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

The incidence of bacterial infections occurring in 132 residents in a Veterans Administration hospital-based nursing home care unit (VA NHCU) was studied retrospectively over a 1 yr period. There were a total of 35 non-Foley-catheter-related bacterial infections documented during this time, occurring in 21 residents. Of these infections, 14 were pulmonary, 18 urinary and 3 of the integument. Of the 23 residents having indwelling urinary catheters, 47.8% became clinically symptomatic due to a urinary infection at least one time during the year. Thirty-six per cent of these infections were due to Pseudomonas aeruginosa and 48% were due to E. coli and Proteus mirabilis. Eighteen of 23 residents (78.3%) with Foley catheters had more than one predominant organism cultured from their urine during the year, making the practice of monthly cultures not very useful in considering treatment. If one grouped all urinary tract infections on the NHCU, the major pathogens were Pseudomonas (19.5%), Klebsiella (17.1%). Proteus (17.1%) and E. coli (14.6%). Documented pulmonary infections were predominantly due to Streptococcus pneumonia (50.0%) and Hemophilus influenza (35.7%). Our data suggest that the location of the institutional setting must be considered in caring for the elderly resident in a skilled nursing facility. Future plans to establish hospital based nursing home units must consider the benefits resulting from easy access to acute health care and educational programs against problems of hospital bacterial flora.
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PMID:Bacterial infections in a hospital-based skilled nursing facility. 711 80

The incidence of bacterial, viral, mycoplasma, and rickettsial infections has been assessed prospectively in 210 adult patients with pneumonia who presented to a district hospital over a six-year period. One hundred and thirteen infective agents were detected in 103 patients. The agent most frequently detected was Mycoplasma pneumoniae which accounted for 30 infections. A bacterial pathogen was found in 43 patients. Streptococcus pneumoniae was the most common of these (24 patients); Staphylococcus aureus (eight), Haemophilus influenzae (four), Klebsiella spp (three), and Legionella pneumophila (three) were all less common. Chlamydial or rickettsial infections (Psittacosis or Q fever) were detected in nine patients. Viral infections were found in 31 patients (22 influenza A, four influenza B, two parainfluenza, and three respiratory syncytial virus). There were 10 patients in whom more than one pathogen was identified. In 107 patients no pathogens could be identified. Seventy-five per cent of these patients had either received antibiotics before entering hospital, or were unable to produce any sputum for culture. The incidence of bacterial pneumonia has probably therefore been underestimated. Nevertheless this survey does emphasise the importance of M pneumoniae as a pathogen in patients with pneumonia presenting to hospital.
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PMID:Causes of pneumonia presenting to a district general hospital. 731 31

The pattern of distribution of bacteria, Mycoplasma pneumoniae and virus isolated from the same specimen recovered from the throat swab or the sputum of 479 patients with respiratory infections who were seen in six private clinics in Sendai City of Japan during the period from October to November in 1992 (period I) and from January to February in 1993 (period II) was documented. Of the 479 patients, 234 had acute pharyngitis, 145 had acute bronchitis, 96 had influenza, 21 had acute tonsillitis, 5 had acute pneumonia and 9 had other respiratory infections. One hundred (42.4%) strains of potential pathogen and one strain of M. pneumoniae were recovered from 236 cases in period I, and 66 (27.2%) strains of potential pathogen, one strain of M. pneumonae and 73 strains of Influenza virus (30.0%: 43 of type A Hong-Kong and 30 of type B) from 243 cases in period II. Of the 166 strains, major isolates were Staphylococcus aureus (56 strains), Streptococcus pneumoniae (12 strains), Streptococcus pyogenes (15 strains), Haemophilus influenzae (17 strains), Esherichia coli (4 strains), Klebsiella spp. (35 strains), Pseudomonas aeruginosa (4 strains) and Acinetobacter spp. (23 strains). Only one strain of S. aureus was resistant to methicillin (MIC: 50 micrograms/ml). None of S. pneumoniae was resistant to 1 microgram/ml of ampicillin. Ciprofloxacin was administered to 113 cases and roxythromycin to 220 cases by doctors in charge.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Studies on respiratory infections in primary care clinic (V). The pattern of distribution on bacteria, Mycoplasma pneumoniae and virus isolated from patients with respiratory infections, who were seen in six private clinics, and clinical efficacy of ciprofloxacin and roxithromycin]. 782 4

