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)

More than 90% of community hospital-isolated strains of Staphylococcus (including methicillin-resistant isolates), Streptococcus, Haemophilus, Neisseria, Branhamella, Bacteroides, Escherichia coli, Klebsiella, Enterobacter aerogenes, Proteus, and Acinetobacter calcoaceticus were inhibited by the sulbactam/ampicillin (1:2) combination at concentrations of 8 micrograms/16 micrograms per ml. The peak serum level from a 15-min infusion of 1 g/2 g of sulbactam/ampicillin is more than seven times this 90% end point. Excellent bactericidal activity was demonstrated against ampicillin-resistant isolates. Ampicillin-resistant strains did not develop resistance to sulbactam/ampicillin when they were serially transferred in the presence of sublethal concentrations of the combination. In mice the combination was active against a variety of acute, fatal infections produced by ampicillin-resistant bacterial isolates, including methicillin-resistant strains of Staphylococcus aureus and mixed anaerobes. The in vitro and in vivo properties of sulbactam/ampicillin, coupled with its reliable pharmacokinetic performance, appear to make the combination ideally suited for the treatment of polymicrobial (aerobe-anaerobe) infections.
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PMID:Sulbactam/ampicillin: in vitro spectrum, potency, and activity in models of acute infection. 302 1

Ampicillin resistance was first reported among clinical isolates of Haemophilus influenzae in 1972. Reports of chloramphenicol resistance followed shortly thereafter. The principal mechanism of resistance to these two antibiotics is enzymatic. Although other mechanisms have been described, they are found in comparatively few strains. The genetic information for the inactivating enzymes is plasmid mediated and therefore readily transmissible to susceptible strains. Consequently, effective therapy for invasive disease caused by this pathogen has been seriously compromised. As antibiotic susceptibility became less predictable, in vitro testing became increasingly important. Unfortunately, the standardization of methods for laboratory testing has been slow and complicated by the fastidious nature of the organisms. This review traces the development of antibiotic resistance in H. influenzae, discusses the mechanisms which appear to be important in mediating resistance, explores newer antimicrobial agents which might be useful in the treatment of infection, and analyzes the various approaches to in vitro testing.
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PMID:Haemophilus influenzae: antibiotic susceptibility. 306 97

Based on a quantitative analysis of sputum cultures, pathogenic bacteria in respiratory ailments isolated in our laboratory during 1984 to 1986 were classified and analyzed. During the study period, the most frequently isolated agent was Haemophilus influenzae followed by Pseudomonas aeruginosa, Branhamella catarrhalis and Streptococcus pneumoniae. They together consisted of 70 approximately 74% of all the respiratory pathogenic bacteria isolated in our study. Susceptibilities of above pathogens to antimicrobial agents were investigated using the agar dilution method. Results are summarized as follows. 1. Ratio of proportion of beta-lactamase producing strains among non beta-lactamase producing strains of H. influenzae markedly decreased in 1986 (6/70, 8.6%) as compared to previous years (11/73, 15.1% in 1984 and 8/49, 16.3% in 1985). In consequence, MIC90 values for penicillins reduced considerably in 1986. Among the antibiotics examined cefmenoxime (CMX) and cefotaxime (CTX) were the most active agents against H. influenzae. A development of resistance to other cephems and new quinolones (norfloxacin, ofloxacin, ciprofloxacin) was not evident during the 3-year survey. 2. Against S. pneumoniae, benzylpenicillin was still the most active agent despite gradual increase of frequency of isolation. Ampicillin (ABPC), piperacillin (PIPC), CMX and CTX were also potent against S. pneumoniae. S. pneumoniae were frequently isolated from patients treated with new quinolones or minocycline (MINO). This phenomenon may be explained by higher MIC values of these agents against S. pneumoniae. 3. Of B. catarrhalis strains isolated, more than 80% were beta-lactamase positive, although MIC90 were not so high (1.56 micrograms/ml for ABPC and 0.20 micrograms/ml for PIPC). Among the antibiotics tested, latamoxef was the most active agent against B. catarrhalis and inhibited all the strains at a concentration of 0.05 micrograms/ml or less. No resistant strains were observed against cephems, new quinolones, erythromycin or MINO. 4. P. aeruginosa appeared to be rapidly developing resistance against new quinolones in patients with chronic P. aeruginosa respiratory infections who had been treated with these agents. In treating chronic respiratory infection due to P. aeruginosa, one must be watchful of rapid development of resistance by the organism or its replacement with S. pneumoniae.
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PMID:[Recent trend of incidence of respiratory pathogenic bacteria and its susceptibility to antimicrobial agents: studies in the year 1984-1986]. 314 25

