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Query: UMLS:C0519030 (Klebsiella)
 21,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postoperative infection occurs more frequently in patients with malignant disease than in patients with benign disease. Postoperative infection control in patients with hepatic cancer, biliary tract cancer and pancreatic cancer is studied. Although in patients with jaundice due to malignancy the rate of positive bacterial culture of the bile collected at the time of PTCD was low, the rate of positive bile culture increased after 10 to 14 days of PTCD. The predominant strain was Enterococcus spp., followed by Klebsiella spp., Enterobacter spp. and E. coli in that order. These bacteria isolated from the bile were considered to be causative organisms of postoperative infection. Prophylactic antibiotics after the operation for jaundice due to malignancy should be chosen based on the results of bile culture. In patients undergoing hepatectomy, which is considered to be an aseptic operation, gram positive cocci such as S. aureus was the most frequently encountered organism. On the other hand, in patients undergoing hepatectomy and intestinal anastomosis, enteric bacteria were frequently isolated from the infectious foci. In this study there were 6 cases of methicillin-resistant S. aureus (MRSA) postoperative infection, 3 cases after pancreatoduodenectomy, and 3 cases after hepatectomy. Even after an aseptic operation, postoperative MRSA infection is likely to occur in patients undergoing a more invasive operation, so hospital infection control should be again emphasized.
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PMID:[Postoperative infection control in patients with hepatic, biliary tract, and pancreatic cancers]. 134 66

We have analyzed the clinical significance of secondary infections associated with lung cancer patients. The incidence of secondary infections was 51.4% in 214 in-patients with lung cancer admitted to our institution in 1988 and 1989, and almost all of them had respiratory tract infections. The incidence was high in patients with cell types other than adenocarcinoma, and in those with hypoproteinemia, impaired cellular immunity and obstruction of the airway. The prognosis in patients with infection was much poorer than that in patients without infection. Major causative pathogens were Staphylococcus aureus including methicillin-resistant S. aureus (MRSA), Haemophilus influenzae, Klebsiella spp. and Pseudomonas aeruginosa. These pathogens except for H. influenzae were isolated at the terminal stage, in cases with airway obstruction and in post cancer-chemotherapeutic phase. The efficacy rate of 194 chemotherapeutic regimens against infection was 57.7%. Although the efficacy rate in 1988 and 1989 exceeded that in the 1970s, there was no significant difference in the efficacy rate between monotherapy (57.1%) and combined therapy (59.3%). The effectiveness was very poor for infections caused by P. aeruginosa and MRSA, or for cases with airway obstruction and marked impairment of pulmonary blood flow. The above results showed that a new combined therapy as well as the measures to improve the general condition of compromised hosts are required in the treatment of secondary infections in these patients.
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PMID:[Respiratory infections associated with lung cancer]. 137 Oct 46

An attempt was made to interpret the clinical significance of secondary infections associated with lung cancer. The incidence of secondary infections was 51.4% in 214 in-patients with lung cancer in our institution in 1988 and 1989, and almost all of them had respiratory infections caused by commonly encountered bacteria. The incidence of infection was high in lung cancer of cell types other than adenocarcinoma, and in those with hypoalbuminemia, impaired cellular immunity and obstruction of the airway. The prognosis in patients with infection was much poorer than that in patients without infection. Major pathogens responsible for infection were Staphylococcus aureus including methicillin-resistant S. aureus (MRSA), Haemophilus influenzae, Klebsiella spp. and Pseudomonas aeruginosa. These pathogens, except for H. influenzae, were isolated in the terminal stage in cases with airway obstruction and post cancer chemotherapy. The efficacy rate of 194 therapeutic regimens against infection was 57.7%. It was thus found that the efficacy rate in 1988 and 1989 exceeded that in the 1970s. The effectiveness was very poor for infections caused by S. aureus and P. aeruginosa, and for cases with airway obstruction and marked impairment of pulmonary blood flow. The efficacy rate of single-drug regimens was 57.1% (80/140) and that of combined regimens was 59.3% (32/54). The above results indicate that a new combined therapy which includes a beta-lactam antibiotic as well as measures to improve the general health of compromised hosts are required in the treatment of secondary infections in these patients.
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PMID:[Clinical significance of respiratory infections associated with lung cancer patients]. 140

