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)

In a prospective study, 105 infants aged 3-12 months with acute otitis media were randomly assigned to one of three treatment groups: amoxycillin/clavulanate ('Augmentin') alone (36 patients), myringotomy plus placebo (35 patients), or augmentin plus myringotomy (34 patients). The last two groups were double-blinded. Bacterial pathogens, mainly Haemophilus influenzae (of which 20% were beta-lactamase producers) and Streptococcus pneumoniae, were isolated from 60% of the ear exudates and all isolates were sensitive to augmentin. Most of the infants improved clinically within 3-6 days irrespective of the treatment protocol. As judged by otoscopy, 60% of the patients receiving augmentin, with or without myringotomy, recovered completely compared with 23% of patients treated with myringotomy plus placebo. Treatment with augmentin was also more effective than myringotomy with regard to persistence of ear infection. In the myringotomy plus augmentin group closure of the incision and resolution of the discharge from the incision site was faster than in the myringotomy plus placebo group. The addition of myringotomy to augmentin did not seem to affect either the persistence of the infection after treatment or the residual middle ear effusion.
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PMID:Randomised study of myringotomy, amoxycillin/clavulanate, or both for acute otitis media in infants. 256 3

Otitis media with effusion (OME) is a common middle ear inflammatory disease in the pediatric population. This article determines concentrations of three functionally and metabolically distinct inflammatory mediators in middle ear effusions (MEE) and corresponding plasma of children with OME. One hundred two patients (mean age, 4.9 years) with persistent OME were studied. Middle ear effusions were collected from all subjects and plasma from a subset at the time of tympanostomy tube insertion. Histamine was assayed radioisotopically, 13,14-dihydro-15-keto-prostaglandin F2 alpha (stable PGF2 alpha metabolite) by radioimmunoassay, and neutrophil chemotactic factor of anaphylaxis by modified Boyden chamber. Mean MEE levels of the mediators (39 +/- 13 ng/mL, 462 +/- 179 pg/mL, and 264% +/- 57% positive control, respectively) were markedly higher than those of corresponding plasma (0.5 +/- 0.1 ng/mL, 285 +/- 127 pg/mL, and 47% +/- 5% positive control, respectively). The mean histamine content of mucoid effusions (43.2 +/- 56.9 ng/mL) was significantly higher than that of purulent (22.5 +/- 10.5 ng/mL) and serous (17.9 +/- 16.8 ng/mL) effusions. Higher histamine levels were observed in effusions positive for Haemophilus influenzae when compared with those with other pathogenic isolates. The high concentrations of these mediators in MEE and their potential for inducing or sustaining the inflammatory process supports a role in the pathogenesis of OME.
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PMID:Inflammatory mediators in chronic otitis media with effusion. 304 37

Bacteriologic investigation of middle ear effusion (MEE), external ear canal, and the nasopharynx was carried out on 458 patients with otitis media with effusion. Staphylococcus epidermidis was the most common bacteria in MEE, even after excluding the contaminants from the external ear canal, which had the same value of minimal inhibitory concentration as the paired MEE. The bacterial agreement of S epidermidis between MEE and the nasopharynx was extremely rare in contrast with Haemophilus influenzae, Streptococcus pneumoniae, and Branhamella catarrhalis, although the organism was also frequently isolated from the nasopharynx. Staphylococcus aureus, having the same minimal inhibitory concentration as that in the nasopharynx, was more frequently found in MEE than S epidermidis. The results suggest that S epidermidis found in MEE is not a pathogen, but rather a contaminant in many instances. Staphylococcus aureus seems to be a causative agent in otitis media with effusion.
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PMID:Staphylococcus epidermidis and Staphylococcus aureus in otitis media with effusion. 326 58

