Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0348321 (Haemophilus)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence and prognostic importance of positive blood cultures were evaluated over a two-year period (1986/87) in 1371 admissions to a multi-disciplinary neonatal and pediatric intensive care unit (ICU). Blood cultures were performed in 439 patients of which 80 cultures were positive. Septicemia was confirmed in 70 cases, the 10 remaining cases being classified as contamination or bacteremia. The incidence of nosocomial, ICU-acquired septicemia was low (7/70). The major causative organisms of sepsis were those commonly encountered in neonatal and pediatric infections, including Haemophilus influenzae (37), Escherichia coli (11, Neisseria meningitidis (9) and group B streptococci (3). Typically nosocomial organisms were rare. In the group of 70 septicemic cases, multiple organ system failure was diagnosed in 23 patients. Nine died, most often due to irreversible septic shock (13% mortality). In order to avoid a selection bias, all admissions were examined for the presence of sepsis syndrome (clinical signs of sepsis with negative blood cultures). Out of 21 such patients, three died. The results suggest that in comparison to intensive care in adults the following conclusions may be drawn: (1) sepsis with positive blood cultures plays a minor role at our unit; (2) the rate of ICU-acquired septicemia is low (10% of all cases of sepsis with positive blood culture); and (3) the prognostic bearing of a positive blood culture in patients with septic signs is not too unfavourable (87% survival rate).
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PMID:[Incidence and prognostic significance of positive blood cultures in neonatal and pediatric intensive care]. 185 44

Cefpirome (CPR, HR 810), a new cephem antibiotic, was investigated for its penetration into cerebrospinal fluid (CSF), and its clinical efficacy against bacterial infections. 1. CSF concentrations of CPR following intravenous injection was investigated in 2 patients with purulent meningitis. In one of them, the concentrations were 2.11 micrograms/ml and 1.31 micrograms/ml on 3 and 8 days, respectively, after start of administration. In the other patient, they were 24.2 micrograms/ml, and 1.35 micrograms/ml on 2 days and 7 days after administration, respectively. 2. Antibacterial activities of CPR against clinical isolates, Escherichia coli, Haemophilus influenzae, Staphylococcus aureus and Streptococcus pneumoniae, except those against Pseudomonas aeruginosa, were clearly superior to those of ceftazidime. 3. Clinical efficacies evaluated in 15 patients were "excellent" in 9, "good" in 5 and "unknown" in 1. The overall efficacy rate was 93.0%. 4. Clinical efficacies were "excellent" in 1 patient with bacteremia, "excellent" in 6 and "good" in one of 7 patients with pneumonia, and "good" in both of the 2 patients with purulent meningitis. Clinical efficacies against other diseases were "excellent" or "good", in 1 patient with pyothorax, 1 patient with purulent lymphadenitis, and 2 patients with facial cellulitis. In 1 patient with biliary tract infection, the results of treatment with CPR were "unknown" due to insufficient clinical data. 5. No adverse reactions were observed except in 1 patient who showed an increase in platelet count.
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PMID:[Clinical evaluation of cefpirome in pediatrics and a study on the penetration into cerebrospinal fluid]. 188 Sep 27

The immunologic basis for protection against Brazilian purpuric fever, a septicemic infection associated with Haemophilus influenzae biogroup aegyptius bacteremia, is unknown. Passive immunization of infant rats with antiserum to whole bacterial cells of the homologous strain protects them from experimental bacteremia following bacterial challenge. In immunoblotting, antibody to a 145-kDa protein (P145) was present in protective antisera but not in nonprotective antisera. As judged by analysis of the antibodies eluted from whole bacterial cells and the agglutination of bacteria by antisera to P145, this protein is surface exposed. We prepared monospecific rat antisera to this protein by three methods: (i) immunization with whole bacterial cells and absorption with a Brazilian purpuric fever strain not expressing P145, (ii) immunization with gel-purified P145, and (iii) immunization with a P145-expressing transformant of a laboratory H. influenzae strain expressing this protein and absorption of the antiserum with the laboratory H. influenzae strain. These antisera had low antilipooligosaccharide antibody titers, were reactive only with P145, and had bactericidal activity in vitro. Following passive immunization, these antisera partially protected infant rats from bacteremia resulting from intraperitoneal challenge with bacteria. As assessed by immunoblotting, pooled adult human sera contained antibodies reactive with P145. Antibody to P145 may contribute to protection against Brazilian purpuric fever.
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PMID:Antibody to a 145-kilodalton outer membrane protein has bactericidal activity and protective activity against experimental bacteremia caused by a Brazilian purpuric fever isolate of Haemophilus influenzae biogroup aegyptius. The Brazilian Purpuric Fever Study Group. 193 17

