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)

3056 cases of purulent meningitis caused by seven rare microorganisms (Staphylococci, Listeria, Pseudomonas, Proteus, Klebsiella, E. coli, Salmonella) were collected from the West European and North American literature of the last 30 years. The average lethality has been calculated for the periods ranging from 1948 to 1962 and from 1963 to 1979 in order to compare the results due to the use of penicillin and older antibiotics with those accomplished with ampicillin and the aminoglycosides. After 1963 the death-rate of each type of meningitis decreased considerably (except for Salmonella meningitis): the lethality of the whole group fell from 48% to 33%, in the subgroup of gram-negative meningitis from 55% to 38%, and in the group of neonatal gram-negative meningitis from 67% to 52%. The best results were seen in Proteus meningitis where lethality decreased from 55% to 15%. In E. coli meningitis there was a reduction from 60% to 43% only. Using the chi-square test all these differences were highly significant (p less than 0.001).
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PMID:[Mortality of rare purulent meningitis, (Staphylococcus, Listeria Pseudomonas, Proteus, Klebsiella, E. coli, Salmonella). An epidemiologic study using the literature from the last 30 years]. 636 45

Three fatal cases of purulent meningitis and one fatal case of thromboembolic necrotizing meningoencephalitis occurred in chimpanzees from the Primate Center TNO, The Netherlands. In addition, two apes had clinical signs of meningitis and were successfully treated. The severity of the residual hemiparesis and dysphagia in one of these two apes was such that it was killed for humane reasons. The histopathological diagnosis was chronic active meningoencephalitis. Streptococcus pneumoniae was isolated from five apes and Klebsiella pneumoniae from one. In the majority of cases, the primary site of infection was the upper respiratory tract. After reducing the population density, initiating a vaccination program using a commercially available human polyvalent pneumococcal vaccine, and changing the cleaning procedure of the animal facilities, no other cases of meningitis or meningoencephalitis have occurred in the chimpanzee colony in the ensuing 3.5 years.
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PMID:Clinicopathologic study of six cases of meningitis and meningoencephalitis in chimpanzees (Pan troglodytes). 637 76

Cervical transverse myelopathy developed in an 8-month-old girl during the early stages of Klebsiella pneumoniae meningitis. Spinal cord dysfunction is an uncommon complication of bacterial meningitis and has not been previously described in patients younger than 1 year old. A literature review of patients 2 years old or older with similar complications showed that young children have cervical cord lesions, whereas the majority of adolescents and adults have thoracic or lumbar lesions. In four of five previously reported cases of patients between 2 and 3 years old, a cardiorespiratory arrest probably played a critical role in the pathogenesis of cord dysfunction. The patient described herein, however, did not experience any cardiorespiratory insufficiency, and cord dysfunction was probably the direct result of local vascular changes and cord ischemia. On follow-up assessment, all patients had persistent neurologic deficits, regardless of age.
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PMID:Spinal cord dysfunction complicating bacterial meningitis. 637 57

The fall in cerebrospinal fluid (CSF) glucose and CSF leukocyte response was studied in cats with experimental meningitis. Klebsiella pneumoniae or Streptococcus pneumoniae were injected intracisternally, and the latter organisms were incubated with CSF in vitro. When 10(6)-10(9)K. pneumoniae were incubated with 4 ml of CSF, the time time necessary for the glucose to decrease to less than 10 mg/dl ranged from 6.5 to 2.5 h, at a rate proportional to the size of the inoculum. When the same numbers of bacteria were injected intracisternally, the time ranged from 9 to 3 h, and the CSF leukocyte response did not exceed 1200 WBC/mm3. At this time, only minimal histological changes in brain and choroid plexus were seen. Twenty hours after intrathecal K. pneumoniae, large numbers of leukocytes (up to 4 X 10(4)/mm3) were recovered from the CSF. Regardless of the number of leukocytes, however, hypoglycorrhachia occurred when the CSF contained more than 10(7) bacteria/ml. At this interval, large numbers of leukocytes were seen invading the stroma of the choroid plexus, leptomeninges and perivascular spaces. When 10(8) S. pneumoniae were injected intracisternally, CSF glucose concentration decreased as rapidly as with K. pneumoniae. The spinal fluid leukocyte response to S. pneumoniae was, however, greater than that to K. pneumoniae. These results suggest that under the conditions of these studies, hypoglycorrhachia of bacterial meningitis is the result of metabolism of the bacteria with little contribution from the leukocytes.
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PMID:Cerebrospinal fluid glucose and leukocyte responses in experimental meningitis. 637 41

