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)

Cefepime and cefpirome are new beta-lactamase resistant parenteral cephalosporin derivatives whose spectrum of activity makes them suitable for use in the treatment of severe infections such as bacterial meningitis. However, the published information on the penetration of these new agents into human CSF and on their use in the treatment of bacterial meningitis are really scarce. Experimental studies have shown that cefepime and cefpirome penetrated remarkably well into the CSF of animals infected with Streptococcus pneumoniae, Streptococcus agalactiae, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae type b or Pseudomonas aeruginosa. The mean changes in bacterial colony count in CSF after cefpirome or cefepime administration express the antibacterial activity of these drugs. Studies in patients show that cefepime and cefpirome crossed the blood-brain barrier and reached concentrations in the CSF that are bactericidal against most potential pathogens. Higher levels are likely to be achieved with multiple dosing and in the presence of inflamed meninges. No study has been performed to investigate the efficacy of cefpirome in the treatment of bacterial meningitis. Cefepime was as effective and safe as cefotaxime for treatment of patients with bacterial meningitis as shown in the only clinical trial.
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PMID:Diffusion of 3-quaternary ammonium cephem antibiotics into cerebrospinal fluid of patients with bacterial meningitis. 873 50

The influence of polar glycopeptidolipids of Mycobacterium chelonae (pGPL-Mc) treatment on the reversal of irradiation-induced leukopenia (granulocytopenia, monocytopenia) and thrombocytopenia and its ability to protect mice against lethal infections were investigated in this study. The administration of pGPL-Mc to irradiated mice significantly accelerated the recovery of leukocyte and thrombocyte numbers in the peripheral blood. Granulocytes and monocytes were the principal cells of the leukocyte population that responded to the potent stimulus of this product. The reversal of granulocytopenia and monocytopenia in treated mice was achieved on day 14 and reached a peak value on day 20. Responses in mice receiving 100 mg/kg of pGPL-Mc was about 40-fold compared to controls and about 4-fold compared to the rhG-CSF-treated group. Normal levels of thrombocytes were reached by day 17 in mice treated with 100 mg/kg and by day 20 in those receiving 25 mg/kg of pGPL-Mc. The administration of pGPL-Mc to mice with irradiation-induced granulocytopenia was characterized by highly significant protection of these animals against lethal Klebsiella pneumoniae or Escherichia coli infections. Therefore, pGPL-Mc appears to possess a considerable potential for improvement of the outcome of radiotherapy and may contribute to the successful avoidance of irradiation-induced toxicities.
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PMID:Effects of polar glycopeptidolipids of Mycobacterium chelonae (pGPL-Mc) on haematopoietic regeneration and resistance to infection of sublethally irradiated mice. 873 27

The value of prophylactic antibiotics for patients with ventricular catheter for monitoring and CSF drainage is uncertain. 228 patients were randomised to receive perioperative antibiotics only (Unasyn, Group I) or prolonged antibiotics for the presence of the ventricular catheter (Unasyn and Aztreonam, Group II). The incidence of intracranial and extracranial infection was documented prospectively. Group II patients had a significantly reduced incidence of CSF infection [3/115 (3%) vs 12/113 (11%), p = 0.01] and extracranial infections [23/115 (20%) vs 48/113 (42%), p = 0.002]. CSF pathogens in Group II patients were MRSA and Candida, whereas in Group I, Staphylococci, E coli and Klebsiella. Although prolonged antibiotic prophylaxis significantly reduced the incidence of serious CSF infection as well as extracranial infections, this policy did select resistant or opportunistic pathogens such as Candida and MRSA.
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PMID:CSF antibiotic prophylaxis for neurosurgical patients with ventriculostomy: a randomised study. 977 69

In a hospital population-based retrospective study of neonatal meningitis, 55 cases were identified over a period of 10 years. The prevalences of meningitis for preterm and term newborns were 3.66 and 0.97 per 1000, respectively (22/6465 vs 33/36638; p < 0.01). The overall prevalence was 1.37 per 1000 live births. Twenty-two (40%) babies with meningitis died, more preterm than term (13/22 vs 9/33; p < 0.05). Known maternal risk factors for neonatal meningitis were observed in 15 (27%) babies. The risk factors were more common in preterm than in term newborns (10/22 vs 5/33; p < 0.05). The common causative organisms were Klebsiella pneumoniae, Escherichia coli and Enterobacter spp. which together accounted for 67% of all CSF isolates. These organisms were evenly distributed between early- and late-onset meningitis, and among term and preterm newborns. Seven of 33 (21%) of the surviving newborns developed neurological complications. The short-term sequelae were hydrocephalus, spastic paresis and seizures.
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PMID:Neonatal meningitis in Addis Ababa: a 10-year review. 992 82