The ingestion of rattlesnake powder capsules is frequent in Mexico in view of their alleged curative properties in various diseases, among them different malignancies. Based on previous reports showing both bacteremia and septicemia in patients with malignant diseases ingesting such capsules, we conducted a study to evaluate the presence of microorganisms in 16 different preparations of rattlesnake powder capsules, obtained in six different cities of our country. We found that all the samples were significantly contaminated with gram-negative coliform bacteria: Escherichia coli, Klebsiella pneumoniae, Enterobacter agglomerans, E. cloacae, Salmonella arizona and Salmonella of groups B, E4 and G. Eighty one percent of the capsules were contaminated with Salmonella sp. The most frequent was S. arizona with a natural reservoir in snakes. Contamination was probably derived from both the flesh of the snake and fecal contamination during the domestic preparation of the powder to produce the capsules. These data, together with those previously published regarding bacteremia and septicemia derived from the ingestion of the capsules, suggests that there is danger in their use.
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PMID:[Desiccated rattlesnake capsules: a potential source of gram-negative bacterial infection]. 179 64

The in vitro activity of cefpodoxime, an oral cephalosporin ester, against 792 bacterial isolates representing 36 species was evaluated in comparison to that of ciprofloxacin and trimethoprim/sulfamethoxazole (TMP/SMX). Cefpodoxime inhibited the majority of Streptococcus spp., Haemophilus influenzae and Proteus mirabilis at a concentration of less than or equal to 0.12 microgram/ml. It was also active against Citrobacter diversus, Escherichia coli, Klebsiella spp., Proteus vulgaris, Serratia marcescens and methicillin-susceptible Staphylococcus aureus isolates. Overall, cefpodoxime appeared to be less active than ciprofloxacin and TMP/SMX against many pathogens common in cancer patients.
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PMID:In vitro activity of cefpodoxime against bacterial isolates obtained from patients with cancer. 191 1

A classic clinical and radiographic picture of Klebsiella pneumonia has emerged in the literature. Patients are typically male, older than 48 years, and have a history of chronic alcoholism. The majority of these pneumonias are community acquired. Bulging interlobar fissures and cavitation are radiographic findings said to be distinctive for Klebsiella pneumonia. We prospectively studied 15 cases of bacteremically proven Klebsiella pneumonia and found clinical and radiographic features strikingly different from those described in the literature. Immunosuppression (from corticosteroids, cytotoxic chemotherapy, neutropenia, hematologic malignancy, and transplantation) now rivals alcoholism as the primary risk factor. Cases tended to be nosocomial rather than community acquired. Neither bulging interlobar fissure nor cavitation was seen in any case. The right upper lobe was involved in 11 of our 15 cases. Pneumonia due to Klebsiella oxytoca was more likely to be isolated from patients with bilateral infiltrates, while Klebsiella pneumoniae was more likely in patients with unilateral infiltrates.
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PMID:Klebsiella pneumonia in the modern era: clinicoradiographic correlations. 199 Apr 53