The incidence of bacterial pneumonia is increased in human immunodeficiency virus (HIV) infection, and bacteremia and recurrences occur frequently. Streptococcus pneumoniae and Haemophilus influenzae are the most common pathogens, but several other organisms have now been identified as etiologies. Several abnormalities in B-cells and humoral immunity, and possibly neutropenia and white blood cell dysfunction, predispose to bacterial pneumonia. Despite the severity of pneumonia in HIV infection, most patients respond well to specific antimicrobial chemotherapy. Potential preventive measures include vaccines, immunoglobulin therapy, and antimicrobial prophylaxis.
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PMID:Bacterial pneumonia in the HIV-infected patient. 195 96

Although Haemophilus influenzae is recognized as a major pathogen of infants, its role in maternal and neonatal infections is not as well appreciated. We analyzed the records of all mothers and neonates infected with H influenzae over a 10-year period. Twenty-eight mother/neonate sets were identified in which at least one had documented infection with H influenzae. Of the 18 mothers with documented infection, 13 had chorioamnionitis, endometritis, or both, and two of these mothers were bacteremic with H influenzae. Of the 23 infected neonates, 15 presented with early sepsis and/or pneumonia and nine had conjunctivitis. During the period of the study, only group B streptococci and Escherichia coli were more common as causes of early neonatal bacteremia. Under the conditions of this retrospective study, maternal infection predicted neonatal infection. However, prospective studies in which asymptomatic patients are cultured will be required to determine how well maternal colonization/infection with H influenzae predicts neonatal infection.
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PMID:Haemophilus influenzae: an important cause of maternal and neonatal infections. 198 34

To investigate the occurrence and outcome of bacteremia associated with otitis media, charts were reviewed from patients who were 3 to 36 months of age, had temperatures greater than or equal to 39 degrees C, and were diagnosed with isolated clinical otitis media. A total of 2982 patients were identified. Blood cultures were obtained from 1666 (56%). Of the 1666 patients, who had blood drawn for cultures, 50 (3.0%) had bacteremia. These included 39 with Streptococcus pneumoniae, 4 with Haemophilus influenzae, 2 with Neisseria meningitidis, 3 with Salmonella species, and 2 with Staphylococcus aureus. The incidence of bacteremia increased at higher temperatures, being 1.9% at temperatures less than or equal to 40 degrees C and 5.0% at temperatures greater than 40 degrees C. Younger children were more likely to have bacteremia; 3.7% less than or equal to 12 months of age, 2.4% 13 to 24 months of age, and 1.9% 25 to 36 months of age had blood culture results that were positive (not significant). Reevaluation of the 50 bacteremic patients showed that 9 patients had continued fever, 3 patients had persistent bacteremia, pneumonia developed in 1 patient, and meningitis developed in 1 patient. It was concluded that (1) 3% of young febrile children with otitis media have bacteremia at the time of evaluation, a rate comparable to that previously reported in children with no focus of infection; (2) the incidence of bacteremia increases at higher temperatures; and (3) most febrile children with otitis media do well. The clinician must therefore weigh the potential benefit of drawing a blood culture to identify children at risk for complications against the inherent cost, inconvenience, and discomfort.
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PMID:Bacteremia with otitis media. 198 18

A Haemophilus influenzae b (Hib) membrane protein with a molecular mass of 28 kDa bound polyclonal antisera raised against a highly purified Hib fimbrial subunit. We cloned the gene encoding this protein and found that the gene was expressed in Escherichia coli. DNA sequence analysis identified an 843-bp open reading frame which predicted a 26.78-kDa protein with an amino-terminal signal sequence and a mature protein with 70% similarity to the 28-kDa lipoprotein of E. coli (F. Yu, S. Inouye, and M. Inouye, J. Biol. Chem. 261:2284, 1986). Colony blot hybridization analysis with an intergenic probe of the cloned gene demonstrated that 29 of 32 H. influenzae strains hybridize with this gene. Insertion of a chloramphenicol acetyltransferase gene into the open reading frame inactivated expression of the 28-kDa protein in E. coli. Isogenic Hib strains were derived by marker exchange mutagenesis to generate mutants which no longer expressed the 28-kDa protein as recognized with Western immunoblot analysis. There was no difference in the rate of nasopharyngeal colonization of infant rats or monkeys by the isogenic mutants which lacked the 28-kDa protein compared with colonization by the wild-type strain. In contrast, the frequency of invasion and density of bacteremia in infant rats caused by the isogenic mutants were reduced relative to those caused by the wild-type Hib strain. We conclude that this 28-kDa outer membrane protein aids transepithelial invasion of type b strains but is not essential.
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PMID:Contribution of a 28-kilodalton membrane protein to the virulence of Haemophilus influenzae. 198 77

