Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 4-month-old infant with congenital heart disease and sepsis and arthritis, and subsequently meningitis, caused by an antibiotic-resistant strain of Haemophilus influenzae type b, failed to respond to sequential therapy with ampicillin and trimethoprim/sulfamethoxazole. Following treatment with ceftizoxime, the infant was well for 42 days, until he returned to the hospital and died. A total of 10 Haemophilus influenzae type b isolates, all outer membrane protein subtype 51, was isolated from the pretreatment blood and synovium, cerebrospinal fluid and subdural fluids, and the petrous pyramids at autopsy. Pretreatment isolates had no detectable plasmid DNA, chloramphenicol acetyltransferase or beta-lactamase; the minimal inhibitory concentration for ampicillin (AM) and chloramphenicol (CM) was 0.2 and 0.8 microgram/ml, respectively. However, all cerebrospinal fluid isolates had a 42-44 mD plasmid and produced chloramphenicol acetyltransferase and beta-lactamase; the minimal inhibitory concentration of these isolates to AM and CM were 12.5 and 25 micrograms/ml, respectively, and were also resistant to tetracycline and sulfonamide. Resistance to AM and CM was cotransferred by filter-mating conjugation at a frequency of one to two transconjugants per 10(5) to an Rd haemophilus recipient. Posttreatment isolates from the petrous pyramids also were resistant to AM and CM and produced chloramphenicol acetyltransferase and beta-lactamase activity, but had no plasmid DNA. These findings and data from genetic studies suggested that plasmid-bearing antibiotic-resistant Haemophilus influenzae type b was selected from a heterogenous population, and that the AM/CM resistance transposons were incorporated into the bacterial chromosome.
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PMID:Ampicillin-chloramphenicol-resistant Haemophilus influenzae: plasmid-mediated resistance in bacterial meningitis. 350 Apr 49

The safety and effectiveness of Timentin were evaluated in 34 adult patients with symptomatic complicated urinary tract infections, principally due to multiply-drug-resistant bacteria. Although a wide variety of organisms, particularly gram-negative bacilli, were found, Escherichia coli was the most frequent, accounting for 14 of 45 (31 percent) pathogens isolated. Ten (22 percent) isolates were Pseudomonas aeruginosa; 11 (24 percent) were Proteus or Morganella species; three (7 percent) were Citrobacter; one (2 percent) was Klebsiella pneumoniae; two (4 percent) were Staphylococcus aureus; and two (4 percent) were enterococci. Ninety-three percent of all pathogens isolated produced a beta-lactamase. Eight (24 percent) infections were polymicrobial; seven (21 percent) were associated with bacteremia. Clinical improvement occurred in 30 of 34 (86 percent) patients. All bacteremias were cured. Although bacteriologic cure occurred in only 32 percent of patients, control of sepsis and temporary eradication of bacteria (bacteriologic improvement) occurred in 96 percent. Not surprisingly, the rates of relapses and reinfections were high. It was concluded that Timentin is a useful agent in the management of complicated urinary tract infection and offers clinicians an alternative to more toxic antibiotics, such as aminoglycosides.
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PMID:Timentin in the treatment of symptomatic complicated urinary tract infections in adult patients. 385 37

Aspoxicillin (ASPC) was evaluated for its efficacy and safety in 30 infants and children with acute bacterial infections. The disease categories included acute respiratory tract (22), soft tissue (3), urinary tract (3) infections, sepsis with pyothorax (1) and purulent meningitis (1). ASPC was effective in all but 1 case of pneumonia due to beta-lactamase-positive H. influenzae (effective rate; 96.7%). Adverse reactions and abnormalities of the laboratory tests were not associated with the ASPC therapy in any of the cases. The serum half-life of ASPC after an intravenous bolus injection was 0.883 +/- 0.194 hour and excretion into urine was rapid. From the present results, ASPC is a safe and effective antibiotic when used in patients with susceptible bacterial infections.
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PMID:[Clinical evaluation of a new parenteral penicillin, aspoxicillin, in children]. 406 22

The antibiotic resistance of Staphylococcus aureus isolated in Bristol from primary skin sepsis and nasal carriers outside hospital was recorded between 1949 and 1969. The proportion of penicillinase-forming strains rose to about 60% but resistance to other antibiotics remained un-common except for a peak about 1957, due to the spread of multiresistant phage-type 80 staphylococci. Reasons are discussed for the failure of other multiresistant staphylococci to increase outside hospital.Recently isolated strains from inside and outside hospital were tested with sulphonamide and trimethoprim. All were sensitive to trimethoprim but 5% of non-hospital strains and 40% of hospital strains were resistant to sulphonamide. It is suggested that sulphonamide-resistant staphylococcal infections should not be treated with sulphonamide-trimethoprim mixtures because of the risk of breeding trimethoprim-resistant strains.
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PMID:Changes in the drug resistance of Staphylococcus aureus in a non-hospital population during a 20-year period. 557 2

