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At least 19 recordsLinked to original sources
PubMedDate not supplied

HIV-associated opportunistic infections. Bacterial infections.

Bacterial infections are the most common opportunistic infections in HIV. Since the advent of highly active antiretroviral therapy (HAART), the incidence of these infections is on the decline. However, globally there is a significant lack of access to care among HIV patients because of limited drug availability and cost of treatment. Furthermore, non-compliance and drug resistance can hinder viral suppression, predisposing patients to opportunistic infections. We review the major bacterial opportunistic infections in HIV positive patients including tuberculosis, Mycobacterium avium complex infections, syphilis, bacterial enteric disease, bacterial pneumonia and bartonellosis. Epidemiology, clinical presentation, diagnosis, treatment and prophylaxis are also reviewed.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Diagnostic possibility in neonatal bacterial infections].

Bacterial infections in neonates may be acquired in utero, as is the case in congenital syphilis, or after delivery, such as late onset B streptococcal meningitis. Although some infections remain localized and may even be self-limiting, the majority of neonatal bacterial infections require speedy diagnosis and immediate and appropriate treatment. Severe invasive bacterial infections are rare but catastrophic; they are more common in intensive care wards. Neonatal, maternal, and environmental factors favoring bacterial infections are discussed together with their main clinical features. Useful diagnostic parameters are examination of the placenta, leukocyte counting, erythrocyte sedimentation rate, and C-reactive protein. If a bacterial infection is suspected in a baby that is sick or in poor general condition (low birth weight, therapies, environmental conditions) a "septic therapeutic approach" must be adopted which includes examination and culture of blood, cerebrospinal fluid, and urine, as well as of any other suitable material according to clinical and laboratory findings. Pathogens most frequently involved in neonatal infections (streptococci, staphylococci, Listeria, gram-negative enteral bacteria) can be presumptively identified by comparatively simple laboratory tests. The valid interpretation of the results of these tests is dependent upon the degree to which the laboratory personnel is familiar with techniques of identification and assessment of sensitivity, as well as on the close cooperation between clinical department and laboratory from the start and all along the course of the disease.

Bacterial Infections↗
PubMedDate not supplied

[Alcoholic hepatitis: bad prognosis due to concomitant bacterial infections].

Bacterial infections increase morbidity and mortality in cirrhosis. Our aim was to investigate whether in alcoholic hepatitis the development of bacterial infections was also a poor prognostic factor. In the retrospective evaluation of 681 hospitalized patients with liver disease, from a single center during a six-year period, 52 (7.5%) cases of alcoholic hepatitis were well documented, 73.1% by liver biopsy with histopathological analysis and the others by well characterized clinical-biochemical data. Males were predominant (ratio 3.3:1.0), mean age of 40 years and mean alcohol intake of 193 g/day. Major complications were: Hepatic encephalopathy (n=5), renal insufficiency (n=4) and digestive bleeding (n=3). Bacterial infections were found in 11 (21%) patients, distributed into: pulmonary (n=5), spontaneous bacterial peritonitis (n=2), urinary (n=3) and dermatological (n=1). Early hospital death occurred in eight (15.4%) patients and comparative analysis between these and those who survived showed that poor prognostic factors were: presence of hepatic encephalopathy (p=0.012), total bilirubin > 20 mg% (p=0.012) and the presence of severe infections (pulmonary and spontaneous bacterial peritonitis) with statistical significance (p=0.004). In conclusion we have demonstrated that severe bacterial infections are poor prognostic factors for alcoholic hepatitis. Our recommendation, based on prophylaxis with antibiotics during digestive bleeding in cirrhosis and in acute hepatic insufficiency, is to extend this prophylaxis to alcoholic hepatitis, in its severe form, in order to prevent bacterial infections and early death.

Adult↗
PubMed1997

Serum C-reactive protein and C3 complement protein levels in severely malnourished Nigerian children with and without bacterial infections.