Chloramphenicol combined with cefotaxime, moxalactam, cefoperazone, aztreonam, or imipenem was tested in vitro against clinical isolates of Klebsiella pneumoniae. By time-kill cultures (killing curves), chloramphenicol interfered with activity of all five beta-lactams. When chloramphenicol was added before the beta-lactams, the action of cefotaxime, moxalactam, or cefoperazone against all isolates was antagonized at all times tested. The action of aztreonam was antagonized against four of six isolates. With imipenem, antagonism occurred against half of the isolates at some time during 24 h when chloramphenicol was added simultaneously, provided that a sufficient inoculum of K. pneumoniae was employed. Generally, less antagonism resulted when chloramphenicol was added after the cephalosporins. Interference of bactericidal activity of three new cephalosporins by chloramphenicol has potential clinical relevance to the therapy of gram-negative bacillary meningitis. The lesser antagonism of aztreonam and imipenem by chloramphenicol is of uncertain clinical relevance but indicates that this in vitro phenomenon may apply to a wide range of beta-lactam antibiotics.
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PMID:Antagonism by chloramphenicol of broad-spectrum beta-lactam antibiotics against Klebsiella pneumoniae. 637 51

Antibiotic sensitivity of 38 strains of enteric bacteria, such as Serratia marcescens Klebsiella pneumoniae and others and Ps. aeruginosa isolated during an outbreak of meningitis in a premature infant resuscitation department was studied. It was shown that all the isolates were multiple resistant, most frequently to 7 antibiotics. All the resistance markers were transferred on conjugation, segregation of some markers being observed. Investigation of the plasmid composition of the clinical strains and transconjugants of E. coli revaled the presence of 2 plasmids with the molecular weights of 40 and 60 Md or one of them. The restriction analysis demonstrated that the plasmids with the same molecular weights isolated from different strains were identical. It was suggested that such plasmids originated from the same source and were distributed by conjugation. The possible part of R plasmids in epidemiological analysis of hospital infections is discussed: the possible part as an additional marker in determination of the infection source and the possible part through its ability to change the host cell phenotype, including the phage and bacteriocin types.
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PMID:[Use of genetic and molecular characteristics of R plasmids as an epidemiological marker in an outbreak of hospital infection]. 642 42

The results of a survey of the major pathological conditions encountered in an established breeding colony of common cotton-eared marmosets (Callithrix jacchus) is presented. 265 home-bred and 70 imported wild-caught marmosets were examined. A Heinz body haemolytic anaemia and skeletal muscle myopathy were the most common pathological findings and were considered to be a result of a complex nutritional deficiency involving vitamin E, selenium and protein. Inflammatory disease of the intestinal tract was also a major feature. Chronic colitis was particularly common in older marmosets. Pneumonia, otitis media, meningitis and brain abscesses were important pathological findings in home-bred marmosets and were commonly associated with bacterial infections, particularly Bordetella bronchiseptica and Klebsiella species. Trichospirura leptostoma within pancreatic ducts of wild-caught marmosets was the only significant parasitic disease encountered. Mycotic infections of the upper alimentary tract with Candida species were occasional findings in debilitated animals. No pathological features suggesting viral diseases were found.
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PMID:A survey of the pathology of marmosets (Callithrix jacchus) derived from a marmoset breeding unit. 643 Nov 78

Six third-generation cephalosporins--cefotaxime, moxalactam, cefoperazone, ceftizoxime, ceftriaxone, and cefmenoxime--are reviewed; covered are chemistry and structure-activity relationships, mechanism of action, spectra of activity, pharmacokinetics, clinical utility, adverse effects, and cost effectiveness. The third-generation cephalosporins have a similar mechanism of action to that of other beta-lactam antibiotics. None of the agents is particularly active against certain gram-positive bacteria, including methicillin-resistant Staphylococcus aureus; the drugs are effective against gonococci, Haemophilus influenzae, and Neisseria meningitidis. Several common gram-negative pathogens are susceptible to the third-generation cephalosporins, including Escherichia coli, Klebsiella, Citrobacter diversus, Proteus, and Morganella. About 50% of Pseudomonas aeruginosa isolates are susceptible. Only moxalactam has good activity against Bacteriodes fragilis. The pharmacokinetic profiles of the six agents reveal some important differences. The half-life of ceftriaxone allows once-daily dosing in many patients; the half-lives of ceftizoxime and cefoperazone permit dosing every 8-12 hours. Cefoperazone and ceftriaxone are highly protein bound, but the clinical relevance of this is unknown. Generally, the agents penetrate most body tissues and fluids well. Moxalactam and cefotaxime and possibly ceftriaxone effectively penetrate into the cerebrospinal fluid well. The third-generation cephalosporins have become the accepted drugs of choice for the treatment of adult gram-negative bacillary meningitis; as more experience is gained, they are likely to become the drugs of first choice for neonatal (with ampicillin) and childhood (except for moxalactam) meningitis. Serious infections of Enterobacteriaceae can be treated with these agents, thereby avoiding use of the aminoglycosides. Moxalactam is comparable with combination therapy in treating intra-abdominal infections. Adverse effects associated with use of the third-generation cephalosporins are generally similar to those that occur with other beta-lactam antibiotics with the exception of coagulopathies and the disulfiram reaction seen with moxalactam and cefoperazone. Despite the relatively high cost of the third-generation cephalosporins, they are often cost effective because of their reduced dosing frequencies, broad spectra of activity, and effectiveness in serious infections for which more toxic antibiotics have been required in the past.
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PMID:Third-generation cephalosporins: a critical evaluation. 643 20

