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 clinical and bacteriologic aspects of chronic sinusitis in childhood were studied. Of 35 children who underwent surgical procedures for chronic sinusitis, 22 had positive bacteriologic cultures of aspirates from the sinus. The most common organisms isolated were Haemophilus influenzae, Streptococcus pneumoniae, and Branhamella catarrhalis. Five of eight S pneumoniae strains were relatively resistant to penicillin and resistant to sulfamethoxazole-trimethoprim. All of the B catarrhalis and 20% of the H influenzae organisms were beta-lactamase positive. Overall, 14 of 28 of the bacteria were penicillin resistant. In addition, all 12 children 2 years of age or younger had a positive bacterial culture as compared with much lower rates in older children. Although the incidence of S pneumoniae strains that are relatively resistant seems to be rising, to our knowledge we report the first description of these organisms as significant pathogens in chronic childhood sinusitis. These results indicate that chronic, difficult to manage sinusitis in very young children is frequently bacterial in origin, especially if the patient is 2 years old or younger. In light of the frequent failure of antibiotic therapy and considering the incidence of relatively resistant S pneumoniae strains, puncture of the sinus should be considered early in the course of chronic sinusitis to isolate pathogenic organisms and determine appropriate antimicrobial therapy.
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PMID:Clinical and bacteriologic features of chronic sinusitis in children. 250 8

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

Upper respiratory tract infection and allergic inflammation are recognized as the important risk factors for acute sinusitis, with upper respiratory tract infection being most common. In children with acute or chronic sinusitis, the respiratory symptoms of nasal discharge, nasal congestion and cough are usually prominent. Radiography has traditionally been used to determine the presence or absence of sinus disease. The radiographic findings most diagnostic of bacterial sinusitis are diffuse opacification, mucous membrane thickening or an air-fluid level. The predominant organisms include Streptococcus pneumoniae, Branhamella catarrhalis and nontypable Haemophilus influenzae. Several viruses including adenovirus and parainfluenzae have also been recovered. Clinical improvement is prompt in nearly all children treated with an appropriate antimicrobial agent.
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PMID:Sinusitis in children. 306 40

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

Study on the incidence of bactericidal (BC) antibodies to a Haemophilus influenzae type b and a non-capsulated H. influenzae was carried out on sera from 50 healthy subjects, and from 30 patients with chronic sinusitis. Of the 50 sera from normal subjects, only one (2.0%) lacked BC antibodies to the H. influenzae type b, whereas 13 (26.0%) lacked BC antibodies to the non-capsulated H. influenzae. All of the 30 sera from patients with chronic sinusitis were bactericidal for the H. influenzae type b, whereas only three (10.0%) lacked BC antibodies to the non-capsulated H. influenzae. Specific IgG, IgM and IgA antibodies to the non-capsulated H. influenzae in serum were determined by the indirect fluorescent antibody assay. Of the 22 sera tested in this study, 15 (68.0%) had antibodies of at least the IgG, IgM, or IgA classes; with IgG occurring most often. These data suggest that a lack of circulating BC antibodies to both H. influenzae isolates is not associated with the chronic carriage of these organisms by patients with chronic sinusitis.
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PMID:Serum bactericidal effect on capsulated and non-capsulated Haemophilus influenzae in chronic sinusitis. 661 Apr 9

In order to evaluate antimicrobial activity of cefmenoxime (CMX), minimum inhibitory concentrations (MICs) of CMX and control drugs were determined against clinical isolates from patients of sinusitis that were obtained in our laboratory from October of 1993 to March of 1994. The results are summarized as follows; 1. CMX showed strong antimicrobial activities against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella subgenus Branhamella catarrhalis that were 3 major aerobic bacteria from sinusitis. Antimicrobial activities of CMX against benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP) and PCG-resistant S. pneumoniae (PRSP) were stronger than those of ampicillin (ABPC), and these strong activities suggested that CMX might have strong antimicrobial activities against beta-lactamase producing H. influenzae and M. (B.) catarrhalis. 2. Antimicrobial activities of CMX against microaerophiles, Streptococcus constellatus, Streptococcus intermedius and Gemella morbillorum and against Peptostreptococcus spp., from chronic sinusitis and odontogenic maxillary sinusitis, were stronger than those of most of the control drugs. 3. The MIC90's of CMX against isolates from patients of sinusitis were < or = 0.025-0.39 micrograms/ml. These values were lower than transitional concentrations in mucous membrane of maxillary sinus obtained when "1% CMX nasal solution" was used with nebulizer. It appears likely that sufficient concentrations exceeding MICs against main organisms would be obtained by nebulizer treatment using CMX nasal solution.
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PMID:[Antibacterial activities of cefmenoxime against recent fresh clinical isolates from patients in sinusitis]. 763 94

