Sample records for bacterial pneumonia

  1. Bacterial Pneumonia in Older Adults. (United States)

    Marrie, Thomas J; File, Thomas M


    Community-acquired pneumonia is common in the elderly person; its presentation in this population is often confounded by multiple comorbid illnesses, including those that result in confusion. Although severity-of-illness scoring systems might aid decision-making, clinical judgment following a careful assessment is key in deciding on the site of care and appropriate therapy.

  2. Immunotolerance during bacterial pneumonia and sepsis

    NARCIS (Netherlands)

    Hoogerwerf, J.J.


    Bacterial pneumonia and sepsis are a major cause of morbidity and mortality worldwide. Massive use of antibiotics promotes pathogen resistance, and, as a consequence, the incidence of drug-resistant bacteria is increasing. Therefore, it is of the utmost importance to expand our comprehension of host

  3. 75 FR 73107 - Draft Guidance for Industry on Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated... (United States)


    ... Pneumonia and Ventilator-Associated Bacterial Pneumonia: Developing Drugs for Treatment; Availability AGENCY... Pneumonia and Ventilator-Associated Bacterial Pneumonia: Developing Drugs for Treatment.'' The purpose of... antimicrobial drugs for the treatment of hospital- acquired bacterial pneumonia (HABP) and...

  4. Klebsiella pneumoniae Siderophores Induce Inflammation, Bacterial Dissemination, and HIF-1α Stabilization during Pneumonia (United States)

    Holden, Victoria I.; Breen, Paul; Houle, Sébastien; Dozois, Charles M.


    ABSTRACT Klebsiella pneumoniae is a Gram-negative pathogen responsible for a wide range of infections, including pneumonia and bacteremia, and is rapidly acquiring antibiotic resistance. K. pneumoniae requires secretion of siderophores, low-molecular-weight, high-affinity iron chelators, for bacterial replication and full virulence. The specific combination of siderophores secreted by K. pneumoniae during infection can impact tissue localization, systemic dissemination, and host survival. However, the effect of these potent iron chelators on the host during infection is unknown. In vitro, siderophores deplete epithelial cell iron, induce cytokine secretion, and activate the master transcription factor hypoxia inducible factor-1α (HIF-1α) protein that controls vascular permeability and inflammatory gene expression. Therefore, we hypothesized that siderophore secretion by K. pneumoniae directly contributes to inflammation and bacterial dissemination during pneumonia. To examine the effects of siderophore secretion independently of bacterial growth, we performed infections with tonB mutants that persist in vivo but are deficient in siderophore import. Using a murine model of pneumonia, we found that siderophore secretion by K. pneumoniae induces the secretion of interleukin-6 (IL-6), CXCL1, and CXCL2, as well as bacterial dissemination to the spleen, compared to siderophore-negative mutants at an equivalent bacterial number. Furthermore, we determined that siderophore-secreting K. pneumoniae stabilized HIF-1α in vivo and that bacterial dissemination to the spleen required alveolar epithelial HIF-1α. Our results indicate that siderophores act directly on the host to induce inflammatory cytokines and bacterial dissemination and that HIF-1α is a susceptibility factor for bacterial invasion during pneumonia. PMID:27624128

  5. Klebsiella pneumoniae Siderophores Induce Inflammation, Bacterial Dissemination, and HIF-1α Stabilization during Pneumonia

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    Victoria I. Holden


    Full Text Available Klebsiella pneumoniae is a Gram-negative pathogen responsible for a wide range of infections, including pneumonia and bacteremia, and is rapidly acquiring antibiotic resistance. K. pneumoniae requires secretion of siderophores, low-molecular-weight, high-affinity iron chelators, for bacterial replication and full virulence. The specific combination of siderophores secreted by K. pneumoniae during infection can impact tissue localization, systemic dissemination, and host survival. However, the effect of these potent iron chelators on the host during infection is unknown. In vitro, siderophores deplete epithelial cell iron, induce cytokine secretion, and activate the master transcription factor hypoxia inducible factor-1α (HIF-1α protein that controls vascular permeability and inflammatory gene expression. Therefore, we hypothesized that siderophore secretion by K. pneumoniae directly contributes to inflammation and bacterial dissemination during pneumonia. To examine the effects of siderophore secretion independently of bacterial growth, we performed infections with tonB mutants that persist in vivo but are deficient in siderophore import. Using a murine model of pneumonia, we found that siderophore secretion by K. pneumoniae induces the secretion of interleukin-6 (IL-6, CXCL1, and CXCL2, as well as bacterial dissemination to the spleen, compared to siderophore-negative mutants at an equivalent bacterial number. Furthermore, we determined that siderophore-secreting K. pneumoniae stabilized HIF-1α in vivo and that bacterial dissemination to the spleen required alveolar epithelial HIF-1α. Our results indicate that siderophores act directly on the host to induce inflammatory cytokines and bacterial dissemination and that HIF-1α is a susceptibility factor for bacterial invasion during pneumonia.

  6. Evolving trends in Streptococcus pneumoniae resistance: implications for therapy of community-acquired bacterial pneumonia. (United States)

    Jones, Ronald N; Jacobs, Michael R; Sader, Helio S


    Pneumonia is a major infectious disease associated with significant morbidity, mortality and utilisation of healthcare resources. Streptococcus pneumoniae is the predominant pathogen in community-acquired pneumonia (CAP), accounting for 20-60% of bacterial cases. Emergence of multidrug-resistant S. pneumoniae has become a significant problem in the management of CAP. Although pneumococcal conjugate vaccine usage in children has led to significant decreases in morbidity and mortality due to S. pneumoniae in all age groups, disease management has been further complicated by the unexpected increase in resistant serotypes, such as 19A, in some regions. Until rapid and accurate diagnostic tests become available, initial treatment of CAP will remain empirical. Thus, selection of appropriate antimicrobial therapy for CAP must be based on prediction of the most likely pathogens and their local antimicrobial susceptibility patterns. This article reviews information on antimicrobial resistance patterns amongst S. pneumoniae and implications for managing CAP.

  7. Lung Dendritic Cells Facilitate Extrapulmonary Bacterial Dissemination during Pneumococcal Pneumonia

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    Alva eRosendahl


    Full Text Available Streptococcus pneumoniae is a leading cause of bacterial pneumonia worldwide. Given the critical role of dendritic cells (DCs in regulating and modulating the immune response to pathogens, we investigated here the role of DCs in S. pneumoniae lung infections. Using a well-established transgenic mouse line which allows the conditional transient depletion of DCs, we showed that ablation of DCs resulted in enhanced resistance to intranasal challenge with S. pneumoniae. DC-depleted mice exhibited delayed bacterial systemic dissemination, significantly reduced bacterial loads in the infected organs and lower levels of serum inflammatory mediators than non-depleted animals. The increased resistance of DC-depleted mice to S. pneumoniae was associated with a better capacity to restrict pneumococci extrapulmonary dissemination. Furthermore, we demonstrated that S. pneumoniae disseminated from the lungs into the regional lymph nodes in a cell-independent manner and that this direct way of dissemination was much more efficient in the presence of DCs. We also provide evidence that S. pneumoniae induces expression and activation of matrix metalloproteinase-9 (MMP-9 in cultured bone marrow-derived DCs. MMP-9 is a protease involved in the breakdown of extracellular matrix proteins and is critical for DC trafficking across extracellular matrix and basement membranes during the migration from the periphery to the lymph nodes. MMP-9 was also significantly up-regulated in the lungs of mice after intranasal infection with S. pneumoniae. Notably, the expression levels of MMP-9 in the infected lungs were significantly decreased after depletion of DCs suggesting the involvement of DCs in MMP-9 production during pneumococcal pneumonia. Thus, we propose that S. pneumoniae can exploit the DC-derived proteolysis to open tissue barriers thereby facilitating its own dissemination from the local site of infection.

  8. Chest physiotherapy in children with acute bacterial pneumonia

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    Lieselotte Corten


    Full Text Available Background: Pneumonia is the single leading cause of death in children younger than 5 years of age. Chest physiotherapy is often prescribed as an additional therapy in children with pneumonia. Different chest physiotherapy techniques are available that aim to improve airway clearance, gas exchange and reduce the work of breathing. However, it is unclear if these techniques are effective in this population.Objective: The present review aimed to determine the efficacy of different chest physiotherapy techniques compared with no physiotherapy or other chest physiotherapy treatments in hospitalised children with bacterial pneumonia.Method: Six electronic databases (PubMed, Medline, Cochrane Library, PEDro, CINAHL and Africa-wide information, and were searched for eligible studies.Results: Two randomised controlled trials and one ongoing study were identified. Neither completed trial reported differences between the control and intervention groups, although one study reported a longer duration of coughing (p = 0.04 and rhonchi (p = 0.03 in the intervention group.Conclusion: Because of the limited number of included articles and different presentations of outcome measures, we could not reject or accept chest physiotherapy as either an effective or harmful treatment option in this population.

  9. Protease activated receptor 4 limits bacterial growth and lung pathology during late stage Streptococcus pneumoniae induced pneumonia in mice. (United States)

    de Stoppelaar, S F; Van't Veer, C; van den Boogaard, F E; Nieuwland, R; Hoogendijk, A J; de Boer, O J; Roelofs, J J T H; van der Poll, T


    Streptococcus pneumoniae is a common causative pathogen of pneumonia and sepsis. Pneumonia and sepsis are associated with enhanced activation of coagulation, resulting in the production of several host-derived proteases at the primary site of infection and in the circulation. Serine proteases cleave protease activated receptors (PARs), which form a molecular link between coagulation and inflammation. PAR4 is one of four subtypes of PARs and is widely expressed by multiple cell types in the respiratory tract implicated in pulmonary inflammation, by immune cells and by platelets. In mice, mouse (m)PAR4 is the only thrombin receptor expressed by platelets. We here sought to determine the contribution of mPAR4 to the host response during pneumococcal pneumonia. Pneumonia was induced by intranasal inoculation with S. pneumoniae in mPAR4-deficient (par4-/-) and wild-type mice. Mice were sacrificed after 6, 24 or 48 hours (h). Blood, lungs, liver and spleen were collected for analyses. Ex vivo stimulation assays were performed with S. pneumoniae and mPAR4 activating peptides. At 48 h after infection, higher bacterial loads were found in the lungs and blood of par4-/- mice (p pneumoniae. Thrombin inhibition resulted in decreased cytokine release after S. pneumoniae stimulation in human whole blood. Our findings suggest that mPAR4 contributes to antibacterial defence during murine pneumococcal pneumonia.

  10. Diagnosis and treatment of bacterial pneumonia in liver transplantation recipients: report of 33 cases

    Institute of Scientific and Technical Information of China (English)

    MA Yu-kui; YAN Lü-nan; LI Bo; LU Shi-chun; HUANG An-hua; WEN Tian-fu; ZENG Yong; CHENG Nan-sheng


    Background Bacterial pneumonia in the recipients of liver transplantation (LTX) is a common postoperative complication influencing the prognosis greatly. In this article, the diagnosis and treatment of bacterial pneumonia in 33 LTX recipients are reported. Methods From February 1999 to January 2003, a total of 103 patients underwent allogeneic LTX at our center; afterwards, a retrospective analysis was made on their postoperative clinical manifestations, including symptoms (expectoration, panting and fever), sign (rale), results of laboratory examinations (white blood cell count and sputum culture of tracheal secretions or pleural fluid culture), and chest X-ray films. The following data of the pneumonia and non-pneumonia groups were collected, and the rank sum test (SPSS 11.0, Wilcoxon's method) was used to analyze the duration of postoperative respirator utilization and the volume of pleural effusion through pleurocentesis or pleural drainage.Results In the 103 patients, 33 experienced 53 episodes of bacterial pneumonia during their hospital stay after transplantation, 14 of them (42.42%) had more than three manifestations of the seven mentioned above. The pathogens causing bacterial pneumonia included Pseudomonas aeruginosa (17.48%), Klebsiella pneumoniae (15.53%), Acinetobacter baumannii (10.68%), and Staphylococcus aureus (7.77%). Amilkacin, tienam, ciprofloxacin, vancomycin, etc. were the antibiotics of choice against those bacteria. Acute rejection occurred during the treatment of bacterial pneumonia in 16 patients, and 5 of them died. Wilcoxon's rank sum test of the data indicated that the pneumonia group had longer duration of postoperative ventilator treatment and larger volume of pleural effusion than the non-pneumonia group (P<0.05).Conclusions The clinical manifestations of pneumonia after LTX might be atypical,and special attention should be paid to the respiratory symptoms and signs within 2 months after LTX. Whenever the diagnosis of bacterial

  11. Viral and bacterial pathogens identification in children hospitalised for severe pneumonia and parapneumonic empyema

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    Jean-Noël Telles


    Full Text Available Pneumonia is caused by respiratory bacteria and/or viruses. Little is known if co-infections are an aggravating factor in hospitalised children with severe pneumonia. We studied the impact of respiratory pathogens on the severity of pneumonia. Between 2007 and 2009, 52 children hospitalised with a well-documented diagnosis of communityacquired pneumonia (CAP, with or without parapneumonic empyema (PPE, were enrolled in the study. The patients were classified into 2 groups: CAP + PPE (n = 28 and CAP (n = 24. The identification of respiratory viruses and bacteria in nasopharyngeal aspirates and pleural effusion samples were performed using conventional bacterial techniques and molecular assays. Using real-time multiplex PCR and antigen detection, Streptococcus pneumoniae was the main agent identified in 76% of the cases by molecular tests and BinaxNOW® in pleural fluid. A total of 8% of pleural fluid samples remained undiagnosed. In nasopharyngeal aspirates, rhinovirus, parainfluenza viruses, human metapneumovirus, and respiratory syncytial virus were detected in both CAP and CAP + PPE populations; however, the percentage of viral co-detection was significantly higher in nasopharyngeal aspirates from CAP + PPE patients (35% compared with CAP patients (5%. In conclusion, viral co-detection was observed mainly in patients with more severe pneumonia. Molecular biology assays improved the pathogens detection in pneumonia and confirmed the S. pneumoniae detection by BinaxNOW® in pleural effusion samples. Interestingly, the main S. pneumoniae serotypes found in PPE are not the ones targeted by the heptavalent pneumococcal conjugate vaccine.

  12. Chest physiotherapy in children with acute bacterial pneumonia



    Background: Pneumonia is the single leading cause of death in children younger than 5 years of age. Chest physiotherapy is often prescribed as an additional therapy in children with pneumonia. Different chest physiotherapy techniques are available that aim to improve airway clearance, gas exchange and reduce the work of breathing. However, it is unclear if these techniques are effective in this population.Objective: The present review aimed to determine the efficacy of different chest physiot...


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    Rajendra Ku.


    Full Text Available INTRODUCTI ON: Endogenous or metastatic endophthalmitis is a very rare sever form of ocular disease which is uncommon now - a - days. Prevalence of endogenous bacterial endophthalmitis is 2 - 8% of all cases of endophthalmitis 1 . Mostly it is associated with chronic disease like diabetes mellitus, renal failure, liver abscesses, prolong placement of catheter, IV line or central venous line, drug abusers and immunocompromise d patients. Gram +bacteria are the most common causative organism of the endogenous bacterial endophthalmitis . 1 A few cases of endogenous bacterial endophthalmitis due to klebsiella pneumonias, a gram - ve organism have been documented and majority of them were in Taiwan . 2, 3,4,5,6, 7 K. pneumonia endophthalmitis is associated with diabetes mellitus and hepatic abscesses can be bilateral and resulted into poor visual outcome . 2,3,4,5,6, 7 K. pneumonia pneumonia has been reported most frequently from patients with alcoholic liver diseases and one of the common cause of acute osteomyelitis and septic arthritis . 8,9 In this scenario we report the case of a Malawian in African Continent who developed bilateral endogenous bacterial endophthalmitis after suffering from pneumonia in immunocompromise state. PURPOSE : to report a case bilateral endogenous endophthalmitis secondary to pneumonia in an AIDS patient . DESIGN : Observational case report . METHODS : A patient with bilateral pain full red eye with diminution of vision was seen in c onsultation by ophthalmology. RESULT : with clinical characteristic and laboratory diagnosis of sputum and blood conf i rmed the causative agent for pneumonia and endophthalmitis is K.pneumonia. CONCLUSION : it is unusual disease, required early detection and prompt treatment.

