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Query: UMLS:C0519030 (Klebsiella)
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The causes of neonatal mortality in foals were studied over a period of two years. The total number of foals studied was 121. Bacterial infection was found to be an important factor. Infection caused by A. equuli (1.6%) which previously was the most important one, has been superseded by E. coli infection (56%). E. coli infections particularly occur during the first weeks of life and, depending on the course of the disease, give rise to various pathological changes. Infections running an acute course are mainly marked by pathological changes of the lung and lymphoid organs. Infections running a subacute course are frequently associated with polyarthritis and polyserositis. Another important cause of infection during the first weeks of life is Klebsiella pneumonia (10%). The pathological changes occurring in this infection are markedly similar to those in subacute E. coli infection. Infections with Salmonella spp. (7%) mainly occur in the older foals (1-3 months) affected with polyarthritis. C. equi and streptococcal infections (11%) also mainly occur in the older foals (1-3 months). The pathological features are characterized by generalized purulent lesions in various organs. In spite of the fact that post-mortem findings suggested septicaemia, bacteriological examination was negative in 12% of the foals. The discussion is concerned with an assessment of the relationship between the pathomorphological findings and the pathogenesis of the various infections.
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PMID:[Studies on the bacterial causes of neonatal mortality in foals. Report on post-mortem findings (author's transl)]. 36 36

Sisomicin, an aminoglycoside antibiotic, is especially effective against Escherichia coli, Klebsiella, Enterobacter, Citrobacter, Serratia, indole-positive and indole-negative Proteus species, Pseudomonas aeruginosa, Salmonella and Staphylococcus aureus. It has a bactericidal action. Although sisomicin is similar to the other aminoglycoside antibiotics, there is not complete cross-resistance to them. Our own pharmacokinetic investigations showed that a dose of 2--3 mg/kg body weight of sisomicin twice daily is necessary in the neonatal period. Infants should be given 2.5 mg/kg body weight three times daily, and school children 1.5--20 mg/kg body weight, likewise three times daily. Excretion of sisomicin in the urine is lower in children than in adults, amounting within 24 hours to only 10--20% in newborns, and 30--40% in school-children. Sisomicin induces excretion of some enzymes in higher quantities from the tubular part of the kidneys, especially alaninaminopeptidase. A report is given on 58 patients, especially newborns and prematures, who were treated for about seven days with sisomicin. The results obtained with a wide variety of infections (such as omphalitis, aspiration of amniotic fluid with broncho-pneumonia, phlegmons of the galea, and also pyelonephritis and mucoviscidosis with pulmonary complications) can be described as good, with a success rate of 85%. On only seven occasions were insignificant transitory side-effects, such as slight increase in transaminases, toxic-allergic exanthema and pain in the region in injection, observed.
Infection 1979
PMID:[Experience with sisomicin in pediatrics (author's transl)]. 38 23

The antibacterial activity of cefotaxim and seven cephalosporins was determined in 1,112 fresh isolates using the microdilution technique. All of the cephalosporins tested were ineffective against enterococci. Cefalotin was the most effective agent against Staphylococcus aureus. Cefaclor was superior to cephalexin against Escherichia coli and Proteus mirabilis, and thus inhibited 20% more Enterobacteriaceae. Cefazolin was as effective as cefamandole against E. coli. Cefuroxime and cefoxitin were almost equally effective against E. coli, Klebsiella and P. mirabilis; more than 95% of the strains were sensitive. Cefuroxime and also cefamandole were much more effective than cefoxitin against Citrobacter and Enterobacter. Cefoxitin on the other hand was superior against Serratia and indol-positive Proteus species. Cefotaxim was by far the most active cephalosporin against Enterobacteriaceae, only 2% of the strains being resistant. More than 90% of the strains of E. coli, Klebsiella, P. mirabilis and Serratia were sensitive to 1 mg/l, the lowest degree of activity being displayed against Enterobacter; 82% of the strains were inhibited by 16 mg/l. Cefotaxim was the only cephalosporin which showed appreciable activity against Pseudomonas.
Infection 1979
PMID:[Antibacterial activity of cefotaxim in comparison with seven cephalosporins]. 38 4

A synergistic effect was shown with gentamicin and tobramycin by means of a triple layer agar technique and enzymatic inactivation of cefamandole after only four hours' incubation. When the strain is sensitive to cefamandole and aminoglycosides, synergy is observed against all the strains studied (Staphylococcus aureus, Proteus, Klebsiella, Escherichia coli, Enterobacter, and Haemophilus influenzae). No significant difference was noted between the cefamandole-tobramycin and the cefamandole-gentamicin combinations when the microbial strains were sensitive to the three antibiotics.
Infection 1979
PMID:In vitro comparison of synergism between cefamandole and gentamicin or tobramycin by the triple layer agar method with enzymatic inactivation. 38 5

Determination of the minimal inhibitory concentration of fosfomycin in the agar dilution test on Mueller-Hinton agar showed that the addition of glucose-6-phosphate to the nutrient medium potentiates the action of fosfomycin against Escherichia coli, Klebsiella, Enterobacter, Citrobacter and Staphylococcus aureus, sometimes by as much as 256-fold. Such a potentiation of action was not detectable with Serratia marcescens, the individual Proteus species, Pseudomonas aeruginosa or enterococci. Fosfomycin is very effective against most medically important bacterial species on Mueller-Hinton agar containing 25 micrograms/ml glucose-6-phosphate. Over 90% of the cultures of E. coli, Citrobacter, Enterobacter, S. marcescens,Proteus mirabilis, Proteus vulgaris, Proteus rettgeri, P. aeruginosa, S. aureus and enterococci examined were inhibited by less than or equal to 64 micrograms/ml fosfomycin.
Infection 1979
PMID:In vitro investigations with fosfomycin on Mueller-Hinton agar with and without glucose-6-phosphate. 38 6

