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

Liver biopsies and serum samples were collected after intravenous application of 2 g cephradin (n = 13) or 2 g cephacetril (n = 11) during surgery. There was no difference in the serum levels of cephradin and cephacetril. 30 min. after i.v. application of cephradin the liver tissue concentration was 72.62 mcg/g. 30 min. after i.v. cephacetril the liver tissue concentration was 5.83 mcg/g. The quotient of liver tissue concentration to serum concentration for cephradin was between 0.36 and 0.83, and for cephacetril between 0.02 and 0.16. The excretion of cephradin and cephacetril in human bile was studied by collecting bile samples from the common bile duct via T-tube drainage (n = 17). Cholecystomized patients were given 2 g of antibiotics intravenously. Serum levels of cephradin were 263 mcg/ml 5 min after application, and 22 mcg/ml after 240 min. Serum levels of cephradin were 263 mcg/ml 5 min after application, and 22 mcg/ml after 240 min. Serum levels of cephacetril were 193 mcg/ml 5 min after application, and 27 mcg/ml after 240 min. The highest levels of cephradin in the bile were found 75 min after injection at a concentration of 86.4 mcg/ml; the highest level for cephacetril was 21.8 mcg/ml at 15 min. In patients with hyperbilirubinaemia cephradin reached a mean maximum concentration of 29.6 mcg/ml in bile samples, in comparison to 117.4 mcg/ml in normal patients, while no difference was seen with cephacetril. After intravenous administration of 2 g cephradin biliary concentration are achieved which may be sufficiently high to be effective not only against the very sensitive gram-positive organisms, but also against most strains of E. coli, Klebsiella and indol-negative Proteus. Cephradin is effective in the treatment of cholangitis and intrahepatic abscesses, as was observed in 18 patients. A free bile-flow is essential.
Infection 1976
PMID:[The liver concentration of cephradin and cephacetril and their elimination in the bile]. 78 53

Clindamycin and gentamicin were used in combination to treat 107 patients empirically for suspected aerobic-anaerobic sepsis. All patients were seriously ill and required initiation of treatment before results of cultures could be obtained. Infections included intraabdominal sepsis, hospital-acquired aspiration pneumonia, and soft tissue infections. Exudate cultured from 65 patients showed that the prediction of a mixed aerobic-anaerobic flora was correct in 46 patients (71%). Isolates from exudate included Escherichia coli, Bacteroides fragilis, clostridia, peptostreptococci, Proteus species, Klebsiella species, and Staphylococcus aureus. In 29 patients with bacteremia, the most frequent blood culture isolate was B. fragilis. Analysis of response to treatment showed that 92 patients were cured, five could not be evaluated adequately, and 10 failed to respond to therapy. Therapeutic failure primarily resulted from overwhelming sepsis, despite susceptibility of the pathogens to prescribed antibiotics.
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PMID:Empiric treatment with clindamycin and gentamicin of suspected sepsis due to anaerobic and aerobic bacteria. 85 96

The prevalence of obligate anaerobes was studied prospectively in 60 patients with severe sepsis of intra-abdominal, soft tissue, female genital or oropulmonary origin. In addition, the efficacy of clindamycin (for anaerobes) plus gentamicin (for aerobic bacteria, especially coliforms) as initial empiric therapy in these patients was evaluated. Among 54 patients with cultural proof of infection, anaerobic pathogens were recovered from 52%. Nineteen patients had bacteremia; Bacteroides fragilis and Klebsiella pneumoniae were the most prevalent pathogens, being isolated in five patients each. Infection was eradicated in 56 of the 60 patients (93%). Mortality related to sepsis was 7% in the entire group, 16% in patients with bacteremia and 2% in patients without bacteremia. Eighty-five percent of aerobic isolates tested were susceptible in vitro to either gentamicin or clindamycin; 97% of anaerobic isolates were inhibited by 5 mug/ml of clindamycin.
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PMID:Clindamycin plus gentamicin as expectant therapy for presumed mixed infections. 100 Apr 57

