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)

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

The acylureidopenicillins azlocillin and mezlocillin cover a broad spectrum of bacteria, including gramnegative and grampositive species as well as anaerobes. Azlocillin is especially active against P. aeruginosa. Mezlocillin has a good activity against Klebsiella. Both antibiotics inhibit Hemophilus, N. meningitidis and D. pneumoniae in low concentrations. Clinical and kinetic studies were made in more than 300 pediatric patients. Elimination-constant halflife, distribution volume and area under the curve were determined to propose dosage recommendations. Concentrations of azlocillin (44) and mezlocillin (77) were measured in the bronchial secretions. Up to hour 5 after i.v. injection a wide range of concentration values were observed. Azlocillin was found in the meconium in different concentrations after a single injection into the newborn. Mezlocillin diffused into the CSF even in uninflamed meninges, 3 h after injection the mean concentrations were 5.5 mg/l. 39 patients, 35 of them infected by P. aeruginosa, were treated by azlocillin. Urinary tract infections, wound infections and dacryocystitis were cured with one exception. Less convincing were the results in complicated bronchopulmonary diseases. The clinical efficacy of mezlocillin was similar. In a group of 59 patients there were only 3 without effect and some with improvement again in complicated pulmonary diseases. Side effects worth to be mentioned were not seen. In 2 patients the azlocillin injection caused nausea. Mezlocillin led to some minor transitory elevations of the transaminases and dyspepsia in some patients.
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PMID:[Experiences using acylureido-penicillins (azlocillin, mezlocillin) in pediatrics]. 669 39

The growth patterns of five potentially pathogenic bacteria (Staphylococcus aureus, Escherichia coli, Listeria monocytogenes, group B beta-hemolytic streptococcus, and Klebsiella pneumoniae) and a commonly encountered, nonpathogenic microorganism (S epidermidis) were compared using CSF, trypticase soy broth (TSB), and a phosphate buffer. Each grew less in CSF than in TSB. Escherichia coli was least affected with a median difference of 2 logarithms between CSF and TSB at 24 hours of growth, whereas S epidermidis was markedly inhibited, with a median difference of 6.85 logarithms. The differences among the remaining four organisms ranged from 3.86 to 5.94 logarithms, all significantly greater than that for E. coli. Similar results were obtained at 48 hours of growth. The non-support of bacterial growth by CSF may constitute a host defense mechanism. The basis of these observations may be the presence of inhibitors or the absence of nutrients required for bacterial growth in the CSF.
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PMID:Effect of CSF on bacterial growth. 677 84

Symptomatic cryptococcal pyelonephritis, meningitis, and disseminated cryptococcosis are described in a renal cadaver transplant recipient who subsequently died of Klebsiella pneumoniae sepsis. The presence of cryptococcuria and a subsequent positive CSF India ink stain led to the initial diagnosis of disseminated cryptococcosis. Therapy with 0.511 g of amphotericin B and 112.5 g of flucytosine for four weeks did not eradicate Cryptococcus from the kidney and was associated with hepatotoxicity. The importance of urinary examination and culture for C neoformans is emphasized. Cryptococcal pyelonephritis should be considered in the differential diagnosis of allograft rejection in the renal transplant patient.
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PMID:Cryptococcal pyelonephritis and disseminated cryptococcosis in a renal transplant recipient. 700 68

Cefoxitin (CFX) was evaluated for its safety and efficacy in children. Fifteen patients were treated with 73-125 mg/kg per day of CFX by intravenous administrations. The diagnosis of the patients were acute pharyngitis (4), pneumonia (2), pertussis and pneumonia (1), urinary tract infection (3); and the remaining 5 patients were esteemed to have nonbacterial infections. All the 10 patients of bacterial infections were cured after the CFX therapy. The pathogens recovered were Streptococcus pyogenes (1), Streptococcus pneumoniae (3), Haemophilus influenzae (2), Escherichia coli (2), enteropathogenic Escherichia coli (1), and Klebsiella pneumoniae (1). All the strains isolated were susceptible to CFX, but the 2 isolates of Haemophilus influenzae had relatively high MIC values (12.5 mcg/ml). Diarrhea (3 cases) and transient neutropenia (1 case) were found to be associated with the CFX therapy. However, no severe adverse reactions were encountered. Half-life of the serum level was short (24.1 minutes) and excretion into the urine was rapid. CSF concentration obtained 30 minutes after an intravenous injection of 50 mg/kg of CFX in 1 case with inflamed meninges was considerably high (8.3 mcg/ml). CFX appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections.
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PMID:[Clinical evaluation of cefoxitin in children (author's transl)]. 728 18