  14. [Immunotherapy by polyvalent bacterial antigen (Broncasma Berna) in the prevention of pneumonia in the elderly]. (United States)

    Suzuki, K; Yamamoto, K; Adachi, S; Yamamoto, T


    Pneumonia in the elderly often occurs repeatedly, and the mortality rate from pneumonia continues to remain high today despite the usual use of antibacterial chemotherapy. Therefore, we conducted immunotherapy using a polyvalent bacterial vaccine (broncasma Berna). We treated 54 elderly patients with Broncasma Berna, containing chief bacterial pathogens responsible for pneumonia in the elderly. Clinical results obtained during 2 years were compared with those of 18 subjects not treated with Broncasma Berna. The survival rate was 64.8% for the group treated with Broncasma Berna and 50% for the group not treated. The frequency of contraction of pneumonia decreased significantly in the group treated. Clinical efficacy was obtained in 63% of the group treated to prevent pneumonia. The death rate from pneumonia was 17.6% for the group treated and 44.4% for the group not treated. Immunologically, reinforcement in humoral and cellular immunities was indicated by immunoglobulin values, positive tuberculin skin tests, and an increase in lymphocyte stimulation index values for Broncasma Berna. Significant pathogens in sputum disappeared or decreased in 6 (54.6%) out of 11 patients. Side effects such as pain or redness at the site of injection were observed in 6 patients. From the above results, it may be concluded that Broncasma Berna can be considered to be effective as a long-term immunoprophylactic agent in the prevention of pneumonia in the elderly.

  15. Pneumonia (United States)

    ... of pneumonia. Be sure to get the following vaccines: Flu vaccine can help prevent pneumonia caused by the flu virus. Pneumococcal vaccine lowers your chances of getting pneumonia from Streptococcus ...

  16. Tea tree oil nanoemulsions for inhalation therapies of bacterial and fungal pneumonia. (United States)

    Li, Miao; Zhu, Lifei; Liu, Boming; Du, Lina; Jia, Xiaodong; Han, Li; Jin, Yiguang


    Tea tree oil (TTO) is a natural essential oil with strong antimicrobial efficacy and little drug resistance. However, the biomedical applications of TTO are limited due to its hydrophobicity and formulation problems. Here, we prepared an inhalable TTO nanoemulsion (nanoTTO) for local therapies of bacterial and fungal pneumonia. The optimal formulation of nanoTTOs consisted of TTO/Cremophor EL/water with a mean size of 12.5nm. The nanoTTOs showed strong in vitro antimicrobial activities on Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Candida albicans. After inhalation to the lung, the nanoTTOs had higher anti-fungal effect than fluconazole on the fungal pneumonia rat models with reduced lung injury, highly microbial clearance, blocking of leukocyte recruitment, and decrease of pro-inflammatory mediators. In the case of rat bacterial pneumonia, the nanoTTOs showed slightly lower therapeutic efficacy than penicillin though at a much lower dose. Taken together, our results show that the inhalable nanoTTOs are promising nanomedicines for local therapies of fungal and bacterial pneumonia with no obvious adverse events.

  17. Role of Autophagy and Apoptosis in the Postinfluenza Bacterial Pneumonia

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    Zhen Qin


    Full Text Available The risk of influenza A virus (IAV is more likely caused by secondary bacterial infections. During the past decades, a great amount of studies have been conducted on increased morbidity from secondary bacterial infections following influenza and provide an increasing number of explanations for the mechanisms underlying the infections. In this paper, we first review the recent research progress that IAV infection increased susceptibility to bacterial infection. We then propose an assumption that autophagy and apoptosis manipulation are beneficial to antagonize post-IAV bacterial infection and discuss the clinical significance.

  18. Role of bacterial surface structures on the interaction of Klebsiella pneumoniae with phagocytes.

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    Catalina March

    Full Text Available Phagocytosis is a key process of the immune system. The human pathogen Klebsiella pneumoniae is a well known example of a pathogen highly resistant to phagocytosis. A wealth of evidence demonstrates that the capsule polysaccharide (CPS plays a crucial role in resistance to phagocytosis. The amoeba Dictyostelium discoideum shares with mammalian macrophages the ability to phagocytose and kill bacteria. The fact that K. pneumoniae is ubiquitous in nature and, therefore, should avoid predation by amoebae, poses the question whether K. pneumoniae employs similar means to counteract amoebae and mammalian phagocytes. Here we developed an assay to evaluate K. pneumoniae-D. discoideum interaction. The richness of the growth medium affected the threshold at which the cps mutant was permissive for Dictyostelium and only at lower nutrient concentrations the cps mutant was susceptible to predation by amoebae. Given the critical role of bacterial surface elements on host-pathogen interactions, we explored the possible contribution of the lipopolysaccharide (LPS and outer membrane proteins (OMPs to combat phagoyctosis by D. discoideum. We uncover that, in addition to the CPS, the LPS O-polysaccharide and the first core sugar participate in Klebsiella resistance to predation by D. discoideum. K. pneumoniae LPS lipid A decorations are also necessary to avoid predation by amoebae although PagP-dependent palmitoylation plays a more important role than the lipid A modification with aminoarabinose. Mutants lacking OMPs OmpA or OmpK36 were also permissive for D. discoideium growth. Except the LPS O-polysaccharide mutants, all mutants were more susceptible to phagocytosis by mouse alveolar macrophages. Finally, we found a correlation between virulence, using the pneumonia mouse model, and resistance to phagocytosis. Altogether, this work reveals novel K. pneumoniae determinants involved in resistance to phagocytosis and supports the notion that Dictyostelium amoebae

  19. Anti-Pseudomonas aeruginosa IgY antibodies augment bacterial clearance in a murine pneumonia model

    DEFF Research Database (Denmark)

    Thomsen, K.; Christophersen, L.; Bjarnsholt, T.


    -P. aeruginosa IgY antibodies on bacterial eradication in a murine pneumonia model. Methods: P. aeruginosa pneumonia was established in Balb/c mice and the effects of prophylactic IgY administration on lung bacteriology, clinical parameters and subsequent inflammation were compared to controls. Results......Background: Oral prophylactic therapy by gargling with pathogen-specific egg yolk immunoglobulins (IgY) may reduce the initial airway colonization with Pseudomonas aeruginosa in cystic fibrosis (CF) patients. IgY antibodies impart passive immunization and we investigated the effects of anti...

  20. Genome-wide identification of Streptococcus pneumoniae genes essential for bacterial replication during experimental meningitis

    DEFF Research Database (Denmark)

    Molzen, T E; Burghout, P; Bootsma, H J


    Meningitis is the most serious of invasive infections caused by the Gram-positive bacterium Streptococcus pneumoniae. Vaccines protect only against a limited number of serotypes, and evolving bacterial resistance to antimicrobials impedes treatment. Further insight into the molecular pathogenesis...... of invasive pneumococcal disease is required in order to enable the development of new or adjunctive treatments and/or pneumococcal vaccines that are efficient across serotypes. We applied genomic array footprinting (GAF) in the search for S. pneumoniae genes that are essential during experimental meningitis...

  1. Bacterial nosocomial pneumonia in Paediatric Intensive Care Unit.

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    Tullu M


    Full Text Available AIMS: To determine the incidence, risk factors, mortality and organisms causing nosocomial pneumonia (NP in intubated patients in Paediatric Intensive Care Unit (PICU. MATERIALS & METHODS: All patients with endotracheal (ET tube with or without mechanical ventilation (MV in a PICU of a tertiary care teaching hospital were included in this prospective study. Clinical parameters and investigations were evaluated in patients who developed nosocomial pneumonia (NP. Colonisation of the ET tube tip was studied by culture and the antibiotic susceptibility pattern of the isolates was determined. RESULTS: Sixty-nine patients had an ET tube inserted and fifty-nine of these underwent MV. ET tube tip colonisation was seen in 70 out of 88 ET tubes inserted. The incidence of NP in patients with ET tube was 27.54% (7.96/100 days of ET intubation. NP developed only in patients undergoing MV. The main risk factors for developing NP were - duration of MV and duration of stay in the PICU. Age, sex, immunocompromised status and altered sensorium did not increase the risk of NP. The mortality in cases with NP was 47. 37%. E. coli and Klebsiella were the commonest organisms isolated from the ET tube tip cultures with maximum susceptibility to amikacin and cefotaxime. CONCLUSIONS: NP developed only in patients undergoing MV. Duration of MV and duration of stay in the PICU increased the risk of developing NP.

  2. A systematic review on the diagnosis of pediatric bacterial pneumonia: when gold is bronze.

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    Tim Lynch

    Full Text Available BACKGROUND: In developing countries, pneumonia is one of the leading causes of death in children under five years of age and hence timely and accurate diagnosis is critical. In North America, pneumonia is also a common source of childhood morbidity and occasionally mortality. Clinicians traditionally have used the chest radiograph as the gold standard in the diagnosis of pneumonia, but they are becoming increasingly aware that it is not ideal. Numerous studies have shown that chest radiography findings lack precision in defining the etiology of childhood pneumonia. There is no single test that reliably distinguishes bacterial from non-bacterial causes. These factors have resulted in clinicians historically using a combination of physical signs and chest radiographs as a 'gold standard', though this combination of tests has been shown to be imperfect for diagnosis and assigning treatment. The objectives of this systematic review are to: 1 identify and categorize studies that have used single or multiple tests as a gold standard for assessing accuracy of other tests, and 2 given the 'gold standard' used, determine the accuracy of these other tests for diagnosing childhood bacterial pneumonia. METHODS AND FINDINGS: Search strategies were developed using a combination of subject headings and keywords adapted for 18 electronic bibliographic databases from inception to May 2008. Published studies were included if they: 1 included children one month to 18 years of age, 2 provided sufficient data regarding diagnostic accuracy to construct a 2x2 table, and 3 assessed the accuracy of one or more index tests as compared with other test(s used as a 'gold standard'. The literature search revealed 5,989 references of which 256 were screened for inclusion, resulting in 25 studies that satisfied all inclusion criteria. The studies examined a range of bacterium types and assessed the accuracy of several combinations of diagnostic tests. Eleven different gold

  3. Role of serum procalcitonin level in early diagnosis of bacterial pneumonia in children, a hospital based study

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    Sheikh Mohd Saleem


    Conclusions: Serum PCT is an important biomarker for prompt diagnosis of bacterial infection and a sensitive indicator to distinguish bacterial from non-bacterial pneumonia. Evaluating serum PCT levels helps in early use of antibiotic therapy and prognosis of underlying disease. [Int J Res Med Sci 2016; 4(5.000: 1518-1521

  4. Detection of Pneumocystis DNA in samples from patients suspected of bacterial pneumonia – a case-control study

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    Helweg-Larsen, J; Jensen, JS; Dohn, G


    Pneumocystis jiroveci (formerly known as P. carinii f.sp. hominis) is an opportunistic fungus that causes Pneumocystis pneumonia (PCP) in immunocompromised individuals. Pneumocystis jiroveci can be detected by polymerase chain reaction (PCR). To investigate the clinical importance of a positive...... Pneumocystis-PCR among HIV-uninfected patients suspected of bacterial pneumonia, a retrospective matched case-control study was conducted....

  5. Acute bacterial meningitis caused by Streptococcus pneumoniae resistant to the antimicrobian agents and their serotypes Meningite bacteriana aguda por Streptococcus pneumoniae resistente aos antimicrobianos e seus sorotipos


    Andrea Maciel de Oliveira Rossoni; Libera Maria Dalla Costa; Denize Bonato Berto; Sônia Santos Farah; Marilene Gelain; Maria Cristina de Cunto Brandileone; Vitor Hugo Mariano Ramos; Sergio Monteiro de Almeida


    The main objectives of this study are to evaluate the resistance rates of Streptococcus pneumonia to penicillin G, ceftriaxone and vancomycin in patients with meningitis; to analyze possible risk factors to the antimicrobian resistance; to describe the serotypes detected and to suggest an initial empirical treatment for meningitis. The sensitiveness and serotypes of all isolated S. pneumoniae of patients with acute bacterial meningitis received by the Paraná State Central Laboratory from Apri...

  6. Fluorocycline TP-271 Is Potent against Complicated Community-Acquired Bacterial Pneumonia Pathogens (United States)

    Fyfe, Corey; O’Brien, William; Hackel, Meredith; Minyard, Mary Beth; Waites, Ken B.; Dubois, Jacques; Murphy, Timothy M.; Slee, Andrew M.; Weiss, William J.; Sutcliffe, Joyce A.


    ABSTRACT TP-271 is a novel, fully synthetic fluorocycline antibiotic in clinical development for the treatment of respiratory infections caused by susceptible and multidrug-resistant pathogens. TP-271 was active in MIC assays against key community respiratory Gram-positive and Gram-negative pathogens, including Streptococcus pneumoniae (MIC90 = 0.03 µg/ml), methicillin-sensitive Staphylococcus aureus (MSSA; MIC90 = 0.25 µg/ml), methicillin-resistant S. aureus (MRSA; MIC90 = 0.12 µg/ml), Streptococcus pyogenes (MIC90 = 0.03 µg/ml), Haemophilus influenzae (MIC90 = 0.12 µg/ml), and Moraxella catarrhalis (MIC90 ≤0.016 µg/ml). TP-271 showed activity (MIC90 = 0.12 µg/ml) against community-acquired MRSA expressing Panton-Valentine leukocidin (PVL). MIC90 values against Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydia pneumoniae were 0.004, 1, and 4 µg/ml, respectively. TP-271 was efficacious in neutropenic and immunocompetent animal pneumonia models, generally showing, compared to the burden at the start of dosing, ~2 to 5 log10 CFU reductions against MRSA, S. pneumoniae, and H. influenzae infections when given intravenously (i.v.) and ~1 to 4 log10 CFU reductions when given orally (p.o.). TP-271 was potent against key community-acquired bacterial pneumonia (CABP) pathogens and was minimally affected, or unaffected, by tetracycline-specific resistance mechanisms and fluoroquinolone or macrolide drug resistance phenotypes. IMPORTANCE Rising resistance rates for macrolides, fluoroquinolones, and β-lactams in the most common pathogens associated with community-acquired bacterial pneumonia (CABP) are of concern, especially for cases of moderate to severe infections in vulnerable populations such as the very young and the elderly. New antibiotics that are active against multidrug-resistant Streptococcus pneumoniae and Staphylococcus aureus are needed for use in the empirical treatment of the most severe forms of this disease. TP-271 is a promising

  7. The mito-DAMP cardiolipin blocks IL-10 production causing persistent inflammation during bacterial pneumonia (United States)

    Chakraborty, Krishnendu; Raundhal, Mahesh; Chen, Bill B.; Morse, Christina; Tyurina, Yulia Y.; Khare, Anupriya; Oriss, Timothy B.; Huff, Rachael; Lee, Janet S.; St. Croix, Claudette M.; Watkins, Simon; Mallampalli, Rama K.; Kagan, Valerian E.; Ray, Anuradha; Ray, Prabir


    Bacterial pneumonia is a significant healthcare burden worldwide. Failure to resolve inflammation after infection precipitates lung injury and an increase in morbidity and mortality. Gram-negative bacteria are common in pneumonia and increased levels of the mito-damage-associated molecular pattern (DAMP) cardiolipin can be detected in the lungs. Here we show that mice infected with Klebsiella pneumoniae develop lung injury with accumulation of cardiolipin. Cardiolipin inhibits resolution of inflammation by suppressing production of anti-inflammatory IL-10 by lung CD11b+Ly6GintLy6CloF4/80+ cells. Cardiolipin induces PPARγ SUMOylation, which causes recruitment of a repressive NCOR/HDAC3 complex to the IL-10 promoter, but not the TNF promoter, thereby tipping the balance towards inflammation rather than resolution. Inhibition of HDAC activity by sodium butyrate enhances recruitment of acetylated histone 3 to the IL-10 promoter and increases the concentration of IL-10 in the lungs. These findings identify a mechanism of persistent inflammation during pneumonia and indicate the potential of HDAC inhibition as a therapy. PMID:28074841

  8. Pneumonia (United States)

    ... better than treating it. Vaccines are available to prevent pneumococcal pneumonia and the flu. Other preventive measures include washing your hands frequently and not smoking. NIH: National Heart, Lung, and Blood Institute

  9. How Is Pneumonia Treated? (United States)

    ... to cure the infection and prevent complications. Bacterial pneumonia Bacterial pneumonia is treated with medicines called antibiotics. ... fewer symptoms such as cough and fever. Viral pneumonia Antibiotics don't work when the cause of ...

