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

The purpose of this study was to elicit the circumstances of occurrence and organism sensitivities of Klebsiella pneumoniae bacteremia in the community hospital, since data on this illness from the community hospital are rare. All records of documented Klebsiella pneumoniae bacteremia (46 cases) at Alachua General Hospital, Gainesville, Florida, over the period July 14, 1982, through July 27, 1985, were reviewed in detail. Fifty-nine percent (27 organisms) were nosocomial, whereas 41% (19 organisms) were community acquired. The most common predisposing disorders in these patients were, in decreasing order, malignancy; following gastrointestinal or biliary surgery; biliary tract obstruction; diabetes; and unknown. Twenty-two percent (10) of the patients died from bacteremia. The majority of organisms tested were sensitive to mezlocillin, cephalothin, cefoxitin, tetracycline, tobramycin, gentamicin, co-trimoxazole and ceftizoxime. Therapy was considered to be appropriate in 89% (41) of the patients and inappropriate in 10.9% (5) of the patients. Contrary to previous thought, Klebsiella pneumoniae bacteremia is a relatively common problem in the community hospital and may be community acquired as well as nosocomial. There are many characteristics of this disease in the community that are different from those reported in studies on Klebsiella pneumoniae bacteremia from large referral centers.
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PMID:Klebsiella pneumoniae bacteremia in the community hospital. 265 4

Children with catheter-associated bacteremia were evaluated for the type of bacteria recovered and the relationship of the bacteria to the predisposing disease. A previously unrecognized observation was that gram-negative isolates, namely, Escherichia coli and Klebsiella sp., were almost exclusively recovered (11 of 12 isolates [92%]) from children with short bowel syndrome (SBS) compared with those from children with other underlying diseases, such as inflammatory bowel disease, malignancies, and other disorders (P less than 0.001). Furthermore, children with SBS had a higher frequency of repeated infection (3.1 catheter-associated infections compared with 1.3 catheter-associated infections in children with other disorders during the same period). Only gram-positive bacteria were isolated from children with malignancies and other predisposing disorders. The very high frequency of catheter-associated gram-negative bacteremia in children with SBS compared with that in children with other bowel disorders, malignancies, and other predisposing diseases requires attention by the clinician in the management of patients in this group.
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PMID:Incidence of catheter-associated gram-negative bacteremia in children with short bowel syndrome. 266 41

Septicemia in hematologic malignancies and infection of herpes zoster in cancer patients were studied, and trend in organisms in a cancer hospital was investigated. 1) Septicemia in hematologic malignancies. The success rate of antibiotic therapy for septicemia was 76% if the patients were not under antibiotic therapy when septicemia developed. But recovery from septicemia was only 25% if the patients were undergoing antibiotic therapy when septicemia developed. Some 90% of neutropenic patients under 500/microliters, who were not under antibiotic therapy when septicemia developed, recovered from septicemia if the neutrophil count increased in the following 5 days. Change in the neutrophil count was an important factor determining the success or failure of antibiotic therapy for septicemia. The use of granulocyte colony-stimulating factor may prevent chemotherapy-induced neutropenia. Shortening of the period of neutropenia or preventing its occurrence should reduce the incidence and the severity of infection. 2) Infection of herpes zoster in cancer patients. Thirty-four cancer patients were associated with herpes zoster. Eleven of them were patients with malignant lymphoma and ten of them were patients of breast cancer. Most patients were heavily pretreated by chemotherapy and/or radiotherapy before the development of herpes zoster. Marked lymphocytopenia was observed at the onset of herpes zoster. Absolute lymphocyte count was under 1000/microliters in 71% of these patients. Development of herpes zoster in cancer patients was considered to be due to the depression of cell-mediated immunity which was the result of repeated and continued anticancer therapy. Acyclovir was found to be effective to treat herpes zoster in these patients. 3) Trend of organisms detected in cancer hospital. The frequency of organisms isolated from clinical materials in the National Cancer Center Hospital was compared during the period from 1978 to 1982 and the period from 1983 to 1987. The most common organism detected in both periods was P. aeruginosa and no change in frequency was observed. But the frequency of gram-negative bacilli, E. coli, Klebsiella and Serratia, decreased significantly in the latter period while the frequency of gram-positive cocci, Enterococcus and Staphylococcus increased markedly in the latter period. The use of cephems of third generation in the latter period could be one reason for the recent change of organisms detected in the hospital. Appropriate therapy for infection based on the latest and accurate information should be used.
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PMID:[Infection and immunosuppression in cancer patients]. 273 15