Tissue concentrations of cefazolin were measured in 18 patients undergoing urological operations. Specimens of skeletal muscle and blood were taken simultaneously at predetermined intervals. The concentrations in serum and homogenized skeletal muscle were determined by means of the agar well diffusion method. A comparison of standard curves obtained with phosphate buffer solution and the supernatant of muscle homogenate revealed no substantial binding of cefazolin to the supernatant of muscle homogenate. Because of methodological difficulties in determining the different compartments of a tissue specimen concentrations in tissue were not corrected. Within two hours after a short infusion (25 min.) of 2 g of Cefazolin in muscle tissue a peak concentration of 20 mug/g was reached. A tissue level above 10 mug/g maintained for three hours. This concentration is high enough to inhibit nearly all strains of E. coli, Klebsiella, Salmonella, Shigella and a large part of Proteus mirabilis, whereas nearly all gram-positive bacteria are inhibited at a lower concentration.
Infection 1976
PMID:Concentrations of cefazolin in human skeletal muscle. 101 77

133 patients in an intensive care unit, who prior to admission had not shown any signs of bacterial infection and had not received antibiotic treatment, were assigned to two groups at random. One group received antibiotic prophylaxis with penicillins or cephalosporins (+Pat.), the other group did not receive antibiotics (-Pat.). Staph. aureus was the most frequent facultative pathogen in tracheal secretions and in the environment of "-Pat.". This organism was significantly more frequent in "-Pat." than in "+Pat." in both the tracheal secretions and the environment. Klebsiella spp. outnumbered all other species in "+Pat.". They were significantly more frequent in tracheal secretions of "+Pat." than of "-Pat.". In the first week of hospitalisation marked changes were seen in bacterial flora of tracheal secretions of "+Pat.". Colonization with grammnegative bacteria rose to nearly 100%, the frequency of Staph. aureus diminishing at the same time. Monitoring by contact cultures revealed that gramnegative rods were significantly more numerous in the environment of "+Pat." than of "-Pat.". Matching bacterial strains cultured from tracheal secretions and from the environment of the patients proved that "+Pat. spread significantly higher numbers of their gramnegative bacteria into the environment. The same is true of "-Pat." for Staph. aureus. Intubation had no noticeable effect on the degree of contamination of the surroundings with Staph. aureus. Gramnegative rods were significantly more frequent in tracheal secretions of patients with intubation than in patients without. The same trend was observed for environmental contamination. As the clinical results of this study have shown, antibiotic prophylaxis does not protect patients from infections to the extent expected. Patients, and particularly intubated patients, receiving antibiotic treatment have to be considered as sources of highly resistant gramnegative organisms.
Infection 1976
PMID:[The patient as a source of bacteria in intensive care units: influence of antibiotics and tracheal intubation (author's transl)]. 101 79

The causes of death were investigated in 315 adults with acute leukemia during a 7-year period (1966-1972). Infection alone or in combination was the most common cause (75%), followed by hemorrhage (24%) and organ failure (9%). Most of the infections were either systemic or pulmonary. Seventy-five percent of the systemic infections and 72% of the pneumonias were caused by bacteria. Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa were the most frequent organisms isolated. After 1968, there was a sharp decrease in the number of fatal infections caused by Pseudomonas aeruginosa and a marked increase in the incidence of fatal infections caused by Klebsiella spp. and E. coli. Infections caused by Gram-positive cocci occurred in only 3% of the cases. The incidence of systemic fungal infections was 13%; most common fungi causing infection were Candida spp. and Aspergillus spp. Eighty-five percent of 159 patients with a terminal neutrophil count of less than 100/mm3 died of infection, compared to 48% of 62 patients with a terminal neutrophil count of greater than 1000/mm3. Hemorrhage was mostly due to thrombocytopenia (61%) and disseminated intravascular coagulation (12%). This study indicates that infection continues to be the most common cause of death in patients with acute leukemia. Although advances in antibiotic therapy have changed the distribution of causative organisms, ultimate control of infection requires further improvements in supportive care measures which rectify impairments in the patients' host defense mechanisms.
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PMID:Causes of death in adults with acute leukemia. 106 11