  10. Pore-Forming Toxins Induce Macrophage Necroptosis during Acute Bacterial Pneumonia.

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    Norberto González-Juarbe


    Full Text Available Necroptosis is a highly pro-inflammatory mode of cell death regulated by RIP (or RIPK1 and RIP3 kinases and mediated by the effector MLKL. We report that diverse bacterial pathogens that produce a pore-forming toxin (PFT induce necroptosis of macrophages and this can be blocked for protection against Serratia marcescens hemorrhagic pneumonia. Following challenge with S. marcescens, Staphylococcus aureus, Streptococcus pneumoniae, Listeria monocytogenes, uropathogenic Escherichia coli (UPEC, and purified recombinant pneumolysin, macrophages pretreated with inhibitors of RIP1, RIP3, and MLKL were protected against death. Alveolar macrophages in MLKL KO mice were also protected during S. marcescens pneumonia. Inhibition of caspases had no impact on macrophage death and caspase-1 and -3/7 were determined to be inactive following challenge despite the detection of IL-1β in supernatants. Bone marrow-derived macrophages from RIP3 KO, but not caspase-1/11 KO or caspase-3 KO mice, were resistant to PFT-induced death. We explored the mechanisms for PFT-induced necroptosis and determined that loss of ion homeostasis at the plasma membrane, mitochondrial damage, ATP depletion, and the generation of reactive oxygen species were together responsible. Treatment of mice with necrostatin-5, an inhibitor of RIP1; GW806742X, an inhibitor of MLKL; and necrostatin-5 along with co-enzyme Q10 (N5/C10, which enhances ATP production; reduced the severity of S. marcescens pneumonia in a mouse intratracheal challenge model. N5/C10 protected alveolar macrophages, reduced bacterial burden, and lessened hemorrhage in the lungs. We conclude that necroptosis is the major cell death pathway evoked by PFTs in macrophages and the necroptosis pathway can be targeted for disease intervention.

  11. [The use of chest X-rays for surveillance of bacterial pneumonias in children in Latin America]. (United States)

    Lagos, Rosanna; di Fabio, José Luis; Moënne, Karla; Muñoz M, Alma; Wasserman, Steven; de Quadros, Ciro


    The Division of Vaccines and Immunization of the Pan American Health Organization (PAHO) is promoting epidemiological surveillance of bacterial pneumonias in children in Latin America in order to generate scientific evidence to support future decisions concerning using vaccines to control such pneumonias in the countries of the Region of the Americas. The diagnosis of these diseases rarely includes bacteriological documentation of the causative agent. Therefore, studies of this type that are carried out around the world accept radiological images of alveolar consolidation as a confirmatory criterion for a presumptively bacterial pneumonia. This piece examines the theoretical rationale and requirements for using thorax radiology as an instrument for epidemiological surveillance of bacterial pneumonias. The piece also summarizes the activities carried out during 2 years of joint efforts between the Center for Vaccine Development (Centro para Vacunas en Desarrollo) of Chile and PAHO's Division of Vaccines and Immunization. During those 2 years, the two groups encouraged the epidemiological study of bacterial pneumonias in Latin American children, using internationally accepted criteria and definitions as well as tools and practical solutions adapted to the reality of the Region of the America. The activities carried out so far show both the need for and the feasibility of standardizing the interpretation of chest radiographs so that they can be used in epidemiological studies.

  12. Using Standardized Interpretation of Chest Radiographs to Identify Adults with Bacterial Pneumonia--Guatemala, 2007-2012.

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    Jonathan M Wortham

    Full Text Available Bacterial pneumonia is a leading cause of illness and death worldwide, but quantifying its burden is difficult due to insensitive diagnostics. Although World Health Organization (WHO protocol standardizes pediatric chest radiograph (CXR interpretation for epidemiologic studies of bacterial pneumonia, its validity in adults is unknown.Patients (age ≥ 15 years admitted with respiratory infections to two Guatemalan hospitals between November 2007 and March 2012 had urine and nasopharyngeal/oropharyngeal (NP/OP swabs collected; blood cultures and CXR were also performed at physician clinical discretion. 'Any bacterial infection' was defined as a positive urine pneumococcal antigen test, isolation of a bacterial pneumonia pathogen from blood culture, or detection of an atypical bacterial pathogen by polymerase chain reaction (PCR of nasopharyngeal/oropharyngeal (NP/OP specimens. 'Viral infection' was defined as detection of viral pathogens by PCR of NP/OP specimens. CXRs were interpreted according to the WHO protocol as having 'endpoint consolidation', 'other infiltrate', or 'normal' findings. We examined associations between bacterial and viral infections and endpoint consolidation.Urine antigen and/or blood culture results were available for 721 patients with CXR interpretations; of these, 385 (53% had endpoint consolidation and 253 (35% had other infiltrate. Any bacterial infection was detected in 119 (17% patients, including 106 (89% pneumococcal infections. Any bacterial infection (Diagnostic Odds Ratio [DOR] = 2.9; 95% confidence Interval (CI: 1.3-7.9 and pneumococcal infection (DOR = 3.4; 95% CI: 1.5-10.0 were associated with 'endpoint consolidation', but not 'other infiltrate' (DOR = 1.7; 95% CI: 0.7-4.9, and 1.7; 95% CI: 0.7-4.9 respectively. Viral infection was not significantly associated with 'endpoint consolidation', 'other infiltrate,' or 'normal' findings.'Endpoint consolidation' was associated with 'any bacterial infection

  13. Allergic airway inflammation decreases lung bacterial burden following acute Klebsiella pneumoniae infection in a neutrophil- and CCL8-dependent manner. (United States)

    Dulek, Daniel E; Newcomb, Dawn C; Goleniewska, Kasia; Cephus, Jaqueline; Zhou, Weisong; Reiss, Sara; Toki, Shinji; Ye, Fei; Zaynagetdinov, Rinat; Sherrill, Taylor P; Blackwell, Timothy S; Moore, Martin L; Boyd, Kelli L; Kolls, Jay K; Peebles, R Stokes


    The Th17 cytokines interleukin-17A (IL-17A), IL-17F, and IL-22 are critical for the lung immune response to a variety of bacterial pathogens, including Klebsiella pneumoniae. Th2 cytokine expression in the airways is a characteristic feature of asthma and allergic airway inflammation. The Th2 cytokines IL-4 and IL-13 diminish ex vivo and in vivo IL-17A protein expression by Th17 cells. To determine the effect of IL-4 and IL-13 on IL-17-dependent lung immune responses to acute bacterial infection, we developed a combined model in which allergic airway inflammation and lung IL-4 and IL-13 expression were induced by ovalbumin sensitization and challenge prior to acute lung infection with K. pneumoniae. We hypothesized that preexisting allergic airway inflammation decreases lung IL-17A expression and airway neutrophil recruitment in response to acute K. pneumoniae infection and thereby increases the lung K. pneumoniae burden. As hypothesized, we found that allergic airway inflammation decreased the number of K. pneumoniae-induced airway neutrophils and lung IL-17A, IL-17F, and IL-22 expression. Despite the marked reduction in postinfection airway neutrophilia and lung expression of Th17 cytokines, allergic airway inflammation significantly decreased the lung K. pneumoniae burden and postinfection mortality. We showed that the decreased lung K. pneumoniae burden was independent of IL-4, IL-5, and IL-17A and partially dependent on IL-13 and STAT6. Additionally, we demonstrated that the decreased lung K. pneumoniae burden associated with allergic airway inflammation was both neutrophil and CCL8 dependent. These findings suggest a novel role for CCL8 in lung antibacterial immunity against K. pneumoniae and suggest new mechanisms of orchestrating lung antibacterial immunity.

  14. Investigating the adaptive immune response in influenza and secondary bacterial pneumonia and nanoparticle based therapeutic delivery (United States)

    Chakravarthy, Krishnan V.

    In early 2000, influenza and its associated complications were the 7 th leading cause of death in the United States[1-4]. As of today, this major health problem has become even more of a concern, with the possibility of a potentially devastating avian flu (H5N1) or swine flu pandemic (H1N1). According to the Centers for Disease Control (CDC), over 10 countries have reported transmission of influenza A (H5N1) virus to humans as of June 2006 [5]. In response to this growing concern, the United States pledged over $334 million dollars in international aid for battling influenza[1-4]. The major flu pandemic of the early 1900's provided the first evidence that secondary bacterial pneumonia (not primary viral pneumonia) was the major cause of death in both community and hospital-based settings. Secondary bacterial infections currently account for 35-40% mortality following a primary influenza viral infection [1, 6]. The first component of this work addresses the immunological mechanisms that predispose patients to secondary bacterial infections following a primary influenza viral infection. By assessing host immune responses through various immune-modulatory tools, such as use of volatile anesthetics (i.e. halothane) and Apilimod/STA-5326 (an IL-12/Il-23 transcription blocker), we provide experimental evidence that demonstrates that the overactive adaptive Th1 immune response is critical in mediating increased susceptibility to secondary bacterial infections. We also present data that shows that suppressing the adaptive Th1 immune response enhances innate immunity, specifically in alveolar macrophages, by favoring a pro anti-bacterial phenotype. The second component of this work addresses the use of nanotechnology to deliver therapeutic modalities that affect the primary viral and associated secondary bacterial infections post influenza. First, we used surface functionalized quantum dots for selective targeting of lung alveolar macrophages both in vitro and in vivo

  15. Population pharmacokinetics of ceftaroline in patients with acute bacterial skin and skin structure infections or community-acquired bacterial pneumonia. (United States)

    Van Wart, Scott A; Forrest, Alan; Khariton, Tatiana; Rubino, Christopher M; Bhavnani, Sujata M; Reynolds, Daniel K; Riccobene, Todd; Ambrose, Paul G


    Ceftaroline, the active form of ceftaroline fosamil, is a broad-spectrum cephalosporin antibiotic. A population pharmacokinetic (PPK) model for ceftaroline was developed in NONMEM® using data from 185 healthy subjects and 92 patients with acute bacterial skin and skin structure infection (ABSSSI). Data from 128 patients with community-acquired bacterial pneumonia (CABP) were used for external model validation. Healthy subjects received 50-2,000 mg ceftaroline fosamil via intravenous (IV) infusion over 1 hour or intramuscular (IM) injection q12h or q24h. ABSSSI and CABP patients received 600 mg of ceftaroline fosamil IV over 1 hour q12h. A three-compartment model with zero-order IV or parallel first-order IM input and first-order elimination described ceftaroline fosamil PK. A two-compartment model with first-order conversion of prodrug to ceftaroline and parallel linear and saturable elimination described ceftaroline PK. Creatinine clearance was the primary determinant of ceftaroline exposure. Good agreement between the observed data and both population (r(2)  = 0.93) and individual post-hoc (r(2)  = 0.98) predictions suggests the PPK model can adequately approximate ceftaroline PK using covariate information. Such a PPK model can evaluate dose adjustments for patients with renal impairment and generate ceftaroline exposures for use in pharmacokinetic-pharmacodynamic assessments of efficacy in patients with ABSSSI or CABP.

  16. Key Role for Scavenger Receptor B-I in the Integrative Physiology of Host Defense during Bacterial Pneumonia


    Gowdy, Kymberly M.; Madenspacher, Jennifer H.; Azzam, Kathleen M.; Kristin A. Gabor; Janardhan, Kyathanahalli S.; Aloor, Jim J.; Fessler, Michael B.


    Scavenger receptor B-I (SR-BI) is a multirecognition receptor that regulates cholesterol trafficking and cardiovascular inflammation. Although it is expressed by neutrophils (PMNs) and lung-resident cells, no role for SR-BI has been defined in pulmonary immunity. Herein, we report that, compared to SR-BI+/+ counterparts, SR-BI−/− mice suffer markedly increased mortality during bacterial pneumonia associated with higher bacterial burden in lung and blood, deficient induction of the stress gluc...

  17. Acute bacterial meningitis caused by Streptococcus pneumoniae resistant to the antimicrobian agents and their serotypes Meningite bacteriana aguda por Streptococcus pneumoniae resistente aos antimicrobianos e seus sorotipos

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    Andrea Maciel de Oliveira Rossoni


    Full Text Available The main objectives of this study are to evaluate the resistance rates of Streptococcus pneumonia to penicillin G, ceftriaxone and vancomycin in patients with meningitis; to analyze possible risk factors to the antimicrobian resistance; to describe the serotypes detected and to suggest an initial empirical treatment for meningitis. The sensitiveness and serotypes of all isolated S. pneumoniae of patients with acute bacterial meningitis received by the Paraná State Central Laboratory from April 2001 to august 2002 have been evaluated. One hundred S. pneumoniae have been isolated, of which 15% were resistant to penicillin, 1% to cephalosporin and 0% to vancomycin. The serotypes most found were 14 (19%, 3 and 23F (10% each. When only the resistant serotypes were analyzed, the most prevalent was the 14 with 44%. The risk factors found in relation to the S. pneumoniae resistance were: age under one year old (p=0.01 and previous use of antibiotic (p=0.046. The resistance rates found, which were moderate to penicillin, low to cephalosporin and neutral to vancomycin, suggest the isolated use of a 3rd generation cephalosporin as an initial empirical therapy for the treatment of acute bacterial meningitis with a communitarian background.Este estudo teve como objetivo avaliar as taxas de resistência de Streptococcus pneumoniae, isolados de pacientes com meningite, à penicilina G, ceftriaxona e vancomicina; avaliar possíveis fatores de risco para resistência antimicrobiana; descrever os sorotipos encontrados e sugerir a terapêutica empírica inicial para meningite. Foram isoladas 100 amostras de S. pneumoniae, encontrando-se 15% de resistência à penicilina, 1% à cefalosporina e 0% à vancomicina. Os sorotipos mais encontrados foram 14 (19%, 3 e 23F (10% cada. Analisando-se os resistentes, o sorotipo 14 (44% também foi o mais freqüente. Os fatores de risco para resistência de S. pneumoniae encontrados foram: idade menor que um ano (p=0,01 e o uso

  18. Influence of the bacterial phenotypes on the clinical manifestations in Klebsiella pneumoniae bacteremia patients: A retrospective cohort study. (United States)

    Togawa, Atsushi; Toh, Hiromi; Onozawa, Kyoko; Yoshimura, Michinobu; Tokushige, Chiemi; Shimono, Nobuyuki; Takata, Tohru; Tamura, Kazuo


    Ninety-four episodes of Klebsiella pneumoniae bloodstream infection were identified at a university hospital in Japan. After excluding extended-spectrum beta lactamase-producing strains, 83 blood isolates from these patients were assayed in terms of their bacterial phenotypes such as the mucoid and hypermucoviscosity phenotypes. Bacterial phenotypes were correlated with the patients' clinical manifestations. The hypermucoviscosity phenotype was significantly associated with septic shock at the onset of infections (odds ratio, 15.92; 95% confidence interval, 1.27-468.12), but was not associated with liver abscess formation. Mortality was determined by the presence of septic shock. RmpA gene was associated with the induction of the hypermucoviscosity phenotype. These results reveal unique roles of bacterial phenotypes on the patient's clinical condition in K. pneumoniae bacteremia.

  19. What Is Pneumonia? (United States)

    ... Share this page from the NHLBI on Twitter. Pneumonia Pneumonia is a bacterial, viral, or fungal infection of ... and trouble breathing. Many factors affect how serious pneumonia is, such as the type of germ causing ...