Bactericidal activity of middle ear effusion (MEE) from children with otitis media with effusion (OME) on one strain of non-typable Haemophilus influenzae was measured and was compared with that of normal human serum. H. influenzae culture negative MEEs had a bactericidal activity on one strain of non-typable H. influenzae (P less than 0.01), and the activity of serous effusions was significantly stronger than that of mucoid ones (P less than 0.01). The bactericidal activity of 20% pooled MEE was almost equal to that of 4% normal human serum. Heat treatment (56 degrees C, 30 min) abolished this activity of both pooled MEE and normal human serum. Addition of fresh guinea pig serum (GPS) as a complement source to the heat-treated pooled MEE restored this activity, while its addition to the heat-treated normal human serum failed to do so. These results suggest that complement factor is important in the bactericidal activity of MEE.
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PMID:Bactericidal activity of middle ear effusion on a single isolate of non-typable Haemophilus influenzae. 326 2

In a double blind study 175 patients with acute otitis media were randomized into 2 treatment groups: 10 days of therapy with cefaclor or 5 days of therapy followed by 5 days of placebo. The dosage of cefaclor was 40 mg/kg/day administered orally in equally divided doses at 12-hour intervals. Tympanocentesis before treatment yielded specimens that contained Streptococcus pneumoniae or Haemophilus influenzae or both in 55% of specimens. Branhamella catarrhalis was isolated from 21% of specimens. Culture of material from the ear canal of patients with spontaneous perforation of the tympanic membrane of less than 24 hours duration yielded pneumococci or H. influenzae or both in 38% of specimens and staphylococci in 31%. Patients were scheduled for follow-up examinations at 5 or 6, 10, 30, 60 and 90 days. Of the 175 children 151 were evaluable at 10 days. There were 123 patients with both tympanic membranes intact at the time of diagnosis. There were 6 (10%) treatment failures of therapy in the 59 patients assigned to 5 days of therapy and 4 (6%) failures and 1 (2%) early relapse in the 64 assigned to 10 days of therapy (difference not significant). There were 28 evaluable patients with spontaneous perforation. There were 8 (53%) failures in the 15 children assigned to 5 days of therapy and only 1 (8%) failure in the 13 children assigned to receive 10 days of therapy (P = 0.016, Fisher exact test). Rates of reinfection and persistent middle ear effusion at 10, 30, 60 and 90 days follow-up were not significant different in patients assigned to 5 to 10 days of therapy. In patients with acute otitis media with intact tympanic membranes we have not been able to show any advantage of the standard duration of 10 days of therapy over a shortened course of 5 days. A 5-day course of antibiotic therapy does not appear to be sufficient for children with acute otitis media and spontaneous purulent drainage.
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PMID:Five vs. ten days of therapy for acute otitis media. 327 53

Because Haemophilus influenzae is one of the most common pathogens in otitis media with effusion, we have investigated the antibody response in the serum and middle ear effusion (MEE) in nontypable H influenzae-induced experimental acute otitis media in the chinchilla, using an enzyme-linked immunosorbent assay. During acute otitis media, a reasonable antibody titer was observed: local antibody titers in the MEEs were equal to or greater than those of the serum samples for four of five MEE samples obtained at one week after inoculation. By two weeks, titers in both serum and MEE samples were increased significantly. However, the bacteria persisted in the middle ear cavity, even in the presence of increasing antibody titers, for up to five weeks after infection. The reason for this persistence of the bacteria in the middle ear is unknown.
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PMID:Antibody response in experimental Haemophilus influenzae otitis media. 351 2

The present investigation was conducted to find out if a relapse of acute purulent otitis media is associated with a decreased sensitivity of nasopharyngeal pathogens to commonly used antimicrobial agents. All but one of 63 children with relapse included in this study yielded one or more of the classical middle ear pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis, S. pyogenes) in their nasopharynx (NPH) secretions. S. pneumoniae was the predominating isolate from NPH (71% of the patients) as well as from middle ear effusion (53%). At a control visit 4 weeks after the start of antibiotic therapy, 91% were NPH carriers of potential pathogens and S. pneumoniae was still the most common isolate (53%). Beta-lactamase was produced by 55% of B. catarrhalis isolates from the NPH specimens on the first visit, but only by 33% of B. catarrhalis isolates on the control visit. Two NPH isolates of H. influenzae produced beta-lactamase. One isolate of S. pneumoniae (serotype 18) was intermediately sensitive to phenoxymethylpenicillin. Generally low MICs were found for erythromycin and cefaclor. H. influenzae isolates were generally sensitive to ampicillin in vitro, but only 1 isolate was fully sensitive to erythromycin. B. catarrhalis isolates were uniformly sensitive to doxycycline and trimethoprim/sulphamethoxazole. No tolerance to penicillin was demonstrated in S. pneumoniae and H. influenzae. The present data indicate that the relapse of acute otitis media is not associated with development of tolerance or resistance to therapeutic antimicrobials commonly used.
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PMID:Relapse of acute purulent otitis media: antibiotic sensitivities of nasopharyngeal pathogens. 361 95

