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Query: UNIPROT:O75191 (H. influenzae)
 4,961 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Haemophilus influenzae is an aerobic pleomorphic gram-negative coccobacillus that requires both X and V factors for growth. It grows poorly, if at all, on ordinary blood agar unless streaked with Staph. aureus. It grows well on chocolate agar. Because this medium is often not used in culturing specimens from adults and because the organism may be overgrown by other bacteria, the frequency of H. influenzae infections has undoubtedly been seriously underestimated. This is aggravated by the failure of many physicians to obtain blood cultures in suspected bacterial infections and the failure of many laboratories to subculture them routinely onto chocolate agar. H. influenzae, along with Streptococcus pneumoniae, is a major factor in acute sinusitis. It is probably the most frequent etiologic agent of acute epiglottitis. It is probably a common, but commonly unrecognized, cause of bacterial pneumonia, where it has a distinctive appearance on Gram stain. It is unusual in adult meningitis, but should particularly be considered in alcoholics; in those with recent or remote head trauma, especially with cerebrospinal fluid rhinorrhea; in patients with splenectomies and those with primary or secondary hypogammaglobulinemia. It may rarely cause a wide variety of other infections in adults, including purulent pericarditis, endocarditis, septic arthritis, obstetrical and gynecologic infections, urinary and biliary tract infections, and cellulitis. Antimicrobial susceptibility testing is somewhat capricious in part from the marked effect of inoculum size in some circumstances. In vitro and in vivo results support the use of ampicillin, unless the organism produces beta-lactamase. Alternatives in minor infections include tetracycline, erythromycin, and sulfamethoxazole-trimethoprim. For serious infections chloramphenicol is the best choice if the organism is ampicillin-resistant or the patient is penicillin-allergic.
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PMID:Haemophilus influenzae infections in adults: report of nine cases and a review of the literature. 31 Sep 43

Cefpodoxime proxetil is a new third generation oral cephalosporin, which shows potent antibacterial activity against both Gram-positive and Gram-negative bacteria, and high stability in the presence of beta-lactamases. Low concentrations of cefpodoxime inhibit most respiratory pathogens, including Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella (Branhamella) catarrhalis. Cefpodoxime reaches concentrations of 0.24 +/- 0.06 mg/kg in tonsils, 0.89 +/- 0.80 mg/kg in lung parenchyma, and 0.91 +/- 0.01 mg/kg in bronchial mucosa; these values exceed by far the minimum inhibitory concentrations (MICs) of cefpodoxime for respiratory pathogens. Preliminary clinical studies were carried out in 181 patients with upper respiratory tract infections: the results indicated an overall clinical response in 88.4% of patients; in 30% the clinical efficacy was excellent and in 58.5% it was good. Further studies showed clinical cure in 90.3% of patients with pharyngotonsillitis, and clinical efficacy (cure plus improvement) in 95% of those with acute sinusitis. Moreover, bacterial eradication was obtained in 78 to 96.7% of cases, most of which involved H. influenzae, streptococci, or M. catarrhalis. Cefpodoxime appears to be an effective new antibacterial that can be recommended as a drug of first choice in the treatment of most upper respiratory tract infections.
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PMID:Cefpodoxime proxetil in upper respiratory tract infections. 172 5

Cefuroxime axetil (C.A.E.) is a broad spectrum cephalosporin, suitable for oral route. Its antibacterial activity includes all the pathogens usually responsible for E.N.T. infection, with low M.I.C.'s: H. influenzae, S. pneumoniae, S. aureus, S. pyogene. The stability of the drug against betalactamases, especially those produced by H. influenzae, associated with good bio availability (50%) and tissue penetration (30%) account for the potent in vivo bactericidal activity and clinical efficacy of cefuroxime axetil. More than 1,000 patients had been enrolled in controlled clinical trials: the success rates yielded by C.A.E. were 98%, 96% and 91%, respectively for pharingitis/tonsilitis, otitis media and acute sinusitis. C.A.E. is at least as effective as amoxycillin/clavulanic acid and safety appears to be better.
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PMID:[Cefuroxime axetil, a new oral cephalosporin for treating infections of the ORL field: clinical synthesis]. 208 17