  20. Contribution of fucose-containing capsules in Klebsiella pneumoniae to bacterial virulence in mice. (United States)

    Wu, June Hsieh; Wu, Albert M; Tsai, Cheng Gie; Chang, Xin-Yu; Tsai, Shih-Feng; Wu, Ting-Shu


    Bacterium Klebsiella pneumoniae (KP) contains a prominent capsule. Clinical infections usually are associated with pneumonia or urinary tract infection (UTI). Emerging evidence implicates KP in severe liver abscess especially in diabetic patients. The goal of this study was to investigate the capsular polysaccharides from KP of liver abscess (hepatic-KP) and of UTI-KP. The composition of capsular polysaccharides was analyzed by capillary high-performance liquid chromatography (HPLC, Dionex system). The terminal sugars were assayed by binding ability to lectins. The results showed that the capsule of a hepatic KP (KpL1) from a diabetic patient contained fucose, while the capsule from UTI-KP (KpU1) did not. The absence of fucose was verified by the absence of detectable polymerase chain reaction (PCR) fragment for fucose synthesis genes, gmd and wcaG in KpU1. Mice infected with the KpL1 showed high fatality, whereas those infected with the KpU1 showed high survival rate. The KpL1 capsule was reactive to lectins AAA and AAL, which detect fucose, while the KpU1 capsule was reactive to lectin GNA, which detects mannose. Phagocytosis experiment in mouse peritoneal cavity indicated that the peritoneal macrophages could interact with KpU1, while rare association of KpL1 with macrophages was observed. This study revealed that different polysaccharides were displayed on the bacterial capsules of virulent KpL1 as compared with the less virulent KpU1. Interaction of KpU1 with mice peritoneal macrophages was more prominent than that of KpL1. The possession of fucose might contribute to KpL1 virulence by avoiding phagocytosis since fucose on bacteria had been implicated in immune evasion.

  1. Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis

    DEFF Research Database (Denmark)

    Østergaard, C; O´Reilly, T; Brandt, C


    was induced by intracisternal injection of approximately 1 x 10(6) CFU Streptococcus pneumoniae, type 3, and the 26 rabbits were either provided with approximately 1 x 10(6) CFU S. pneumoniae intravenously at 0 hour ("bacteraemic" rabbits, n = 9), immunized with paraformaldehyde-killed S. pneumoniae for 5...

  2. Isolation of Bacterial Agents from the Lungs of Cattle with Pneumonia and Detection of Pasteurella Spp. by Polymerase Chain Reaction


    KILIÇ, Ayşe; MUZ, Adile


    Lungs from 8222 cattle slaughtered at an abattoir in Elazığ were examined macroscopically, and pneumonia was detected in 500 (6.1%) lungs. These samples were inoculated onto blood agar supplemented with 7% sheep blood for isolation of bacterial agents. A polymerase chain reaction (PCR) based upon the use of species-specific primers was carried out on DNA samples extracted from suspected Pasteurella spp. isolates. In addition, a mouse inoculation test was carried out on suspected Pasteurella m...

  3. Bone marrow-derived cells participate in stromal remodeling of the lung following acute bacterial pneumonia in mice. (United States)

    Serikov, Vladimir B; Mikhaylov, Viatcheslav M; Krasnodembskay, Anna D; Matthay, Michael A


    Bone marrow-derived cells (BMDC) have been shown to graft injured tissues, differentiate in specialized cells, and participate in repair. The importance of these processes in acute lung bacterial inflammation and development of fibrosis is unknown. The goal of this study was to investigate the temporal sequence and lineage commitment of BMDC in mouse lungs injured by bacterial pneumonia. We transplanted GFP-tagged BMDC into 5-Gy-irradiated C57BL/6 mice. After 3 months of recovery, mice were subjected to LD(50) intratracheal instillation of live E. coli (controls received saline) which produced pneumonia and subsequent areas of fibrosis. Lungs were investigated by immunohistology for up to 6 months. At the peak of lung inflammation, the predominant influx of BMDC were GFP(+) leukocytes. Postinflammatory foci of lung fibrosis were evident after 1-2 months. The fibrotic foci in lung stroma contained clusters of GFP(+) CD45(+) cells, GFP(+) vimentin-positive cells, and GFP(+) collagen I-positive fibroblasts. GFP(+) endothelial or epithelial cells were not identified. These data suggest that following 5-Gy irradiation and acute bacterial pneumonia, BMDC may temporarily participate in lung postinflammatory repair and stromal remodeling without long-term engraftment as specialized endothelial or epithelial cells.


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    Full Text Available OBJECTIVES: To outline the spectrum of bacteria causing pneumonia and the pattern of antimicrobial sensitivity in outpatients with pneumonia in a tertiary care hospital in Himachal Pradesh. METHODS: Sputum of 108 immuno competent pneumonia patients attending outpatient departments of Medicine and Pulmonary medicine of Dr. R. P. Government Medical College , Kangra at Tanda was sent for Gram staining and culture and sensitivity testing. RESULTS: Commensals were detected in most of the cases (32 , 29.6% followed by Staphylococcus aureus in 17(15.7% and Streptococcus pneumoniae in 16(14.8%. This was followed by three Gram negative organisms namely E Coli (11 , 10.2% , Pseudomonas (10 , 9.2% and Klebsiella (8 , 7.2%. No growth was obtained in 7(6.5% and other organisms were isolated in 7(6.5% specimens. Staphylococcus aureus was sensitive to vancomycin , clindamycin , cefoxitin , azithromycin and cotrimoxazole. Streptococcus pneumoniae was found to be sensitive to vancomycin , clindamycin , gentamicin , azithromycin , penicillin , cotrimoxazole , amoxicillin +clavulanic acid. Klebsiella was found to be sensitive to imipenem , azithromycin , ciprofloxacin , gentamicin and amoxicillin +clavulanic acid. E coli was sensitive to imipenem , gentamicin and amoxicillin +clavulanic acid. Pseudomonas aeruginosa was found to be sensitive to gentamicin , cefta zidime , imipenem , ticarcillin and piperacillin. CONCLUSION: Staphylococcus aureus and Streptococcus pneumoniae are the commonest organism causing pneumonia. Streptococcus pneumoniae is resistant to many antibiotics. Azithromycin can be the first line therapy for pneumonia.

  5. Viral and bacterial aetiology of community-acquired pneumonia in adults

    NARCIS (Netherlands)

    Huijskens, Elisabeth G. W.; van Erkel, Adriana J. M.; Palmen, Fernand M. H.; Buiting, Anton G. M.; Kluytmans, Jan A. J. W.; Rossen, John W. A.


    BACKGROUND: Modern molecular techniques reveal new information on the role of respiratory viruses in community-acquired pneumonia. In this study, we tried to determine the prevalence of respiratory viruses and bacteria in patients with community-acquired pneumonia who were admitted to the hospital.

  6. Comparative effects of carbapenems on bacterial load and host immune response in a Klebsiella pneumoniae murine pneumonia model. (United States)

    Hilliard, Jamese J; Melton, John L; Hall, LeRoy; Abbanat, Darren; Fernandez, Jeffrey; Ward, Christine K; Bunting, Rachel A; Barron, A; Lynch, A Simon; Flamm, Robert K


    Doripenem is a carbapenem with potent broad-spectrum activity against Gram-negative pathogens, including antibiotic-resistant Enterobacteriaceae. As the incidence of extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacilli is increasing, it was of interest to examine the in vivo comparative efficacy of doripenem, imipenem, and meropenem against a Klebsiella pneumoniae isolate expressing the TEM-26 ESBL enzyme. In a murine lethal lower respiratory infection model, doripenem reduced the Klebsiella lung burden by 2 log(10) CFU/g lung tissue over the first 48 h of the infection. Treatment of mice with meropenem or imipenem yielded reductions of approximately 1.5 log(10) CFU/g during this time period. Seven days postinfection, Klebsiella titers in the lungs of treated mice decreased an additional 2 log(10) CFU/g relative to those in the lungs of untreated control animals. Lipopolysaccharide (LPS) endotoxin release assays indicated that 6 h postinfection, meropenem- and imipenem-treated animals had 10-fold more endotoxin in lung homogenates and sera than doripenem-treated mice. Following doripenem treatment, the maximum endotoxin release postinfection (6 h) was 53,000 endotoxin units (EU)/ml, which was 2.7- and 6-fold lower than imipenem or meropenem-treated animals, respectively. While the levels of several proinflammatory cytokines increased in both the lungs and sera following intranasal K. pneumoniae inoculation, doripenem treatment, but not meropenem or imipenem treatment, resulted in significantly increased interleukin 6 levels in lung homogenates relative to those in lung homogenates of untreated controls, which may contribute to enhanced neutrophil killing of bacteria in the lung. Histological examination of tissue sections indicated less overall inflammation and tissue damage in doripenem-treated mice, consistent with improved antibacterial efficacy, reduced LPS endotoxin release, and the observed cytokine induction profile.

  7. Pneumonia in slaughtered sheep in south-western Iran: pathological characteristics and aerobic bacterial aetiology

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    Shahrzad Azizi


    Full Text Available In this study, the lungs of 1,000 sheep carcasses were subjected to gross examination and those suspected to be infected with pneumonia were studied at histopathological level as well as examined for presence of bacteria. Pneumonia was detected in 42 (4.2% carcasses. Based on histopathological lesions, 45.24% were affected with suppurative bronchopneumonia, 20.93% with interstitial pneumonia, 11.9% bronchointerstitial pneumonia, 7.14% with fibrinous bronchopneumonia and 2.38% with embolic pneumonia. In addition, 11.9% of the lungs showed lung abscesses and 2.33% were affected with pleuritis without involving pulmonary parenchyma. Bacteriological examination revealed presence of ovine pathogens, such as Pasteurella multocida (24.53%, Staphylococcus aureus (20.75%, Klebsiella pneumoniae (15.09%, Corynebacterium pseudotuberculosis (7.55% and Actinomyces pyogenes (1.89%. The most common form of pneumonia was suppurative bronchopneumonia with moderate amounts of fibrin deposits on the pleural surface and inside the bronchioles and alveoli.

  8. Interleukin-35 is upregulated in response to influenza virus infection and secondary bacterial pneumonia. (United States)

    Chen, Yi; Wang, Chuan-jiang; Lin, Shi-hui; Zhang, Mu; Li, Sheng-yuan; Xu, Fang


    Postinfluenza pneumococcal pneumonia is an important cause of global morbidity and mortality. What causes this increased susceptibility is not well elucidated. IL-35 is a newly described cytokine in infectious tolerance. A murine model was established to study postinfluenza pneumococcal pneumonia and evaluate the role of IL-35 in host defense against postinfluenza pneumococcal pneumonia. Pulmonary IL-35 was rapidly up-regulated during murine influenza infection, which was partially mediated by type I IFN-α/β receptor signaling pathway. Secondary pneumococcal infection led to a synergistic IL-35 response in influenza-infected mice. Clinical analysis showed that IL-35 levels were significantly elevated in the patients with influenza infection compared with healthy individuals and influenza infection could induce IL-35 production from human peripheral blood mononuclear cells. These data suggest that IL-35 contributes to the increased susceptibility to secondary pneumococcal pneumonia at least in part by inhibiting the early immune response.

  9. Klebsiella pneumoniae subsp.pneumoniae引起云南省香蕉细菌性叶斑病%A New Bacterial Leaf Spot of Banana Caused by Klebsiella pneumoniae subsp.pneumoniae in Yunnan Province of China

    Institute of Scientific and Technical Information of China (English)

    陈丽华; 黄敏; 何鹏飞; Hon-hing HO; 吴毅歆; 何月秋


    To identify the pathogen causing a new bacterial leaf spot on banana (Musa sapientum L.) in Xinping County,Yunnan Province of China,the bacterium was isolated from the infected banana plant and identified by cultural and morphological studies,pathogenicity test,physiological and biochemical detection as well as sequences analyses of gyrB,16S rDNA and rpoB genes.The results showed that the leaf spot disease was caused by Klebsiella pneumoniae subsp.pneumoniae.The pathogen could infect banana fruit,pseudo-stem and leaf.Black spots appeared on diseased pseudo-stems within 3 days after inoculation and they enlarged lengthwise in both directions,causing massive brown necrosis of the internal tissues within the pseudo-stem in 7 days.This is the first report of K.pneumoniae subsp.pneumoniae causing leaf spot of banana plants in the world.%为明确一种新的香蕉(Musa sapientum)细菌性叶斑病病原菌,以云南省新平县香蕉园区发现的一种新病害为供试材料,通过分离培养、形态观察、致病性测定、生理生化试验和gyrB,16S rDNA和rpoB基因片段分析,对病原菌进行了鉴定.该病由克雷伯氏肺炎球菌肺炎亚种(Klebsiella pneumoniae subsp.pneumoniae)引起,病菌可侵染香蕉叶片、假茎和果实.茎干被病原菌侵入3d后即可出现黑色小斑点,在接种部位附近呈上下方向蔓延趋势,7d后茎干上出现大面积棕色坏死,内部组织褐变.本文在世界上首次报道克雷伯氏肺炎球菌肺炎亚种可侵染香蕉植株,引起香蕉细菌性叶斑病.

  10. Increased Risk of Pneumonia and Bronchiolitis after Bacterial Colonization of the Airways as Neonates

    DEFF Research Database (Denmark)

    Vissing, Nadja Hawwa; Chawes, Bo Lk; Bisgaard, Hans


    Rationale: The frequency of pneumonia and bronchiolitis exhibits considerable variation in otherwise healthy children, and suspected risk factors explain only a minor proportion of the variation. We hypothesized that alterations in the airway microbiome in early life may be associated with suscep......Rationale: The frequency of pneumonia and bronchiolitis exhibits considerable variation in otherwise healthy children, and suspected risk factors explain only a minor proportion of the variation. We hypothesized that alterations in the airway microbiome in early life may be associated...... with susceptibility to pneumonia and bronchiolitis in young children. Objectives: To investigate the relation between neonatal airway colonization and pneumonia and bronchiolitis during the first three years of life. Methods: Participants comprised children of the COPSAC2000 cohort; a prospective birth cohort study...... of 411 children born to asthmatic mothers. Aspirates from the hypopharynx at age four weeks were cultured for S.pneumoniae, H.influenzae, M.catarrhalis, and S.aureus. Clinical information on pneumonia and bronchiolitis within the first three years of life was prospectively collected by the research...

  11. Review of Non-Bacterial Infections in Respiratory Medicine: Viral Pneumonia. (United States)

    Galván, José María; Rajas, Olga; Aspa, Javier


    Although bacteria are the main pathogens involved in community-acquired pneumonia, a significant number of community-acquired pneumonia are caused by viruses, either directly or as part of a co-infection. The clinical picture of these different pneumonias can be very similar, but viral infection is more common in the pediatric and geriatric populations, leukocytes are not generally elevated, fever is variable, and upper respiratory tract symptoms often occur; procalcitonin levels are not generally affected. For years, the diagnosis of viral pneumonia was based on cell culture and antigen detection, but since the introduction of polymerase chain reaction techniques in the clinical setting, identification of these pathogens has increased and new microorganisms such as human bocavirus have been discovered. In general, influenza virus type A and syncytial respiratory virus are still the main pathogens involved in this entity. However, in recent years, outbreaks of deadly coronavirus and zoonotic influenza virus have demonstrated the need for constant alert in the face of new emerging pathogens. Neuraminidase inhibitors for viral pneumonia have been shown to reduce transmission in cases of exposure and to improve the clinical progress of patients in intensive care; their use in common infections is not recommended. Ribavirin has been used in children with syncytial respiratory virus, and in immunosuppressed subjects. Apart from these drugs, no antiviral has been shown to be effective. Prevention with anti-influenza virus vaccination and with monoclonal antibodies, in the case of syncytial respiratory virus, may reduce the incidence of pneumonia.

