Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0519030 (Klebsiella)
 21,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The development of local immunity to Klebsiella pneumoniae in the lower respiratory tract is described. Immunity to intranasal infection is produced by systemic immunization resulting in high titers of circulating antibody. Protection also follows intranasal immunization with glutaraldehyde-killed organisms. Low levels of antibodies develop in serum after intranasal immunization. IgA antibody can be detected in the serum of these mice whereas little IgA antibody is detected in the serum of mice immunized systemically. Both IgA and IgG antibodies can be found in the pulmonary secretions of locally immunized mice. IgA and IgG from these secretions may be used to passively transfer protection when used to opsonize the infecting dose of K. pneumoniae. Protection mediated by IgA is not due to any interaction of IgA with cells present in the lower respiratory tract during infection, but exerts its protective effect in the upper respiratory tract, thereby preventing the spread of bacterial infection to the lower respiratory tract.
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PMID:Local immunity to klebsiella pneumoniae in the lungs of mice. 633 31

In an attempt to prevent infections complicating bone marrow transplantation, 22 patients received oral nonabsorbable antibiotics in protected environments. The standard antibiotic regimen consisted of gentamicin, vancomycin and nystatin. The vast majority of fecal organisms initially cultured were completely suppressed by about one week after initiation of antibiotic prophylaxis. The antibiotics had to be taken regularly to keep the gastrointestinal tract decontaminated. However, Candida was often cultured despite prophylaxis. The best method for continuously suppressing Candida was considered to be administering an adequate antifungal drug before intestinal decontamination. The throat, however, was far more difficult to decontaminate than the stool. Lincomycin inhalation was most effective in suppressing anaerobic bacteria. Some of the organisms cultured persistently or intermittently from the throat tended to appear sooner or later in the stool during prophylaxis, although they were not always resistant. The pattern of reappearance of the fecal flora after intestinal decontamination was similar to that observed in newborn infants. However, none of the Enterobacteriaceae strains which reappeared in the stool were identical to those cultured initially. Absorption of gentamicin and vancomycin from the gastrointestinal tract was negligible. A gentamicin-induced small-colony variant of Klebsiella pneumoniae was isolated from one patient. Amphotericin B was more tolerable than nystatin, which often produced nausea and vomiting in association with the preparative radio-chemotherapy for marrow transplantation. Hypoprothrombinemia and hypocholesterolemia were noted during prophylaxis. Three episodes of exogenous bacterial infection occurred despite strict isolation procedures.
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PMID:Total intestinal decontamination for prevention of infection in bone marrow transplantation. 633 74

The purpose of this study was to elucidate the frequency of bacterial infection of intrahepatic bile in relation to biliary tract pathology. Bile was aspirated during percutaneous transhepatic cholangiography, with or without combined biliary tract drainage, and subjected to bacteriological investigations in 295 patients with various hepatobiliary diseases. Bile was infected in 89% of the 92 patients who had high fever and were on antibiotics at the time of study. Positive cultures were obtained in 39% of the patients who were not so ill as to require antibiotics. The overall incidence of biliary infection was 90% in bile duct stones, particularly high in patients with primary intrahepatic stones, regardless of the presence of stones in the common bile duct, and in patients who had dilation of the common bile duct, presumably due to obstructive involvement of the ampulla of Vater. E. coli and Klebsiella were the most frequent among the aerobic species isolated, and mixed infection involving these organisms was common. Anaerobes were much less frequent, always mixed with aerobes, but positive cultures would increase with more rigorous anaerobic conditions for culture. Duodenal fluid collected simultaneously did not always grow the same microorganisms, but showed a 86-87% coincidence with intrahepatic bile in terms of positive or negative cultures. It is recommended that bile be cultured at the time of percutaneous transhepatic cholangiography.
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PMID:Bacteriological study of transhepatically aspirated bile. Relation to cholangiographic findings in 295 patients. 636 89

Bacterial infection of the lower respiratory tract is initiated by colonization of the upper respiratory tract followed by aspiration of small volumes of contaminated secretions into the lungs. Failure of lung antibacterial defenses results in pneumonia. Strategies for prevention involve prevention of colonization, avoidance of aspiration, or enhancement of lung defenses. Effective prevention against specific organisms can be provided by immunization which enhances lung defenses for vaccinated strains. This approach has limited applicability because of the time required for development of protective antibody and the selective spectrum of protection. Aspiration of small quantities of oropharyngeal secretions is probably unavoidable in seriously ill patients. Prevention of colonization of the upper respiratory tract by pathogenic organisms would provide an effective prophylactic strategy. Although much has been learned about the role of bacterial adherence to regional epithelial cells in determining colonization, manipulation of this adherence phenomenon in the respiratory tract is not clinically possible at this time. The use of topical antimicrobial agents provides another means of preventing colonization with susceptible organisms. In human subjects and experimental animals, topical polymyxin B has successfully reduced cases of pneumonia due to Pseudomonas aeruginosa and Klebsiella pneumoniae, although colonization and occasional infections with resistant organisms occur. However, prevention of pneumonia by manipulation of the bacterial flora of the upper respiratory tract is an approach that warrants further investigation.
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PMID:Prevention of respiratory tract infection. 637 81