A total of 368 episodes of Klebsiella bacteremia occurred in 330 cancer patients, representing a rate of four episodes per 1000 hospital admissions. Eighty-eight percent of these infections were acquired nosocomically and 58% of the patients received antibiotics during the preceding 10-day period. There was pulmonary infection in 24% of the patients, shock in 25%, and disseminated intravascular coagulation in 7%. The overall response rate was 69%. Response rates were significantly lower among patients with shock (25% versus 83%), hemorrhage (29% versus 76%), and pneumonia (37% versus 79%). The combination of a cephalosporin plus an aminoglycoside produced the highest response rate (79%). Klebsiella sp continue to be an important cause of infection in patients with cancer.
Cancer 1989 Dec 01
PMID:Klebsiella bacteremia. A 10-year review in a cancer institution. 280 29

The ability of 22 strains of intestinal bacteria to bind the mutagenic pyrolyzates--3-amino-1,4-dimethyl-5H-pyrido-[4,3-b]indole [(Trp-P-1) CAS: 62450-06-0], 3-amino-1-methyl-5H-pyrido [4,3-b]indole [(Trp-P-2) CAS: 62450-07-1], 2-amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole [(Glu-P-1) CAS: 67730-11-4], 2-aminodipyrido[1,2-a:3',2'-d]imidazole [(Glu-P-2) CAS: 67730-10-3], 2-amino-3-methylimidazo[4,5-f]quinoline [(IQ) CAS: 76180-96-6], 2-amino-3,4-dimethylimidazo[4,5-f]quinoline [(MeIQ) CAS: 77094-11-2], and 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline [(MeIQx) CAS: 77500-04-0]--was investigated and compared to their ability to bind to some dietary fibers (corn bran, apple pulp, soy bean fiber, cellulose, chitin, and chitosan). The pyrolyzates are potent mutagenic and carcinogenic heterocyclic amines formed during cooking. Solution of these amines was mixed with aqueous suspension of bacterial cells or dietary fibers, and removal of these amines from the reaction mixture by centrifugation was defined as the binding. Trp-P-1 and Trp-P-2 were effectively bound to all gram-positive and some gram-negative bacterial cells, corn bran, apple pulp, and soy bean fiber. Binding of Trp-P-1 and Trp-P-2 to Escherichia coli, Klebsiella pneumoniae, and cellulose was moderate, and to chitin and chitosan it was little. None but corn bran bound Glu-P-1 and Glu-P-2 effectively. Corn bran effectively bound all mutagens tested. The quantity of the binding of IQ, MeIQ, and MeIQx was dependent on the strain of bacteria and the kind of fiber. The mechanism of binding of Trp-P-2 to freeze-dried feces, Lactobacillus casei YIT 9018 (LC9018), and corn bran was investigated. The binding was pH dependent, occurred instantaneously, and was inhibited by the addition of metal salts. These results indicate that the binding was mostly due to a cation-exchange mechanism, but some irreversible binding of Trp-P-2 was observed, most notably to freeze-dried feces. The mutagenicity of Trp-P-2 for Salmonella typhimurium TA98 in the presence of S9 mix was inhibited by the addition of LC9018 or corn bran to the reaction mixture. The results indicate that bound Trp-P-2 did not cause mutation under the assay conditions.
J Natl Cancer Inst 1986 Jul
PMID:In vitro binding of potent mutagenic pyrolysates to intestinal bacteria. 301 97

Aerobic and facultative gram-negative bacilli (GNB) have been reported to increase on various body surfaces in the seriously ill and debilitated patient. This study examined quantitative aspects of GNB succession at five oral sites in cancer patients before and during myelosuppressive chemotherapy. GNB concentrations increased sharply during chemotherapy at 25 to 50% of the oral sites in both acute nonlymphocytic leukemia and small-cell lung carcinoma patients. Most sites did not exhibit shifts of GNB to levels higher than 0.1% of the cultivable flora. When shifts occurred, all sites sampled in the mouth were usually affected and GNB usually represented more than 10% of the cultivable flora. Low levels of indigenous microflora were observed in most sites exhibiting GNB shifts. None of the subjects harboring high levels of GNB developed the symptoms of acute infection which are commonly observed in myelosuppressed patients. Although Pseudomonas aeruginosa and Klebsiella pneumoniae were recovered from some sites, most GNB were nonpathogenic species of Pseudomonas; Pseudomonas pickettii was the most frequently recovered.
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PMID:Oral succession of gram-negative bacilli in myelosuppressed cancer patients. 301 36

