Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A number of immunological and non-immunological techniques have been recently used to detect soluble microbial substances in body fluids of patients with acute meningitis, bacteremia, and lobar pneumonia. By the immunological methods capsular highly polymerized polisaccharide group- or type-specific antigens of the most common C. N. S. pathogens (N. meningitidis A, B, and C; Str. pneumoniae, H. influenzae type b, E. coli K1, mucoid Pseudomonas, Cryptococcus neoformans) can be detected and quantitated in spinal fluids, sera, urine and other fluids specimens from meningitic patients. Capsular type-specific antigens from pneumococcus, and likely from H. influenzae as well, can be detected in sputum from patients with lower respiratory infection. Among the various techniques, the radioimmunoassay appears as the most sensitive one, but high diagnostic sensitivity can be also achieved by using the latex agglutination, haemoagglutination inhibition and coagglutination tests. Counterimmunoelectrophoresis, however, is still the far most used technique for determining soluble microbial antigens, albeit its sensitivity is significantly less than the one of the above mentioned methods. High specificity and some advantages in serotyping the causal organisms are probably the main reasons of such preferential employment. Among the non-immunological techniques the evaluation of lactate and lactic dehydrogenase has been used by some Author for differentiating between bacterial and non bacterial meningitis, and the limulus test for detecting Gram-negative bacterial endotoxins with a high degree of sensitivity and specificity. Finally, the liquid gas chromatography has been evaluated in detection of some organic products (microbial?), such as acids, amines, neutral compounds, in spinal fluid, allowing the differential diagnosis between bacterial, tuberculous, viral, and cryptococcal meningitis. In the present review sensitivity, specificity, and other properties of each test alone and in comparison with the conventional microbiological methods (Gram and culture) are evaluated and the biological and pathogenic role and significance of the soluble microbial antigens and endotoxin are discussed.
 ...
PMID:[Research of the soluble microbial substances in organic fluids for the rapid diagnosis of some infections and particularly of bacterial meningitis (author's transl)]. 2 97

We report the development and testing of an enzyme-linked immunosorbent assay with excellent sensitivity for the detection of Haemophilus influenzae type b (HI(b)) antigen in clinical specimens from patients with HI(b) meningitis. The assay, an indirect sandwich technique, uses polystyrene balls as a solid phase and an alkaline phosphatase-labeled goat anti-rabbit globulin conjugate. Specimens are incubated with polystyrene balls armed with burro anti-HI(b) antiserum, and recognition antibody is visualized by addition of alkaline phosphatase-labeled anti-globulin, together with the enzyme substrate p-nitrophenyl phosphate. Concentrations of antigen are determined from standard curves prepared by using purified HI(b) capsular antigen polyribophosphate. The assay reproducibly detects polyribophosphate at concentrations between 1 and 5 ng/ml. Cross-reactions have not as yet been encountered in simulated and authentic clinical specimens containing other species including Escherichia coli, Klebsiella pneumoniae, group B Streptococcus, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus aureus, Neisseria meningitidis, and Listeria monocytogenes. In preliminary tests with 11 spinal fluid specimens, 2 serum specimens, and 5 urine specimens from patients with culture-proved HI(b) meningitis, antigen was detected in all specimens in concentrations ranging from 1 to 7,000 ng/ml. Antigen was not detected in any of 62 clinical specimens which were culture negative for HI(b), including 11 spinal fluid specimens from patients with bacterial meningitis caused by microorganisms other than HI(b). The enzyme-linked immunosorbent assay technique described here is considerably simpler than radioimmunoassay and, based on concurrent tests with 14 positive clinical specimens, may be more sensitive than counterimmunoelectrophoresis. It seems, therefore, to hold considerable promise for clinical use in rapid detection of systemic HI(b) infections.
 ...
PMID:Indirect sandwich enzyme-linked immunosorbent assay for rapid detection of Haemophilus influenzae type b infection. 39 14

Forty-two patients were treated with intravenous cefoxitin, a new cephamycin antibiotic. These patients had postoperative abdominal sepsis (26), intrathoracic infections (6), urinary tract infections (5), gram-negative bacterial meningitis (2), septic arthritis (1), epidural abscess (1) and isolated septicemia (1). The antibacterial spectrum of cefoxitin was found to be one which included all gram-positive organisms except enterococci, most gram-negative organisms except Pseudomonas aeruginosa, and almost all of the important anaerobic organisms. The only five treatment failures included one patient with empyema and one with septic arthritis, both caused by Serratia marcescens, initially only moderately susceptible to cefoxitin, which subsequently developed increased resistance, two patients with contaminated intravenous catheters, and one patient with epidural abscess and cerebritis, who was treated late in the course. There was one serious clinical superinfection with P. aeruginosa. The drug levels noted in the pus and joint fluid were half to two-thirds of the simultaneous serum level. In inflamed meninges, up to 30% of the serum level was noted in the cerebrospinal fluid, and as the process resolved, 10 to 15% was noted. Toxicity of cefoxitin was mild and constituted skin rash in three patients (7%) and phlebitis in eight (19%).
 ...
PMID:Use of cefoxitin, new cephalosporin-like antibiotic, in the treatment of aerobic and anaerobic infections. 74 74