Plasma half life and in vitro activity were major criteria for selection of sulphonamides which are likely to give a strong synergistic action with trimethoprim in vivo. On the basis of literature data six sulphonamides, sulphadiazine, sulphachloropyridazine, sulphamethoxazole, sulphaisodimidine, sulphamerazine and sulphamethomidine appeared particularly suitable for combination with trimethoprim. An investigation of the activity in vitro of these compounds and their combinations with the latter against clinically isolated, sulphonamide-sensitive Klebsiella-Enterobacter and Escherichia coli strains showed optimal synergy at trimethoprim-sulphonamide ratios between 1:10 and 1:40, but that appreciable mutual potentiation occurred within a rather broad range of concentration ratios. Limited experiments indicated that synergy occurs less frequently and is less pronounced against sulphonamide resistant bacteria. The different sulphonamides behaved rather similarly in their combinations with trimethoprim, and in order to find the best sulphonamide, detailed comparisons of the pharmacokinetic properties of the different combinations are necessary.
Infection 1979
PMID:Development of sulphonamide-trimethoprim combinations for urinary tract infections. Part I: Comparison of the antibacterial effect of sulphonamides alone and in combination with trimethoprim. 38 12

Over a period of 11 years, commencing in December 1967, 31 cardiac transplants, 10 orthotopic and 21 heterotopic, were performed at Groote Schuur Hospital. Two patients with orthotopic transplants have a long survival, 1 for 7 1/2 and 1 for 9 1/2 years, and 1 with a heterotopic transplant for 4 years. Eighteen patients have died, and autopsy was performed from 13 to 623 days postoperatively. Rejection of the donor heart was found in 61,1% and was the cause of death in 44,4% of cases. Infection, attributable to immunosuppression, was a common finding and consisted of extensive pneumonia, usually due to Klebsiella aerogenes and Pseudomonas aeruginosa (38,8%), herpesvirus infection (38,8%), cytomegalic virus infection (37,5%), aspergillosis and other opportunistic infections. A combination of cardiac rejection and infection accounted for most of the deaths. The cardinal microscopic features of acute rejection were interstitial lymphocytic infiltration and myocytolysis, while chronic rejection was typified by obliterative myo-intimal proliferation of coronary arteries, with concurrent lipid deposition in the major coronary arteries. These lesions resembled atherosclerosis and caused graft failure due to myocardial ischaemia. Ultrastructurally, severe myofibre damage was reflected in extensive loss of cytoplasmic myofilaments. The advantages of heterotopic over orthotopic transplantation are discussed.
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PMID:The pathology of human cardiac transplantation: an assessment after 11 years' experience at Groote Schuur Hospital. 39 Jul 37

Five hundred and eighty-six strains of eight species of Enterobacteriaceae were tested for their resistance against cefaclor, cefamandole, cephalothin, ampicillin, mezocillin, tetracycline and co-trimoxazole. Cefaclor showed a low rate of resistance against Escherichia coli (1.2%), Klebsiella (2%) and Proteus mirabilis (3.1%), but a high rate of resistance against indole-positive Proteus species (60%) and Serratia (80%). Cefamandole was also effective against cefaclor and ampicillin resistant strains. Multiresistant strains were predominant especially amongst Enterobacter, Serratia and indole-positive Proteus species. Of 266 ampicillin resistant strains, 198 strains (74.4%) proved to be sensitive to cefaclor. Among the orally administered antibiotics cefaclor exhibited the best result with 12.1% resistant strains compared to 14.8% strains resistant to co-trimoxazole and 45.4% resistant to ampicillin.
Infection 1979
PMID:[Resistance of gram-negative bacteria against cefaclor and other antibiotics (author's transl)]. 39 43

The antibacterial activity of the new oral cephalosporin cefaclor was investigated using 623 freshly isolated bacterial strains. A high degree of efficacy of cefaclor was noticed against Escherichia coli, Proteus mirabilis and Klebsiella. Nearly all strains which were sensitive to ampicillin, tetracycline and co-trimoxazole were also inhibited by cefaclor. Some of the strains resistant to the three above-mentioned antibiotics were also sensitive to cefaclor as follows: all of ten P. mirabilis strains resistant to co-trimoxazole, 54% of the E. coli strains resistant to ampicillin, tetracycline and co-trimoxazole, and 18% of the Klebsiella strains resistant to tetracycline and co-trimoxazole.
Infection 1979
PMID:[The antibacterial efficacy of cefaclor against bacteria resistant to ampicillin, tetracycline and co-trimoxazole (author's transl)]. 39 44

The determination of the minimal inhibitory concentration (MIC), which is usually performed after 18 to 24 hours of incubation, results in the case of cefaclor in a false picture of the actual activity. Cefaclor is chemically so unstable that after 24 hours only 2-5% of the substance is microbiologically active. In order to compare the activity of cefaclor and cephalexin, the effect of subinhibitory concentrations of both antibiotics against Escherichia coli and Klebsiella pneumoniae strains was studied by means of turbidimetry. After eight hours the absolute inhibitory concentration of cefaclor was lower than that of cephalexin with both methods. At the same time the effect of subinhibitory concentrations of both antibiotics was equal. Automatic measurement over 20 hours showed at the end of the experiment a higher MIC, and also a higher subinhibitory range, for cefaclor than for cephalexin. In our opinion the absolute inhibitory concentration after eight hours should be the criterion used to evaluate the effectiveness of cefaclor and cephalexin, and not the MIC which is usually used. The eight-hour criterion should also be applied in clinical use.
Infection 1979
PMID:[Subinhibitory activity of cefaclor and cephalexin (author's transl)]. 39 46


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