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)

Ninety patients with serious infections, including 61 with septicaemia, pneumonia, peritonitis or meningitis, were treated with ceftazidime. Of these patients, 85.6% were clinically cured (73.3%) or improved (12.2%) by the antibiotic. In this study, 57.7% had infections due to Escherichia coli (24.7%), Klebsiella sp. (14.5%) and Pseudomonas sp. (18.5%). Two children with cystic fibrosis and Pseudomonas pneumonia and an adult with Legionella pneumonia responded well to ceftazidime treatment. Seventy patients had fever before treatment and most of them became apyrexial in less than 2 to 3 days. Ceftazidime was given either intramuscularly (42 patients) or intravenously (48 patients), in a dose of 1 g tds in 71 patients or 2 g tds in severe infections in 11 patients, or reduced to suit the renal function (7 patients) or in paediatric doses (2 children). Blood ceftazidime levels were measured in eight patients with normal renal function. The average level one hour post dosing was 45.2 mg/l and the average trough level was 8.1 mg/l. Six patients were suffering from variable degrees of renal insufficiency (serum creatinine 149 to 668 mmol/l). Their average blood level 1 h post-dosing was 68.8 mg/l. In a patient with meningitis, the CSF level was 2.4 mg/l 2 h after a 1 g dose. These levels are several times the ceftazidime MIC values for most clinical bacterial isolates. Ceftazidime is a valuable and safe alternative to aminoglycoside therapy.
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PMID:Ceftazidime: a new approach in the treatment of moderate and severe infections. 635 15

Ceftazidime, a beta-lactamase stable cephalosporin, was administered to 57 patients. Substantial underlying disease was present in the majority of patients, and 50% were in critical or poor condition. Ceftazidime inhibited all initial isolates of Enterobacteriaceae at 8 mg/L or less, regardless of resistance to other antibiotics and the majority of Pseudomonas aeruginosa at 12 mg/L or less. The mean serum level after infusion of 1 g during 30 minutes was 62 mg/L. Overall clinical response was 84%, and the bacteriological response was 72% excluding cystic fibrosis patients. No major adverse effects were encountered. Resistance developed in Pseudomonas from patients with cystic fibrosis and in Enterobacter from two other patients. Ceftazidime was an effective, safe therapy for serious infection due to multiply resistant Pseudomonas and other aerobic gram-negative bacilli including aminoglycoside-resistant Serratia and Klebsiella.
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PMID:Clinical efficacy of ceftazidime. Treatment of serious infection due to multiresistant Pseudomonas and other gram-negative bacteria. 641 90

For a 3 1/2-year period, a mucoid strain of Klebsiella ozaenae supplanted the growth of Pseudomonas aeruginosa in the respiratory tract of a patient with cystic fibrosis. He showed no clinical signs of ozena. While the patient was colonized with K ozaenae, his pulmonary status essentially remained unchanged. However, his clinical condition deteriorated rapidly when P aeruginosa colonization again became predominant.
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PMID:Klebsiella ozaenae in a patient with cystic fibrosis. 642 Dec 59

P. aeruginosa and Staphylococcus were isolated respectively from 46.7 and 30.9 per cent of the children with mucoviscidosis. Proteus, Klebsiella and hemophilic bacilli were isolated from 11.2, 2.8 and 2.8 per cent of the patients respectively. All the isolates of Proteus, 95.8 per sent of the staphylococcal strains and 16.7 per cent of the P. aeruginosa strains were highly sensitive to gentamicin. No gentamicin resistant strains were detected. The studies on the gentamicin pharmacokinetics showed that the maximum levels of the drug in the blood and sputum of the children treated with the antibiotic injected intramuscularly in doses of 1.2 and 2-2.5 mg/kg were attained in 1 hour. The concentration of gentamicin in the sputum amounted to 60-80 per cent of its concentration in the blood serum. Within 11 hours the antibiotic sputum levels were higher than the MIC for the organisms sensitive to gentamicin. After a single endobronchial administration of the drug it was detected in the sputum for 6 days in concentrations exceeding the MIC for the moderately sensitive strains.
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PMID:[Microflora study and the pharmacokinetic characteristics of gentamycin in children with mucoviscidosis]. 669 4