  12. Focus on JNJ-Q2, a novel fluoroquinolone, for the management of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections

    Directory of Open Access Journals (Sweden)

    Jones TM


    Full Text Available Travis M Jones,1,2 Steven W Johnson,1,3 V Paul DiMondi,1,4 Dustin T Wilson,1,2 1Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, 2Department of Pharmacy, Duke University Hospital, Durham, 3Department of Pharmacy, Forsyth Medical Center, Novant Health, Winston-Salem, 4Department of Pharmacy, Durham VA Medical Center, Durham, NC, USA Abstract: JNJ-Q2 is a novel, fifth-generation fluoroquinolone that has excellent in vitro and in vivo activity against a variety of Gram-positive and Gram-negative organisms. In vitro studies indicate that JNJ-Q2 has potent activity against pathogens responsible for acute bacterial skin and skin structure infections (ABSSSI and community-acquired bacterial pneumonia (CABP, such as Staphylococcus aureus and Streptococcus pneumoniae. JNJ-Q2 also has been shown to have a higher barrier to resistance compared to other agents in the class and it remains highly active against drug-resistant organisms, including methicillin-resistant S. aureus, ciprofloxacin-resistant methicillin-resistant S. aureus, and drug-resistant S. pneumoniae. In two Phase II studies, the efficacy of JNJ-Q2 was comparable to linezolid for ABSSSI and moxifloxacin for CABP. Furthermore, JNJ-Q2 was well tolerated, with adverse event rates similar to or less than other fluoroquinolones. With an expanded spectrum of activity and low potential for resistance, JNJ-Q2 shows promise as an effective treatment option for ABSSSI and CABP. Considering its early stage of development, the definitive role of JNJ-Q2 against these infections and its safety profile will be determined in future Phase III studies. Keywords: JNJ-Q2, fluoroquinolone, ABSSSI, CABP, MRSA

  13. Comparative in-vitro efficacy of fluoroquinolones against Streptococcus pneumoniae recovered from bacterial keratitis as determined by E-test

    Directory of Open Access Journals (Sweden)

    Ramakrishnan R


    Full Text Available Background and Objectives: The advent of new fluoroquinolones has drawn the attention for reliable methods on the in-vitro susceptibility testing of Streptococccus pneumoniae. This study attempts to determine the minimum inhibitory concentration (MIC of second-generation (ciprofloxacin and ofloxacin, third-generation (levofloxacin and the fourth-generation (moxifloxacin and gatifloxacin fluoroquinolones against S. pneumoniae recovered from bacterial keratitis. Materials and Methods: In retrospect, the MICs of 50 strains of S. pneumoniae isolated from the corneal scrapes of patients with bacterial keratitis were determined against ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin and moxifloxacin using E-tests. The National Committee of Clinical Laboratory Standards (NCCLS susceptibility patterns and the potencies of the MICs were statistically compared. Results: The median MIC of ciprofloxacin (0.25μg/ml was found to be lower than the median MICs of ofloxacin (0.5μg/ml (P < 0.449 and levofloxacin (1.0μg/ml (P < 0.001. The median MICs of gatifloxacin (0.1μg/ml was lower than the median MICs of ciprofloxacin (0.25μg/ml (P < 0.001, ofloxacin (0.5μg/ml (P < 0.001 and levofloxacin (1.0μg/ml (P < 0.001. Moxifloxacin (0.06μg/ml had showed lower median MICs than gatifloxacin (0.1μg/ml (P < 0.001 levofloxacin (1.0μg/ml (P < 0.001, ofloxacin (0.5μg/ml (P < 0.001 and ciprofloxacin (0.25μg/ml (P < 0.001. Moxifloxacin (0.06μg/ml had a lower MIC50 (μg/ml than gatifloxacin (0.1μg/ml, levofloxacin (1.0μg/ml, ciprofloxacin (0.25μg/ml and ofloxacin (0.5μg/ml. MIC90 (μg/ml of moxifloxacin (0.06μg/ml was found to be lower than the MIC90 (μg/ml of gatifloxacin (0.5μg/ml, levofloxacin (1.0μg/ml, ofloxacin (0.5μg/ml and ciprofloxacin (0.5μg/ml. Conclusion: Based on in-vitro testing, the five portrayed fluoroquinolones 100% sensitivity to S. pneumoniae. However, the fourth-generation fluoroquinolone, moxifloxacin appeared to be more

  14. Clinical evaluation of the role of ceftaroline in the management of community acquired bacterial pneumonia

    Directory of Open Access Journals (Sweden)

    Maselli DJ


    Full Text Available Diego J Maselli1, Juan F Fernandez1, Christine Y Whong2, Kelly Echevarria1,3, Anoop M Nambiar1,3, Antonio Anzueto1,3, Marcos I Restrepo1,3,41University of Texas Health Science Center, San Antonio, Texas, 2Memorial Hermann – Texas Medical Center, Houston, TX, 3South Texas Veterans Health Care System Audie l Murphy Division, San Antonio, TX, 4Veterans Evidence Research Dissemination and Implementation Center (VERDICT, San Antonio, TX, USAAbstract: Ceftaroline fosamil (ceftaroline was recently approved for the treatment of community-acquired pneumonia (CAP and complicated skin infections. This newly developed cephalosporin possesses a broad spectrum of activity against gram-positive and gram-negative bacteria. Most importantly, ceftaroline demonstrates potent in vitro antimicrobial activity against multi-drug resistant Streptococcus pneumoniae and methicillin-resistant strains of Staphylococcus aureus. In two Phase III, double-blinded, randomized, prospective trials (FOCUS 1 and FOCUS 2, ceftaroline was shown to be non-inferior to ceftriaxone for the treatment of CAP in hospitalized patients. Ceftaroline exhibits low resistance rates and a safety profile similar to that of other cephalosporins. In this review, we will evaluate the pharmacological characteristics, safety, antimicrobial properties, and efficacy of ceftaroline and its applications in the treatment of CAP.Keywords: s. pneumoniae, s. aureus, cephalosporins, pneumonia, ceftaroline, community acquired pneumonia

  15. Pneumonia associada à ventilação mecânica: impacto da multirresistência bacteriana na morbidade e mortalidade Ventilator-associated pneumonia: impact of bacterial multidrug-resistance on morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Paulo José Zimermann Teixeira


    : Retrospective cohort study. Over 40 consecutive months, 91 patients on mechanical ventilation developed pneumonia. Cases were grouped into those caused by multidrug-resistant microorganisms and those caused by drug-sensitive microorganisms. RESULTS: Multidrug-resistant bacteria were isolated in 75 cases (82.4% and drug-sensitive bacteria in 16 (17.6%. Clinical and epidemiological characteristics were not statistically different between the groups. Staphylococcus aureus was responsible for 27.5% of ventilator-associated pneumonia episodes and Pseudomonas aeruginosa for 17.6%. Early-onset ventilator-associated pneumonia occurred in 33 patients (36.3% and late-onset in 58 (63.7%. Time on mechanical ventilation, length of intensive care unit stay and overall length of hospital stay were not statistically different between groups. Empirical treatment was considered inadequate in 42 patients with pneumonia caused by multidrug-resistant microorganisms (56% and in 4 with pneumonia caused by drug-sensitive microorganisms (25% (p = 0.02. Death occurred in 46 patients with pneumonia caused by multidrug-resistant microorganisms (61.3% and in 4 with pneumonia caused by drug-sensitive microorganisms (25% (p = 0.008. CONCLUSION: Bacterial multidrug-resistance had no impact on morbidity but was associated with higher mortality.

  16. Atg7 deficiency impairs host defense against Klebsiella pneumoniae by impacting bacterial clearance, survival and inflammatory responses in mice. (United States)

    Ye, Yan; Li, Xuefeng; Wang, Wenxue; Ouedraogo, Kiswendsida Claude; Li, Yi; Gan, Changpei; Tan, Shirui; Zhou, Xikun; Wu, Min


    Klebsiella pneumoniae (Kp) is a Gram-negative bacterium that can cause serious infections in humans. Autophagy-related gene 7 (Atg7) has been implicated in certain bacterial infections; however, the role of Atg7 in macrophage-mediated immunity against Kp infection has not been elucidated. Here we showed that Atg7 expression was significantly increased in murine alveolar macrophages (MH-S) upon Kp infection, indicating that Atg7 participated in host defense. Knocking down Atg7 with small-interfering RNA increased bacterial burdens in MH-S cells. Using cell biology assays and whole animal imaging analysis, we found that compared with wild-type mice atg7 knockout (KO) mice exhibited increased susceptibility to Kp infection, with decreased survival rates, decreased bacterial clearance, and intensified lung injury. Moreover, Kp infection induced excessive proinflammatory cytokines and superoxide in the lung of atg7 KO mice. Similarly, silencing Atg7 in MH-S cells markedly increased expression levels of proinflammatory cytokines. Collectively, these findings reveal that Atg7 offers critical resistance to Kp infection by modulating both systemic and local production of proinflammatory cytokines.

  17. [Case report: Löffler's syndrome due to Ascaris lumbricoides mimicking acute bacterial community--acquired pneumonia]. (United States)

    Acar, Ali; Oncül, Oral; Cavuşlu, Saban; Okutan, Oğuzhan; Kartaloğlu, Zafer


    In this study we present a patient with Loeffler's syndrome caused by Ascaris lumbricoides who presented with the clinical findings of community-acquired pneumonia (CAP). Our patient, who was twenty-five years old, and who had had symptoms such as coughing, expectorating, dyspnea and fever for approximately ten days, was hospitalized. We auscultated polyphonic rhonchuses at the both hemithoraxes. A chest X-ray revealed bilateral lower zone patch consolidation. Acute bacterial community acquired pneumonia (CAP) was diagnosed due to these findings and empirical antibiotic treatment was begun. Repeated sputum Gram stains were negative, and both sputum and blood cultures were sterile. A sputum smear was negative for acid-fast bacilli. The patient's fever and respiratory complaint did not respond to the empirical antibiotics therapy. During the course of advanced investigations, we measured peripheric eosinophilia, and high levels of total Eo and total IgE, and observed Ascaris lumbricoides eggs during stool examination. The patient was given a diagnosis of Loeffler's syndrome. Thereupon the patient was treated successfully with one dose of albendazol 400 mg. In conclusion, we suggest that Loeffler's syndrome must be considered early in the differential diagnosis for CAP when peripheric eosinophilia is seen in patients if they live in an endemic area for parasitic disease.

  18. Detection of respiratory viral and bacterial pathogens causing pediatric community-acquired pneumonia in Beijing using real-time PCR

    Institute of Scientific and Technical Information of China (English)

    Tie-Gang Zhang; Ai-Hua Li; Min Lyu; Meng Chen; Fang Huang; Jiang Wu


    Objective: The aim of this study was to determine the etiology and prevalence of pediatric CAP in Beijing using a real-time polymerase chain reaction (PCR) technique. Methods: Between February 15, 2011 and January 18, 2012, 371 pediatric patients with CAP were enrolled at Beijing Children's Hospital. Sixteen respiratory viruses and two bacteria were detected from tracheal aspirate specimens using commercially available multiplex real-time reverse transcription PCR (RT-PCR) kits. Results: A single viral pathogen was detected in 35.3%of enrolled patients, multiple viruses in 11.6%, and virus/bacteria co-infection in 17.8%. In contrast, only 6.5%of patients had a single bacterial pathogen and 2.2%were infected with multiple bacteria. The etiological agent was unknown for 26.7% of patients. The most common viruses were respiratory syncytial virus (RSV) (43.9%), rhinovirus (14.8%), parainfluenza virus (9.4%), and adenovirus (8.6%). In patients under three years of age, RSV (44.6%), rhinovirus (12.8%), and Streptococcus pneumoniae (9.9%) were the most frequent pathogens. In children aged 3e7 years, S. pneumoniae (38.9%), RSV (30.6%), Haemophilus influenzae (19.4%), and adenovirus (19.4%) were most prevalent. Finally in children over seven years, RSV (47.3%), S. pneumoniae (41.9%), and rhinovirus (21.5%) infections were most frequent. Conclusions: Viral pathogens, specifically RSV, were responsible for the majority of CAP in pediatric patients. However, both S. pneumoniae and H. influenzae contributed as major causes of disease. Commercially available multiplexing real-time PCR allowed for rapid detection of the etiological agent. Copyright © 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (

  19. Bacterial pneumonia following bone marrow transplantation: HRCT findings Achados de TCAR nas pneumonias bacterianas após transplante de medula óssea

    Directory of Open Access Journals (Sweden)

    Luiz Otávio de Mattos Coelho


    Full Text Available OBJECTIVE: To describe HRCT findings in patients with bacterial pneumonia following bone marrow transplantation (BMT. METHODS: This was a retrospective study involving 30 patients diagnosed with bacterial pneumonia in whom HRCT of the chest was performed within 24 h after the onset of symptoms and the diagnosis was confirmed, based on a positive culture of sputum or bronchial aspirate, together with a positive pleural fluid or blood culture, within one week after symptom onset. There were 20 male patients and 10 female patients. The median age was 21 years (range, 1-41 years. The BMT had been performed for the treatment of the following: chronic myeloid leukemia, in 14 cases; severe aplastic anemia, in 6; acute myeloid leukemia, in 4; Fanconi's anemia, in 3; and acute lymphocytic leukemia, in 3. Two radiologists analyzed the HRCT scans and reached their final decisions by consensus. RESULTS: The most common HRCT findings were air-space consolidation (in 60%, small centrilobular nodules (in 50%, ground-glass opacities (in 40%, bronchial wall thickening (in 20%, large nodules (in 20%, pleural lesions (in 16.7% and tree-in-bud opacities (in 10%. The pulmonary lesions were distributed in the central and peripheral areas in 15 patients, whereas they were exclusively peripheral in 11. Lesions were located in the lower and middle lobes of the lung in 22 and 20 patients, respectively. CONCLUSIONS: The most common HRCT findings in our patient sample were air-space consolidation, small centrilobular nodules and ground-glass opacities, most often in the central and peripheral regions of the middle and lower lung zones.OBJETIVO: Descrever os achados de TCAR em pacientes com pneumonia bacteriana após transplante de medula óssea (TMO. MÉTODOS: Estudo retrospectivo com 30 pacientes diagnosticados com pneumonia bacteriana, documentada com TCAR do tórax realizada em até 24 h do início dos sintomas, e com diagnóstico comprovado com base em cultura positiva

  20. Computed tomography for the diagnosis and treatment monitoring of bacterial pneumonia in Indian pythons (Python molurus). (United States)

    Pees, M; Kiefer, I; Oechtering, G; Krautwald-Junghanns, M-E


    Eight Indian pythons (Python molurus) with clinical and microbiological evidence of pneumonia were examined by computed tomography (ct) before and after treatment. The results were assessed subjectively and measurements were taken following a standard protocol. Changes in the lung tissue of all the pythons were diagnosed, and the extent of the disease could be assessed. ct examinations after treatment showed an improvement in the six pythons whose clinical condition had improved, but in the other two pythons they demonstrated the severity of the disease. The subjective assessments were superior to the evaluation of measurements of attenuation in regions of interest. However, the average and the maximum attenuation provided additional information on the extent of the disease. Except for one python with only mild clinical signs, the attenuation after successful treatment was still higher than in healthy pythons.

  1. Sphingosine Prevents Bacterial Adherence to Endotracheal Tubes: A Novel Mechanism to Prevent Ventilator-Associated Pneumonia (United States)


    VAP is multifactorial, but is undeniably related to the presence of the endotracheal tube (ETT). Tracheal intubation inhibits the cough the presence of the endotracheal tube (ETT). Tracheal intubation inhibits the cough reflex, affects mucociliary clearance, provides direct access...AFRL-SA-WP-TR-2016-0009 Sphingosine Prevents Bacterial Adherence to Endotracheal Tubes: A Novel Mechanism to Prevent Ventilator

  2. Prevent Pneumonia

    Centers for Disease Control (CDC) Podcasts


    CDC’s Matthew Westercamp explains what pneumonia is, its symptoms, and how to prevent it.  Created: 8/6/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Respiratory Diseases Branch (RDB).   Date Released: 8/6/2015.


    Xu, Yongan; Ge, Lin; Abdel-Razek, Osama; Jain, Sumeet; Liu, Zhiyong; Hong, Yucai; Nieman, Gary; Johnson, Francis; Golub, Lorne M; Cooney, Robert N; Wang, Guirong


    Staphylococcus aureus is a common cause of nosocomial pneumonia frequently resulting in acute respiratory distress syndrome (ARDS). Surfactant protein B (SP-B) gene expresses two proteins involved in lowering surface tension and host defense. Genotyping studies demonstrate a significant association between human SP-B genetic variants and ARDS. Curcumins have been shown to attenuate host inflammation in many sepsis models. Our hypothesis is that functional differences of SP-B variants and treatment with curcumin (CMC2.24) modulate lung injury in bacterial pneumonia. Humanized transgenic mice, expressing either SP-B T or C allele without mouse SP-B gene, were used. Bioluminescent labeled S. aureus Xen 36 (50 μL) was injected intratracheally to cause pneumonia. Infected mice received daily CMC2.24 (40 mg/kg) or vehicle alone by oral gavage. Dynamic changes of bacteria were monitored using in vivo imaging system. Histological, cellular, and molecular indices of lung injury were studied in infected mice 48 h after infection. In vivo imaging analysis revealed total flux (bacterial number) was higher in the lung of infected SP-B-C mice compared with infected SP-B-T mice (P pneumonia than mice with SP-B-T allele, and that CMC2.24 attenuates lung injury thus reducing mortality.

