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 penicillins are a large group of bicyclic ring compounds which contain a 4-membered beta-lactam ring (penams) fused to a 5-membered thiazolidine ring. Benzylpenicillin (penicillin G) was the first natural penicillin with potent activity against all Gram-positive pathogens, Gram-negative cocci and some spirochaetes and actinomycetes. For the last 50 years benzylpenicillin has been the mainstay of therapy for serious pneumococcal, streptococcal, meningococcal and gonococcal infections. However, the past decade has seen the emergence of resistance in certain parts of the world, initially among the gonococci, and more recently among the pneumococci and meningococci. Discovery of the 6-aminopenicillinamic acid nucleus has led to considerable manipulation of the basic ring structure, resulting initially in the synthesis of ampicillin, and subsequently the other aminopenicillins, analogues, esters and prodrugs. These drugs have the advantages of improved oral bioavailability and superior activity against Haemophilus influenzae, certain Gram-negative bacilli, salmonellae, enterococci and Listeria monocytogenes, making these agents popular in the treatment of upper and lower respiratory tract infections and urinary tract infections. The increasing spread of bacterial resistance, particularly among Enterobacteriaceae and H. influenzae, has curtailed the usefulness of these drugs in these clinical settings. To counteract this problem, a number of agents combining a penicillin and a beta-lactamase inhibitor (e.g. clavulanic acid, tazobactam and sulbactam) have been developed. These inhibitors have no intrinsic antibacterial activity, but combining them with a penicillin (e.g. amoxicillin/clavulanic acid) confers greater stability to beta-lactamases and hence a broader spectrum of activity. The emergence of penicillinase-producing staphylococci that rendered benzylpenicillin ineffective also stimulated the search for penicillinase-resistant penicillins--methicillin and nafcillin, followed by the acid-stable isoxazolyl penicillins. These agents are now the principle antistaphylococcal treatment. Methicillin-resistant coagulase-negative staphylococci are currently a major cause of hospital sepsis, and are resistant to these latter agents. Enteric Gram-negative bacilli have been the predominant cause of serious hospital infections during the last 30 years. Further manipulation of the penicillin structure has resulted in compounds with broader activity against Gram-negative bacilli, particularly Pseudomonas aeruginosa, while retaining activity against Gram-positive pathogens. The carboxypenicillins were the first step in this direction, but have been largely superseded by the ureidopenicillins. These agents have better activity against P. aeruginosa, and are still effective against Gram-negative and Gram-positive bacteria, including enterococci and anaerobic organisms.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Penicillins. A current review of their clinical pharmacology and therapeutic use. 769 96

The in-vitro activity of the parenteral cephem FK-037 was compared to those of cefpirome, ceftazidime, cefuroxime, cefixime, amoxycillin and co-amoxiclav. Against the Enterobacteriaceae FK-037 was generally > or = 16-fold more active than cefuroxime and two- to four-fold more active than ceftazidime and similar in activity to cefpirome. Pseudomonas aeruginosa displayed similar susceptibilities to ceftazidime and FK-037 (MIC90 4 and 8 mg/L respectively). Methicillin-resistant Staphylococcus aureus were inhibited by < or = 4 mg/L of FK-037. The MIC of FK-037 for 90% of Streptococcus pneumoniae was 0.5 mg/L. Haemophilus influenzae and Moraxella catarrhalis were inhibited by < or = 2 mg/L FK-037.
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PMID:The in-vitro activity of FK-037, a new broad spectrum injectable cephalosporin. 770 58

The in vitro activity of cefpirome, a new injectable cephalosporin was studied against 1,082 clinical isolates in a multicentre study. Minimum inhibitory concentrations were determined using an agar dilution method. Cefpirome was active against Enterobacteriaceae. On naturally non-producing beta-lactamase species, cefpirome was active on most of the strains with MICs < or = 0.5 mg/l, including strains producing an acquired penicillinase: E. coli 0.03-0.06, P. mirabilis 0.06-0.12, Salmonella spp. 0.06-0.06, Shigella spp. 0.016-0.03. MICs of K. pneumoniae (0.06-4) ranged from 0.016 to 32:MICs were high against expanded-spectrum betalactamase producers strains. Against species producing cephalosporinase, cefpirome was also active on most of the strains with MICs < or = 0.5: E. cloacae 0.06-2, Citrobacter spp. 0.03-1, S. marcescens 0.06-0.5, P. indol + 0.06-0.25, P. stuartii 0.12-0.5. Cefpirome was less active on Pseudomonas aeruginosa, (8-32) and on A. baumanii (16-32). MICs of cefpirome were low against Haemophilus spp. betalactamase producing or not (0.01-0.03) and M. catarrhalis (0.6-4). Activity of cefpirome on methicillin-sensitive staphylococci, was higher than other third generation cephalosporins (0.25-2) comparable to that of cephalotin and cefamandol. Methicillin-resistant strains should be considered as resistant. Pneumococci (0.01-0.03), except for penicillin-R strains, and streptococci A, B, C, G (0.01-0.06) were very susceptible. Enterococci were of low sensitivity or resistant. Among anaerobes, C. perfringens appeared often susceptible, and Bacteroides spp. resistant.
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PMID:[In vitro antibacterial activity of cefpirome: a new cephalosporin; results of a multicenter study]. 772 47

