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Query: UMLS:C0348321 (Haemophilus)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

While the bacterial origin of otitis media has been studied extensively in children, there are few data regarding adults with this disease. We undertook this study to identify the incidence, prevalence, and bacteriologic origin of purulent otitis media in adults. This was accomplished through a review of the English-language literature on adult otitis media and a retrospective review of adult patients with this disease who were hospitalized at our institution. Results of literature review indicate that Streptococcus pneumoniae and Haemophilus influenzae are the most common causes of otitis media in ambulatory adults, but this illness is uncommon, with an incidence of only 0.25%. Hospitalized patients in whom this diagnosis was established suffered a variety of serious suppurative complications such as mastoiditis, meningitis, or brain abscess. Otalgia and fever were the most common symptoms noted in this patient population. Further studies of adult otitis media need to be performed to determine bacteriologic, symptomatic, and high-risk patient groups.
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PMID:Purulent otitis media in adults. 144 90

Seventy-one adult patients with 72 infections were treated, by random selection, with intravenous/oral ciprofloxacin or intravenously administered ceftazidime. Twenty-seven additional patients with 29 infections who were not appropriate for random assignment were treated in an open study with intravenously administered ciprofloxacin only; the latter infections were generally more serious or were caused by ceftazidime-resistant organisms. The most common doses were ciprofloxacin, 200 mg intravenously and 500 mg orally every 12 hours and ceftazidime, 1 to 2 g intravenously every eight to 12 hours. Forty-seven ciprofloxacin-treated infections and 31 ceftazidime-treated infections were evaluable for determination of efficacy. Infections included lower respiratory tract (21 infections), urinary (37 infections), skin/soft tissue (14 infections), bacteremia/endocarditis (four infections), colitis (one infection), and mastoiditis (one infection). Median minimal inhibitory concentrations of ciprofloxacin and ceftazidime were, respectively: for Enterobacteriaceae, Haemophilus influenzae, and Branhamella catarrhalis, no more than 0.06 and no more than 0.25 micrograms/ml; for Pseudomonas aeruginosa, 0.25 and 4 micrograms/ml; for Enterococcus faecalis, 1 and more than 32 micrograms/ml; and for Staphylococcus aureus, 0.25 and 8 micrograms/ml. Ciprofloxacin, 200 mg intravenously, yielded mean serum concentrations 0.5 and eight hours post-intravenous infusion of 2.3 and 0.7 micrograms/ml, respectively. Satisfactory clinical responses were achieved in 17 (81 percent) of 21 patients with intravenous/oral ciprofloxacin, 22 (71 percent) of 31 patients with ceftazidime, and 20 (77 percent) of 26 patients with intravenous ciprofloxacin. The most common treatment failures occurred in complicated skin/soft-tissue infections treated with intravenous/oral ciprofloxacin, complicated urinary tract infections treated with ceftazidime, and necrotizing P. aeruginosa pneumonia treated with intravenous ciprofloxacin; the pneumonia patients all had respiratory failure and had been previously unresponsive to treatment with other appropriate drugs. Serious adverse reactions were observed in three patients, seizures with intravenous ciprofloxacin in two patients, and Clostridium difficile diarrhea with ceftazidime in one patient. We conclude that sequential intravenous/oral ciprofloxacin and ceftazidime were comparable in efficacy and safety; the ability to change from intravenous to oral therapy is a major convenience. Intravenous ciprofloxacin was useful for more serious infections, often caused by ceftazidime-resistant organisms.
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PMID:Intravenous/oral ciprofloxacin versus ceftazidime in the treatment of serious infections. 258 61

A recent increase in numbers of beta-lactamase-producing strains of aerobic and anaerobic Gram-negative bacteria in upper respiratory tract infections has been associated with increased failure rates of penicillins in eradication of these infections. These organisms include Staphylococcus aureus, Haemophilus influenzae, Branhamella catarrhalis and Bacteroides spp. These infections include chronic otitis media, chronic sinusitis and mastoiditis, and chronic recurrent tonsillitis. The indirect pathogenicity of these organisms is apparent through their ability not only to survive penicillin therapy but also to protect penicillin-susceptible pathogens from these drugs. The direct and indirect virulence characteristics of these bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections.
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PMID:The concept of indirect pathogenicity by beta-lactamase production, especially in ear, nose and throat infection. 269 86