The role of operation for anorectal infections associated with perineal gangrene and cellulitis in children with myelo-suppression from cancer chemotherapy is unclear. We evaluated anorectal/perineal infections caused by Pseudomonas aeruginosa in 16 children with malignant diseases seen over 27 years. In 12 of 16 patients, leukemia was the underlying malignancy (ALL 10, AML 2), and in 13 of 16, severe neutropenia (absolute neutrophil count less than 500/mm3) was present at diagnosis. Cultures of the lesions showed multiple organisms in 14 of 16 patients with Escherichia coli, Klebsiella species, and Enterococcus being the most frequent coexisting organisms. All positive blood cultures grew P aeruginosa exclusively. Of three patients with necrotizing infections, two had complete resolution with medical treatment alone; the other patient who developed this problem while on terminal care died. In none of the 16 patients was a major operation (debridement or diversion) performed. Five patients died, three of whom were considered terminally ill when the anorectal infections occurred. Four of the five deaths occurred before 1974. Since then, only 1 of 7 patients died. Excluding the three terminally ill patients, the success rate of medical therapy alone is 85% (11/13). The antibiotic regimen should include an aminoglycoside in synergistic combination with anti-Pseudomonas penicillin. These results suggest that operative management may have no role in the management of anorectal infections caused by P aeruginosa in children with cancer.
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PMID:Management of anorectal/perineal infections caused by Pseudomonas aeruginosa in children with malignant diseases. 205 13

Bactericidal activity in compromised host's serum i.e. patients with cancer, the elderly, diabetes, was stronger than that in normal serum against Proteus mirabilis (P. mirabilis) but was weaker against Klebsiella pneumoniae (K. pneumoniae). Against Escherichia coli (E. coli), bactericidal activity on serum of patients with cancer was weaker in the following order, that in elderly serum, that in diabetic serum. Against Proteus vulgaris (P. vulgaris), bactericidal activity in elderly serum was similar to that in normal serum but was stronger than that in serum of patients with cancer. Against Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus), bactericidal activity in elderly serum and diabetic serum was similar to that in normal serum but was weaker than that in serum of patients with cancer. Piperacillin showed bactericidal activity in nutrient broth, normal serum and compromised host's serum at a concentration of 1/4 MIC against E. coli, P. mirabilis and P. aeruginosa. Aspoxicillin showed bactericidal activity in nutrient broth, and bactericidal or bacteriostatic activity in normal serum and serum of patients with cancer against E. coli and P. aeruginosa. While cefazolin and cefmetazole slightly inhibited the growth of bacteria in nutrient broth, they showed hardly any bactericidal activity in normal serum and compromised host's serum.
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PMID:[Studies on the sub-MIC of beta-lactam antibiotics--bactericidal activity in compromised host's serum]. 207 67

The in vitro activity of sparfloxacin, a new quinolone, was compared with those of ciprofloxacin and fleroxacin against gram-positive and gram-negative bacteria, greater than 90% of which were isolated from blood culture specimens of cancer patients. Sparfloxacin was extremely active against Acinetobacter species, Aeromonas hydrophila, Citrobacter diversus, Enterobacter species, Escherichia coli, Klebsiella species, Proteus vulgaris, and Serratia marcescens (inhibiting greater than 90% of these isolates at a concentration of 0.5 microgram/ml) and moderately active against Pseudomonas species, other Proteus species, and Citrobacter freundii. Sparfloxacin inhibited greater than 90% of staphylococci (including methicillin-resistant and coagulase-negative strains) at a concentration of 0.12 microgram/ml and greater than 90% of streptococci (including Streptococcus pneumoniae) at a concentration of 1.0 microgram/ml. It was also active against Bacillus cereus, Enterococcus species, and Corynebacterium jeikeium, organisms that have become fairly common in cancer patients.
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PMID:In vitro activity of sparfloxacin (CI-978; AT-4140) against clinical isolates from cancer patients. 212 48

47 patients with pulmonary abscesses were analysed. The type of bacteria cultured from the sputum, type of chemotherapy and clinical outcome were assessed. Most of the patients (34) were already treated prior to admission to the Department. Most often with doxycycline and gentamycin. The following organisms were cultured: Streptococcus viridans, Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. Antibiotic therapy was always instituted according to the antibiogram. Most often amikacin and cefamandole was given. The mean duration of hospitalization was 48 days. 44% of the patients were fully cured, in 40% only an improvement was seen. 7 patients expired (16%)--all of these patients were addicted to alcohol or had malignancy.
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PMID:[Pulmonary abscesses in material from tuberculosis and lung disease clinics of the Academy of Medicine in Gdansk]. 221 12


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