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)

Ceftriaxone has a very long serum half-life and enhanced in vitro activity against common pediatric pathogens. Therefore we evaluated the efficacy and safety of once daily ceftriaxone therapy in 57 children with serious infections including: meningitis (26 patients); ventriculitis (3); pyelonephritis (7); osteomyelitis (6); abscess (4); septic arthritis (3); sepsis (2); and miscellaneous infections (6). The most common isolates were Haemophilus influenzae (23), Escherichia coli (9) and Staphylococcus aureus (8). Ceftriaxone was given intravenously or intramuscularly in a dose of 50 mg/kg for non-central nervous system (CNS) infections. Patients with CNS infections received an initial dose of 100 mg/kg followed by 80 mg/kg 12 hours later and once daily thereafter. In a limited number of patients no major differences in serum ceftriaxone concentrations were found after intravenous or intramuscular injection. Of 57 patients with pathogens isolated 55 were completely cured; in one patient with Klebsiella pneumoniae ventriculitis, intraventricular gentamicin was briefly added to the regimen. Another patient with an anaerobic liver abscess recovered after metronidazole was administered. In three patients a delayed response to ceftriaxone was noted. One patient with previous recurrent infections had a second episode of H. influenzae meningitis 22 days after cessation of therapy. Clinical side effects were noted in 10 of 71 patients (including 14 treated patients who had negative cultures). Seven patients had diarrhea, one each had fever or rash and one had fever, rash and arthralgia. Laboratory side effects in 16 of 71 patients included eosinophilia (7), thrombocytosis (7), elevated liver enzymes (4) and leukopenia and neutropenia (2).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Once daily ceftriaxone for central nervous system infections and other serious pediatric infections. 372 39

In vitro susceptibilities of bacterial pathogens to beta-lactam antibiotics were determined. Bacterial pathogens examined included various isolates from the patients of respiratory tract infections at the hospitals of Kyoto-Shiga area in 1981 and 1983. Major organisms isolated from clinical specimens were Haemophilus spp., Klebsiella spp., Pseudomonas spp., S. aureus and Streptococcus spp. An increase in the isolation frequency of P. aeruginosa, a decrease in the isolation frequency of H. influenzae and no change in the isolation frequency of the other organisms were observed between the years 1981 and 1983. Data from susceptibility tests of clinical isolates confirmed that cefazolin (CEZ) and cefotiam (CTM) showed good antibacterial activity against S. aureus and cefmenoxime (CMX) was highly effective on Streptococcus spp., but that the susceptibilities of both organisms to CEZ, CTM, and cefmetazole (CMZ) in 1983 were lower than in 1981. Although CMX also showed good antibacterial activity against Klebsiella spp., there were no changes in the effectiveness of CTM, CMZ, and CEZ between the years 1981 and 1983. The in vitro antibacterial activities of CMX and cefoperazone against Haemophilus spp. were superior to those of the other beta-lactams tested, but there was a decline in the efficacy for CEZ. Although cefsulodin and piperacillin were highly active against Pseudomonas spp., declines in their effectiveness was observed between the years 1981 and 1983.
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PMID:[In vitro susceptibility of bacterial isolates from patients with respiratory tract infections to beta-lactam antibiotics]. 373 68

Susceptibilities in various types of clinical isolates to cefmetazole (CMZ) were determined by the disk method and the serial agar dilution method for MIC measurement. CMZ showed high antibacterial activity for all Gram-positive cocci except E. faecalis, and for H. influenzae, E. coli, Klebsiella sp. and Proteus sp.. CMZ was administered on 33 patients with infections, mainly biliary tract infections, in the field of internal medicine. The clinical efficacy of the drug was 86.7% for infections of the biliary tract, 80.0% for respiratory tract infections, 100% for urinary tract infections and 76.7% for all cases. There were no adverse reaction or changes in laboratory findings caused by CMZ in any of the patients.
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PMID:[Experimental and clinical studies on cefmetazole in the field of internal medicine]. 385 74