Bacterial infections are the major determinants of fatality in severe protein-energy malnutrition (PEM). Unfortunately, these infections are difficult to diagnose clinically. C-reactive protein (CRP) levels were determined in 17 infected and 10 non-infected Nigerian children with severe PEM and compared with age/sex-matched apparently healthy controls. The aim was to study the response of this acute phase protein to bacterial infections as well as to assess its value in the diagnosis of infections in severe PEM. C3 complement protein levels were also determined in the same group of subjects. The major organisms isolated in samples from these subjects were S. aureus and the coliforms. Mean CRP level in the non-infected children with severe PEM was 13.8 +/- 6.21 mg/l and rose to 159.83 +/- 124.07 mg/l in the presence of infection. The mean value in healthy non-infected controls was 2.01 +/- 0.96 mg/l. The difference in the mean CRP levels between the infected and non-infected PEM children was statistically significant at p < 0.01. The mean difference between the non-infected and the control subjects was not significant. Using a diagnostic level of 20.00 mg/l of CRP gave a sensitivity of 85.0% and a specificity of 80.0%. This CRP level is a useful index of bacterial infections in severe PEM. C3 complement protein was low in the non-infected malnourished group, but rose significantly in the presence of infection to values similar to that of the healthy controls. C3 protein thus behaves as an acute phase reactant in the presence of infection in severe PEM, and does not appear to be consumed, probably due to a deficiency in the early components of the complement cascade. This suggests a role for C3 measurement in the monitoring of bacterial infections in severe PEM.

Bacterial Infections↗
PubMed1999

Self-reported bacterial infections among women with or at risk for human immunodeficiency virus infection.

Bacterial infections are a major cause of morbidity and mortality in persons with human immunodeficiency virus (HIV) infection, particularly women. We performed a cross-sectional analysis of a history of bacterial infections among 1,310 women with or at risk for HIV infection. HIV-seropositive women were significantly more likely than seronegative women to report recent and lifetime histories of bacterial infection, even after history of injection drug use since 1977 was adjusted for; this included recent pneumonia (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.5-6.6), sinusitis (OR, 1.4; 95% CI, 1.0-2.0), and urinary tract infection (OR, 1.5; 95% CI, 1.1-2.1). Compared with HIV-negative women, women with CD4 cell counts of <200 were about eight times more likely to report recent pneumonia (OR, 7.8; 95% CI, 3.4-17.7); those with CD4 cell counts of 200-500 were almost three times more likely to do so (OR, 2.6; CI, 1.2-5.7). Logistic regression analysis revealed that only CD4 cell category and a recent history of smoking had a significant relationship to self-reported pneumonia.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Childhood visceral leishmaniasis complicated by bacterial infections.

Bacterial superinfection is one of the major complications leading to death in patients with visceral leishmaniasis. We studied the frequency and type of bacterial infection in 54 patients admitted to hospital with visceral leishmaniasis. The patients were children who ranged in age from 3 1/2 months to 7 years. Bacterial infections were found in 22 (41%) of the patients. Bacteria were isolated in patients with pneumonia, septicaemia, otitis media, urinary tract infections and skin infections. Enterobacteriaceae were the most common bacterial agents isolated. In infants with visceral leishmaniasis, fatal bacterial infections can be accompanied by nonspecific signs and symptoms. Thus, it is important to initiate antibiotic treatment early.

Age Distribution↗
PubMed2000

Canine and feline primary ocular bacterial infections.

Bacterial infections are frequently associated with diseases of the eyelids, cornea, and conjunctiva. Animals sustaining KCS commonly have bacterial infections of the external eye owing to a lack of antimicrobial properties present in the normal tearfilm. Infection can occur in the nasolacrimal duct or lacrimal sac, which is referred to as dacryocystitis. Severe corneal ulcers are frequently infected with bacteria, especially Pseudomonas sp. Three new topical ophthalmic antibiotics have recently become commercially available: ciprofloxacin, norfloxacin, and ofloxacin.

Animals↗
PubMed1990

[Tuberculosis sequelae: secondary bacterial infections].