An investigation was undertaken to determine the isolation rate and antibiotic resistance of Haemophilus influenzae from the nasopharynx of young children. The 996 subjects studied were up to 6 years of age. H. influenzae was isolated from 304 (30.5%) and strains of capsular type b from 11 (1.1%). Age, sibling status, season, respiratory infection and antibiotic therapy all influenced isolation rates. The overall prevalence of antibiotic resistance in the strains isolated was ampicillin 5.4% (all beta-lactamase producers), cefaclor 0.3%, chloramphenicol 1.3%, erythromycin 38.2%, tetracycline 1.3%, trimethoprim 5.4% and sulphamethoxazole 0%. Ampicillin resistance was more common in type b than non-capsulated strains.
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PMID:Nasopharyngeal carriage and antibiotic resistance of Haemophilus influenzae in healthy children. 325 68

From January to April 1986 all 21 Clinical Microbiology Laboratories in Wales took part in a survey to determine the prevalence of antibiotic resistance in Haemophilus influenzae. All isolates were collected and despatched to a central laboratory where identification was confirmed and antibiotic sensitivity tests repeated. One thousand four hundred and forty strains were available for analysis. Resistance was present in 128 (8.9%) to ampicillin, 23 (1.6%) to cefaclor, 28 (1.7%) to chloramphenicol, 282 (19.6%) to erythromycin, 43 (3.0%) to tetracycline, 90 (6.2%) to sulphonamide and 66 (4.6%) to trimethoprim. One hundred and twenty-one strains (8.4%) were beta-lactamase producers. Thirteen (0.9%) were resistant to four or more antibiotics and included one type b strain isolated from cerebrospinal fluid resistant to ampicillin, chloramphenicol, tetracycline, trimethoprim and sulphonamide. The prevalence of resistance to ampicillin and trimethoprim was higher than that recorded previously in two large studies elsewhere in the United Kingdom. Ampicillin resistance was more common in strains from hospital inpatients than those from general practice.
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PMID:The prevalence of antibiotic resistance in Haemophilus influenzae in Wales. Report from the Standing Specialist Advisory Group for Microbiology in Wales. 325 60

A total of 2,811 clinical isolates of Haemophilus influenzae were obtained during 1986 from 30 medical centers and one nationwide private independent laboratory in the United States. Among these, 757 (26.9%) were type b strains. The overall rate of beta-lactamase-mediated ampicillin resistance was 20.0%. Type b strains were approximately twice as likely as non-type b strains to produce beta-lactamase (31.7 versus 15.6%). The MICs of 12 antimicrobial agents were determined for all isolates. Ampicillin resistance among strains that lacked beta-lactamase activity was extremely uncommon (0.1%). Percentages of study isolates susceptible to cefamandole, cefaclor, cephalothin, and cephalexin were 98.7, 94.5, 87.3, and 43.3%, respectively. For 14 strains (0.5% of the total), chloramphenicol MICs were greater than or equal to 8.0 micrograms, and thus the strains were considered resistant. All of these resistant strains produced chloramphenicol acetyltransferase. In addition, all 14 strains were resistant to tetracycline; 11 produced beta-lactamase. The percentage of isolates susceptible to tetracycline was 97.7%. In contrast, erythromycin and sulfisoxazole were relatively inactive. The combination of erythromycin-sulfisoxazole (1/64) was more active than erythromycin alone but essentially equivalent in activity to sulfisoxazole alone. Finally, small numbers of clinical isolates of H. influenzae were resistant to trimethoprim-sulfamethoxazole and rifampin.
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PMID:National collaborative study of the prevalence of antimicrobial resistance among clinical isolates of Haemophilus influenzae. 325 21