In sinus empyema, H. influenzae is the most prevalent pathogen in some subpopulations and in case of therapeutic failure. Cefixime, the first oral cephalosporin of the 3rd generation, is highly potent in vitro against H. influenzae. To study the efficacy and safety of cefixime in adults with acute sinusitis, a coordinated, double-blind multicenter trial was designed for purulent cases, as confirmed by antral aspiration. A total of 364 patients were enrolled in the study with 125 cases randomized to the reference group, assigned to treatment with cefaclor. Evaluation was based on clinical outcome and on antral reaspiration (86% of the cases). No significant differences between the treatment groups were found, as regards short-term or long-term clinical outcome. However, the clinical examination overestimated the therapeutic results. Only 4% of the patients were considered as failures, but the re-aspiration demonstrated remaining suppuration in 14% of all cases (p less than 0.001). Based on re-aspiration, the failure rate among patients with initial growth of pathogens was lower for cefixime (8%) than for cefaclor (20%) (p less than 0.05). Such a difference was not found among patients with growth of H. influenzae. No serious adverse reactions were recorded, but loose stools and diarrhoea were significantly more frequent in the cefixime treatment group. Five patients (2%) in the cefixime treatment group discontinued their treatment due to adverse events.
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PMID:Treatment of sinus empyema in adults. A coordinated Nordic multicenter trial of cefixime vs. cefaclor. 220 Nov 63

The immunological response of 30 patients with acute sinusitis was examined by using an enzyme-linked immunosorbent assay (ELISA) designed to detect antibodies against outer membrane vesicles of Haemophilus influenzae. Using this ELISA, we found that 15 patients had slight increases in specific antibody in their convalescent serum. Maxillary sinus secretions from 15 patients had specific antibodies. IgG and IgA antibodies were detected with equal frequency, but IgA antibody was often found in maxillary sinus secretions while it was absent from serum. Thus it appears that patients with acute sinusitis respond systemically and locally with the specific antibody to H. influenzae.
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PMID:Immunological response to outer membrane vesicles of Haemophilus influenzae in patients with acute sinusitis. 348 45

Pneumonia counts as one of the most frequent severe Haemophilus influenzae infections to afflict adults. 60% of patients with pneumonia caused by type b H. influenzae are more than 50 years old, 30% to 40% are alcoholics, and 30% to 40% have chronic pulmonary disease or other concurrent illness. In the majority of cases there is multilobular, maculate, diffuse and usually bilateral involvement of the pulmonary tissue. The mortality rate due to type b H. influenzae pneumonia ranges between 30% and 40%. In patients with non-bacteriaemic pneumonia caused by non-encapsulated strains of H. influenzae it is rare for several lobes to be involved, there is little exudation and the mortality rate is low. H. influenzae is a significant pathogen in acute epiglottitis in adults and it also appears to play an important role in acute exacerbations of chronic obstructive lung disease (COLD) and acute sinusitis. beta-lactamase production mediated by R-factors or plasmids of gram-negative bacteria is responsible for ampicillin resistance. In 1978 the overall rate of resistance of H. influenzae to ampicillin in American hospitals amounted to 18%. H. influenzae are found in the nasopharynx of people exposed to others infected with H. influenzae. The risk of secondary infection in children who come into contact with patients infected with type b H. influenzae amounts to approximately 2.1%. Adults in close contact with children suffering from severe H. influenzae infections must be warned of the possible risks of secondary infection.
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PMID:[Respiratory tract infections caused by Haemophilus influenzae in adults]. 349 6

An average of 1.4% of the more than 30,000 participants in a treatment study were diagnosed as having acute sinusitis. 62% of all cases of sinusitis arose in patients aged between 15 and 44 years. Treatment with antibiotics is indicated in purulent sinusitis whilst non-purulent sinusitis is treated either with local or systemic antiphlogistic agents. The secondary bacterial infection is usually caused by Haemophilus influenzae, Streptococcus pneumoniae and anaerobic bacteria. In Scandinavia these probably account for 90% of the purulent sinusitis cases whilst Branhamella catarrhalis is responsible for the remaining 10%. Penicillin V is the agent of choice in acute sinusitis. Cefaclor is preferable in combatting H. influenzae. In a double blind study comparing doxycycline to cefaclor in the management of acute sinusitis (108 patients with cefaclor, 105 patients with doxycycline, no difference emerged between the two groups in the subjective assessment of the treatment results. Objective evaluation recorded excellent results for 88% and 83% of the patients in the cefaclor and doxycycline groups, respectively. Side-effects were noted by 7% of the cefaclor and by 13% of the doxycycline patients. The difference between the incidence of side-effects was not statistically significant. Taking into account the treatment results, the side-effects and ecological aspects, cefaclor is second only to penicillin as the agent of choice in suspected or confirmed purulent sinusitis (e. g. in presence of penicillin allergies or failure of the infection to respond to penicillin V).
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PMID:[Acute sinusitis in adults]. 349 8