All cases of unusual types of gram-negative bacillary meningitis in a university hospital over a five year period were retrospectively analyzed. These patients comprised 4.2 per cent of cases of bacterial meningitis among all patients, 69 per cent of neurosurgical cases and 42 per cent of neonatal cases. The over-all mortality was 40.3 per cent. The two most common bacterial isolates were Escherichia coli in patients younger than one year and Klebsiella species in patients above that age. Infection may be acquired at birth or at the time of surgery, or may be secondary to spread of infection from other body sites. Gram-negative bacillary meningitis is a nosocomial infection and this diagnosis should be suspected in patients in whom central nervous system infection develops in the hospital.
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PMID:Gram-negative bacillary meningitis. 110 20

Fungal, bacterial and malarial infections, as well as malnutrition caused heavy mortality in a group of wild-trapped canvasbacks (Aythya valisineria) held in 10 X 3 X 2 m open-water pens. Deaths occurred between 21 and 158 days after confinement and were associated with infections of Aspergillus fumigatus, Escherichia coli, Staphylococcus sp., Streptococcus sp., Klebsiella sp., Enterobacter sp., and Plasmodium sp. Infection and mortality was believed to result from reduced resistance associated with confinement. Fourteen canvasbacks released onto large ponds survived throughout the period during which the penned birds died.
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PMID:Infection and mortality in captive wild-trapped canvasback ducks. 125 9

Five hundred urinary pathogens, collected from patients of general practitioners and hospital in-patients, were identified and tested for susceptibility to fosfomycin, ampicillin, cephalexin, nalidixic acid, nitrofurantoin, trimethoprim and sulfamethoxazole. Overall, 83% of the isolates were sensitive to fosfomycin, comprising 89% of the out-patient strains and 77% of the in-patient isolates. This degree of sensitivity was similar to that of cephalexin, nalidixic acid and trimethoprim, but higher than that observed with ampicillin, nitrofurantoin and sulfamethoxazole. Fosfomycin generally showed a broad spectrum of activity, but was less active than some other compounds against Klebsiella spp. and streptococci. More than 70% of strains resistant to ampicillin, sulfamethoxazole or trimethoprim were sensitive to fosfomycin indicating that cross resistance is not presently a problem.
Infection 1992
PMID:The comparative activity of fosfomycin trometamol against organisms isolated from infected urines. 129 22

MICs of fosfomycin trometamol were estimated for 40 strains of bacteria (20 gram-positive cocci, 20 gram-negative bacilli) by the agar incorporation method (Iso-Sensitest agar) in the presence of the potentiating agent, glucose-6-phosphate (25 mg/l). Titrations were carried out in duplicate under aerobic and anaerobic conditions. For 22 strains (12 gram-negative bacilli), a fourfold or greater reduction in MIC was observed in tests conducted under anaerobic conditions. The effect was particularly marked with Klebsiella spp., four of five strains of which showed a 16- to 32-fold reduction in MIC in anaerobic conditions. To investigate the reasons for the effect of anaerobiosis, selected strains were examined in an opacity monitoring device in which cultures can be grown in aerobic or anaerobic atmosphere. Surprisingly, the effect of anaerobiosis observed by continuous turbidimetric monitoring was much less than that seen in agar incorporation MIC titrations: under anaerobic conditions, there was little or no reduction in the concentration of fosfomycin trometamol required to cause a lytic effect on dense bacterial cultures, and a small, but variable effect on the emergence of resistant variants.
Infection 1992
PMID:The influence of anaerobiosis on the activity of fosfomycin trometamol. 129 23


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