Bacterial infections is one of the most important complications in the patients with pulmonary tuberculosis. We reported the causative microorganisms in these cases with special reference to various clinical features and presented the recommended treatment and prophylaxis against respiratory bacterial infections in the patients with pulmonary tuberculosis sequelae. In 1988 and 1989, 63 patients with tuberculosis sequela were demonstrated to have been infected with respiratory pathogenic bacteria by the quantitative sputum culture method (greater than or equal to 10(7)/ml) in Tokyo National Chest Hospital. The male/female ratio of these patients was 3.5, and their average age was 62.5 years. Causative microorganisms of the secondary infections in the patients with tuberculosis sequela were essentially similar in those with other lower respiratory tract infections, i.e., chronic bronchitis, bronchiectasis, diffuse panbonchiolitis, chronic pulmonary emphysema, etc. Pseudomonas aeruginosa, other glucose-nonfermentative Gram-negative bacilli (GNF-GNB), and glucose-fermentative Gram-negative bacilli (GF-GNB) were the major pathogenic bacteria responsible for the chronic respiratory failure and/or fatal outcome in the post-tuberculous patients. Patients with complications, including aspergillosis, atypical mycobacteriosis, bronchial asthma, and so forth, showed no specific causative microorganism for the secondary infections except frequent isolation of Haemophilus influenzae. Our clinical observations clearly demonstrated that there were differences between the causative microorganisms in patients hospitalized during 1988 to 1989 and those in patients without admission. Gram-negative bacilli, including P. aeruginosa, GNF-GNB and GF-GNB, and Staphylococcus aureus were predominant in hospitalized patients. On the contrary, Streptococcus pneumoniae, H. influenzae, and Branhamella catarrhalis were major pathogenic bacteria in patients without hospitalization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1998

Coordinate regulation of complex T cell populations responding to bacterial infection.

Bacterial infections activate complex T cell populations that differ in size and antigen specificity. We used tetramerized MHC class I molecules complexed with Listeria monocytogenes-derived epitopes to characterize four distinct CD8+ T lymphocyte populations during bacterial infection. Surprisingly, T cell populations differing in antigen specificity expand, contract, and enter the T cell memory compartment synchronously. Because the four L. monocytogenes epitopes are presented with different efficiencies and have distinct stabilities in infected cells, our findings suggest that these factors do not determine in vivo T cell dynamics. While T cell activation requires antigen presentation, the timing and extent of T cell expansion appear to be regulated in a coordinated fashion independent of antigen quantity and stability.

Animals↗
PubMed2000

Identifying vaccine antigens and assessing delivery systems for the prevention of bacterial infections.

Bacterial infections in the respiratory tract and middle ear continue to be a major cause of morbidity and mortality despite the availability of antibiotic therapies. To assist development of vaccines for preventing these infections, animal models have been established in rodents. These models have been used effectively to evaluate different vaccination strategies. Our studies have found that for respiratory tract infections caused by Streptococcus pneumoniae, nontypeable Haemophilus influenzae (NTHI) and Moraxella catarrhalis, a primary immunisation targeted to the gut-associated lymphoid tissue was extremely effective in enhancing bacterial clearance. For the gram-negative pathogens, NTHI and M. catarrhalis, this mucosal immunisation was significantly more effective than systemic immunisation, however, for S. pneumoniae systemic immunisation was as effective. A strategy using these models has effectively been used to determine the potential of antigens from each of the pathogens to protect against infection. Antigens that demonstrate significant vaccine potential have been used to investigate delivery systems. One of the major challenges that still exists is to find mechanisms that will effectively deliver protein antigens to mucosal surfaces. Several strategies have been investigated and resulted in varying degrees of success.

Animals↗
PubMed1983

Bacterial infections of the skin. I: primary and secondary infections.

Bacterial skin infections are important to recognize because we have the means to eradicate almost all of them. Primary skin infections are mainly caused by staphylococci or streptococci. Staphylococci infections present as furuncles and carbuncles, superficial folliculitis, impetigo or rarely the Scalded Skin Syndrome. Streptococcal infections present as impetigo, ecthyma, erysipelas or cellulitis. Corynebacteria causes erythrasma, trichomycosis or pitted keratolysis. Gram-negative primary skin infections, although uncommon, may occur; bacterial cultures are generally necessary for diagnosis. Secondary bacterial infections of pre-existing wounds, burns, dermatitic skin, or retention cysts are common events.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Neonatal bacterial infections].