Over a two year period, we prospectively studied 110 adult patients with Community Acquired Pneumonia (CAP) who presented to the Black Lion Hospital, Addis Ababa, Ethiopia. Pneumococcal infection was diagnosed in 41% by the detection of pneumococcal antigen in sputum and other biologic fluids; in 72% by Gram stain of Lung Aspirate (LA) and in 67.5% by Gram stain of sputum. Blood and Lung Aspirate culture grew Streptococcus Pneumoniae in 4 cases (6%), Staphylococcus Aureus in 4 (6%), Enterobacteriacae in 3(5%), Pseudomonas, Klebsiella Pneumoniae and Strep. Viridans in one case each. Other non-bacterial causes included Mycoplasma Pneumoniae in 4 (4%) Influenza A in 4 (4%), Influenza B in 3 (3%) and Psittacosis/LGV in a 4 (4%). There was no case of Legionnaires disease. 39% had taken treatment before coming to hospital. The mortality was 11%. The study showed that antibiotic treatment during the preceding 36 hours did not affect the outcome of the Gram stain.
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PMID:The etiology of community acquired pneumonia in adults in Addis Ababa. 784 Nov 1

We prospectively studied 110 adult patients coming to Black Lion Hospital between August 1987 and July 1989 with community acquired pneumonia (CAP) for various etiologic agents and clinical and radiographic presentation. Streptococcus pneumoniae was the most common offending pathogen in 72% and 67.5% from sputum and lung aspirate (LA) Gram stain respectively, and in 41% by pneumococcal serotyping of sputum. Blood and LA culture grew Streptococcus pneumoniae in 4 (6%), Staphylococcus aureus in 4 (6%), Enterobacteriaceae in (3%), Pseudomonas, Klebsiella and Streptococcus viridans in one case each. Non-bacterial pathogens included Mycoplasma pneumoniae in 3 (3%), Influenza A in 4 (4%), Influenza B in 3 (3%) and psittacosis/LGV in 4 (4%). Fever, cough, chest pain, tachypnea and coarse crepitations/bronchial breathing were the most common presenting signs and symptoms. Thirty per cent had associated diarrhoea and vomiting initially and 9% had altered state of consciousness at admission. Six patients came in a state of shock. Thirty-nine per cent had underlying illnesses. Ninety-three per cent had either segmental or lobar consolidation. Parapneumonic effusion occurred in 14%. The mortality was 11%. Tachypnea, the presence of underlying illness, altered state of consciousness, extreme leucocytosis and the presence of bilateral and multilobar lung involvement were found to be signs of poor prognosis. Our finding is similar to those from other African countries, except that we are reporting psittacosis/LGV for the first time in Africa.
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PMID:Community acquired pneumonia in adults in Addis Abeba: etiologic agents, clinical and radiographic presentation. 803 77

Age-related changes, for example reduced elasticity and earlier airways collapse, predispose the elderly to respiratory infection. Other factors such as a lifetime of smoking, the use of hypnotics, or the development of stroke also predispose. Pneumonia becomes increasingly common with advancing age, and both morbidity and mortality increase with associated disease burden. Diagnosis of pneumonia may be more difficult in the aged because of physiological changes. However, careful physical examination with accurate, regular recording of body temperature will usually reveal the characteristic features of pneumonia, which should be confirmed by chest radiograph. In the frail elderly, the onset of impaired function, such as confusion, immobility, falling or incontinence, should raise suspicion of infection. Pneumonia is classified as community-acquired, nursing home-acquired or nosocomial, which helps in the empirical choice of antibiotics. Streptococcus pneumoniae is the most common organism in the community, then Haemophilus influenzae and Branhamella catarrhalis. Gram-negative organisms like Klebsiella and Escherichia coli are more common in nosocomial infections. Nursing home patients with pneumonia tend to be more frail than those in the community. Treatment is directed at eradication of the organism with the appropriate antibiotic, maintaining hydration and oxygenation, as well as managing impaired mobility, faecal loading, urinary incontinence and confusion. Influenza vaccination is strongly recommended for the frail elderly. Tuberculosis remains an important diagnosis in the frail elderly and should always be considered, especially in patients with respiratory infection who fail to respond to conventional therapy.
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PMID:Treatment recommendations for respiratory tract infections associated with aging. 845 84

One-hundred-and-thirty-two children with clinical and radiological evidence of bronchopneumonia/pneumonia were studied over a 1-year period for isolation/detection of bacterial and viral aetiological pathogens. Throat swab, nasopharyngeal aspirate (NPA), and lung aspirate were studied for bacterial and viral cultures. NPA was also subjected to latex agglutination test (LA) for H. influenzae and S. pneumoniae; and immunofluorescent technique (IFAT) and enzyme immunoassay (EIA) for respiratory syncytial virus (RSV). Blood culture for bacterial pathogens, and LA of blood and urine was also undertaken. Haemophilus influenzae was the commonest organism (15 per cent) isolated as the sole pathogen followed by RSV (14 per cent), Klebsiella (13 per cent) and S. pneumoniae (12 per cent). E. coli was the commonest organism (50 per cent) in infants <3 months and was closely followed by RSV (44 per cent), Klebsiella (25 per cent), and S. pneumoniae (18 per cent). Isolation rate of E. coli gradually declined with age. RSV (47 per cent) and H. influenzae (31 per cent) were the commonest organisms between 7 and 24 months. S. pneumoniae and Staph. aureus were common bacterial pathogens identified in all age groups with maximum isolation of 20 and 40 per cent, respectively, in children more than 5 years. Isolation of E. coli, Klebsiella and Staph. aureus was highest from NPA culture, while as S. pneumoniae and H. influenzae were most often detected by LA. Out of 12 cases from whom a lung aspirate was collected, bacterial pathogen could be isolated in six cases (50 per cent). Detection of RSV by EIA was higher than by culture or IFAT. Most of the organisms were resistant to chloramphenicol except for H. influenza. All the isolates of S. pneumoniae were sensitive to all the antibiotics. Bacterial pathogens were isolated/detected in 74 per cent of cases and RSV was the aetiological agent in 49 per cent of cases investigated for viral aetiology. Higher detection rate of RSV is attributed to selection of cases in winter months during a period of suspected epidemic of RSV.
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PMID:Aetiology of pneumonia in hospitalized children. 882 Jun 15