  4. 细菌生物被膜与慢性难治性肺部感染%Bacterial Biofilm and Chronic Refractory Pneumonia

    Institute of Scientific and Technical Information of China (English)

    张乃芬; 张继华


    目的:了解细菌生物被膜的形成及在肺部感染中的作用。方法:收集近年有关细菌生物被膜与难治性肺部感染的研究资料并加以归纳综合。结果:细菌生物被膜与难治性肺部感染的发生密切相关。结论:细菌生物被膜的形成与治疗研究对肺部感染的防治有可观的前景。%Objective: To investigate the formation and functions of bacterial biofilm in pneumonia. Methods:Collecting and summarizing the related literatures about bacteria biofilm and refractory pneumonia in recent years. Results: Refractory pneumonia is closely related to bacteria biofilm. Conclusions: The formations and treatments studying of bacterial biofilm have bright future in the preventmem and treatment of pneumonia.

  5. Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates

    Directory of Open Access Journals (Sweden)

    Ana Carolina Souza-Oliveira

    Full Text Available Abstract Ventilator-associated pneumonia is the most prevalent nosocomial infection in intensive care units and is associated with high mortality rates (14–70%. Aim This study evaluated factors influencing mortality of patients with Ventilator-associated pneumonia (VAP, including bacterial resistance, prescription errors, and de-escalation of antibiotic therapy. Methods This retrospective study included 120 cases of Ventilator-associated pneumonia admitted to the adult adult intensive care unit of the Federal University of Uberlândia. The chi-square test was used to compare qualitative variables. Student's t-test was used for quantitative variables and multiple logistic regression analysis to identify independent predictors of mortality. Findings De-escalation of antibiotic therapy and resistant bacteria did not influence mortality. Mortality was 4 times and 3 times higher, respectively, in patients who received an inappropriate antibiotic loading dose and in patients whose antibiotic dose was not adjusted for renal function. Multiple logistic regression analysis revealed the incorrect adjustment for renal function was the only independent factor associated with increased mortality. Conclusion Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations.

  6. TLR2 signaling decreases transmission of Streptococcus pneumoniae by limiting bacterial shedding in an infant mouse Influenza A co-infection model.

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    Aimee L Richard


    Full Text Available While the importance of transmission of pathogens is widely accepted, there is currently little mechanistic understanding of this process. Nasal carriage of Streptococcus pneumoniae (the pneumococcus is common in humans, especially in early childhood, and is a prerequisite for the development of disease and transmission among hosts. In this study, we adapted an infant mouse model to elucidate host determinants of transmission of S. pneumoniae from inoculated index mice to uninfected contact mice. In the context of co-infection with influenza A virus, the pneumococcus was transmitted among wildtype littermates, with approximately half of the contact mice acquiring colonization. Mice deficient for TLR2 were colonized to a similar density but transmitted S. pneumoniae more efficiently (100% transmission than wildtype animals and showed decreased expression of interferon α and higher viral titers. The greater viral burden in tlr2-/- mice correlated with heightened inflammation, and was responsible for an increase in bacterial shedding from the mouse nose. The role of TLR2 signaling was confirmed by intranasal treatment of wildtype mice with the agonist Pam3Cys, which decreased inflammation and reduced bacterial shedding and transmission. Taken together, these results suggest that the innate immune response to influenza virus promotes bacterial shedding, allowing the bacteria to transit from host to host. These findings provide insight into the role of host factors in the increased pneumococcal carriage rates seen during flu season and contribute to our overall understanding of pathogen transmission.

  7. Two Cases of Bacterial Pneumonia in Bottle-nosed Dolphins (Tursiops Gillii at the Seoul Zoo, Korea

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    Kyung-Yeon Eo and Oh-Deog Kwon


    Full Text Available Two bacterial pneumonia cases of bottle-nosed dolphins (Tursiops gillii were found in Seoul Zoo. Firstly, severe fibrous pleuropneumonia was revealed in a 14-year-old male bottle-nosed dolphin on its necropsy. The clinical signs included anorexia, listing posture, and vertical submerging after the initial signs of low activity and avoiding trainers. White blood cell count increased up to 31.80 × 103/µl. Despite aggressive antibiotics therapy of intramuscular injection and nebulization it died two months later. At early time of illness Staphylococcus aureus and Proteus mirabilis were isolated. Lately Pseudomonas aeruginosa was isolated from the exhaled air culture and direct sample of lung parenchyma on necropsy. Secondly, a 6-year-old male bottle-nosed dolphin with anorexia and tendency to avoid trainers was completely recovered after prompt treatment with antibiotics and NSAIDs for six days prior to diagnosis. The diagnosis was based on history, clinical signs, blood cell count, and mucous culture from blowhole. The count of white blood cell dramatically decreased from 25.36 × 103/µl to 7.28 × 103/ µl after four days of antibiotics therapy. Staphylococcus aureus was isolated from the culture.

  8. Atypical pneumonia (United States)

    Walking pneumonia; Community-acquired pneumonia - atypical ... Bacteria that cause atypical pneumonia include: Mycoplasma pneumonia is caused by the bacteria Mycoplasma pneumoniae . It often affects people younger than age 40. Pneumonia due ...

  9. Clinical Significance of CRP and PCT Detection for the Diagnosis of Bacterial Pneumonia and Mycoplasma Pneumonia in Children%CRP及PCT检测对儿童细菌性肺炎及支原体肺炎诊断的临床意义

    Institute of Scientific and Technical Information of China (English)



    目的:探讨C反应蛋白(CRP, C-reactive protein)及降钙素原(PCT, Procalcitonin)与儿童细菌性肺炎及支原体肺炎发病及病程的相关性。方法采用透射比浊法对140例儿童支原体肺炎及细菌性肺炎和70例健康受试者进行了检测。采用SPSS11.0软件包统计分析各组别间的差异性。结果细菌性肺炎组及支原体肺炎组的CRP水平均高于正常对照组,差异具有统计学意义(P<0.05)。细菌性肺炎组的CRP水平较支原体肺炎的CRP水平高(P<0.05)。细菌性肺炎及支原体肺炎组经治疗3d后与治疗前相比, CPR水平均显著性降低(P<0.05)。细菌性肺炎组的PCT水平高于正常对照组,有统计学意义(P<0.01)。此外,细菌性肺炎的PCT水平亦高于支原体肺炎组。治疗3d后细菌性肺炎组的PCT水平较支原体肺炎组高,两组之间有显著性差异(P<0.01)。结论 CRP对儿童细菌性肺炎和支原体肺炎反应性较好,可以作为临床诊断的依据;PCT对于细菌性肺炎有较好的指示作用,且对疾病的进程判断有参考价值。%Objective To investigate the correlation of C-reactive protein (CRP) and procalcitonin (PCT) level and diagnosis and prognosis of bacterial pneumonia and mycoplasma pneumonia in children.Methods Turbidimetric method was applied to detect the concentration of CRP and PCT in 140 cases children mycoplasma pneumonia and bacterial pneumonia respectively,and 70 healthy subjects were also enrolled for controls. SPSS11.0 software package Statistical was used to analysis the differences between groups. Results The results indicated that the CRP level in children with bacterial pneumonia or mycoplasma pneumonia was higher than the normal controls (P<0.05).CRP level in children with bacterial pneumonia group was higher than those with mycoplasma pneumonia (P<0.05).The CRP level in childeren accepted treatment for bacterial pneumonia or mycoplasma

  10. Influence of cAMP receptor protein (CRP) on bacterial virulence and transcriptional regulation of allS by CRP in Klebsiella pneumoniae. (United States)

    Xue, Jian; Tan, Bin; Yang, Shiya; Luo, Mei; Xia, Huiming; Zhang, Xian; Zhou, Xipeng; Yang, Xianxian; Yang, Ruifu; Li, Yingli; Qiu, Jingfu


    cAMP receptor protein (CRP) is one of the most important transcriptional regulators, which can regulate large quantities of operons in different bacteria. The gene allS was well-known as allantoin-utilizing capability and involving in bacterial virulence in Klebsiella pneumoniae (K. pneumoniae). The specific DNA recognition motif of transcription regulator CRP was found in allS promoter region. Therefore, this study is aimed to investigate the function of CRP on virulence and its transcriptional regulation mechanism to gene allS in K. pneumoniae. The wild-type (WT) K. pneumoniae NTUH-2044, crp knockout (Kp-Δcrp) and the complemented knockout (KpC-Δcrp) strains were used to determine the function of crp gene. The lacZ fusion, qRT-PCR, electrophoretic mobility shift and DNase I footprinting assays were performed to study the transcriptional regulation of CRP on allS. The result showed a decreased virulence in crp knockout strain. Complement through supplementing crp fragment in expression plasmid partially restore virulence of knockout bacteria. The CRP could bind to the allS promoter-proximal region and the binding site was further refined to be located from 60bp to 94bp upstream of the allS promoter. Based on these results, we proposed that CRP is an essential virulence regulator and knock out of crp gene will result in reduced virulence in K. pneumoniae. In the meantime, the transcription of gene allS is positively regulated by CRP via directly binding to upstream of allS promoter.

  11. Recent trends in pediatric bacterial meningitis in Japan--a country where Haemophilus influenzae type b and Streptococcus pneumoniae conjugated vaccines have just been introduced. (United States)

    Shinjoh, Masayoshi; Iwata, Satoshi; Yagihashi, Tatsuhiko; Sato, Yoshitake; Akita, Hironobu; Takahashi, Takao; Sunakawa, Keisuke


    To investigate the trends in incidence and the characteristics of bacterial meningitis in Japan where Haemophilus influenzae type b (Hib) vaccine and 7-valent pneumococcal conjugated vaccine (PCV7) were introduced in 2008 and 2010, respectively, which was 5-20 years after their introduction in western countries. The nationwide Japanese survey of pediatric and neonatal bacterial meningitis was performed in 2011 and 2012. We analyzed the epidemiological and clinical data, and compared the information obtained in the previous nationwide survey database. We also investigated the risk factors for disease outcome. In the 2011-2012 surveys, 357 patients were evaluated. H. influenzae, Streptococcus pneumoniae, Streptococcus agalactiae and Escherichia coli were the main organisms. The number of patients hospitalized with bacterial meningitis per 1000 admissions decreased from 1.31 in 2009 to 0.43 in 2012 (p influenzae and S. pneumoniae meningitis also decreased from 0.66 to 0.08 (p < 0.001), and 0.30 to 0.06 (p < 0.001), respectively. Only 0-2 cases with Neisseria meningitidis were reported each year throughout 2001-2012. The median patient age was 10-12 months in 2001-2011, and became lower in 2012 (2 month old) (p < 0.001). The fatality rate for S. agalactiae is the highest (5.9% (11/187)) throughout 2001-2012 among the four organisms. Risk factors for death and sequelae were convulsions at onset, low CSF glucose, S. agalactiae etiology, and persistent positive CSF culture. Hib vaccine and PCV7 decreased the rate of bacterial meningitis. Earlier introduction of these vaccines may have prevented bacterial meningitis among Japanese children.

  12. C-反应蛋白检测在小儿细菌性肺炎与支原体肺炎中的临床比较%Clinical value of detection of C-reaction protein in diagnosis of pediatric bacterial pneumonia and Mycoplasma pneumonia:a comparative study

    Institute of Scientific and Technical Information of China (English)



    OBJECTIVE To study the clinical value of C-reactie protein (CRP) detection in diagnosis of the pediatric bacterial pneumonia and the Mycoplasma pneumonia so as to guide the diagnosis of infantile pneumonia.METHODS The children with bacterial pneumonia (the bacterial pneumonia group) and the children with Mycoplasma pneumonia (the Mycoplasma pneumonia group),who were treated in the pediatrics department from Sep 2010 to Sep 2012,were enrolled in the study,the healthy children receiving the medical examination (the control group)were also selected,with 80 cases in each group,then the change of CRP level was determined.RESULTS The CRP level of the control group was (3.24 ±0.45)mg/L,the bacterial pneumonia group before treatment (44.03±5.83) mg/L,the bacterial pneumonia group 3 days after the treatment (15.12±6.21) mg/L,the Mycoplasma pneumonia group before treatment (13.97±4.96) mg/L,the Mycoplasma pneumonia group 3 days after the treatment (5.29 ± 2.33) mg/L,the CRP level of the bacterial pneumonia group and the Mycoplasma pneumonia group before the treatment was significantly higher than that of the control group (P<0.05),the CRP level of the bacterial pneumonia group was higher than that of the Mycoplasma pneumonia group (P<0.05),the CRP level of the bacterial pneumonia group 3 days after treatment was higher than that of the Mycoplasma pneumonia group (P<0.05),the difference in the CRP level before and after the treatment between the bacterial pneumonia group and the Mycoplasma pneumonia group was statistically significant (P< 0.05).The positive rates of the CRP of the bacterial pneumonia group were 100.00% before the treatment and 52.50% 3 days after the treatment,which were respectively 66.25 % and 21.25 % in the Mycoplasma pneumonia group,the difference in the positive rate before and after the treatment between the bacterial pneumonia group and the Mycoplasmapneumonia group was statistically significant (P<0.05).CONCLUSION The positive

  13. 16S rRNA gene sequencing is a non-culture method of defining the specific bacterial etiology of ventilator-associated pneumonia. (United States)

    Xia, Li-Ping; Bian, Long-Yan; Xu, Min; Liu, Ying; Tang, Ai-Ling; Ye, Wen-Qin


    Ventilator-associated pneumonia (VAP) is an acquired respiratory tract infection following tracheal intubation. The most common hospital-acquired infection among patients with acute respiratory failure, VAP is associated with a mortality rate of 20-30%. The standard bacterial culture method for identifying the etiology of VAP is not specific, timely, or accurate in identifying the bacterial pathogens. This study used 16S rRNA gene metagenomic sequencing to identify and quantify the pathogenic bacteria in lower respiratory tract and oropharyngeal samples of 55 VAP patients. Sequencing of the 16S rRNA gene has served as a valuable tool in bacterial identification, particularly when other biochemical, molecular, or phenotypic identification techniques fail. In this study, 16S rRNA gene sequencing was performed in parallel with the standard bacterial culture method to identify and quantify bacteria present in the collected patient samples. Sequence analysis showed the colonization of multidrug-resistant strains in VAP secretions. Further, this method identified Prevotella, Proteus, Aquabacter, and Sphingomonas bacterial genera that were not detected by the standard bacterial culture method. Seven categories of bacteria, Streptococcus, Neisseria, Corynebacterium, Acinetobacter, Staphylococcus, Pseudomonas and Klebsiella, were detectable by both 16S rRNA gene sequencing and standard bacterial culture methods. Further, 16S rRNA gene sequencing had a significantly higher sensitivity in detecting Streptococcus and Pseudomonas when compared to standard bacterial culture. Together, these data present 16S rRNA gene sequencing as a novel VAP diagnosis tool that will further enable pathogen-specific treatment of VAP.

  14. Autophosphorylation of the Bacterial Tyrosine-Kinase CpsD Connects Capsule Synthesis with the Cell Cycle in Streptococcus pneumoniae.