From clinical studies on T-2588, an oral ester type cephem, the following results were obtained. Ten patients with acute tonsillitis, 3 with acute pharyngolaryngitis, 2 with acute sinusitis, 1 with acute exacerbation of chronic sinusitis and 2 with acute exacerbation of chronic otitis media were treated with T-2588 at a daily dose of 300 or 600 mg. Clinical responses were excellent in 12, good in 4, fair in 1 and poor in 1. Clinical efficacy was 88.9%. Bacteriologically, all isolates except one strain of S. aureus were eliminated. Clinical efficacies classified by clinical isolates correlated well with bacteriological efficacies. The MICs of T-2525 against clinical isolates were determined and compared with those of cephalexin, cefaclor and amoxicillin. The T-2525 showed potent antibacterial activity against Gram-positive and Gram-negative bacteria including S. pneumoniae, H. influenzae and beta-Streptococcus, but the activity of T-2525 against S. aureus was similar to that of the other antibiotics examined. Neither side effect nor abnormal laboratory finding was observed.
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PMID:[Clinical studies on T-2588 in the field of otorhinolaryngology]. 380 56

Microbiological, pharmacokinetic and clinical studies on sulbactam/cefoperazone (SBT/CPZ) were carried out in the field of pediatrics. Antimicrobial activity The MIC80 of SBT/CPZ was 6.25 micrograms/ml for clinically isolated 24 strains of S. aureus (24 beta-lactamase producing strains), 0.39 micrograms/ml for 17 strains of S. pyogenes, 3.13 micrograms/ml for 24 strains of E. coli (22 beta-lactamase producing strains), 3.13 micrograms/ml for 22 strains of K. pneumoniae (22 beta-lactamase producing strains), 1.56 micrograms/ml for 22 strains of P. mirabilis and 0.20 microgram/ml for 15 strains of H. influenzae (13 beta-lactamase producing strains). In comparison with CPZ in respect to the MIC, SBT/CPZ exhibited synergistic effect on 31 strains out of 81 beta-lactamase producing strains (included 6 strains of S. aureus, 9 of E. coli, 5 of K. pneumoniae and 11 of H. influenzae) which was scarcely observed against 43 non-beta-lactamase producing strains. Absorption and excretion Serum levels and urinary excretion of SBT/CPZ were studied in 7 children aged 5 to 12 years. The mean serum concentration of SBT at 15 minutes following a single intravenous injection of 10 mg/kg of SBT/CPZ was 14.2 micrograms/ml and that of CPZ was 30.4 micrograms/ml. The mean urinary recovery rates at 6 hours following the intravenous injection were 57.8% and 18.3%, respectively. The mean serum concentrations of SBT and CPZ after 1-hour infusion of 10 mg/kg of SBT/CPZ were 10.9 micrograms/ml and 17.6 micrograms/ml, respectively. The urinary recovery rates of SBT and CPZ at 7 hours after the infusion were 100.0% and 27.7% on average, respectively. The mean serum levels of SBT and CPZ at 15 minutes after a single intravenous injection of 20 mg/kg of SBT/CPZ were 25.6 micrograms/ml and 66.0 micrograms/ml, respectively and urinary elimination until up to 6 hours were 72.5% on average for SBT and 21.1% for CPZ. Clinical study SBT/CPZ was used for the treatment of a total of 20 pediatric patients aged 1 month to 14 years to evaluate its clinical effectiveness, bacteriological efficacy and adverse effects. The clinical efficacy in 6 patients with acute pneumonia, 3 with staphylococcal scalded skin syndrome, 2 each with acute purulent tonsillitis and acute pyelonephritis, 1 each with acute purulent lymphadenitis, acute sinusitis, acute bronchitis, peritonitis and acute enteritis was judged to be excellent in 15 cases and good in 3 cases with an efficacy ratio of 100%. The clinical efficacy in 6 patients whose infections were caused by beta-lactamase producing strains was judged to be excellent in all the cases.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Studies on sulbactam/cefoperazone in the field of pediatrics]. 609 65

Maxillary sinus aspiration and quantitative culture of the aspirate were performed in 50 patients, ranging in age from 1 to 16 years, with clinical and radiographic evidence of acute sinusitis. Of 79 sinuses aspirated, at least one was found to be infected in 35 (70%) children. Streptococcus pneumoniae, Branhamella catarrhalis, and Haemophilus influenzae were the most common organisms recovered. All H. influenzae were nontypeable. Twenty percent of the H. influenzae and 27% of the B. catarrhalis organisms were beta-lactamase positive and amoxicillin resistant. The subjects received either amoxicillin or cefaclor at a dose of 40 mg/kg/day in three doses for 10 days. The clinical cure rate with amoxicillin was 81%, compared to 78% with cefaclor. Radiographic improvement was similar in both treatment groups. Antibiotic therapy failed in four patients; three had been given amoxicillin, and one cefaclor. In three of these, a beta-lactamase-positive antibiotic-resistant bacterial species was recovered from the maxillary sinus aspirate; the fourth aspirate was sterile.
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PMID:Treatment of acute maxillary sinusitis in childhood: a comparative study of amoxicillin and cefaclor. 636 60


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