Sulbactam, a new beta-lactamase inhibitor, in combination with cefoperazone was administered to 18 pediatric patients, 7 months to 10 years 6 months of age, at a daily dose of 56-320 mg/kg divided into 4 times by intravenous bolus infusion for 3 to 11 days, and the sum of 2.6-74.0 g of the drug was given. A total of 18 cases comprised 8 with RTI, 1 with gastric tract infection, 4 with UTI and 5 with sepsis (suspected). Clinical efficacy was excellent in 10 cases, good in 3 cases, fair in 1 case and poor in 4 cases, and efficacy rate was 72.2%. Out of 8 strains (1 of S. aureus, 1 of P. aeruginosa, 1 of Salmonella subgenus I, 2 of E. coli, 2 of P. mirabilis and 1 of K. pneumoniae), possible causative organisms isolated before the treatment, 6 strains were disappeared, 1 strain of K. pneumoniae persisted, and 1 strain of P. aeruginosa was replaced by S. aureus. Diarrhea was noted in 1 case as subjective side effect, and as abnormal laboratory findings, GOT and GPT elevations in 1 case, GPT elevation in 1 case and eosinophil elevation in 1 case were observed.
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PMID:[Clinical studies on sulbactam/cefoperazone in the pediatric field]. 609 61

We tested the activity of piperacillin against 491 bacterial local clinical isolates in comparison with ampicillin, mezlocillin, cefazolin, cefoperazone, cefotaxime, ceftazidime, moxalactam, and gentamicin, using an agar dilution technique and inocula of 10(6) and 10(4) colony forming units. The results confirmed the broad-spectrum activity of piperacillin against a wide range of bacterial pathogens. The activity against Pseudomonas aeruginosa was encouraging, and it was one of the most active agents tested against that species. Its lack of stability for certain types of beta-lactamases was manifested by large differences in the minimal inhibitory concentration (MIC) activity between inocula of 10(6) and 10(4), and by the high MIC to inhibit 90% of strain of certain species compared with the MIC to inhibit 50% of strain. The activity of piperacillin suggests its clinical evaluation for use in combination with other agents in serious sepsis, in situations where beta-lactamase-producing strains are rare, and in antipseudomonal therapy.
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PMID:In vitro activity of piperacillin and other microbials on 491 bacterial isolates. 621 9

A clinical and bacteriological evaluation of antibiotic therapy in surgical sepsis is performed on two groups of patients examined in 1979 and 1980 with particular regard to use of cephalosporins. In the first group have been administered cephalosporins not beta-lactamase resistant, tetracyclines, chloramphenicol and aminoglycosides on the basis of antimicrobial susceptibility testing; in the cases of urinary tract infections nitrofurans and nalidixic acid were also employed. In the second group the chemotherapy has been performed with beta-lactamase resistant cephalosporins only or associated with aminoglycosides. The results of this study suggest that the use of beta-lactamase resistant cephalosporins may be clinically advantageous, but the incidence of bacterial selection and resistances may avoided with a constant vigilance and bacteriological screening.
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PMID:[Use of cephalosporins in surgical patients]. 621 7

Twenty-five patients undergoing elective intraabdominal surgery received either 1 or 2 g of ampicillin together with 1 g of sulbactam intravenously before surgery. The peritoneal levels of the agent were measured. Both compounds penetrated peritoneal fluid readily; the mean percentage of penetration by ampicillin was 92%; that of sulbactam was 96%. After 1 g of each agent, the peritoneal levels of sulbactam were 47% greater than those of ampicillin. Our results suggest that 2 g of ampicillin plus 1 g of sulbactam should provide peritoneal levels that would inhibit most susceptible beta-lactamase-producing pathogens encountered in intraabdominal sepsis.
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PMID:Penetration of sulbactam and ampicillin into peritoneal fluid. 631 89

A total of 94 clinical isolates of Haemophilus influenzae were studied to analyze the relationship of biotype to site of isolation, serotype, and pattern of antimicrobial susceptibility. Systemic infections were caused most commonly by biotype I, and the majority of these isolates possessed type b capsular polysaccharide. Other noncapsulated biotypes of H. influenzae, particularly biotype V, also were associated with invasive disease. Antimicrobial susceptibility testing was performed on all isolates by an agar dilution method against ampicillin, chloramphenicol, cefoxitin, rifampin, and rosoxacin, and all isolates were screened for beta-lactamase activity. Except for 15 isolates that produced beta-lactamase, no other substantial differences in antimicrobial susceptibilities among biotypes of H. influenzae were detected. Encapsulated strains of biotype I had the highest frequency of ampicillin resistance.
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PMID:Biotypes of Haemophilus influenzae: relationship to clinical source of isolation, serotype, and antibiotic susceptibility. 633 87

Anaerobic bacteria outnumber aerobes at most oropharyngeal sites, with counts up to 10(11)/ml of fluid, and have been implicated in infections of all structures of the head and neck. They are common in chronic otitis media, chronic sinusitis, and various soft-tissue infections. These infections are initiated primarily by mucosal breaks. Bacterial factors such as adhesiveness and antileukocytic activity also may play a role. Among the complications of these infections are brain abscess, aspiration pneumonia, and anaerobic sepsis. Treatment includes surgical drainage and use of antimicrobial agents active against the mixed flora commonly found. Penicillin is currently the drug of choice, but this may change with the emergence of beta-lactamase-producing strains of anaerobes such as Bacteroides melaninogenicus.
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PMID:Anaerobes in infections of the head and neck and ear, nose, and throat. 637 19


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