In Lebanon, knowledge of the prevailing pattern of bacterial resistance to antimicrobial agents has been limited, particularly because of 15 years of civil strife. Thus, the current study was conducted to determine the antimicrobial susceptibility patterns of nonselected bacterial isolates recovered from recent clinical specimens, using the standardized disk agar diffusion technique. A total of 5216 isolates (1443 Gram positive and 3773 Gram negative) were examined. Over 92% of Staphylococcus aureus and coagulase-negative staphylococci (CNS) were resistant to penicillins. Methicillin resistance was more frequently noted among CNS (28%) compared with S. aureus (18%). For the pneumococci, 27% of the isolates were resistant to penicillin G. High but variable rates of multidrug resistance were encountered among Acinetobacter spp., Pseudomonas spp., Serratia spp., Citrobacter spp., and Enterobacter spp. Ampicillin resistance was detected in 65% of Escherichia coli and in 20% of Haemophilus influenzae isolates. Although one resistant Salmonella typhi strain was observed, 17% of other Salmonella spp. and 60% of Shigella spp. proved to be resistant to ampicillin, chloramphenicol, and cotrimoxazole. Among Vibrio cholerae isolates, high resistance to tetracycline (71%) and trimethoprim-sulfamethoxazole (94%) was observed. The overall antimicrobial resistance rates in Lebanon seem to fall between figures reported from the Arabian Gulf countries (higher) and those from medical centers in the United States (lower).
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PMID:Antimicrobial susceptibility patterns of bacterial isolates at the American University Medical Center in Lebanon. 787 82

The profile of infection and pattern of bacterial resistance in Eastern Europe is distinct from that observed in other parts of the world. Several Polish investigations have reported that environmental pollution may increase the risk of respiratory disease. Studies from Hungary and Romania have documented a dramatic increase in the proportion of Streptococcus pneumoniae strains resistant to antibiotics. In comparison, resistance to these agents amongst Polish pneumococci isolates is lower, although these pathogens and Streptococcus pyogenes have displayed increasing tetracycline resistance. 20% of Polish Haemophilus influenzae isolates and a high percentage of Moraxella catarrhalis strains exhibit ampicillin resistance. Methicillin-resistant Staphylococcus aureus (MRSA) has been found to constitute 22% of Polish S. aureus strains. Two major clones of MRSA have been identified in Poland which differ in their degree of antimicrobial resistance. The pattern of antimicrobial resistance amongst Polish respiratory pathogens is undoubtedly a reflection of management policies and the use of these drugs. It is hoped that the economic and political changes taking place within Eastern Europe will provide the information and resources to establish more efficient infection control and antibiotic policy and thus delay and limit the appearance of bacterial resistance.
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PMID:Bacterial resistance in eastern Europe--selected problems. 804 55

Antimicrobial susceptibilities and beta-lactamase production of clinical isolates from 1986 to 1991 except 1988 were determined. beta-Lactamase was detected frequently in Escherichia coli (84.7%), Klebsiella pneumoniae (65.4%), Staphylococcus aureus (62.3%), and not frequently in Haemophilus influenzae (22.4%). Methicillin-resistant S. aureus was also resistant to many antimicrobials except to arbekacin and minocycline, and imipenem showed markedly high activity against methicillin-sensitive S. aureus. Susceptibilities of E. coli and K. pneumoniae to cefuzonam, imipenem and ofloxacin were quite high and that of H. influenzae to ofloxacin and cefuzonam was also very high.
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PMID:[In vitro antimicrobial susceptibilities and beta-lactamase production of clinical isolates. beta-Lactamase Study Group in Chubu-area]. 811 69

In vitro activities of broad-spectrum quinolones (sparfloxacin (SPFX), ciprofloxacin (CPFX), lomefloxacin (LFLX), fleroxacin (FLRX), and levofloxacin (LVFX) were examined against clinical bacterial isolates: Klebsiella pneumoniae, Haemophilus influenzae, Moraxella subgenus Branhamella catarrhalis, Methicillin-sensitive Staphylococcus aureus (MSSA), Methicillin-resistant Staphylococcus aureus (MRSA), Enterococcus faecalis, Enterococcus faecium, and Streptococcus pneumoniae). Antibacterial activities of SPFX, CPFX, and LVFX against Gram-negative bacteria such as K. pneumoniae, M. (B) catarrhalis and H. influenzae were better than those of FLRX and LFLX. SPFX showed the highest activity against all Gram-positive bacteria tested in this study. However, strains showed high MIC (> or = 16 micrograms/ml) to SPFX were found among MRSA, E. faecalis, and E. faecium, whose isolation frequencies were 28.6%, 10.0%, and 6.7%, respectively. The results of this study suggest that resistant strains of Gram-positive bacteria against new quinolone might increase among clinical isolates.
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PMID:[In vitro antibacterial activities of broad spectrum quinolones against clinical bacterial isolates]. 811 70

