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

An epidemic of pertussis occurred among hospital staff caring for paediatric patients. Eight physicians and five nurses were affected. Pertussis developed in six newborn infants exposed to infected hospital staff in the nursery. Erythromycin prophylaxis was used to control the epidemic. Clinical pertussis developed in five adults infected with Bordetella pertussis before erythromycin was used, whereas symptoms developed in only one of the eight adults who became infected after erythromycin prophylaxis was started. Pertussis vaccine was given to adult volunteers in the hospital, and in 77% of two hundred and eighty-six vaccinees there was a fourfold rise in pertussis agglutinins. Local reactions were common, and in two vaccinees generalised rashes developed. One of these required treatment with corticosteroids. The risk of pertussis occurring in adults providing medical care for children should be recognised, and employees with symptoms should be removed from the hospital environment.
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PMID:Use of pertussis vaccine in an epidemic involving hospital staff. 5 54

Sixty-five patients with pertussis were identified by a clinical criterion, and Bordetella pertussis was isolated from 75% of these patients or their symptomatic household contacts. Negative nasopharyngeal cultures were usually associated with either a history of antibiotic therapy with erythromycin or tetracycline (two of three patients), two or more diphtheria and tetanus toxoids with pertussis (DTP) vaccines (six of eight patients), or both (two of three patients). Erythromycin therapy resulted in the elimination of B. pertussis from the nasopharynx in 2 to 7 days (mean, 3.6 days) compared with 7 to 17 or more days (mean, greater than 12 days) in patients treated with no antibiotics, but had no effect on the duration or severity of illness as judged by length of hospitalization. Adenoviruses were recovered from five of 44 patients cultured. Four of these isolates were from throat swabs obtained early in the illness and the remaining isolate was from one of 33 repeated viral cultures obtained two to three weeks later; B. pertussis was also isolated from these five patients. Paired serum samples were obtained from only two of these patients. Neither demonstrated a fourfold rise in adenoviral complement-fixing antibodies. Therefore, in these patients, adenoviral isolation may have been secondary to reactivation of a latent viral infection by infection with B. pertussis.
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PMID:The role of antibiotics, immunizations, and adenoviruses in pertussis. 20 99

The effectiveness of oral erythromycin and amoxycillin in eradicating Bordetella pertussis from the nasopharynx was compared. Erythromycin in a dosage of 40--50 mg/kg/day was significantly more effective than amoxycillin in a dosage of 25--30 mg/kg/day. The organism did not disappear in three cases receiving a lower dosage of erythromycin. As antibiotic treatment does not affect the clinical course of fully-developed whooping cough, erythromycin is indicated primarily when particularly susceptible individuals are threatened by exposure. In such cases erythromycin should be given as soon as whooping cough is suspected.
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PMID:Effect of erythromycin and amoxycillin on Bordetella pertussis in the nasopharynx. 21 55

A neonate admitted to the newborn nursery was found to have bacteriologically proven Bordetella pertussis whooping cough, and two of seven infants exposed to this child became infected. Erythromycin administration to the seven infants apparently prevented further infection as well as the appearance of clinical disease in the two infected infants. This limited experience supports previous reports of the efficacy of erythromycin in preventing B. pertussis infection and disease in susceptible children.
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PMID:Erythromycin prophylaxis for pertussis. 85 Jun 3

An outbreak of pertussis was recognized and investigated in a ward for neurologically impaired residents. Of 50 residents ranging in age from 8 to 25 years old, 41 (82%) had serological or bacteriological evidence of pertussis infection and 28 (56%) developed typical symptoms of pertussis. Of the 50 residents, nine were immunized and 41 were unimmunized. There were no significant differences in the rate of infection and rate of developing typical symptoms between the immunized and unimmunized (9/8/4 vs 41/33/24). Of 43 carers, 6 (14%) developed typical symptoms and four of the six showed serological evidence of pertussis infection. Epidemiological survey of this outbreak revealed that pertussis was introduced and spread by the carers. Erythromycin which was administered only to the residents did not prevent the spread of pertussis. We conclude that pertussis immunization including a booster dose should be considered for neurologically impaired people in a closed environment and erythromycin prophylaxis should include adult carers.
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PMID:Outbreak of pertussis in a residential facility for handicapped people. 183 84