Hepatolithiasis is associated with bile stasis and bacterial infection. Gallstones found in the intrahepatic bile duct are mostly calcium bilirubinate stones, the presence of which is closely related to the presence of bacteria. In the present study, a high incidence of bile infection was found in hepatolithiasis: 52 of 54 cases (96.3%). This is in concordance with the other reports from Japan as well as from East Asia. E coli was the most frequent isolate followed by Klebsiella, Streptococcus (D), and Pseudomonas. Because of the frequent isolation of E coli in calcium bilirubinate stone cases, beta-glucuronidase from E coli has been thought to be responsible for the formation of calcium bilirubinate stones by effecting hydrolysis of bilirubin glucuronide to free bilirubin, which is insoluble in water. The recent introduction of improved anaerobic culture techniques has led to an increasing number of reports on the presence of anaerobes in the biliary tract. Anaerobes were isolated in 6 of 29 cases of hepatolithiasis (20.7%) in our series but more frequently in Kaohsiung, Taiwan (25 of 57 cases, or 44.4%). Bacteroides and Clostridium were the most frequent isolates from the biliary tract and were shown to have beta-glucuronidase activity. Anaerobes were often found together with aerobes, suggesting the possibility of a synergistic effect that may influence the occurrence and development of cholangitis, which is often associated with hepatolithiasis. Though the biliary tract and liver are usually sterile, when an infection of the biliary tract occurs the route by which bacteria reach the region is thought to be hematogenous, lymphatic, or direct intraluminal ascending infection, the last being the most likely. Treatment of cholangitis associated with hepatolithiasis should be directed toward the removal of stones and termination of bile stasis. When cholangitis ensues, control of bacterial infection by antibiotics should be started without delay. The choice of antibiotics in controlling cholangitis is presented.
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PMID:Bacteriology of hepatolithiasis. 638 75

The results of several published studies suggest that bacterial infection plays an important role in the mortality of Neonatal Intensive Care Unit (NICU) patients. To evaluate more thoroughly this role we have routinely performed postmortem cultures of blood and cerebrospinal fluid on all infants who die in our NICU. During a 5-year review period 25.9% of infants who died had one or both cultures positive for an organism considered to be pathogenic in the neonate. The organisms most commonly cultured were Klebsiella pneumoniae, Escherichia coli and Group B Streptococcus. Of those infants who had positive postmortem cultures and who had an autopsy, 95% had histologic evidence of infection. Forty-three percent of our infants with positive postmortem cultures were not suspected of having a serious infection and had not received antibiotics before death. Postmortem cultures appeared to be helpful in identifying NICU patients in whom serious infection may have played a role in mortality. Unsuspected serious infection is a common finding in infants who die in a neonatal intensive care setting.
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PMID:Immediate postmortem cultures in an intensive care nursery. 639 77

1. MIC of 6059-S against 92 strains of clinically isolated bacteria were measured. The compound was active against most of Gram-negative rods, but was not active against Staphylococcus aureus. 2. 20 mg/kg of 6059-S (newly synthesized oxacephem antibiotics) was administered to the pediatric patients and its blood concentration was measured by agar well method using E. coli 7437 as a test organism. 3. The mean blood concentrations were maximum at 15 minutes after intravenous one-bolus injection. Maximum levels were 94.5 mcg/ml in the patients of below 5 years old and 98.7 mcg/ml above 6 years old. Their half-life of the blood levels were 95.4 and 110.6 minutes respectively. 4. The mean blood concentrations were highest at the end of the infusion in the cases of 60 minutes drip injection. Maximum levels were 85.0 mcg/ml in the patients of below 5 years old and 64.8 mcg/ml above 6 years old. 5. Clinical efficacy of 6059-S in 6 cases pyelonephritis, 2 cases of sepsis, 1 case of meningitis, 1 case of intraperitoneal abscess, 9 cases pneumonia and 2 case of tonsillitis was 100%. In the case of urinary tract infection, 4 patients were treated successfully by the administration of 20 mg/kg/day of 6059-S. Other bacterial infections were treated with 55 to 200 mg/kg/day. 6. 100% of the causative organisms were eliminated by 6059-S. They were E. coli, Klebsiella pneumoniae, Serratia marcescens, H. influenzae and beta-Streptococcus. 7. No remarkable side effect was noticed during administration.
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PMID:[Basic and clinical examinations of 6059-S in pediatrics (author's transl)]. 645 66