To determine the importance of bacteremia in hospitalized patients with diarrhea in Bangladesh, from September 1982 through August 1983 the authors obtained blood for culture from 1,824 patients who were suspected of having sepsis (44% of all admissions). Nontyphoid bacteremia occurred in 243 patients. The most common pathogens were the Enterobacteriaceae (n = 66 episodes), Staphylococcus aureus (n = 65), Pseudomonas aeruginosa and other non-glucose-fermenting bacilli (n = 50), Streptococcus pneumoniae (n = 40), and Haemophilus influenzae (n = 16). When compared with an equal number of control patients without bacteremia, bacteremic patients were significantly (p less than 0.05) more likely to be under 1 year of age (46.5% of bacteremic patients vs. 30.0% of control patients) and more often had abdominal tenderness (20.1% vs. 11.5%), hypoproteinemia (a serum protein level less than 60 g/liter) (58.9% vs. 42.9%), and a prior intravenous infusion (49.0% vs. 30.9%). The case-fatality rate was 29.7% in bacteremic patients versus 7.8% in controls (relative risk (RR) = 3.8, p less than 0.001). Factors that were associated with an increased risk of death in bacteremic patients were infection with a Gram-negative pathogen (RR = 2.48), decreased peristalsis (RR = 2.66), hypoproteinemia (RR = 3.36), hypothermia (RR = 2.54), and hypotension (RR = 2.19). Bacteremia appears to be an important link between diarrheal illness and death in Bangladesh. In children with diarrhea who are suspected of being septic, early implementation of antimicrobial therapy that is effective against the broad range of pathogens identified appears to be indicated.
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PMID:Bacteremia during diarrhea: incidence, etiology, risk factors, and outcome. 200 Aug 55

A BACTEC aerobic nonradiometric medium, PEDS Plus, designed for diagnosis of pediatric bacteremia was evaluated in three hospital centers. Equivalent blood volumes (up to 5 ml) were inoculated into and incubated in BACTEC NR-6A (6A) and PEDS Plus broths. Among 4,581 compliant sets, 289 clinically significant organisms, representing more than 20 bacterial and two Candida species, were isolated. One hundred eighty-one isolates were recovered in both bottles, 75 in PEDS Plus only, and 33 in 6A only (P less than 0.001). Time to detection when both bottles were positive was the same for 129 isolates, detection with PEDS Plus was earlier for 39, and detection with 6A was earlier for 13 (P less than 0.005). Staphylococcus aureus was recovered significantly more often in PEDS Plus than in 6A (P less than 0.01), and more coagulase-negative staphylococci and pediatric pathogens (pneumococci, Haemophilus influenzae, and Streptococcus agalactiae) were recovered in PEDS Plus than in 6A. Coagulase-negative staphylococci and H. influenzae were detected significantly earlier in PEDS Plus (P less than 0.05 and less than 0.01, respectively). When the eight species of the family Enterobacteriaceae isolated were considered together, recovery in PEDS Plus was better than in 6A (P less than 0.05). For 66 of the 143 isolates from patients known to be on antimicrobial therapy at the time blood was drawn, PEDS Plus was superior to 6A. In 45 cases, organisms were isolated from PEDS Plus only (P less than 0.001) and in 21 cases they were isolated from PEDS Plus before 6A (P less than 0.01). PEDS Plus broth aids diagnosis of pediatric bacteremia by increasing recovery of etiologic agents and decreasing the time required for detection.
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PMID:Performance of a BACTEC nonradiometric medium for pediatric blood cultures. 200 44

We conducted a retrospective review of 60 patients with Haemophilus influenzae type b bacteremia initially treated as outpatients, to test the hypothesis that a subgroup of these patients is at low risk of continuing invasive infection and thus requires a less comprehensive reevaluation. These patients were 6% of the 975 patients with invasive H. influenzae type b infection identified by active surveillance in Dallas County, Texas, during a 6 1/2-year period. The clinical assessment of "ill" appearance and persistent fever (greater than or equal to 38.0 degrees C) on the return visit were the two most useful variables in identifying patients at risk of continuing infection. Among 25 (42%) patients who were considered "ill" (febrile or afebrile), 20 (80%) had continuing invasive infection and 14 (56%) had a subsequent culture that was positive for H. influenzae type b. Among 8 patients who were considered "well" but who remained febrile, 3 (38%) had continuing infection, including 1 (13%) patient with a second culture that was positive. By contrast, among 27 (45%) patients who were considered "well" and who were afebrile, continuing invasive infection was identified in only 2 (7%) patients, and all repeat cultures were negative. These results suggest that when patients return for reevaluation of H. influenzae type b bacteremia, clinical assessment by an experienced physician, together with the febrile status of the patient, can identify those at high versus low risk of continuing invasive infection and thus guide the extent of diagnostic reevaluation.
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PMID:Reevaluation of the ambulatory pediatric patient whose blood culture is positive for Haemophilus influenzae type b. 200 21


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