The endogenous genital flora is a major source of infections of the female genital tract, especially in patients with cervical or endometrial cancer. Until recently the "radiosterilisation of the vagina", respectively a prophylactic and/or therapeutic effect of irradiation (external high voltage as well as intracavitary-radium) concerning infections was postulated in the literature. This theory was disproved in a prospective clinical and bacteriological study covering 48 patients with advanced cervical cancer undergoing primary intracavitary radium-irradiation and 38 patients with inoperable endometrical cancer, undergoing primary Iridium-192-afterloading. Following intracavitary radium for cervical cancer some typical nosocomial pathogens like Streptococcus faecalis, Enterobacter, Klebsiella, Proteus and Pseudomonas were isolated significantly more frequently than before treatment. Likewise, the mean number of aerobic bacterial species increased significantly after irradiation. Also primary Ir-192 (afterloading) irradiation did not alter the frequency of isolation of the resident flora in endometrial cancer patients. Therefore, "radiosterilisation" of the vagina as result of radiotherapy does not exist.
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PMID:[Does radiosterilization of the vagina occur through therapeutic radiation dosages?]. 309 58

The in vitro activity of SCH-34343, a new penam antibiotic, was tested against gram-positive and gram-negative isolates from cancer patients, and compared to that of 7 other antimicrobial agents. SCH-34343 was extremely active against the Enterobacteriaceae with MIC90 ranging from 0.39 to 6.25 micrograms/ml for Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus spp. and Serratia marcescens. It was less active against Acinetobacter spp. (MIC90 6.25-12.5 micrograms/ml) and had poor activity against Pseudomonas aeruginosa. Among gram-positive isolates group A and G beta-hemolytic Streptococci were extremely susceptible to SCH-34343 (MIC90 0.025-0.05 micrograms/ml). Good activity against methicillin-susceptible coagulase-positive and coagulase-negative Staphylococci and Listeria monocytogenes, and moderate activity against Enterococci was also seen.
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PMID:In vitro activity of SCH-34343, a new penam, and other antimicrobial agents against clinical isolates from cancer patients. 310 Jan 47

Fiscal considerations prompted comparison of cefotaxime (a third generation cephalosporin) with cefamandole (a second generation cephalosporin) for prophylaxis in the surgical treatment of the biliary tract. One hundred and eight patients who underwent an operation upon the biliary tract received three 1 gram doses of cefotaxime (54 patients) or cefamandole (54 patients) at induction of anesthesia and then one and three hours later. The study was prospective, blinded and randomized. The groups (cefotaxime versus cefamandole) were statistically comparable for age, sex, diagnosis, type and duration of operation and positive cultures. The most prevalent bacteria isolated from qualitative aerobic and anaerobic cultures of bile and the wall of the gallbladder were Escherichia coli, Streptococcus and Klebsiella. The incidence of bactibilia in patients with one of these conditions was: 75 per cent for cancer; 69 per cent for patients more than 60 years old; 33 per cent for jaundice; 58 per cent for pancreatitis; 60 per cent for exploration of the common bile duct, and 22 per cent for acute cholecystitis. Microbiologic agar diffusion assays of tissue from the wall of the gallbladder, subcutaneous fat and rectus muscle and samples of bile and serum obtained 30 minutes after the second dose of antibiotic showed a statistically significant greater concentration of cefamandole in the wall of the gallbladder. Otherwise there was no difference between the concentration of cefamandole and cefotaxime. The groups showed no statistical difference for temperature of more than or equal to 38 degrees C. on two consecutive measurements, postoperative wound and urinary infections, postoperative hospital stay and days in the intensive care unit and incidence of readmission within a month. Prophylactic use of cefotaxime in a three dose regimen provided no advantage in prophylaxis compared with cefamandole.
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PMID:A comparison of cefotaxime versus cefamandole in prophylaxis for surgical treatment of the biliary tract. 310 45

In addition to the well-known T-cell dysfunctions in AIDS, hypergammaglobulinemia, mostly IgG, and autoimmune phenomena indicate that B cells are also involved. Reports of HIV-infected and activated B cells suggest T cell-independent B-cell abnormalities. In order to assess the IgG subclasses involved in hypergammaglobulinemia, we examined all four IgG subclasses in sera and in vitro with an enzyme-linked immunosorbent assay (ELISA). The in vitro studies included 7-day cultures of mononuclear cells and highly purified B cells stimulated with a T cell-independent polyclonal B-cell activator (Klebsiella pneumoniae, KlebsM). Cultures were done with cells from seven patients with AIDS, seven patients with persistent generalized lymph node enlargement and HIV antibodies, and normal controls. In vivo, hypergammaglobulinemia was found to be restricted to the IgG1 subclass. In vitro, high spontaneous levels of IgG were not elevated significantly under stimulatory conditions, as demonstrated by the measurement of all four IgG subclasses in the culture supernatants. In vitro, hypergammaglobulinemia also resulted from IgG1. These results indicate that there are B-cell abnormalities in pre-AIDS and AIDS, in that the B-cell preactivation in vivo resulting in hypergammaglobulinemia is restricted to IgG1.
Cancer Detect Prev 1988
PMID:Predominance of the IgG1 subclass in the hypergammaglobulinemia observed in pre-AIDS and AIDS. 318 Jan 25


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