Whereas bacterial polysaccharides, classified as T-cell-independent antigens, elicit protective antibodies in adults, booster injections fail to produce an augmented response or promote antibody class switching. Because T-cell-dependent antigens, typically proteins, both produce boosted antibody levels and promote antibody class switching, it has been considered highly desirable to attempt to convert the T-cell-independent polysaccharide antigens into T-cell-dependent antigens, particularly for use in high-risk groups. A number of clinical trials now report the efficacy of conjugate vaccines in inducing the production of antibody in response to a number of previously poorly immunogenic--mainly T-cell-independent--antigens. In addition to conjugate vaccines containing bacterial polysaccharides, vaccines containing relevant peptides from a variety of pathogens are also being formulated and investigated. Questions remain, however, regarding their synthesis, use, and efficacy. The best ages for vaccine administration and selection of the optimal protein carrier are still under investigation, as are questions regarding the use of adjuvants, which can greatly affect the vaccine's potency. Spacing and size of epitope and size and composition of the final structure also must be considered; the importance of molecular size and aggregation of antigen in increasing immunogenicity have been well documented. These questions must be addressed for the much-needed development of conjugate vaccines against some common infections worldwide, including malaria, bacterial meningitis, and infections from Pseudomonas aeruginosa and Neisseria gonorrhoeae because of increasing susceptibility to these infections and resistance of the pathogens to chemotherapeutic agents and/or antibiotics.
 ...
PMID:Rational design of conjugate vaccines. 143 86

A new carbapenem antibiotic, meropenem (MEPM), was evaluated for its safety and efficacy in 33 infants and children. MEPM was effective in all the 32 evaluable cases including 4 cases of bacterial meningitis and 5 cases of Pseudomonas aeruginosa infections. The mean half life of plasma concentrations of MEPM was 0.84 +/- 0.09 hours after 30 minutes intravenous drip infusion. Mild diarrhea (2 cases), transient elevation of transaminases (8 cases), and transient eosinophilia (2 cases) were associated with the MEPM therapy, but none of them was problematic. These data suggest that MEPM is safe in infants and children and could be one of the therapeutic agents for severe infections or infections in compromised hosts.
 ...
PMID:[Clinical evaluation of a new carbapenem, meropenem, in infants and children]. 152 78

The search for new antimicrobial agents in the treatment of bacterial meningitis is justified by a rate of mortality that currently remains unacceptably high and by the emergence of bacterial resistance. Because of their excellent in vitro activity against gram-negative organisms and good penetration into the cerebrospinal fluid, the new fluoroquinolones may have a potential role in the treatment of central nervous system (CNS) infections. Although there are few reports on the use of fluoroquinolones in treatment of patients with CNS infections, experience to date indicates that pefloxacin, the most intensively studied agent, and ciprofloxacin provide effective treatment for patients with meningitis caused by susceptible pathogens. Since they cannot be used in patients whose skeletal growth is incomplete, the place of the fluoroquinolones in the treatment of Haemophilus influenzae meningitis is obviously very limited. Neisseria meningitidis is still exquisitely sensitive to penicillin G and ampicillin, and there is thus no reason to replace these agents by fluoroquinolones, except when patients are allergic to beta-lactam agents, or when parental administration is impossible. A potential use of the new fluoroquinolones would be in the treatment of meningitis due to gram-negative bacilli, including Pseudomonas aeruginosa, and Acinetobacter.
 ...
PMID:Potential role of fluoroquinolones in the treatment of bacterial meningitis. 186 89

In ongoing studies in Europe and the United States, 10 pediatric patients with bacterial meningitis caused by Pseudomonas species were treated with ceftazidime. Pseudomonas aeruginosa was isolated from the CSF of 7 patients and other Pseudomonas species from the remaining 3. Eight of the 10 patients had received previous antimicrobial treatment which included aminoglycosides in 6, along with ticarcillin and ureidopenicillins in 3. Ceftazidime was administered 10 to 42 days in dosages ranging from 109 to 300 mg/kg/day. Seven of the 10 patients received ceftazidime only for 10 to 42 days. The other 3 patients received amikacin in 2 and gentamicin and tobramycin in the other. Seven patients were cured clinically and 3 died; 9 were cured bacteriologically and one who was presumed cured on the basis of clinical response subsequently died. Sterilization of the cerebrospinal fluid occurred at 48 hours to 12 days. Ceftazidime appears useful in treating bacterial meningitis caused by Pseudomonas species.
 ...
PMID:Treatment of Pseudomonas meningitis with ceftazidime with or without concurrent therapy. 217 45