Irradiation increases susceptibility to bacterial infection. Exogenous proinflammatory cytokines can alter the response of mice to gamma radiation, but the role of endogenous inflammatory cytokines after bacterial infection in irradiated animals is not known. Gene expression of hematopoietic (GM-CSF) and proinflammatory (IL-1 beta, IL-6 and TNF-alpha) cytokines were examined in spleens of B6D2F1/J female mice after irradiation alone (1.0- and 7.0-Gy), and after irradiation followed by Klebsiella pneumoniae s.c. challenge 4 days postirradiation by using the reverse transcription-polymerase chain reaction (RT-PCR) and Southern blot hybridization. At 4, 8, and 24 h after bacterial challenge in 7.0-Gy-irradiated mice, GM-CSF mRNA increased (p < 0.05). TNF-alpha mRNA in irradiated mice were slightly decreased, whereas after bacterial challenge, TNF-alpha mRNA elevated at 30 h in 7.0-Gy-irradiated mice; at 4, and 8 h in 1.0-Gy-irradiated mice, and at 1 h in sham-irradiated mice (p < 0.05). IL-6 mRNA displayed a biphasic response in 7.0-Gy-irradiated mice, and, after bacterial challenge, in both irradiated mice (1.0- and 7.0-Gy) and sham-irradiated mice. IL-1 beta mRNA remained at or below normal for 8 h and increased at 24 h after bacterial challenge on day 4 in 7.0-Gy-irradiated mice. These results indicate that sublethal gamma radiation alters the patterns of the hematopoietic and proinflammatory cytokine responses to bacterial challenge in vivo. Consequently, treatment protocols may need to take into account changes in cytokine gene responses to resolve infection after irradiation.
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PMID:Ionizing radiation and bacterial challenge alter splenic cytokine gene expression. 1121 Aug 28

Acute bacterial meningitis is one of the most important causes of morbidity and mortality in developing countries. Though a wide range of antibiotics is available for therapy, judicious and rational use of antimicrobial agents needs to be ascertained. The choice of antimicrobial agents depends mainly on the age of the patient and its CSF penetrability. Neonatal meningitis is commonly caused by Gram Negative organisms such E. coli, Klebsiella and Pseudomans;Group B streptococciand Listeria, though other organisms like Staphylococcus sp. also contribute. The neonatal meningitis is best treated with a combination of amplicillin and a third generation cephalosporin given for 14-21 days. Post-neonatal meningitis usually occurs due to S. pneumoniae, N. meningitidis and H. influenzae and is best treated with third generation cephalosporins used with or without crystalline penicillin or ampicillin depending on the clinical situation. The therapy should be modified, if necessary, on availability of culture sensitivity report. The use of dexamethasone in meningitis due to the organisms other than H. influenzae still remains controversial.
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PMID:Rational antibiotics therapy in bacterial meningitis. 1198 Apr 57

We described a case of discitis and meningitis following spinal anaesthesia for transurethral resection of the prostate. The patient received antibiotics for a month before surgery, because of Klebsiella prostatitis. Spinal anaesthesia was performed in L3-L4 interspace by using 22G Quincke needle. Bacteriaemia occurred during the first postoperative hours. Ten days after spinal anaesthesia, patient suffered from lumbar pain, exacerbated by vertebral percussion, and motor weakness within lower limb, which was marked on right side. MRI examination showed L3-L4 discitis with psoas abcess in regard, and epiduritis marked around L3 right spinal root. CSF examination confirmed meningitis but no bacteria was found. Antibiotics were administered over a 6 weeks period, and then patient discharged from hospital without neurological sequellae. Infectious discitis related to disk puncture during spinal anaesthesia and postoperative bacteriaemia was likely in our patient.
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PMID:[Discitis after spinal anesthesia for transurethral resection of the prostate]. 1253 22