Thirty children with acute mastoiditis were identified over a 12-year-period and their hospital records were reviewed retrospectively. All had abnormal tympanic membranes and 26 (87%) had swelling above or posterior to the ear that deviated the pinna. Findings on mastoid roentgenograms included clouding (n = 12) and osteitis (n = 7); six were normal. From 13 patients, bacteria were recovered from normally sterile sites and included Pneumococcus (n = 5), group A streptococcus (n = 3), Haemophilus (n = 2), and anaerobes (n = 3). Complications occurred in 13 children, including subperiosteal abscess (n = 7), meningitis (n = 4), osteitis (n = 7), facial palsy (n = 1), and subdural empyema and brain abscess (n = 1). Four of the six children with neurological complications had no external signs of acute mastoiditis on physical examination. Overall, 19 (63%) of the children recovered without mastoidectomy. We conclude that children without meningitis or subperiosteal abscess may be treated initially with antimicrobial therapy plus myringotomy. The need for mastoidectomy should be reassessed in children who fail to respond in 24 to 48 hours.
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PMID:Acute mastoiditis. Diagnosis and complications. 287 23

Anaerobic bacteria form the predominant flora of the oral cavity, outnumbering facultative organisms by 10-1,000: 1. The type of anaerobic bacteria and their concentration depend on the anatomical site and the degree of anaerobiosis in the different sites in the mouth. Three groups of anaerobic bacteria inhabit the oral cavity; the strict anaerobes, the moderate anaerobes, and the microaerophilic group of organisms. The majority of anaerobic bacterial infections occurring in the region of the mouth, head and neck are caused by the commensal flora. These infections include dental and periodontal disease where the predominant organisms are Bacteroides species, Veillonella, Bifidobacteria, Peptococcus, Peptostreptococcus and Propionibacterium species. More recently, Bacteroides endontalis has been isolated from a periapical abscess of endodontal origin and B. gingivalis, B. intermedius, Haemophilus actinomycetemcomitans and Wollinella species in chronic periodontal disease. Treponema species and other strict anaerobes are seen in smears of severe periodontal disease and acute necrotising gingivitis, but have not yet been isolated in pure culture. Until such time, their role in disease remains uncertain. Fusobacterium nucleatum is specially associated with severe orofacial infections which may extend into the mediastinum. Other anaerobic infections include chronic otitis media, chronic sinusitis and mastoiditis, and brain abscess. Treatment of these conditions should include the use of beta-lactamase resistant antimicrobials, such as clindamycin or one of the nitroimidazoles with penicillin.
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PMID:Anaerobic infections in the head and neck region. 307 69

Staphylococcus aureus, Haemophilus influenzae, Bacteroides sp. (Bacteroides melaninogenicus, Bacteroides oralis, and Bacteroides fragilis), peptostreptococci and fusobacterium sp. are important pathogens in respiratory tract infections (RTI). These organisms are often recovered mixed with other aerobic, facultative and anaerobic bacteria. A recent increase in numbers of bet-lactamase producing strains of anaerobic gram-negative bacteria in RTI has been associated with increased failure rates of penicillins in eradication of these infections. These infections include chronic otitis media, chronic sinusitis and mastoiditis, chronic recurrent tonsillitis and lung abscesses. The indirect pathogenicity of these organisms is apparent through their ability not only to survive penicillin therapy but also to protect penicillin susceptible pathogens from that drug. These direct and indirect virulence characteristics of anaerobic bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections.
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PMID:The role of beta-lactamase-producing bacteria in respiratory tract infections. 307 71

We have summarized our experience in recovery of beta-lactamase-producing bacteria (BLPB) in head and neck infection (HNI). These HNI include conjunctivitis, serous and chronic otitis media, cholesteatoma, chronic mastoiditis, chronic sinusitis, adenoiditis, recurrent tonsillitis in children and adults, peritonsillar abscess, and retropharyngeal abscess. Beta-lactamase-producing bacteria were found in 262 (51%) of 513 patients with HNI; 72% had aerobic BLPB and 57% had anaerobic BLPB. The infections, where these organisms were most frequently recovered, were adenoiditis (85% of patients), tonsillitis in adults (82%) and children (74%), retropharyngeal abscess (71%), and chronic otitis media (57%). The predominant BLPB were Staphylococcus aureus (49% of patients with BLPB), the Bacteroides-melaninogenicus group (28%), the Bacteroides fragilis group (20%), Pseudomonas aeruginosa (13%), Hemophilus influenzae (5%), and Branhamella catarrhalis (3%). The high incidence of recovery of BLPB in head and neck infections may have important implications on the antimicrobial management of these infections.
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PMID:Beta-lactamase-producing bacteria in head and neck infection. 325 96