Pefloxacin was applied to a newborn suffering from ventriculitis caused by Klebsiella pneumoniae after failure of routine antibiotics. Treatment was successful. Blood and CSF levels were high, thus documenting good CSF penetration. In addition to this case report, a review of the literature regarding seven neonates with CNS infection treated with fluoroquinolones and from whom CSF levels were obtained, is presented. In conclusion, due to their excellent activity against gram-negative microorganisms, fluoroquinolones may be considered in the treatment of neonatal CNS infections if the pathogen is resistant to routinely used antibiotics. Only limited experience is available with fluoroquinolones in pediatric patients given their potential for cartilage toxicity in young animals.
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PMID:Ventriculitis caused by Klebsiella pneumoniae successfully treated with pefloxacin in a neonate. 792 20

Prompt, cytokine-mediated restoration of hematopoiesis is a prerequisite for survival after irradiation. Therapy with biologic response modifiers (BRMs), such as LPS, 3D monophosphoryl lipid A (MPL), and synthetic trehalose dicorynomycolate (S-TDCM) presumably accelerates hematopoietic recovery after irradiation by enhancing expression of cytokines. However, the kinetics of the cytokine gene response to BRMs and/or irradiation are poorly defined. One hour after sublethal (7.0 Gy) 60Cobalt gamma irradiation, B6D2F1/J female mice received a single i.p. injection of LPS, MPL, S-TDCM, an extract from Serratia marcescens (Sm-BRM), or Tween 80 in saline (TS). Five hours later, a quantitative reverse transcription-PCR assay demonstrated marked splenic gene expression for IL-1 beta, IL-3, IL-6, and granulocyte-CSF (G-CSF). Enhanced gene expression for TNF-alpha, macrophage-CSF (M-CSF), and stem cell factor (SCF) was not detected. Injection of any BRM further enhanced cytokine gene expression and plasma levels of CSF activity within 24 h after irradiation and hastened bone marrow recovery. Mice injected with S-TDCM or Sm-BRM sustained expression of the IL-6 gene for at least 24 h after irradiation. Sm-BRM-treated mice exhibited greater gene expression for IL-1 beta, IL-3, TNF-alpha, and G-CSF at day 1 than any other BRM. When challenged with 2 LD50/30 of Klebsiella pneumoniae 4 days after irradiation, 100% of Sm-BRM-treated mice and 70% of S-TDCM-treated mice survived, whereas < or = 30% of mice treated with LPS, MPL, or TS survived. Thus, sublethal irradiation induces transient, splenic cytokine gene expression that can be differentially amplified and prolonged by BRMs. BRMs that sustained and/or enhanced irradiation-induced expression of specific cytokine genes improved survival after experimental infection.
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PMID:Gene expression of hematoregulatory cytokines is elevated endogenously after sublethal gamma irradiation and is differentially enhanced by therapeutic administration of biologic response modifiers. 805 28