Bacterial infections during the first months of life remain a significant cause of neonatal mortality and morbidity. This article reviews the recent knowledges of responsible bacteria and pathogenetic mechanisms as well as advancements in life support therapy, in antimicrobial agents and in immunotherapy.

Adrenal Cortex Hormones↗
PubMed2005

The RATIO observatory: French registry of opportunistic infections, severe bacterial infections, and lymphomas complicating anti-TnFalpha therapy.

The RATIO observatory collects nationwide data on opportunistic infections, severe bacterial infections, and lymphomas in patients with a past or present history of tumor necrosis factor alpha (TNFalpha) antagonist treatment in France. The cases are validated by a committee of experts, and the capture-recapture method is used to check and to improve case ascertainment. A nested case-control comparison is carried out to identify risk factors for the events of interest. The registry differs from other biological registries in that the inclusion criterion is occurrence of the event (infection or lymphoma) instead of administration of the treatment. This method ensures collection of a far larger number of cases. The RATIO observatory is a remarkable example of a three-way partnership of learned societies, pharmaceutical companies, and institutions (the French research institute INSERM and the French drug safety agency AFSSAPS). Over 100 events were reported in the first 16 months, a large increase compared to European registries of fixed patient cohorts monitored for 4-5 years. This result validates our original approach, which will probably need to be extended to other biotherapies for inflammatory joint disease and to other potential adverse events. The strong commitment of rheumatologists in France, who are the main prescribers of TNFalpha antagonists, and of the French Society for Rheumatology explain the high case-ascertainment and must continue to ensure that answers are rapidly provided to the drug safety questions that are vital to our patients.

Bacterial Infections↗
PubMed1996

Synthesis and antibacterial activity of U-100592 and U-100766, two oxazolidinone antibacterial agents for the potential treatment of multidrug-resistant gram-positive bacterial infections.

Bacterial resistance development has become a very serious clinical problem for many classes of antibiotics. The 3-aryl-2-oxazolidinones are a relatively new class of synthetic antibacterial agents, having a new mechanism of action which involves very early inhibition of bacterial protein synthesis. We have prepared two potent, synthetic oxazolidinones, U-100592 and U-100766, which are currently in clinical development for the treatment of serious multidrug-resistant Gram-positive bacterial infections caused by strains of staphylococci, streptococci, and enterococci. The in vitro and in vivo (po and iv) activities of U-100592 and U-100766 against representative strains are similar to those of vancomycin. U-100592 and U-100766 demonstrate potent in vitro activity against Mycobacterium tuberculosis. A novel and practical asymmetric synthesis of (5S)-(acetamidomethyl)-2-oxazolidinones has been developed and is employed for the synthesis of U-100592 and U-100766. This involves the reaction of N-lithioarylcarbamates with (R)-glycidyl butyrate, resulting in excellent yields and high enantiomeric purity of the intermediate (R)-5-(hydroxymethyl)-2-oxazolidinones.

Acetamides↗
PubMed2003

Impaired phagocyte antibacterial effector functions in beta-thalassemia: a likely factor in the increased susceptibility to bacterial infections.

Bacterial diseases are serious complications of beta-thalassemia syndromes but the mechanisms underlying the increased susceptibility to these infections are not fully understood. Factors which are likely to be involved are anemia, splenectomy, iron-overload and alterations in innate/adaptive immune responses. There is substantial evidence that a defect in innate effector functions of phagocytes (neutrophils, monocytes/macrophages) plays an important role in the weakened resistance to pathogenic bacteria and is at least in part due to iron overload. There is substantial evidence of an iron-related defect in bacterial phagocytosis by neutrophils. Moreover, reduced chemotaxis by these phagocytes has been repeatedly demonstrated. Similarly, an impairment of monocyte bacterial phagocytosis and generation of anti-bacterial compounds have recently been delineated but any relation to iron overload needs to be established. Additional mechanisms of defective innate immune responses such as altered expression of pathogen recognising receptors and function seem possible and have to be explored. Further insight into innate phagocyte effector functions in beta-thalassemia is essential for understanding the increased susceptibility to bacterial infections and their management.

Anemia↗