Six transtracheal aspirations (TTA) and expectorated sputum specimens were collected from four children suffering from cystic fibrosis who had pulmonary infection. Specimens obtained from both sites were cultured for aerobic bacteria and TTA aspirates were also cultured for anaerobes. Differences in bacteria isolated in TTA and sputum aspirates were present in all instances. Six isolates were recovered in both sites (three Pseudomonas aeruginosa, two Staphylococcus aureus and one Aspergillus flavus). Five aerobic isolates were recovered only in the expectorated sputum and not in TTA aspirations (two Klebsiella pneumoniae and one each of P. aeruginosa, Escherichia coli and Proteus mirabilis). Nine organisms were isolated only from the TTA (two each of Veillonella parvula and Alpha hemolytic streptococci, and one each of Bacteroides fragilis, B. melaninogenicus, Lactobacillus sp., Haemophilus influenzae and Gamma hemolytic streptococci). The recovery of anaerobic organisms from four of the six TTA specimens suggests a possible role for these organisms in the etiology of pulmonary infection in cystic fibrosis. We found TTA to be helpful in the bacterial diagnosis and management of pulmonary infections in cystic fibrosis.
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PMID:Transtracheal aspiration in pulmonary infection in children with cystic fibrosis. 682 49

Levels and types of bacterial contamination were compared in enteral feeds prepared and administered in hospital or in the home. Samples of feed administered to children suffering from cystic fibrosis were collected for microbiological analysis immediately after preparation, immediately prior to use (unless administered after preparation) and at the end of feeding. No bacteria were detected in 51 (70%) of the 73 feeds sampled on the hospital ward, and in most of the remaining feeds viable counts were less than 10(1) colony-forming units (cfu) ml-1. However, only four (18%) of the feeds sampled in the home were free from bacterial growth and the remaining 18 feeds contained from 10(1) to more than 10(6) cfu ml-1. Bacteria isolated from feeds sampled both in hospital and the home, included Staphylococcus spp., Bacillus spp., viridans and faecal streptococci, Klebsiella spp. and Enterobacter spp. Enterobacter cloacae was isolated from 11 of the 73 hospital feeds and four of the 22 home feeds. Staphylococcus aureus was isolated from five of the home feeds but from none of the hospital feeds. The higher incidence and numbers of bacteria found in home enteral feeds indicate that further, more detailed studies need to be carried out to find the sources and routes of this contamination and devise methods to minimize the problem.
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PMID:A comparative study of the numbers of bacteria present in enteral feeds prepared and administered in hospital and the home. 809 47

Alginate is a viscous extracellular polymer produced by mucoid strains of Pseudomonas aeruginosa that cause chronic pulmonary infections in patients with cystic fibrosis. Alginate is polymerized from GDP-mannuronate to a linear polymer of beta-1-4-linked residues of D-mannuronate and its C5-epimer, L-guluronate. We previously identified a gene called algG in the alginate biosynthetic operon that is required for incorporation of L-guluronate residues into alginate. In this study, we tested the hypothesis that the product of algG is a C5-epimerase that directly converts D-mannuronate to L-guluronate. The DNA sequence of algG was determined, and an open reading frame encoding a protein (AlgG) of approximately 60 kDa was identified. The inferred amino terminus of AlgG protein contained a putative signal sequence of 35 amino acids. Expression of algG in Escherichia coli demonstrated both 60-kDa pre-AlgG and 55-kDa mature AlgG proteins, the latter of which was localized to the periplasm. An N-terminal analysis of AlgG showed that the signal sequence was removed in the mature form. Pulse-chase experiments in both E. coli and P. aeruginosa provided evidence for conversion of the 60- to the 55-kDa size in vivo. Expression of algG from a plasmid inan algG (i.e., polymannuronate-producing) mutant of P. aeruginosa restored production of an alginate containing L-guluronate residues. The observation that AlgG is apparently processed and exported from the cytoplasm suggested that it may act as a polymer-level mannuronan C5-epimerase. An in vitro assay for mannuronan C5 epimerization was developed wherein extracts of E. coli expressing high levels of AlgG were incubated with polymannuronate. Epimerization of D-mannuronate to L-guluronate residues in the polymer was detected enzymatically, using a L-guluronate-specific alginate lyase of Klebsiella aerogenes. Epimerization was also detected in the in vitro reaction between recombinant AlgG and poly-D-mannuronate, using high-performance anion-exchange chromatography. The epimerization reaction was detected only when acetyl groups were removed from the poly-D-mannuronate substrate, suggesting that AlgG epimerization activity in vivo may be sensitive to acetylation of the D-mannuronan residues. These results demonstrate that AlgG has polymer-level mannuronan C5-epimerase activity.
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PMID:Pseudomonas aeruginosa AlgG is a polymer level alginate C5-mannuronan epimerase. 814 47