Therapeutic efficacy of two newer cephalosporins, cefmenoxime and ceftriaxone, was evaluated in newborn rats with experimental bacteraemia and meningitis due to an ampicillin-resistant strain of Haemophilus influenzae type b, and the results were compared with those of ampicillin, chloramphenicol and co-trimoxazole (trimethoprim/sulphamethoxazole). Measured by MICs and MBCs, cefmenoxime and ceftriaxone were at least a hundred-fold more active in vitro than chloramphenicol. Co-trimoxazole was bacteriostatic in vitro. For in-vivo studies, the following daily doses were used: 200 mg/kg for ampicillin; 100 mg/kg and 200 mg/kg for chloramphenicol; 10/50 mg/kg, 20/100 mg/kg and 100/500 mg/kg for trimethoprim/sulphamethoxazole; 10 mg/kg and 50 mg/kg for cefmenoxime; and 10 mg/kg and 25 mg/kg for ceftriaxone. Cefmenoxime and ceftriaxone were highly efficacious, even at a dose of 10 mg/kg/day, in eradicating the organism from blood and CSF, preventing bacteriological relapse and improving the survival rate. In contrast, chloramphenicol was effective in reducing mortality, but failed to eradicate the organism or to prevent relapse, while co-trimoxazole was least effective in that all but one survivors suffered relapse with positive blood and CSF cultures. Ampicillin gave unexpected results in that the organism was eradicated in all survivors and bacteriological relapse was prevented in most animals (73-75%).
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PMID:Therapeutic efficacy of chloramphenicol, co-trimoxazole (trimethoprim/sulphamethoxazole), cefmenoxime and ceftriaxone in experimental bacteraemia and meningitis caused by ampicillin-resistant Haemophilus influenzae type b. 326 31

Over the past six years, many new agents have become available for the treatment of bacterial central nervous system (CNS) infections. Certain principles guide the use of these agents for CNS infections: first, an antimicrobial agent must be able to penetrate the CNS to be effective; second, the CNS is a "relatively immunoincompetent site" so that an antimicrobial must achieve levels within the CNS capable of killing the offending bacterium. The lack of efficacy of chloramphenicol for meningitis due to gram-negative aerobes is probably due to its failure to achieve such killing levels, whereas the success of the newer cephalosporins, such as cefotaxime and ceftriaxone, is due to their very high killing activity against these organisms. Penicillin remains the first choice for pneumococcal and meningococcal meningitis. Ampicillin plus chloramphenicol is still recommended as initial therapy for meningitis due to Hemophilus influenzae. The newer cephalosporins are now the first choice for the treatment of meningitis due to many gram-negative bacilli. Trimethoprim-sulfamethoxazole may also be useful in some of these infections and those due to Listeria monocytogenes. In the treatment of severe CNS infections, a team approach is advised to ensure optimal therapy.
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PMID:Chemotherapy for bacterial infections of the central nervous system. 331 56

Acute epiglottitis is seldom encountered in adults, but the condition is probably more frequent than reported in the literature. Nineteen cases of adult epiglottitis were analysed retrospectively. In 53% of the patients, the symptoms were present for less than 24 h prior to hospitalization. Sore throat and dysphagia were invariably present. Three patients presented with stridor and 2 with complete airway obstruction. Throat cultures from 5 patients grew beta-haemolytic streptococci and from 2 Haemophilus influenzae type B was grown. Two tracheotomies and 1 nasotracheal intubation were performed. One death occurred. It is emphasized that any adult with an acute sore throat and dysphagia should undergo indirect laryngoscopy and that blood cultures should always be part of the routine bacteriological investigation. Cooperation and understanding among otolaryngologists and anaesthesiologists is of paramount importance in the management of acute adult epiglottitis, as nasotracheal intubation and cricothyroidotomy appear to be the methods of choice in securing an airway. Ampicillin and chloramphenicol are recommended in the medical treatment.
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PMID:Acute epiglottitis in adults: bacteriology and therapeutic principles. 332 11

The data on blood culture isolates for 1983 and January - July 1984 reported by the Antibiotic Study Group of South Africa have been analysed to determine national and regional prevalences of different micro-organisms and resistance to certain antibiotics. Although there are significant differences in isolation frequencies between the various centres, overall the five most frequent isolates are Staphylococcus aureus (1983 - 15%; 1984 - 14%), Escherichia coli (13%), Klebsiella spp. (11%; 10%), Streptococcus pneumoniae (9%), and Salmonella typhi (7%; 13%). Staph. aureus ranks first in most centres for 1983 but is displaced in some in 1984 by enteric Gram-negative bacilli. In Durban S. typhi is the most common isolate for the entire period. Methicillin resistance among Staph. aureus is common (approximately 30% overall), especially in the Transvaal. Gentamicin resistance among certain Gram-negative bacilli is a problem in many centres and is especially disturbing in the case of Klebsiella spp., of which over 30% of total isolates are resistant. Ampicillin resistance for Haemophilus influenzae varies from nil to over 30% in different centres, and penicillin-resistant pneumococci are still encountered (nil to over 10%).
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PMID:An analysis of blood culture isolates from 7 South African teaching hospital centres. 348 60


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