We previously demonstrated that exposure to febrile-range hyperthermia (FRH) accelerates pathogen clearance and increases survival in murine experimental Klebsiella pneumoniae peritonitis. However, FRH accelerates lethal lung injury in a mouse model of pulmonary oxygen toxicity, suggesting that the lung may be particularly susceptible to injurious effects of FRH. In the present study, we tested the hypothesis that, in contrast with the salutary effect of FRH in Gram-negative peritonitis, FRH would be detrimental in multilobar Gram-negative pneumonia. Using a conscious, temperature-clamped mouse model and intratracheal inoculation with K. pneumoniae Caroli strain, we showed that FRH tended to reduce survival despite reducing the 3 day-postinoculation pulmonary pathogen burden by 400-fold. We showed that antibiotic treatment rescued the euthermic mice, but did not reduce lethality in the FRH mice. Using an intratracheal bacterial endotoxin LPS challenge model, we found that the reduced survival in FRH-treated mice was accompanied by increased pulmonary vascular endothelial injury, enhanced pulmonary accumulation of neutrophils, increased levels of IL-1beta, MIP-2/CXCL213, GM-CSF, and KC/CXCL1 in the bronchoalveolar lavage fluid, and bronchiolar epithelial necrosis. These results suggest that FRH enhances innate host defense against infection, in part, by augmenting polymorphonuclear cell delivery to the site of infection. The ultimate effect of FRH is determined by the balance between accelerated pathogen clearance and collateral tissue injury, which is determined, in part, by the site of infection.
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PMID:Febrile-range hyperthermia augments neutrophil accumulation and enhances lung injury in experimental gram-negative bacterial pneumonia. 1574 6

Meningitis is a serious problem in newborn infants and has high mortality and frequent neurological sequelae. In neonates, signs and symptoms of serious infections are often obscure and clinical examination cannot distinguish septicemic babies with or without meningitis. Therefore, lumbar puncture is often not done in time and thus diagnosis of meningitis is missed. This study aimed to discover the prevalence of meningitis among these cases based on laboratory investigation. We prospectively enrolled the blood culture positive septicaemia cases which were not labeled as cases of meningitis during routine clinical evaluation. Out of 30 septicemic cases, eight (26.7%) had abnormal CSF cytology and biochemistry suggestive of meningitis. Among these eight cases, four had positive CSF culture; [Klebsiella pneumoniae (n = 3) and Pseudomonas aeruginosa (n = 1)], which were similar to the blood isolate of the respective patient. The clinical manifestations were similar in both septicemia and meningitis cases. Mortality was high among the meningitis cases compared with those having septicemia alone (37.5% vs. 13.3%), indicating the need for early diagnosis of this disease. Our data confirmed that it is important to do a lumbar puncture, along with blood culture, for all suspected septicemia cases.
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PMID:Septicemic neonates without lumbar puncture: what are we missing? 1596 72

We have previously demonstrated that mice exposed to sublethal hyperoxia (an atmosphere of >95% oxygen for 4 days, followed by return to room air) have significantly impaired pulmonary innate immune response. Alveolar macrophages (AM) from hyperoxia-exposed mice exhibit significantly diminished antimicrobial activity and markedly reduced production of inflammatory cytokines in response to stimulation with LPS compared with AM from control mice in normoxia. As a consequence of these defects, mice exposed to sublethal hyperoxia are more susceptible to lethal pneumonia with Klebsiella pneumoniae than control mice. Granulocyte/macrophage colony-stimulating factor (GM-CSF) is a growth factor produced by normal pulmonary alveolar epithelial cells that is critically involved in maintenance of normal AM function. We now report that sublethal hyperoxia in vivo leads to greatly reduced alveolar epithelial cell GM-CSF expression. Systemic treatment of mice with recombinant murine GM-CSF during hyperoxia exposure preserved AM function, as indicated by cell surface Toll-like receptor 4 expression and by inflammatory cytokine secretion following stimulation with LPS ex vivo. Treatment of hyperoxic mice with GM-CSF significantly reduced lung bacterial burden following intratracheal inoculation with K. pneumoniae, returning lung bacterial colony-forming units to the level of normoxic controls. These data point to a critical role for continuous GM-CSF activity in the lung in maintenance of normal AM function and demonstrate that lung injury due to hyperoxic stress results in significant impairment in pulmonary innate immunity through suppression of alveolar epithelial cell GM-CSF expression.
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PMID:GM-CSF and the impaired pulmonary innate immune response following hyperoxic stress. 1689 99


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