Third-generation cephalosporins are important additions to the range of antibiotics available for treating children with serious bacterial infections. They are highly active against the common pathogens, which cause bacterial meningitis in children. Strains of Haemophilus influenzae type b resistant to both ampicillin and chloramphenicol, and Streptococcus pneumoniae relatively resistant to penicillin remain susceptible to cefotaxime and ceftriaxone. Escherichia coli, Klebsiella pneumoniae, Citrobacter diversus, as well as the other more common gram-negative bacilli isolated from neonates and children are susceptible to these agents. However, Listeria monocytogenes is not cephalosporin-sensitive. Ceftazidime is the only third-generation cephalosporin useful for treating serious infections due to Pseudomonas aeruginosa in children. As with other beta-lactam antibiotics, the clearance of cephalosporins is prolonged in neonates, particularly premature babies. Cefotaxime and ceftriaxone are equivalent to ampicillin and chloramphenicol for the treatment of bacterial meningitis in children over two to three months of age with respect to neurologic outcome and safety, despite the in vitro activity of cefotaxime and ceftriaxone being much greater than the standard antibiotics for the meningeal pathogens. Cefotaxime and ceftriaxone are effective in the treatment of serious gram-negative infections in children. In many instances, ceftriaxone can be administered once daily, which allows for more convenient therapy, particularly on an outpatient basis. Although controversial, ceftazidime has been used as single-agent therapy for empiric treatment of neutropenic immunocompromised children with fever.
 ...
PMID:Serious pediatric infections. 218 5

Many of the major alterations in plasma proteins characteristic of the hepatic acute phase response are regulated by IFN-beta 2/IL-6. Using a specific bioassay for IFN-beta 2/IL-6, which relies on the induction of the hepatic acute phase plasma protein alpha 1-antichymotrypsin in the human hepatoma cell line Hep3B clone 2 and its inhibition by anti-rIFN-beta 2/IL-6 antiserum, we have detected high levels of IFN-beta 2/IL-6 in the body fluids of patients with acute bacterial infections. Cerebrospinal fluid from four patients with acute bacterial meningitis (Streptococcus pneumoniae, Staphylococcus aureus, two cases of Listeria monocytogenes) all had high levels of IFN-beta 2/IL-6 (up to 500 ng/ml). Two of these patients with concomitant bacteremia had lower concentrations of IFN-beta 2/IL-6 in the serum (5 to 70 ng/ml). Three additional patients with Escherichia coli, Pseudomonas aeruginosa, and Neisseria meningitidis bacteremia had high levels of serum IFN-beta 2/IL-6, as did the ankle fluid of a patient with Streptococcus canis arthritis. Normal cerebrospinal fluid and serum had little detectable IFN-beta 2/IL-6. A combination of immunoaffinity chromatography and immunoblotting procedures were used to characterize the IFN-beta 2/IL-6 species present in a representative sampling of serum and cerebrospinal fluids. Multiple immunoreactive species of IFN-beta 2/IL-6 in the size range 23 to 30 kDa as well as immunoreactive complexes in the range 60 to 70 kDa were detected in human body fluids. This is the first demonstration that previous descriptions of heterogeneity in human IFN-beta 2/IL-6 species produced in cell culture correspond to observations in the infected host.
 ...
PMID:Multiple forms of IFN-beta 2/IL-6 in serum and body fluids during acute bacterial infection. 253 16

A review of two third-generation cephalosporins, ceftazidime and cefotaxime, is presented. Ceftazidime, often used as a single agent, has shown greater activity than cefotaxime against Pseudomonas aeruginosa and other Pseudomonas species, Enterobacteriaceae, Acinetobacter sp, and Enterobacter sp. It has been effective as monotherapy in the treatment of peritonitis, gynecologic infections, chronic bronchitis, and infections in patients with leukemia and granulocytopenia, as has cefotaxime when in combination with an aminoglycoside. Cefotaxime has shown good activity against most aerobic gram-negative bacilli and against Staphylococcus. It has been used in respiratory infections, urinary tract infections, and septicemia. In contrast to first-generation and most second-generation cephalosporins, third-generation cephalosporins have proven useful in some types of meningitis. Ceftazidime and cefotaxime successfully penetrate into the cerebrospinal fluid and cures of bacterial meningitis have been reported with both drugs. Both ceftazidime and cefotaxime have been successfully used in children, infants, and neonates, as well as adults. Safety profiles of ceftazidime compare favorably with those of other third-generation cephalosporins.
 ...
PMID:Ceftazidime and cefotaxime--the clinician's choice. 266 Sep 95


1 2 3 4 5 6 7 Next >>