    Directory of Open Access Journals (Sweden)

    Julien Nourikyan


    Full Text Available Bacterial capsular polysaccharides (CPS are produced by a multi-protein membrane complex, in which a particular type of tyrosine-autokinases named BY-kinases, regulate their polymerization and export. However, our understanding of the role of BY-kinases in these processes remains incomplete. In the human pathogen Streptococcus pneumoniae, the BY-kinase CpsD localizes at the division site and participates in the proper assembly of the capsule. In this study, we show that the cytoplasmic C-terminal end of the transmembrane protein CpsC is required for CpsD autophosphorylation and localization at mid-cell. Importantly, we demonstrate that the CpsC/CpsD complex captures the polysaccharide polymerase CpsH at the division site. Together with the finding that capsule is not produced at the division site in cpsD and cpsC mutants, these data show that CPS production occurs exclusively at mid-cell and is tightly dependent on CpsD interaction with CpsC. Next, we have analyzed the impact of CpsD phosphorylation on CPS production. We show that dephosphorylation of CpsD induces defective capsule production at the septum together with aberrant cell elongation and nucleoid defects. We observe that the cell division protein FtsZ assembles and localizes properly although cell constriction is impaired. DAPI staining together with localization of the histone-like protein HlpA further show that chromosome replication and/or segregation is defective suggesting that CpsD autophosphorylation interferes with these processes thus resulting in cell constriction defects and cell elongation. We show that CpsD shares structural homology with ParA-like ATPases and that it interacts with the chromosome partitioning protein ParB. Total internal reflection fluorescence microscopy imaging demonstrates that CpsD phosphorylation modulates the mobility of ParB. These data support a model in which phosphorylation of CpsD acts as a signaling system coordinating CPS synthesis with

  15. The roles of epithelial cell contact, respiratory bacterial interactions and phosphorylcholine in promoting biofilm formation by Streptococcus pneumoniae and nontypeable Haemophilus influenzae. (United States)

    Krishnamurthy, Ajay; Kyd, Jennelle


    Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) often share a common niche within the nasopharynx, both associated with infections such as bronchitis and otitis media. This study investigated how the association between NTHi and S. pneumoniae and the host affects their propensity to form biofilms. We investigated a selection of bacterial strain and serotype combinations on biofilm formation, and the effect of contact with respiratory epithelial cells. Measurement of biofilm showed that co-infection with NTHi and S. pneumoniae increased biofilm formation following contact with epithelial cells compared to no contact demonstrating the role of epithelial cells in biofilm formation. Additionally, the influence of phosphorylcholine (ChoP) on biofilm production was investigated using the licD mutant strain of NTHi 2019 and found that ChoP had a role in mixed biofilm formation but was not the only requirement. The study highlights the complex interactions between microbes and the host epithelium during biofilm production, suggesting the importance of understanding why certain strains and serotypes differentially influence biofilm formation. A key contributor to increased biofilm formation was the upregulation of biofilm formation by epithelial cell factors.

  16. Aspiration pneumonia (United States)

    Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis ... The type of bacteria that caused the pneumonia depends on: Your ... facility, for example) Whether you were recently hospitalized ...

  17. Mycoplasma pneumonia (United States)

    Walking pneumonia; Community-acquired pneumonia - mycoplasma; Community-acquired pneumonia - atypical ... Mycoplasma pneumonia usually affects people younger than 40. People who live or work in crowded areas such as schools ...

  18. Community-acquired bacterial pneumonia in human immunodeficiency virus-infected patients: validation of severity criteria. The Grupo Andaluz para el Estudio de las Enfermedades Infecciosas. (United States)

    Cordero, E; Pachón, J; Rivero, A; Girón, J A; Gómez-Mateos, J; Merino, M D; Torres-Tortosa, M; González-Serrano, M; Aliaga, L; Collado, A; Hernández-Quero, J; Barrera, A; Nuño, E


    Severity criteria for community-acquired pneumonia (CAP) have always excluded patients with human immunodeficiency virus (HIV) infection. A 1-yr, multicenter, prospective observational study of HIV-infected patients with bacterial CAP was done to validate the criteria used in the American Thoracic Society (ATS) guidelines for CAP, and to determine the prognosis-associated factors in the HIV-infected population with bacterial CAP. Overall, 355 cases were included, with an attributable mortality of 9.3%. Patients who met the ATS criteria had a longer hospital stay (p = 0.01), longer duration of fever (p < 0.001), and higher attributable mortality (13.1% versus 3.5%, p = 0.02) than those who did not. Three factors were independently related to mortality: CD4(+) cell count < 100/microl, radiologic progression of disease, and shock. Pleural effusion, cavities, and/or multilobar infiltrates at admission were independently associated with radiologic progression. A prognostic rule based on the five criteria of shock, CD4(+) cell count < 100/microl, pleural effusion, cavities, and multilobar infiltrates had a high negative predictive value for mortality (97.1%). The attributable mortality for severe pneumonia was 11.3%, as compared with 1.3% for nonsevere disease (p = 0.008). The ATS severity criteria are valid in HIV-infected patients with bacterial CAP. Our study provides the basis for identification of patients who may require hospitalization determined by clinical judgment and the five clinical criteria of shock, a CD4(+) cell count < 100/microl, pleural effusion, cavities, and multilobar involvement. These prognostic factors should be validated in independent cohort studies.

  19. Surveillance of bacterial resistance in Streptococcus pneumoniae%肺炎链球菌的耐药性监测

    Institute of Scientific and Technical Information of China (English)



    As the prevalence of resistant Streptococcus pneumoniae has been increased significantly, understanding the characteristic of resistant strains and applying surveillance for them are helpful to guide clinical therapy and control the prevalence of resistant strains. This review describes Streptococcus pneumoniae resistance, resistance mechanism and their clinical surveillance.%肺炎链球菌耐药率不断上升,监测其耐药性并掌握耐药特征,有助于指导临床合理选药及控制肺炎链球菌耐药株流行.本文综述肺炎链球菌的耐药现状、相关机制及监测方法.


    Directory of Open Access Journals (Sweden)

    Raveendra Kodur


    Full Text Available ABSTRACT: BACKGROUND: Most of the times a Community Acquired Pneumonia (CAP patient is being treated with empirical antibiotics by best guess method by the clinician.MDR strains are being reported from c/s reports and Gram negative rods are fast increasing both in the etiolog y and mortality of CAP patients AIM OF STUDY: 1. To find out the profile of different bacteria causing CAP at a tertiary hospital. 2. To know the treatment outcome & drug resistance pattern among culture positive CAP patients. MATERIALS & METHODS: 450 CAP patients admitted & treated between Jan. to Dec.2012 at Victoria Hospital, Bangalore were included in this hospitalized cross sectional study. All relevant investigations including sputum c/s were done. RESULTS: Positive culture reports were obtained in 165(36.33% out of 450 patients Following are the isolates - Strept.pnemoniae 32.7%, Klebsiella 18.2%, Staph.aureas 10.9%, Psedomonas 10.9%, E.coli 5.4%, Acinetobacter 7.3%, H.influenza 5.4%, Mixed growth 10%. 76% of patients recovered from CAP, 6% went a gainst medical advice, 6.6% showed unresolved pneumonia & deaths in 5.33% of patients. High degree of resistance was noted to many antibiotics including to latest cephalosporins. CONCLUSION: This study highlights the importance of culture tests and selection of proper antibiotics and to avoid misuse & abuse of higher antibiotics to prevent the emergence of MDR strains. An antibiotic policy at every level may help.

  1. Study on the Drug Resistance of Bacterial Pneumonia and Antibiotics in Our Hospital%我院细菌性肺炎的病原学研究

    Institute of Scientific and Technical Information of China (English)

    詹达天; 王秀川


    目的 研究我院细菌性肺炎患者对不同抗生素的耐药性.方法 共120例感染有细菌性肺炎患者,进行不同抗生素的药敏试验、抑菌圈大小和治愈人数的研究.结果 细菌对一线抗菌药物的耐药比例为28.3%.二线抗生素,如亚胺培南西司他丁钠、羧噻吩青霉素钠-棒酸钾的耐药的比例分别为:2.5%、4.2%.对三线抗生素的耐药比例为0%.一线抗生素中,氧哌嗪青霉素和阿奇霉素的抑菌圈最小,头孢呋肟、左氧氟沙星其次;二线抗生素其次;三线抗生素的抑菌圈最大.通过使用一二线抗生素,100%的患者可达到抗菌和治疗疾病的效果.结论 我院细菌性肺炎患者对不同抗生素的耐药性研究效果满意,且用一线和二线抗生素就能达到较好的临床效果.%Objective To study the drug resistance of bacterial pneumonia to different antibiotics in Wenchang district of Hainan province.Methods 120 patients with bacterial pneumonia were given drug sensitivity test of different antibiotics.The size of inhibition zone and curative rate were studied.Results The bacterial in patients had high drug resistance to first-line antibacterials such as Piperacillin ( 34/120 = 28.3% );the resistance to second-line antibiotics such as imipenem and cilasatin sodium,ticarcillin sodiumpotassium clavulanate was bad ( 2.5% ,4.2% ); the resistance rate to third-line antibiotics was 0%.Among first-line antibiotics, piperacillin and azithromycin had the smallest size of inhibition zone, cefuroxime and levofloxacin were the second.The size of all the second-line antibiotics were rather large.Vancomycin had the biggest inhibition zone among third-line antibiotics.Patients can obtain good effect through the use of firstline and second-line antibiotics.Conclusion The study effect of drug resistance of bacterial pneumonia to different antibiotics is satisfactory in our hospital.The use of first-line and second-line antibiotics can obtain better

  2. C-反应蛋白检测在小儿细菌性肺炎及支原体肺炎中的应用%Detection of C-reactive protein applied in diagnosis of children with bacterial pneumonia and mycoplasma pneumonia

    Institute of Scientific and Technical Information of China (English)



    目的 对比分析C反应蛋白检测在小儿细菌性肺炎和支原体肺炎的诊断价值.方法 选取148例肺炎患儿及同期进行健康体检的150例健康小儿作为研究对象,对所有受试者进行C-反应蛋白、肺炎支原体、血常规检测,对148例肺炎患儿治疗前后进行C-反应蛋白水平检测,比较健康小儿、支原体肺炎患儿、细菌性肺炎患儿的C-反应蛋白水平,比较细菌性肺炎患儿与支原体肺炎患儿治疗前后的C-反应蛋白水平,比较C-反应蛋白对不同类型肺炎患儿的阳性检测率,综合评价C-反应蛋白在肺炎患儿诊断鉴别中的价值.结果 健康患儿、肺炎支原体患儿、细菌性肺炎患儿的C反应蛋白分别为(3.58±0.79)、(14.82±3.69)、(68.54±28.31)mg/L;组间比较,肺炎组患儿明显高于健康组患儿(P<0.05),而细菌性肺炎组患儿明显高于支原体肺炎组患儿(P<0.05);细菌性肺炎患儿C-反应蛋白的阳性率为93.3%、支原体肺炎患儿为45.6%,患儿经治疗后,C-反应蛋白均明显下降,上述指标组间比较及治疗前后比较,差异均有统计学意义(P<0.05).结论 C-反应蛋白检测可作为鉴别细菌性肺炎和支原体肺炎的有效手段,有助于临床医师采取相应的治疗方法及早治疗患儿,以免耽误病情.%OBJECTIVE To compare and analyze the C-reactive protein detection for the diagnosis of the children with bacterial pneumonia and mycoplasma pneumonia. METHODS A total of 148 children with pneumonia and 150 healthy children were chosen as the research subjects. All subjects were taken with the C-reactive protein, Mycoplasma pneumoniae. and blood testing. The levels of C-reactive protein of 148 cases of pneumonia children were tested before and after the treatment. The C-reactive protein levels of the healthy children, the children with mycoplasma pneumonia, and the children with bacterial pneumonia were compared. The C-reactive protein levels of the children

  3. Autophosphorylation of the Bacterial Tyrosine-Kinase CpsD Connects Capsule Synthesis with the Cell Cycle in Streptococcus pneumoniae

    NARCIS (Netherlands)

    Nourikyan, Julien; Kjos, Morten; Mercy, Chryslène; Cluzel, Caroline; Morlot, Cécile; Noirot-Gros, Marie-Francoise; Guiral, Sébastien; Lavergne, Jean-Pierre; Veening, Jan-Willem; Grangeasse, Christophe


    Bacterial capsular polysaccharides (CPS) are produced by a multi-protein membrane complex, in which a particular type of tyrosine-autokinases named BY-kinases, regulate their polymerization and export. However, our understanding of the role of BY-kinases in these processes remains incomplete. In the

  4. A compendium for Mycoplasma pneumoniae

    Directory of Open Access Journals (Sweden)

    Gretchen Lynn Parrott


    Full Text Available Historically, atypical pneumonia was a term used to describe an unusual presentation of pneumonia. Currently, it is used to describe the multitude of symptoms juxtaposing the classic symptoms found in cases of pneumococcal pneumonia. Specifically, atypical pneumonia is a syndrome resulting from a relatively common group of pathogens including Chlamydophila sp., and Mycoplasma pneumoniae. The incidence of M. pneumoniae pneumonia in adults is less than the burden experienced by children. Transmission rates among families indicate children may act as a reservoir and maintain contagiousness over a long period of time ranging from months to years. In adults, M. pneumoniae typically produces a mild, walking pneumonia and is considered to be one of the causes of persistent cough in patients. M. pneumoniae has also been shown to trigger the exacerbation of other lung diseases. It has been repeatedly detected in patients with bronchitis, asthma, chronic obstructive pulmonary disorder and cystic fibrosis. Recent advances in technology allow for the rapid diagnosis of M. pneumoniae through the use of polymerase chain reaction (PCR or rapid antigen tests. With this, more effort has been afforded to identify the causative etiologic agent in all cases of pneumonia. However, previous practices, including the overprescribing of macrolide treatment in China and Japan, have created increased incidence of macrolide-resistant M. pneumoniae. Reports from these countries indicate that >85% of M. pneumoniae pneumonia pediatric cases are macrolide-resistant. Despite its extensively studied past, the smallest bacterial species still inspires some of the largest questions. The developments in microbiology, diagnostic features and techniques, epidemiology, treatment and vaccines, and upper respiratory conditions associated with M. pneumoniae in adult populations are included within this review.

  5. Comparison of bacterial cultivation, PCR, in situ hybridization and immunohistochemistry as tools for diagnosis of Haemophilus somnus pneumonia in cattle

    DEFF Research Database (Denmark)

    Tegtmeier, Conny; Angen, Øystein; Ahrens, Peter


    The aim of the present study was to compare the potential of bacterial cultivation (BC), PCR, in situ hybridisation (ISH), and immunohistochemistry (MC) in the diagnosis of Haemophilus somnus, when applied to pneumonic bovine tissue. Lungs from 65 field cases submitted for bacteriological...... on a swab from the main bronchus of the right cranial lung lobe). In order to examine the pathological significance of the findings, a histopathological examination of the cases was performed. H. somnus was detected by one or more techniques in 33 cases in total. By BC the bacterium was isolated from 10...

  6. 血清降钙素原在小儿病毒性肺炎及细菌性肺炎中的诊断价值%The diagnostic values of serum procalcitonin for viral pneumonia and for bacterial pneumonia in children

    Institute of Scientific and Technical Information of China (English)

    陈建群; 丁银云; 崔倪


    Objective To compare the levels of procalcitonin (PCT) in children with viral pneumonia and in children with bacterial pneumonia, and evaluate the clinical value of PCT for the diagnosis of viral pneumonia and bacterial pneumonia in children and provide clinical reference for the treatment of pneumonia in children. Methods 96 cases of pediatric patients with viral pneumonia and 96 cases of pediatric patients with bacterial pneumonia were selected randomly from March 2014 to April 2015 in our hospital as observation group and control group, respectively, for the study. PCT level was measured and analyzed for the diagnosis value. Age, gender, height and weight were also recorded. Results The average level of PCT of the control group was (0.29 ±0.14) ng/ml, with the positive rate of 9.38%; the average level of PCT of the observation group was (3.18 ±0.74)ng/ml, with the positive rate of 93.75%,showing a significant difference between these two groups (P<0.05). Conclusion PCT level was higher in children with viral pneumonia than that with bacterial pneumonia; it could be used as a clinical indicator of diagnosis of viral pneumonia in children.%目的:对比分析血清降钙素原(PCT)在小儿病毒性肺炎及细菌性肺炎中不同表现,明确PCT在小儿病毒性肺炎及细菌性肺炎中临床价值,为治疗小儿肺炎提供临床参考。方法随机选取2014年3月至2015年4月收治的小儿病毒性肺炎患者96例(观察组),另选取同期本院收治的细菌性肺炎患者96例(对照组),两组儿童均接受PCT相关检测,并行统计分析相关检测结果以及应用价值。同时记录患儿年龄、性别、身高、体重等一般情况,应用统计学软件对以上数据进行分析。结果观察组患儿PCT平均值为(0.29±0.14)ng/ml,阳性率为9.38%;对照组患儿PCT平均值为(3.18±0.74)ng/ml,阳性率为93.75%,组间对比差异有统计学意义(P<0.05

  7. Chlamydia pneumoniae Infection Among Basic Underwater Demolition/SEAL (BUD/S) Trainees, Coronado, California, July 2008 (United States)


    including Streptococcus pneumoniae, Chlamydophila pneu- moniae, Mycoplasma pneumoniae, Legionella pneumophila , and Bordetella pertussis . 3 CAP...pneumoniae , L pneumophila , or M pneumoniae . Although the samples proved to be negative for viral etiologies, testing against the bacterial panel dem...controls for L pneumophila (487 bp), M pneumoniae (360 bp), C pneumoniae (283 bp), and B pertussis (122 bp). Delivered by Publishing Technology to