We sought an explanation for the accumulation, and apparent poor degradation by alveolar phagocytes, of alginate in cystic fibrosis lung. A crude intracellular lyase preparation extracted from Klebsiella pneumoniae was able to degrade seaweed alginic acid as well as forms purified from Pseudomonas aeruginosa bacteria from Cystic Fibrosis (CF) patient lungs. This was by a beta-eliminative mechanism, as detected by an increase in the 232nm absorbance and activity was enhanced by deacetylation of the Pseudomonas aeruginosa alginates. Conditioned media or cell lysates from unstimulated or triggered phagocytic cells (including resident mouse peritoneal macrophages and the human macrophage cell line U937) had no effect in the same system. Free radicals generated by chemical systems or by gamma irradiation of water degraded alginate. Depolymerisation by free radicals, as detected by viscosity determinations and polyacrylamide gel electrophoresis, generated a wide range of fragment sizes. In contrast, mouse peritoneal macrophages or human polymorphonuclear neutrophils stimulated to generate free radicals had no significant effect on alginate. Under the conditions of our experiments, phagocytic cells representative of the CF lung are not able to degrade Pseudomonas aeruginosa alginate. This may explain the gross accumulation of alginate in CF lung.
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PMID:Alginate may accumulate in cystic fibrosis lung because the enzymatic and free radical capacities of phagocytic cells are inadequate for its degradation. 822 Feb 49

The literature data and the data of the authors on the pathogenesis and pathogenetic and etiotropic therapy of mucoviscidosis are presented. The use of ofloxacin as an antibacterial agent in the complex treatment of mucoviscidosis is considered expedient. The drug was administered intravenously in a dose of 400 mg twice a day for 5 days followed by the oral use of the drug in the form of tablets according to the same scheme. The microbiological investigation of the sputum specimens revealed diagnostically significant titers of Pseudomonas aeruginosa, Staphylococcus aureus and Klebsiella spp. The isolates except for one case (Ps.aeruginosa) were susceptible to ofloxacin. The treatment with ofloxacin in accordance with the above scheme resulted in a rapid improvement of the patient state: the intoxication lowered, the expectoration and the sputum viscosity decreased, the body temperature normalized by the 5th day. The drug tolerance after the intravenous and enteral administration was good. The intravenous injections of ofloxacin induced a 1.5-fold increase in the intensity of the neutrophil oxygen burst. After the drug enteral administration there was observed a 2-fold increase the intensity of the neutrophil oxygen burst.
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PMID:[An attempt to use ofloxacin in patients with mucoviscidosis]. 900 85

The in-vitro activity of colistin sulphomethate sodium was compared with that of other commonly used antimicrobial agents against 377 recent clinical isolates of Gram-negative bacteria (including 94 strains of Pseudomonas aeruginosa from patients with cystic fibrosis) and 16 organisms with defined resistance patterns. Colistin was active against most strains of P. aeruginosa (MIC90 4 mg/L), Shigella spp. (MIC90 0.5 mg/L), Salmonella spp. (MIC90 1 mg/L), Acinetobacter spp. (MIC90 2 mg/L), Citrobacter spp. (MIC90 1 mg/L), Escherichia coli (MIC90 1 mg/L), Klebsiella spp. (MIC90 8 mg/L) and Enterobacter spp. (MIC50 1 mg/L). No useful activity was demonstrated against Providentia spp. or Serratia spp. The results show that colistin remains a useful antimicrobial agent against Gram-negative bacteria, particularly those strains which are resistant to more commonly used antibiotics.
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PMID:A reassessment of the in-vitro activity of colistin sulphomethate sodium. 906 49


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