
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PMID:Injury of respiratory epithelium. 625 Aug 14

Of 44 children with clinical pertussis 29 (66%) had serological evidence of concurrent infection with respiratory viruses or Mycoplasma pneumoniae. The commonest superinfection was by mycoplasma (32%), followed by respiratory syncytial virus (27%) and adenoviruses (16%). The high prevalence of viral infections, many being multiple, supports the theory that pertussis predisposes to such infections or vice versa.
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PMID:Viral infections in clinical pertussis. 662 45

Clinical trials of 9,3"-diacetylmidecamycin (MOM), a new macrolide antibiotic were carried out on 46 pediatric patients of 1 month to 11 years old with infections (acute pharyngitis 12, acute tonsillitis 1, acute bronchitis 14, asthmatic bronchitis 10, acute pneumonia 1, primary atypical pneumonia 2, Mycoplasma pneumonia 4 and pertussis 2). As a rule, MOM was given orally at a daily dose of 20 approximately 40 mg/kg divided into 3 times. The clinical results were excellent in 5 patients, good in 21, fair in 7 and poor in 13 and the efficacy rate was 56.5%. Side effects were observed in 4 patients (diarrhea, exanthema, urticaria and eosinophilia, 1 patient respectively). MOM is easy to take and a useful antibiotic for treating patients with bacterial infections, in particular, respiratory tract infection caused by Mycoplasma pneumoniae.
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PMID:[Clinical studies of 9,3"-diacetylmidecamycin in pediatric field (author's transl)]. 697 41

A retrospective analysis of absolute numbers in 802 white blood counts and 396 sedimentation rates of 407 children, admitted between 1973-78, with 9 "classic" infections was done and evaluated for diagnostic usefulness. As diagnostic meaningful it was found: Lymphocytosis in pertussis; lymphocytopenia and slight increased sedimentation rate in measles; nothing particular in mumps; slight increased sedimentation rate in chicken pox; increase in mononuclear cells, particularly atypical lymphocytes and sedimentation rate in infectious mononucleosis; leucocytopenia caused by neutrocytopenia and lymphocytopenia in exanthema subitum (roseola infantum); increased sedimentation rate in scarlet fever; lymphocytopenia and a high sedimentation rate in mycoplasma-pneumonia; leucocytopenia with lymphocytopenia in rubella.
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PMID:[Leucocyte number, differential count and sedimentation rate in 9 "classic" childhood infections. (author's transl)]. 719 42

Estimates based upon notifications indicate that there was in the 1977-9 triennium in the United Kingdom the largest outbreak of whooping cough for 20 years or more. During this triennium there was also a sharp increase in other infections diseases of childhood, notably in non-notifiable respiratory infections. Isolates of certain respiratory viruses ran in parallel and collectively outnumbered those of Bordetella pertussis during the period of increase in notifications. There was highly significant positive correlation between isolates of B pertussis and of ECHO viruses, of Mycoplasma pneumoniae and rhinoviruses and, in Scotland only, of Coxsackie virus. Deaths in which whooping cough was certified as the immediate of underlying cause were lower than in previous outbreaks. Only a minority were bacteriologically confirmed. A closer study of the outbreak in Glasgow disclosed considerable variations in notification procedure and lack of correlation with isolates of B pertussis at the peak of the notification period. Attack rates calculated from notification were higher in deprived areas. Birth cohort studies showed a significantly higher proportion of notifications in unvaccinated children aged 1-4 and this was confirmed in family studies of clinical whooping cough in home contacts. But, overall, about 35% of reported cases were children who had received three injections of triple vaccine. Acceptance of pertussis vaccine fell sharply in 1975 but about 95% of unvaccinated children in age groups 0-5, including the 1977 and the 1977 and 1978 birth cohorts, either escaped infection or were not notified.
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PMID:Whooping cough in relation to other childhood infections in 1977-9 in the United Kingdom. 729 39

Concurrent outbreaks of illnesses that were manifested by cough and that were suspected to be due to Bordetella pertussis and Mycoplasma pneumoniae infection were investigated in a midwestern town in Illinois. Three studies were conducted: questionnaires on the clinical and epidemiological characteristics of illness were administered to patients; serological tests were performed to confirm the presence of each pathogen and to develop case definitions for each illness; and case definitions were applied to responses to a mail-in questionnaire for estimating the magnitude of both outbreaks. In 135 cases of suspected pertussis and 42 cases of suspected mycoplasmal infection, subjects had a cough for > or = 14 days (the pertussis outbreak case definition). Among 20 laboratory-confirmed cases, a cough for > or = 14 days had a specificity of 20% for pertussis, and a cough for > or = 28 days plus whoop and/or vomiting had a specificity of 90% for pertussis. Six hundred-seventeen pertussis cases per 100,000 population and 1,179 cases of M. pneumoniae infection per 100,000 population occurred. In this setting, the standard outbreak case definition for pertussis lacked adequate specificity to distinguish pertussis from mycoplasmal infection. The magnitude of each outbreak was greater than the number of reported cases suggested.
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PMID:Concurrent outbreaks of pertussis and Mycoplasma pneumoniae infection: clinical and epidemiological characteristics of illnesses manifested by cough. 775 86

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.
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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.
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PMID:Update of the rapid diagnosis of infectious diseases. I: Bacteria, fungi and parasites. 799 14


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