Cefoperazone was used in the treatment of 23 cases of serious bacterial infection in 20 patients. Ten postoperative scalp wound infections, five infections at the site of tracheostomy, four cases of extradural spinal cord abscess, three cases of sepsis, and one abscess of the cerebellopontine angle were treated with cefoperazone (1 to 2 gm BID, usually for seven to 27 days). There were excellent or good clinical responses in 87% (20/23) of the cases (14 of the 15 postsurgical wound infections, three of the four cases of spinal cord abscess, and all three cases of sepsis). Most of the organisms isolated from the patients' cultures were sensitive to cefoperazone. Excellent or good responses occurred in ten of the 12 infections due to Staphylococcus aureus, in all three infections due to Pseudomonas sp, all three due to Citrobacter freundii, the two due to Serratia marcescens, one of the two due to Klebsiella sp, and the one due to Escherichia coli. Two patients with ventriculitis were clinically improved by three 1-gm infusions, via a shunt, of cefoperazone. No adverse effects of the antibiotic therapy were reported.
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PMID:Cefoperazone in the treatment of postsurgical wound infection, sepsis, and abscess of the spinal cord and brain. 650 63

Fundamental and clinical studies were made on cefadroxil, a new oral cephalosporin, and the following results were obtained. (1) Antibacterial activity of the drug against S. aureus, S. epidermidis, E. coli, Klebsiella, Salmonella and P. mirabilis was almost equal to that of cephalexin. The MIC of indole positive Proteus. Enterobacter, Citrobacter, S. marcescens and P. aeruginosa to cefadroxil was higher than 100 microgram/ml in almost all strains. (2) Serum concentrations following an oral administration of 10.0 to 14.3 mg/kg of cefadroxil dry syrup was highest at 2 hours in 2 cases and 1 hour in 1 case, respectively, which were 13.4 to 17.1 microgram/ml, and 1.8 to 6.8 microgram/ml at 4 hours with an T 1/2 of 1.04 to 1.62 hours and apparently longer continuation of serum concentration than that of cephalexin. Urinary recovery rate was 75-96% up to 6 hours. (3) Fourteen patients, i.e., 6 with tonsillitis and 8 with urinary tract infection, were treated with a daily oral dose of 30-50 mg/kg divided in 4 doses except 1 case divided in 3 doses. The overall efficacy rate was 100%, i.e., excellent in 13, good in 1 and no failure. Causative organisms disappeared in all cases. (4) Adverse reactions, such as diarrhea and skin rash, were not noted at all and 1 case presented a mild elevation of GOT and GPT. (5) Taste and flavor of the drug was well palatable to children. (6) Based on the above results, it is concluded cefadroxil dry syrup is a new potent cephalosporin for oral use in the treatment of acute bacterial infection in children. Daily dose of 40 mg/kg in 3-4 divided doses appeared to be appropriate.
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PMID:[Fundamental and clinical studies on cefadroxil dry syrup in children (author's transl)]. 724 5

Infections by gram-negative bacteria are one of the major causes of death in newborns. Bacterial clearance is deficient in septic neonates, which seems to increase their susceptibility to infections. In this study, we observed a significant improvement in clearance of Klebsiella pneumoniae in newborn wistar rats inoculated by intraperitoneal via with 800 mg k soybean phosphatidylcholine (PC), compared to the control group injected with PBS (p 0.05). The overall survival rate was improved (p 0.05) and the white blood cell counts showed a greater leukocytosis and neutrophilia during the peak of bacteremia in the PC treated animals. Circulating levels of interleukin-6 were greater in the PC group, which developed an intense splenic hematopoiesis of the granulocyte (p 0.05) and megakariocyte series (p 0.01). No significant changes were observed in bone marrow granulocyte deposits in both study groups. The improvement in survival rate, the changes in leukocyte counts and the splenic hematopoiesis may be associated with the increased production of IL-6. These results suggest that IL-6 plays a role in the protection mechanism induced by PC in this experimental model of newborn septicemia. PC seems to be an immunomodulator of the acute response to gram-negative bacterial infection.
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PMID:[Phosphatidylcholine induces an increase in the production of interleukin-6 and improves survival of rats with neonatal sepsis caused by Klebsiella pneumoniae]. 749 35


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