Changes in nasopharyngeal flora were investigated in children with acute otitis media and with acute exacerbations of chronic sinusitis in whom antibiotic therapy of relatively long duration was required until substantial improvement in clinical findings was achieved. 1. The antibiotics used were two cephalosporins, i.e., cefaclor (CCL) and cefixime (CFIX), administered to 18 patients each for 1 week and to 26 and 20 patients, respectively, for 2 weeks. Bacteriologic examination of the nasopharyngeal mucosa was performed at the first visit and at 1 week in those who underwent antibiotic therapy for 1 week, and at the first visit and at 1 and 2 weeks in those treated with antibiotics for 2 weeks. 2. The elimination rates for the infecting microorganisms in the patients in the CCL-treated group were 30% for Haemophilus influenzae, 83% for Staphylococcus aureus, 100% for Streptococcus pyogenes and 100% for Streptococcus pneumoniae at 1 week, and 18% for H. influenzae, 100% for S. aureus and 100% for S. pyogenes at 2 weeks of antibiotic therapy. Replacement of S. aureus and S. pyogenes by H. influenzae was observed. 3. The elimination rates for infecting bacteria in the patients in the CFIX-treated groups were 61% for H. influenzae, 50% for S. aureus, 75% for S. pyogenes, 80% for S. pneumoniae and 100% for Moraxella catarrhalis at 1 week, and 72% for H. influenzae, 0% for S. aureus, 100% for S. pyogenes, and 0% for S. pneumoniae at 2 weeks of antibiotic therapy. The elimination rate for H. influenzae at 2 weeks was significantly higher than the corresponding value for the CCL-treated group. Replacement of H. influenzae by S. aureus and S. pneumoniae and of S. pyogenes by S. aureus was detected. 4. There was one patient with acute otitis media in the CFIX-treated group in whom a clinical relapse occurred due to H. influenzae persisters in the nasopharynx. Thus the diagnosis in this patient was so-called "recurrent otitis media". 5. H. influenzae tended to persist after exposure to therapeutically adequate concentrations of CCL, as did S. aureus and S. pneumoniae following treatment with CFIX. Thus, it would seem that ample heed must be given to persistence, particularly of H. influenzae and S. pneumoniae, the most common causative agents of acute otitis media in childhood. 6. A significant rise in the MICs of the cephalosporins was observed in 4 of 43 patients in whom the same type of organism was isolated from the nasopharynx at weekly intervals during antibiotic therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The effect of cefaclor and cefixime on nasopharyngeal pathogens in children]. 778 74

A total of 251 adults with chronic sinusitis were enrolled into this prospective multicentre, double-blind, double-placebo comparison of ciprofloxacin (500 mg twice daily) with amoxycillin/clavulanic acid (500 mg three times daily). The diagnosis of chronic sinusitis (persistence of clinical symptoms for at least 3 months) was confirmed by computerized tomography scan and/or sinusoscopy prior to therapy. Patients at inclusion had purulent or muco-purulent rhinorrhoea. Staphylococcus aureus (n = 45), Haemophilus influenzae (n = 35), Streptococcus pneumoniae (n = 32) and enterobacteriaceae (n = 31) were isolated from pre-treatment aspirates of the middle meatus. Treatment lasted 9 days, at the end of which nasal discharge disappeared in 71/118 (60.2%) patients of the ciprofloxacin group and 69/123 (56.1%) of those in the amoxycillin/clavulanic acid group. The clinical cure and bacteriological eradication rates were 58.6% versus 51.2% and 88.9% versus 90.5% for ciprofloxacin and amoxycillin/clavulanic acid, respectively. These differences were not significant, however, amongst patients who had a positive initial culture and who were evaluated 40 days after treatment. Ciprofloxacin recipients had a significantly higher cure rate than those treated with amoxycillin/clavulanic acid (83.3% vs. 67.6%, p = 0.043). Clinical tolerance was significantly better with ciprofloxacin (p = 0.012), essentially due to a large number of gastro-intestinal related side-effects in the amoxycillin/clavulanic acid group (n = 35). Ciprofloxacin proved to be at least as effective as amoxycillin/clavulanic acid. The superior safety profile, a twice daily dosage regimen, suggests that ciprofloxacin may be a useful therapeutic alternative for the treatment of chronic sinusitis.
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PMID:A double-blind comparison of ciprofloxacin and amoxycillin/clavulanic acid in the treatment of chronic sinusitis. 780 31


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