Moxalactam (LY127935) is a 1-oxa-beta-lactam which was active in vitro against the majority of 128 strains of gram-negative enteric bacilli isolated from meningitis in neonates. Pharmacokinetics and bacteriological efficacy of LY127935 were studied in a lapin meningitis model. The average penetration of this investigational oxa-cephalosporin into cerebrospinal fluid of infected rabbits was 23% compared with 25% for netilmicin and 11% for ampicillin. The cerebrospinal fluid concentrations of LY127935 produced median bactericidal titers of 1:64 to 1:128 against five coliform organisms (two Escherichia coli K1 strains, Klebsiella pneumoniae, Salmonella saint-paul, and Citrobacter diversus) used in these experiments compared with median titers of 1:2 to 1:8 for netilmicin and 1:2 to 1:4 for ampicillin. LY127935 was statistically significantly more effective than netilmicin or ampicillin in reducing cerebrospinal fluid bacterial colony counts and in sterilizing cerebrospinal fluid of experimentally infected rabbits. These results suggest that LY127935 has theoretical advantages over netilmicin and ampicillin for therapy of gram-negative bacillary meningitis.
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PMID:Pharmacokinetics and bacteriological efficacy of moxalactam (LY127935), netilmicin, and ampicillin in experimental gram-negative enteric bacillary meningitis. 644 76

Experimental and clinical studies were conducted on a new synthetic cephalosporin antibiotic cefoperazone (CPZ). Antibacterial activity of CPZ against S. aureus, E. coli, Klebsiella sp., Proteus sp. and P. aeruginosa was compared with that of cefazolin (CEZ), cephalothin (CET), gentamicin (GM) and cefotaxime (CTX). Ordinary cephalosporin C antibiotics, CEZ and CET showed an excellent antibacterial activity against S. aureus, while CPZ showed a low MIC of 3.13 mcg/ml even 10(6)/ml inoculation. CPZ showed an antibacterial activity against Gram-negative bacteria such as E. coli, Klebsiella sp. and Proteus sp. Its activity was very similar to CTX and superior to CET and CEZ. CPZ showed the greatest activity against P. aeruginosa, i.e., 2 tubes greater than CTX. By intravenous injection, the peak of blood concentration of CPZ treated with 25 mg/kg was 42 mcg/ml (4 cases); in the case of 1 hr. drip infusion, the peak of blood concentration with same dose was 41.25 mcg/ml at the end of drip infusion. By both routes of administration, the half lives were noted to be as long as 101.4 and 84.8 minutes, respectively. The recovery rates (3 cases) in the urine were quite different: 60.8%, 22.6% and 76.8% at 6 hours after administration. The spinal fluid concentration of CPZ was about 5 mcg/ml in the acute stage during the first 5 days and the CSF/serum ratio was above 10%. Clinical evaluation of CPZ was performed in a total of 31 cases; 13 cases of respiratory tract infection, 8 cases of urinary tract infection, 2 cases of staphylococcal scalded skin syndrome, 2 cases of enterocolitis, 2 cases of septicemia and 4 cases of purulent meningitis. Of 31 cases, CPZ proved to be markedly effective or effective in 28 cases, an efficacy rate of 90.3%. CPZ was found to e ineffective in 1 case of pyothorax and 2 cases of septicemia. Of the two cases of septicemia, one who had been also suffering from ecthyma gangrenosum suspected to be caused by P. aeruginosa and died within 10 hours of admission. Therefore, it may be better to consider this case an unknown case. Side effects observed during the therapy were 1 case of rash and 1 case of a rise of BUN.
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PMID:[Experimental and clinical studies on cefoperazone (author's transl)]. 645 29


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