Empyemas develop following bacterial pneumonias, thoracic trauma and surgery which are still among the common diseases, causing illness and death throughout the developing world. With the advent of potent antibiotics the mortality of empyema has been drastically reduced. In this study 52 patients (29 boys and 23 girls) with thoracic empyema were evaluated retrospectively. In this series the causes of empyema were postpneumonic in 50 patients, esophageal anastomotic leak in one patient, and thoracic trauma in one patient. The diagnosis was suspected clinically and by the finding of a pleural effusion on chest roentgenogram. Definitive diagnosis was confirmed by pleural aspiration which pus was obtained. Responsible organisms included; Staphylococcus aureus, Streptococcus pneumonia, Haemophilus influenza, pseudomonas, and Klebsiella. The most common is Staphylococcus aureus. The patients were treated in various ways; 14 patients were treated with antibiotics and thoracentesis, 38 patients were treated with a closed tube thoracostomy. Eight of 38 patients had the chest tube converted to an open empyema tubes for long term management. Fourteen of 38 patients developed abcess formation. Nine of 14 patients were treated with computed tomography guided catheter placement, five patients encountered thoracotomy and decortication. In this article, appropriate treatment and result of long-term follow-up of empyema were evaluated.
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PMID:Empyema in children. 953 46

The uses of Pentanisia prunelloides in Zulu traditional medicine indicate that the plant is believed to be effective in relieving inflammation, bacterial and viral infections and also stimulating uterine contraction. Aqueous, ethanolic and ethyl acetate extracts of leaves and roots were screened for prostaglandin-synthesis inhibitors and antibacterial and antiviral activity. In the results of the anti-inflammatory assay all the extracts showed cyclooxygenase-1 inhibition. The ethanolic and ethyl acetate extracts showed greater antibacterial activity than the aqueous extracts against Gram-positive (Bacillus subtilis, Staphylococcus aureus) and Gram-negative bacteria (Escherichia coli, Klebsiella pneumoniae). Both root and leaf extracts were found to inhibit viral replication of the Influenza A virus. The ethyl acetate extract was fractionated by silica vacuum liquid chromatography and anti-inflammatory activity was found to be most pronounced in the more polar fractions. The presence of antibacterial activity was confirmed by running the fractions on a thin layer chromatography (TLC) plate and performing a bioautographic assay. The active fraction was further purified by TLC and the major antibacterial compound in the ethyl acetate root extract was identified by GC/MS as palmitic acid.
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PMID:The pharmacological screening of Pentanisia prunelloides and the isolation of the antibacterial compound palmitic acid. 1174 2

The multicomponent VP-4 vaccine from Klebsiella pneumonia, Staphyloccocus aureus, Proteus vulgaris, Escherichia coli antigens was used to prevent acute respiratory diseases (ARD) at preschoolchildren's establishments. Prevention was effected during an influenza epidemic with a drastic rise in the incidence of ARD. The VP-4 use involved 3 nasal and 6-9 oral administrations of the drug at an interval of 3-4 days. The duration of the course was 26 +/- 4 days. The preventive action of VP-4 on the incidence of ARD was followed up for 14 months after vaccination. One group comprised 89 vaccinated children, a matched group included 69 children whose age was 2 to 6 years. Immunoprophylaxis was found to promote a reduction in the number of children who had 4 ARD episodes or more during the whole follow-up. Administration of VP-4 prevented the development of repeated episodes ARD in a group of children aged 2-3 years and in frequently ill children who had 3 infections or more in the previous year. The slight reactogenicity of the drug and its long-term preventive effect allow this method of immunoprophylaxis to be recommended for frequently ill children, for those at high risk, and for those in the junior age group (under 4 years) before going to preschoolchildren's establishments.
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PMID:[Use of the multi-component VP-4 vaccine to prevent acute respiratory diseases at preschool children's establishments]. 1192 23


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