Total (radioimmunoassay) and immunoglobulin class-specific (enzyme-linked immunosorbent assay) antibodies to four pneumococcal capsular polysaccharide types were measured in serum and middle ear effusion (MEE) samples of 14 children who had received an injection of either a 14-valent pneumococcal capsular polysaccharide vaccine or a control, Haemophilus influenzae, type b capsular polysaccharide vaccine. Serum samples were collected before and 1 to 4 weeks after the vaccination and MEE samples at the time of the postvaccination serum. Only MEE negative for pneumococci by culture and antigen detection methods were included. Total and immunoglobulin G antibody to each of the four pneumococcal types correlated well between the corresponding serum and MEE samples. The quantity of such anti-pneumococcal antibodies in both the MEE and serum was usually larger in children who had received pneumococcal rather than control vaccine. Immunoglobulin M class antibodies seemed to penetrate poorly into the MEE. In some children, also the immunoglobulin A class antibodies in serum and MEE correlated well, whereas others had an aberrantly large amount of immunoglobulin A antibody in the MEE independent of the type of vaccine they had received, suggesting an ongoing local antibody response to a recent pneumococcal infection.
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PMID:Antibody response of young children to parenteral vaccination with pneumococcal capsular polysaccharides: a comparison between antibody levels in serum and middle ear effusion. 375 38

The total concentration of secretory IgA (SIgA) and secretory component (SC) as well as the occurrence of pathogen specific serum type (IgG, IgA and IgM) and secretory type antibodies against Streptococcus pneumoniae and Haemophilus influenzae in the middle ear effusion during an attack of otitis media were studied by using the ELISA method. The middle ear effusion samples were taken at 2 to 4 weeks' intervals from patients with recurrent acute otitis media (RAOM) or secretory otitis media (SOM). In the samples of the RAOM patients the SC/SIgA ratio was 2.2, while in the SOM samples the ratio was 13.6. Both serum and secretory type antibodies to the infecting bacteria could be detected in the middle ear effusions in both of the patient groups. The results of this study show that the middle ear can develop antigenic specific antibodies against the infecting bacteria. The increased production of SC seems to be related to the pathogenesis of SOM.
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PMID:Secretory IgA, secretory component and pathogen specific antibodies in the middle ear effusion during an attack of acute and secretory otitis media. 383 1

It is known that bacterial endotoxin on the outer surface of most gram-negative bacteria (GNB) is not only biologically active material, but also the modulator of the immune response. The earlier experiment documented that the endotoxin of killed Haemophilus influenzae was responsible for induction of chronic otitis media with effusion (OME). Recent study by DeMaria et al. determined the endotoxin of human middle ear effusion (MEE) by means of limulus amebocyte lysate assay. It was concluded the endotoxin was present in a high percentage of the effusion in human tympanic cavities. The present study was undertaken to quantitatively determine the endotoxin in human MEE by use of chromogenic substrate technique which is more sensitive and accurate than limulus assay. Sixty samples of mucoid and serous effusion were subjected to chromogenic substrate method. It was revealed that the mucoid effusion showed a significantly high level of endotoxin at 282 pg/ml in average, though the serous effusion contained only 35.9 pg/ml. It is assumed that the bacterial endotoxin may greatly contribute to the pathogenesis of otitis media with mucoid effusion.
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PMID:Quantitative determination of bacterial endotoxin in middle ear effusions by chromogenic substrate method. 383 50


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