A prospective, randomized controlled trial was performed from January 1988 to August 1989 involving 66 (33 in each group) children over 3 months of age diagnosed with bacterial meningitis in the pediatric hospital of the All India Institute of Medical Sciences. Children were administered chloramphenicol alone intravenously at a dose of 100 mg.kg-1.day-1 in 4 divided doses. Those who received chloramphenicol + penicillin were given 100 mg.kg-1.day-1 of chloramphenicol and 300,000-400,000 IU.kg-1.day-1 of crystalline penicillin in 6-hourly doses intravenously. Chloramphenicol was given orally after 3-5-days' treatment, if there was an improvement in sensorium and no vomiting. The antibiotics were prescribed for 10-14 days. The cell count ranged from 525 to 16,000 per mcl, while the protein level varied from 53 to 1000 mg.dl. The CSF glucose level as a proportion of the blood glucose ranged from 0 to 69%. There were 3 deaths (4.5%): all in the chloramphenicol + penicillin group. 1 death occurred within 4 hours of admission from Waterhouse-Friderichsen syndrome; in 1 fatal case, the causative agent was a Klebsiella pneumoniae strain resistant to both chloramphenicol and penicillin. Treatment failure (deaths + change of treatment) was recorded for 3 patients (9%) in the chloramphenicol-alone group and for 4 patients (12%) in the chloramphenicol + penicillin group (P 0.05). Intravenous therapy was continued for 4.27 + or - 1.01 days in the chloramphenicol-alone group, while it was required for 10.3 + 1.99 days in the chloramphenicol + penicillin group )P 0.01). Significant thrombophlebitis occurred in 17 patients (58.6%) in the combination group but only in 1 patient (3.3%) in the chloramphenicol-alone group (P 0.001). Drug fever occurred in 3 patients in the combination group and in 1 patient in the chloramphenicol-alone group. After a week of therapy, none of the patients had a total leukocyte count 4000.
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PMID:Antibiotic therapy for bacterial meningitis in children in developing countries. 849 Sep 81

We examined the clinical features and significance of pathogenic microbes isolated from sputum and blood of patients with lung cancer during anti-cancer therapy. Pathogenic bacteria were more likely to be isolated from patients with episodes of fever than from afebrile patients. The major species of bacteria isolated from sputum were Staphylococcus aureus, including methicillin-resistant strains, and Gram-negative bacilli, which are known to be frequently involved in hospital-acquired infections. The presence of an indwelling central venous catheter for intravenous hyperalimentation was an important risk factor for the development of a febrile episode, which indicates that bacteremia was a major cause of fever. In one quarter of the blood cultures from the patients with persistent fever, various species of pathogenic microbes were recovered, one-third of which were fungi. Bacteriological examinations done before and after the introduction of granulocyte-colony stimulating factor (G-CSF) revealed that strains of Klebsiella spp. decreased and those of methicillin-resistant S. aureus increased. There was no firm evidence that G-CSF decreased the incidence of episodes of fever. However, remains G-CSF may a allow the dose intensity of anti-cancer agents to be increased, which would lead to severe leukocytopenia. However, more detailed investigation is needed to clarify the role of G-CSF against bacterial infection during anti-cancer therapy.
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PMID:[Microorganisms cultured from sputum and blood in association with episodes of fever during anti-cancer therapy in patients with lung cancer]. 854 76

From November 1991 through April 1992, 8 infants developed systemic infections due to antibiotic multiple resistant Klebsiellaa (MRK). All were premature and 6 of the 8 weighed less than 1100 g; 7 of the 8 had received previous antibiotic therapy. Five infections occurred during the first week of life. MRK were isolated from blood (8 cases), tracheal secretions (TS-6), stool (3), and CSF (1). All Klebsiella blood isolates were resistant to ampicillin, mezlocillin, and cefotaxime, 7 of 8 to ceftazidime and amikacin, and 4 of 7 to aztreonam; all isolates were sensitive to quinolones and imipenem. Four infants died. In all 4 of the isolates, they were sensitive only to quinolones and imipenem, and the empiric therapy used for suspected sepsis proved to be inappropriate. The outbreak was terminated by temporary closure of NICU in May 1992. Strict hand washing practices were reemphasized, and the previous empiric antibiotic protocol used for suspected sepsis (mezlocillin plus amikacin, and lately ceftazidime plus amikacin) was changed to imipenem and amikacin in the risk population. At closure, 5 additional infants had MRK in stools and/or tracheal suction specimens. Development of MRK organisms should dictate a rational use of empiric antibiotics for neonatal infections in NICU.
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PMID:An outbreak of antibiotic multiresistant Klebsiella at the Neonatal Intensive Care Unit, Kaplan Hospital, Rehovot, Israel, November 1991 to April 1992. 867 94


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