Isolation of the causative agent remains the "gold standard" for the early diagnosis of pertussis. For this purpose, the nasopharynx is swabbed with a calcium alginate swab. Cephalexin-containing charcoal horse blood medium is used for the transport of the swabs to the bacteriology laboratory. As an alternative, the isolation of bordetellae can be performed at the paediatrician's office by direct inoculation of charcoal horse blood agar plates. Long-lasting cough of unknown aetiology is the main field for pertussis serology (ELISA). Even today, severe courses of whooping cough requiring hospitalization are not rare, especially in infants. Erythromycin (given in high doses for 14 days) is the antibiotic of choice for pertussis. As an alternative to the macrolides, cotrimoxazole may be administered or amoxycillin. Salbutamol and the corticosteroids have been shown to be useful for the symptomatic treatment of severe pertussis in infants.
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PMID:[Pertussis: diagnosis, clinical aspects and therapy]. 219 59

During the period 1975-1985, 35 women with serology- or culture-confirmed pertussis at the time of labor were admitted to the Danderyd Hospital (Danderyd, Sweden). In 32 cases, the mothers were allowed to nurse their newborns while receiving erythromycin therapy. Erythromycin prophylaxis was given to 28 newborns. None of the newborns developed clinical or laboratory signs of whooping cough. The therapy was well tolerated by the newborns and did not affect the microflora in the gut. Maternal antibodies to pertussis toxin and to the filamentous hemagglutinin were found in cord blood, and levels decreased during the follow-up period. The study demonstrated that mothers with pertussis can safely be allowed to nurse their infants if both receive erythromycin.
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PMID:Use of erythromycin to prevent pertussis in newborns of mothers with pertussis. 288 39

Erythromycin, first introduced for clinical use 30 years ago, was found to be effective for the treatment of gram-positive bacterial infections. Emergence of resistance and the advent of penicillinase-resistant penicillins limited the use of erythromycin for serious staphylococcal infections; however, erythromycin remains among the drugs of choice for the treatment of acne, infections of the skin and soft tissues, streptococcal pharyngitis, bronchitis, pneumonitis, diphtheria, carriers of pertussis, and, when administered with a sulfonamide, otitis media. Erythromycin is the drug of choice for the empiric treatment of outpatients with pneumonitis. Erythromycin is also the drug of choice for the treatment of Legionella pneumonia and is effective therapy for Chlamydia infections. Other uses of erythromycin include prophylaxis for elective colon operations and treatment of Campylobacter enteritis, genitourinary infections, and some sexually transmitted diseases.
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PMID:Erythromycin: a microbial and clinical perspective after 30 years of clinical use (2). 388 13

A tube dilution test to evaluate the effectiveness of antibiotics against Bordetella pertussis is described. Five B. pertussis strains, including a well-characterized research strain and four fresh clinical isolates, were tested with several antibiotics. Erythromycin showed the highest in-vitro activity of the antibiotics tested. A concentration of 0.12 microgram/ml was bacteriostatic for all strains, while 2 microgram/ml was bactericidal. Minimal inhibitory and minimal bactericidal concentrations for ampicillin by tube tests were found to be higher than values previously reported for agar plate tests.
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PMID:Antibiotic susceptibility testing of Bordetella pertussis. 625 13

Some of the factors influencing the isolation rate of Bordetella pertussis during a whooping cough epidemic in West Glamorgan, Wales, are reported. The organism was isolated from 39% of patients with clinical whooping cough, pernasal swabbing being much more successful than cough plates. Isolation rates were increased in the non-immunized, particularly in the first year of life. Erythromycin and co-trimoxazole significantly reduced the isolation rate of B. pertussis but this did not occur with penicillin. In this study 20% of patients were culture positive 6 weeks after the onset of their infection. It is suggested that the Department of Health and Social Security recommendation of a minimum period of three weeks exclusion of children from school is inadequate. During the epidemic, the proportion of strains of B. pertussis containing antigen 2 more than doubled.
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PMID:Bordetella pertussis isolation in general practice: 1977-79 whooping cough epidemic in West Glamorgan. 630 Feb 27


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