Of 155 highlands children with purulent culture-positive meningitis studied from March 1980 to September 1984, 84% were aged twelve months or less and 92% were infected with either Haemophilus influenzae, Streptococcus pneumoniae or both organisms. Other pathogens were Neisseria meningitidis (8 isolations), Streptococcus pyogenes (2 isolations) and Streptococcus agalactiae and Klebsiella species (1 of each). Among H. influenzae isolates, serotype b strains predominated (83%) and most (96%) belonged to biotype I or II. Infections due to non-b haemophili included serotype a (9 strains), serotype f (1 strain) and non-serotypable variants (3 strains). Of 67 S. pneumoniae strains 22% were resistant to benzylpenicillin, with minimal inhibitory concentrations of 0.1-1.0 micrograms/ml. The commonest serotypes were types 5 (11 isolates), type 7 (9 isolates) and types 2, 6 and 46 (6 of each). No resistance to chloramphenicol was detected in either H. influenzae or S. pneumoniae and only one of 56 strains of H. influenzae was insensitive to betalactam antibiotics. The known case fatality rate in this study was 37%. More children with pneumococcal infection died (46%) than those with haemophilus infection (30%), though the difference was not statistically significant; 79% of all deaths occurred in children aged less than twelve months. There is an urgent need for H. influenzae and S. pneumoniae vaccines that are effective in young children.
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PMID:The aetiology of purulent meningitis in highland children: a bacteriological study. 386 56

120 consecutive clinical isolates of various species of Enterobacteriaceae and 30 consecutive clinical isolates of Haemophilus influenzae (including 5 which produced beta-lactamase) were assessed for susceptibility to temocillin using a broth microdilution technique and both 'light' (10(3) CFU/ml) and 'heavy' (10(6) CFU/ml) inocula. At the lighter inoculum, 90% of the Enterobacteriaceae were inhibited by temocillin at a concentration of 4 mg/L. 90% of the H. influenzae were similarly inhibited at a concentration of 0.5 mg/L, and no differences were observed between producers and non-producers of beta-lactamase. At the heavier inoculum, a significant inoculum effect was observed: minimum inhibitory concentrations (MICs) increased up to 128-fold for H. influenzae and somewhat less than that for the Enterobacteriaceae. Klebsiella pneumoniae was least affected by inoculum, showing only a 2- to 4-fold increase in the MIC. It is concluded that temocillin is active in vitro against the species tested and warrants further clinical trial.
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PMID:In vitro activity of temocillin against gram-negative clinical isolates. 387 72

A new cephem cefminox (CMNX, MT-141) was used in the treatment of 22 cases of respiratory tract infections without taking into account background factors of patients. The dosage was 2 to 4 g/day in 2 divided doses and the treatment was continued for a period 2 to 17 days. The breakdown of the diseases treated was; pneumonia in 7 cases, secondary lung abscess (rS3)+middle lobe syndrome in 1 case, chronic bronchitis in 3 cases, bronchiectasis in 10 cases and intrapulmonary lymphangitis carcinomatosa (suspected) in 1 case. The clinical results were rated as excellent in 7 cases, good in 11 cases, fair in 1 case and unknown in 3 cases, with an excellent rate of 36.8% and excellent+good rate of 94.7%. The causative organisms were identified in 10 cases and included H. influenzae for 8 cases, Klebsiella sp. for 1 case and S. aureus for 1 case. The analysis of bacteriological study revealed disappearance of all of these organisms. However, in 3 out of 8 cases where H. influenzae was isolated and in 1 case where Klebsiella sp. was isolated the changes of organisms to P. aeruginosa were observed. As the adverse reactions, rashes developed in 1 case and moreover laboratory test results revealed elevation in transaminase in 3 cases. All of these symptoms were mild in nature and none of our cases experienced serious adverse reactions attributable to CMNX. From these results, we believe that CMNX is one of the useful drugs for the treatment of respiratory tract infections.
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PMID:[Clinical study of cefminox in respiratory tract infections]. 393 Jul 83

Klebsiella aerogenes strain W70 has an inducible pathway for the degradation of d-arabitol which is comparable to the one found in Aerobacter aerogenes strain PRL-R3. The pathway is also similar to the pathway of ribitol catabolism in that it is composed of a pentitol dehydrogenase, d-arabitol dehydrogenase (ADH), and a pentulokinase, d-xylulokinase (DXK). These two enzymes are coordinately controlled and induced in response to d-arabitol, the apparent inducer of synthesis of these enzymes. We obtained mutants which lacked a functional d-xylose pathway and were constitutive for the ribitol catabolic pathway. These mutants were able to grow on the unusual pentitol, xylitol, only if they contained the functional DXK of the d-arabitol pathway. This provided us with a specific selection technique for DXK(+) transductants. As in A. aerogenes, mutants constitutive for ADH were able to use this enzyme to convert the hexitol d-mannitol to d-fructose. With mutants blocked in the normal d-mannitol catabolic pathway, growth on d-mannitol became a test for ADH constitutivity. Growth of such mutants on xylitol, d-arabitol, and d-mannitol was utilized to classify transductants in mapping, by transductional analysis, the loci involved in d-arabitol utilization. Three-point crosses gave the order dalK-dalD-dalC, where dalK is the DXK structural gene, dalD is the ADH structural gene, and dalC is a regulatory site controlling synthesis of both enzymes.
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PMID:D-Arabitol catabolic pathway in Klebsiella aerogenes. 436 26