Antimicrobial activity of cefuroxime axetil (CXM-AX) was compared with those of other cephem antibiotics against clinically isolated strains obtained mainly from outpatients of our center in a period from January to September of 1990 and 1993. Minimum inhibitory concentrations were determined and the following results were obtained. 1. The results suggested that, compared with reports of studies conducted with clinical isolates in early 1980's, MIC80 of CXM were equal to or lower against Staphylococcus spp., Streptococcus pyogenes, Escherichia coli, Klebsiella spp., Proteus mirabilis, Haemophilus influenzae, Moraxella subgenus Branhamella catarrhalis, Neisseria gonorrhoeae, Peptostreptococcus spp., and Propionibacterium acnes, except for Streptococcus pneumoniae, MIC80 which was slightly higher. 2. MIC90 of comparator drugs reflected those of new resistant organisms recently appeared, such as benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP), cephem-resistant E. coli and Klebsiella spp., new quinolone-resistant H. influenzae and N. gonorrhoeae. Methicillin-resistant Staphylococcus aureus (MRSA) was detected also from specimens of community acquired infections. From the nature of MRSA detected in those situations MRSA appeared to present a continuing problem. 3. MIC90 against strains obtained from patients with community acquired infections was a good index of increases of multidrug-resistant organisms in the past. Therefore, the determination of MIC90 is important in examining changes with time of sensitivities or resistances of clinically isolated strains to antimicrobial drugs. 4. Antimicrobial activities of CXM against recent clinical isolates showed the existence of problems as mentioned above. However, MIC of CXM as well as those of comparator drugs indicated that antimicrobial activities of CXM against Staphylococcus spp., Streptococcus spp., H. influenzae appeared to be relatively strong, and it is concluded that cefuroxime axetil still is one of the clinically useful oral antimicrobial drugs in the 1990's.
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PMID:[Antimicrobial activities of cefuroxime against recent clinical isolates]. 820 67

The antimicrobial activity of cefpirome was compared with amoxycillin/clavulanic acid, ampicillin/sulbactam, cefuroxime, ceftazidime, gentamicin and amikacin against 743 non-duplicate clinical isolates. MIC50 and MIC90 showed that the antibiotic was active against both Gram-negative and Gram-positive organisms. Cefpirome was highly active against most of the Enterobacteriaceae, including indole-positive Proteus spp., Aeromonas spp. (MIC < or = 1 mg/L) and Salmonella spp. (MIC < or = 0.5 mg/L). Neisseria gonorrhoeae and Haemophilus influenzae (including beta-lactamase producers) were all susceptible, with MIC less than 0.5 and 0.25 mg/L respectively. Cefpirome was more active than cefuroxime and ceftazidime against Campylobacter spp. (MIC < or = 2 mg/L), but less active than ceftazidime against Pseudomonas aeruginosa. Cefpirome was active against Streptococcus pneumoniae. Streptococcus bovis and coagulase-negative staphylococci (MIC < or = 0.5 mg/L) and methicillin-sensitive Staphylococcus aureus (MIC < or = 2 mg/L). Methicillin-resistant S. aureus, Gram-positive and Gram-negative anaerobes were resistant to cefpirome. The stability of cefpirome to TEM-1, TEM-2, PSE-1, SHV-1 and the chromosomal-mediated P99 and K-1 beta-lactamases was comparable to ceftazidime.
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PMID:The antimicrobial activity and beta-lactamase stability of cefpirome, a new fourth-generation cephalosporin in comparison with other agents. 833 98

Recent trends in the development of resistance of the Staphylococcus aureus and Streptococcus pneumoniae to antibiotics were investigated, using a questionnaire delivered to participants at a meeting of the Kinki District Society of Infections. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 55.4% of all isolated S. aureus, and more than 80% of MRSA was detected within hospitals. In outpatients, MRSA was often detected in pus, while in hospitalized patients, MRSA was often detected in sputum. Further, MRSA was accompanied by some other organisms (most frequently Pseudomonas aeruginosa) in 64.7% of MRSA positive patients. The sensitivity of MRSA to vancomycin (VCM) was 100%, to sulfamethoxazole-trimethoprim (ST) 99.2%, and to arbekacin, 98.6%. In contrast, Penicillin-resistant Streptococcus pneumoniae (PRSP) accounted for 42.4% of all isolates of Streptococcus pneumoniae. About 50% of PRSP was detected in out-patients. For both hospitalized patients and outpatients, PRSP was most frequently detected in sputum. PRSP was accompanied by some other organisms (most frequently Haemophilus influenzae) in 49.3% of PRSP positive patients, PRSP had high sensitivity to cephems, carbapenems and VCM.
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PMID:[An epidemiological investigation for MRSA and PRSP in Kinki area. Kinki Infection Working Group]. 974 19


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