Pediatric patients with serious infections are usually hospitalized for parenteral antibiotic treatment. We studied prospectively 74 pediatric patients with community-acquired serious infections and used once daily intramuscular ceftriaxone. Seventeen patients (23%) were initially hospitalized and 57 (77%) patients were treated entirely as outpatients. An initial intramuscular dose of 75 mg/kg was followed by daily doses of 50 mg/kg (maximum, 1.5 g). Infections treated included periorbital/buccal cellulitis, other cellulitis, urinary tract infections, pneumonia, osteomyelitis, mastoiditis, suppurative arthritis and orbital cellulitis. Organisms were recovered from cultures of 37 (50%) patients and 6 (8%) patients were bacteremic. Bacteria included Gram-positive (mostly Staphylococcus aureus) and Gram-negative (mostly enteric bacilli and Haemophilus influenzae organisms). No serious side effects were observed. Of 74 patients 72 (97%) were cured and improvement was usually observed within 24 hours. Two patients did not improve: one with chronic Pseudomonas mastoiditis; and one with lung abscess. Based on previous experience it is estimated that 376 hospitalization days were saved. All 72 successfully treated patients and their parents resumed normal activity within 72 hours of starting therapy. Our data suggest that ceftriaxone can be used for outpatient treatment of some infectious diseases.
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PMID:Outpatient treatment of serious community-acquired pediatric infections using once daily intramuscular ceftriaxone. 332 38

In a multicenter randomized trial, 107 children with bacterial meningitis were initially given either cefuroxime or ampicillin plus chloramphenicol. Patients were alternately assigned to 7- or 10-day courses of the designated antimicrobial regimen. CSF isolates included Haemophilus influenzae type b (89, of which 25% were beta-lactamase positive), Streptococcus pneumoniae, and Neisseria meningitidis. Although mean CSF bactericidal titers against Haemophilus isolates were 1:6 in each treatment group, H. influenzae was cultured from CSF in four of 39 patients receiving cefuroxime, 24 to 48 hours after initiation of therapy, compared with none of 40 patients given ampicillin plus chloramphenicol (P = 0.11). Clinical cure rates were similar (95%); one death occurred in each group. One child given cefuroxime had persistent meningitis after 5 days of therapy, and mastoiditis with secondary bacteremia developed in one on day 10. Three patients had relapse or reinfection. One patient who received cefuroxime for 10 days had a relapse of epiglottitis 17 days later, and of the patients given ampicillin plus chloramphenicol, one had a relapse of meningitis 1 week after 7 days of therapy, and bacteremia developed in one 42 days after completion of 10 days of therapy. No increase in either in-hospital complications or relapses occurred with a 7-day treatment course. Proof of the equivalence of the antibiotic regimens and the efficacy of 7-day courses of treatment, as well as the consequences of delayed CSF sterilization, will require additional investigation.
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PMID:Cefuroxime versus ampicillin plus chloramphenicol in childhood bacterial meningitis: a multicenter randomized controlled trial. 352 32

The work was undertaken to investigate the spectrum of bacteria responsible for acute mastoiditis and to find out whether it is affected by intake of antibiotics prior to surgical treatment. The records were reviewed of 22 children with acute mastoiditis in whom mastoidectomy had been performed and bacterial cultures obtained. Eleven of the patients had had antibiotic treatment prior to admission (9 penicillin V and 2 erythromycin). Streptococcus pneumoniae was found in 8 of the purulent discharges: Haemophilus influenzae, Streptococcus beta-hemolyticus and Staphylococcus aureus in 2 each; Proteus mirabilis, Pseudomonas pyocyaneus and a Bacteroides strain in 1 each, while five discharges-all from patients pretreated with antibiotics-yielded no growth. None of the 9 patients pretreated with penicillin V provided pure cultures of pneumococci or beta-hemolytic streptococci, while one or the other of these species was found in 8 of the 11 untreated patients. Gram-negative bacteria were found both among those with and those without antibiotic pretreatment. The data indicate that pneumococci and beta-hemolytic streptococci are more likely to cause mastoiditis than are the other pathogens found in acute otitis media, and that, when drained at operation, purulent discharges are often found to have been sterilized by the pre-operative antibiotic treatment.
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PMID:Acute mastoiditis. Influence of antibiotic treatment on the bacterial spectrum. 373 92


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