Klebsiella aerogenes strain W70 has separate inducible pathways for the degradation of the pentitols ribitol and d-arabitol. These pathways are closely linked genetically as determined by transduction with phage PW52. There are two regulatory sites for the ribitol catabolic pathway as defined by loci for mutations to constitutive synthesis of ribitol dehydrogenase and d-ribulokinase, rbtB and rbtC. The two control sites are separated by a site represented by the dalB22 mutation. This mutation deprives the cell of the ability to induce synthesis of d-arabitol dehydrogenase and d-xylulokinase activities. Two additional regulatory mutations for the d-arabitol pathway, dalC31 and dalC37, map to the opposite side of rbtB13 relative to dalB22. The order of the genetic sites thus far determined for this region is dalK-dalD-dalC31, dalC37-rbtB13-dalB22-rbtC14-rbtD-rbtK, where dalK and dalD represent structural genes for the kinase and dehydrogenase of the d-arabitol pathway, respectively, and rbtK and rbtD represent the corresponding genes for the ribitol pathway. The two mutations that lead to constitutive synthesis of the d-arabitol-induced enzymes, dalC31 and dalC37, have different phenotypes with regard to their response to xylitol. The growth of dalC31 is inhibited by xylitol, but the toxicity can be reduced by increasing the levels of ribitol dehydrogenase either by induction with ribitol or by selection of a ribitol dehydrogenase-constitutive mutation.
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PMID:Close genetic linkage of the determinants of the ribitol and D-arabitol catabolic pathways in Klebsiella aerogenes. 436 63

Ticarcillin was administered as initial therapy during 73 episodes of infections occurring in 69 adults with neoplastic diseases. During the first six infections, doses of 5 gm were dissolved in 200 ml of solvent and administered intravenously over a 2-h period every 6 h. Four of six infections responded to therapy. However, two of the five Pseudomonas infections failed to respond, whereas the organisms causing the infection were sensitive to ticarcillin in vitro. During the remaining 67 infections, doses of 3.5 g were similarly dissolved and administered intravenously over a 2-h period every 4 h. The overall response to ticarcillin in these 67 infections was 43%. However, 18 of 20 Pseudomonas infections, three Proteus spp. infections, and one infection caused by H. influenzae responded. Only 1 of 7 infections caused by mixed organisms and 5 of 13 infections in which the etiologic agent could not be identified responded. Ticarcillin was ineffective against the majority of Escherichia coli and Klebsiella spp. infections, organisms which were resistant to ticarcillin in vitro. The majority of patients were neutropenic, but the response rate was not dependent on the number of circulating polymorphonuclear neutrophilic leukocytes. Superinfection occurred in seven patients. Erythematous skin rash occurred in two patients, which subsided after discontinuation of the drug. No liver or renal toxicity occurred that could be attributed to ticarcillin.
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PMID:Ticarcillin therapy of infections. 479 3

Adult patients with bacterial infections of the lower respiratory tract were given either cefoperazone or cefamandole in a multicenter clinical study of the clinical and bacteriologic efficacy of cefoperazone. Clinical diagnoses included pneumonia, bronchitis, lung abscess, and bronchiectasis. Efficacy was evaluated in 119 patients given cefoperazone and 73 patients given cefamandole. Major pathogens isolated included Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Satisfactory clinical responses were noted for 96% of the patients in both treatment groups, including 14 of 17 patients given cefoperazone who were primarily infected with P. aeruginosa. Satisfactory bacteriologic responses were noted for 88% of the group given cefoperazone and 89% of the group given cefamandole. Adverse reactions related to the antibiotic occurred infrequently in each treatment group. The results of this study indicate that cefoperazone is a safe and effective antibiotic for the treatment of lower respiratory tract infections due to S. pneumoniae, H. influenzae, S. aureus, and many gram-negative bacilli, including susceptible strains of P. aeruginosa, in adult patients.
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PMID:Multicentered clinical evaluation of cefoperazone for the treatment of lower respiratory tract infections. 622 83


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