  8. A brief retrospective review of medical records comparing outcomes for inpatients treated via telehealth versus in-person protocols: is telehealth equally effective as in-person visits for treating neutropenic fever, bacterial pneumonia, and infected bacterial wounds? (United States)

    Assimacopoulos, Aristides; Alam, Rabiul; Arbo, Manuel; Nazir, Jawad; Chen, Ding-Geng; Weaver, Susan; Dahler-Penticoff, Marilyn; Knobloch, Karla; DeVany, Mary; Ageton, Cheryl


    The incidence of infectious diseases in the United States has been increasing since 1980. Re-emergent conditions, multidrug-resistant bacteria, newly identified infections, and bioterrorism have prompted public health surveillance and control initiatives, including the use of telehealth technology. Infectious diseases, such as West Nile Virus, pose a particular threat to rural areas, where access to infectious disease specialists (IDS) is limited. Initial, in-patient IDS consultations are reimbursed by Centers for Medicare & Medicaid Services for in-person and for telehealth services. Follow-up consultation and subsequent care visits are reimbursed when delivered via in-person care, but not reimbursed when delivered via telehealth. The purpose of this study is to investigate the efficacy of telehealth technology (interactive videoconferencing) in providing timely, efficient, and prudent infectious disease care for rural patients. We conducted a retrospective, comparative review of medical records (n = 107) from inpatients at a metropolitan hospital (n = 59) in a rural state who received in-person IDS treatment, with records from inpatients at nonmetropolitan, rural, and frontier hospitals (n = 48) in the same state who received telehealth IDS treatment. Outcome measures, including number of days hospitalized, number of days receiving intravenous antibiotic, survival, and transfer to another hospital, were compared for three commonly occurring infectious diseases: neutropenic fever, bacterial pneumonia, or bacterial wound infection. Patients treated via telehealth had fewer days on antibiotics and fewer days hospitalized than patients treated via in-person intervention. Survival rates did not differ significantly between groups, but were lower for telehealth patients. Fewer in-person patients required transfer to hospitals offering a higher level of care. Ninety percent of telehealth patients were able to remain at their local hospital for treatment. Results were

  9. Pneumonia (image) (United States)

    Pneumonia is an inflammation of the lungs caused by an infection. Many different organisms can cause it, including bacteria, viruses, and fungi. Pneumonia is a common illness that affects millions of ...

  10. Osteopontin promotes host defense during Klebsiella pneumoniae-induced pneumonia. (United States)

    van der Windt, G J W; Hoogerwerf, J J; de Vos, A F; Florquin, S; van der Poll, T


    Klebsiella pneumoniae is a common cause of nosocomial pneumonia. Osteopontin (OPN) is a phosphorylated glycoprotein involved in inflammatory processes, some of which is mediated by CD44. The aim of this study was to determine the role of OPN during K. pneumoniae-induced pneumonia. Wild-type (WT) and OPN knockout (KO) mice were intranasally infected with 10⁴ colony forming units of K. pneumoniae, or administered Klebsiella lipopolysaccharides (LPS). In addition, recombinant OPN (rOPN) was intranasally administered to WT and CD44 KO mice. During Klebsiella pneumonia, WT mice displayed elevated pulmonary and plasma OPN levels. OPN KO and WT mice showed similar pulmonary bacterial loads 6 h after infection; thereafter, Klebsiella loads were higher in lungs of OPN KO mice and the mortality rate in this group was higher than in WT mice. Early neutrophil recruitment into the bronchoalveolar space was impaired in the absence of OPN after intrapulmonary delivery of either Klebsiella bacteria or Klebsiella LPS. Moreover, rOPN induced neutrophil migration into the bronchoalveolar space, independent from CD44. In vitro, OPN did not affect K. pneumoniae growth or neutrophil function. In conclusion, OPN levels were rapidly increased in the bronchoalveolar space during K. pneumoniae pneumonia, where OPN serves a chemotactic function towards neutrophils, thereby facilitating an effective innate immune response.

  11. Klebsiella pneumoniae inoculants for enhancing plant growth

    Energy Technology Data Exchange (ETDEWEB)

    Triplett, Eric W. (Middleton, WI); Kaeppler, Shawn M. (Oregon, WI); Chelius, Marisa K. (Greeley, CO)


    A biological inoculant for enhancing the growth of plants is disclosed. The inoculant includes the bacterial strains Herbaspirillum seropedicae 2A, Pantoea agglomerans P101, Pantoea agglomerans P102, Klebsiella pneumoniae 342, Klebsiella pneumoniae zmvsy, Herbaspirillum seropedicae Z152, Gluconacetobacter diazotrophicus PA15, with or without a carrier. The inoculant also includes strains of the bacterium Pantoea agglomerans and K. pneumoniae which are able to enhance the growth of cereal grasses. Also disclosed are the novel bacterial strains Herbaspirillum seropedicae 2A, Pantoea agglomerans P101 and P102, and Klebsiella pneumoniae 342 and zmvsy.

  12. Granzyme A impairs host defense during Streptococcus pneumoniae pneumonia. (United States)

    van den Boogaard, Florry E; van Gisbergen, Klaas P J M; Vernooy, Juanita H; Medema, Jan P; Roelofs, Joris J T H; van Zoelen, Marieke A D; Endeman, Henrik; Biesma, Douwe H; Boon, Louis; Van't Veer, Cornelis; de Vos, Alex F; van der Poll, Tom


    Streptococcus pneumoniae is the most common causative pathogen in community-acquired pneumonia (CAP). Granzyme A (GzmA) is a serine protease produced by a variety of cell types involved in the immune response. We sought to determine the role of GzmA on the host response during pneumococcal pneumonia. GzmA was measured in bronchoalveolar lavage fluid (BALF) harvested from CAP patients from the infected and contralateral uninfected side and in lung tissue slides from CAP patients and controls. In CAP patients, GzmA levels were increased in BALF obtained from the infected lung. Human lungs showed constitutive GzmA expression by both parenchymal and nonparenchymal cells. In an experimental setting, pneumonia was induced in wild-type (WT) and GzmA-deficient (GzmA(-/-)) mice by intranasal inoculation of S. pneumoniae In separate experiments, WT and GzmA(-/-) mice were treated with natural killer (NK) cell depleting antibodies. Upon infection with S. pneumoniae, GzmA(-/-) mice showed a better survival and lower bacterial counts in BALF and distant body sites compared with WT mice. Although NK cells showed strong GzmA expression, NK cell depletion did not influence bacterial loads in either WT or GzmA(-/-) mice. These results implicate that GzmA plays an unfavorable role in host defense during pneumococcal pneumonia by a mechanism that does not depend on NK cells.

  13. Klebsiella pneumoniae FimK Promotes Virulence in Murine Pneumonia. (United States)

    Rosen, David A; Hilliard, Julia K; Tiemann, Kristin M; Todd, Elizabeth M; Morley, S Celeste; Hunstad, David A


    Klebsiella pneumoniae, a chief cause of nosocomial pneumonia, is a versatile and commonly multidrug-resistant human pathogen for which further insight into pathogenesis is needed. We show that the pilus regulatory gene fimK promotes the virulence of K. pneumoniae strain TOP52 in murine pneumonia. This contrasts with the attenuating effect of fimK on urinary tract virulence, illustrating that a single factor may exert opposing effects on pathogenesis in distinct host niches. Loss of fimK in TOP52 pneumonia was associated with diminished lung bacterial burden, limited innate responses within the lung, and improved host survival. FimK expression was shown to promote serum resistance, capsule production, and protection from phagocytosis by host immune cells. Finally, while the widely used K. pneumoniae model strain 43816 produces rapid dissemination and death in mice, TOP52 caused largely localized pneumonia with limited lethality, thereby providing an alternative tool for studying K. pneumoniae pathogenesis and control within the lung.

  14. Pharmacokinetic/pharmacodynamic analysis to evaluate ceftaroline fosamil dosing regimens for the treatment of community-acquired bacterial pneumonia and complicated skin and skin-structure infections in patients with normal and impaired renal function. (United States)

    Canut, A; Isla, A; Rodríguez-Gascón, A


    In this study, the probability of pharmacokinetic/pharmacodynamic target attainment (PTA) of ceftaroline against clinical isolates causing community-acquired bacterial pneumonia (CABP) and complicated skin and skin-structure infection (cSSSI) in Europe was evaluated. Three dosing regimens were assessed: 600 mg every 12 h (q12 h) as a 1-h infusion (standard dose) or 600 mg every 8 h (q8 h) as a 2-h infusion in virtual patients with normal renal function; and 400 mg q12 h as a 1-h infusion in patients with moderate renal impairment. Pharmacokinetic and microbiological data were obtained from the literature. The PTA and the cumulative fraction of response (CFR) were calculated by Monte Carlo simulation. In patients with normal renal function, the ceftaroline standard dose (600 mg q12 h as a 1-h infusion) can be sufficient to treat CABP due to ceftazidime-susceptible (CAZ-S) Escherichia coli, CAZ-S Klebsiella pneumoniae, meticillin-susceptible Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis (CFR>90%). However, against meticillin-resistant S. aureus (MRSA), the CFR was 72%. In cSSSI, the CFR was also <80% for MRSA. Administration of ceftaroline 600 mg q8 h as a 2-h infusion or 400 mg q12 h as a 1-h infusion in patients with moderate renal insufficiency provided a high probability of treatment success (CFR ca. 100%) for most micro-organisms causing CABP and cSSSI, including MRSA and penicillin-non-susceptible S. pneumoniae. These results suggest that in patients with normal renal function, ceftaroline 600 mg q8 h as a 2-h infusion may be a better option than the standard dose, especially if the MRSA rate is high.

  15. 降钙素原与 C-反应蛋白联合检测在成人细菌性肺炎中的临床评价%Clinical evaluation of combined detection of serum procalcitonin and C-reactive protein for bacterial pneumonia in adults

    Institute of Scientific and Technical Information of China (English)

    曹校校; 李强; 陈荣


    OBJECTIVE To evaluate clinical effect of combined detection of serum procalcitonin (PCT ) and C-reactive protein (CRP) on diagnosis and treatment of bacterial pneumonia in adults in order to facilitate diagnosis and treatment for diseases . METHODS Patients with bacterial pneumonia , viral pneumonia and mycoplasma pneumonia of each 60 cases treated from Jan .2013 to Jun .2013 in our hospital were randomly selected and respectively received combined PCT and CRP detection .The 60 patients with bacterial pneumonia were grouped according to the severity of illness .PCT and CRP contents in patients of each group were summarized and the data were processed by statistical software SPSS17 .0 .RESULTS PTC of pneumonic patients was (9 .31 ± 4 .76)μg/L in the bacterial pneumonia group ,(1 .30 ± 0 .68)μg/L in the viral pneumonia group and (1 .45 ± 0 .87)μg/L in the mycoplasma pneumonia group .CRP was (64 .21 ± 16 .97) mmol/L in the bacterial pneumonia group ,(30 .05 ± 10 .02) mmol/L in the mycoplasma pneumonia group and (4 .79 ± 1 .22) mmol/L in the viral pneumonia group . The difference between the three groups was significant (P<0 .05) .The level of PCT and CRP increased along with the severity of bacterial pneumonia .CONCLUSION PCT and CRP levels are closely related with bacterial pneumonia ,the combined detection of the two indexes can provide good guidance for diagnosis and treatment as well as prognosis for bacterial pneumonia in adults .%目的:探讨血清降钙素原(PCT)和C-反应蛋白(CRP)联合检测在成人细菌性肺炎诊断与治疗中的临床评价,以利于疾病的诊断治疗。方法随机选取2013年1-6月进行治疗的细菌性肺炎、病毒性肺炎、支原体肺炎患者各60例,分别对其进行PCT和CRP联合的检测,将60例细菌性肺炎患者按病情轻重程度分组,统计各组PCT和CRP含量,采用SPSS17.0统计软件对数据进行处理。结果肺炎患者PCT水平细菌性肺炎组为(9.31±4

  16. 3岁以下小儿社区获得性肺炎细菌病原学监测分析%The bacterial etiology pattern of community - acquired pneumonia in children under 3 years old in Yiwu area

    Institute of Scientific and Technical Information of China (English)

    何成川; 赵耀


    目的 了解当地3岁以下小儿社区获得性肺炎(CAP)的细菌病原学流行情况.方法 对2006年6月至2010年5月间3岁以下CAP住院患儿的细菌病原学监测资料进行回顾性分析.结果 细菌总检出率为32.1%,其中金黄色葡萄球菌、大肠埃希菌、肺炎链球菌、肺炎克雷伯菌、阴沟肠杆菌占80.7%.金黄色葡萄球菌、肺炎链球菌、肺炎克雷伯菌和阴沟肠杆菌的检出与患儿年龄有关(P值均<0.05),金黄色葡萄球菌的检出与发病季节有关(P<0.05),金黄色葡萄球菌、肺炎克雷伯菌的检出与患儿来源有关(P值均<0.01).结论 当地3岁以下小儿CAP细菌病原学以金黄色葡萄球菌、大肠埃希菌、肺炎链球菌、肺炎克雷伯菌、阴沟肠杆菌为主,并受患儿年龄、发病季节、患儿来源影响.%Objective To investigate the bacterial etiology pattern of community - acquired pneumonia ( CAP ) in children under 3 years old in Yiwu area.Methods The pathogenic bacteria isolated from hospitalized children under 3 years old with CAP between June 2006 and May 2010 were retrospectively analyzed.Results Bacteria pathogens were determined in 649 of 2019 cases ( 32.1% ).The isolates of Staphylococcus aureas, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Eenterabacter cloacae accounted for 80.7 %.The detection rates of Staphylococcus aureas, Streptococcus pneumoniae, Klebsiella pneumoniae, and Eenterabacter cloacae were associated with the age of children (P < 0.01, P < 0.05 ).The detection rate of Staphylolcoccus aureas was associated with the season ( P < 0.05 ).The detection rate of Staphylolcoccus aureas, Streptococcus pneumoniae were associated with the source of children ( P < 0.01, P < 0.05 ).Conclusion The main pathegenic bacteria responsible for community - acquired pneumonia in children under 3 years old in Yiwu area includes Staphylolcoccus aureas, Eecherichia coli, Straptococcus pneumonias

  17. The value of signs and symptoms in differentiating between bacterial, viral and mixed aetiology in patients with community-acquired pneumonia

    NARCIS (Netherlands)

    Huijskens, Elisabeth G. W.; Koopmans, Marion; Palmen, Fernand M. H.; van Erkel, Adriana J. M.; Mulder, Paul G. H.; Rossen, John W. A.


    Current diagnostics for community-acquired pneumonia (CAP) include testing for a wide range of pathogens, which is costly and not always informative. We compared clinical and laboratory parameters of patients with CAP caused by different groups of pathogens to evaluate the potential for targeted dia

  18. The clinical efficacy of Tanreqing injections combined with antibiotics for bacterial pneumonia%痰热清注射液联合抗生素治疗细菌性肺炎临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    宋军平; 谢丽华; 傅冬莲; 李建华


    Objective To explore the clinical efficacy and safety of Tanreqing injections combined with antibiotics in the treatment of bacterial pneumonia.Methods 96 patients with bacterial pneumonia were divided into study group ( 57 patients ) and control group ( 39 patients ).The study group received combination therapy with Tanreqing injections and antibiotics,while the control group received antibiotics alone.The clinical efficacy and adverse reactions were observed in the two groups.Results Time to disappearance or improvement of symptoms including fever,cough,and expectoration was significantly shorter in the study than in the control group ( P< 0.01 ).The total effectiveness rate was obviously higher in the study group than in the control group ( 100% vs.94.87%,P < 0.05 ).No marked adverse reactions were found both groups.Conclusions Combination therapy with Tanreqing injections and antibiotics bacterial pneumonia is efficacious and has quick onset of action effect,thus making it a better therapeutic regimen.%目的 探讨痰热清注射液联合抗生素治疗细菌性肺炎的临床疗效及安全性.方法 将96例细菌性肺炎患者分为观察组(57例)和对照组(39例),观察组给予痰热清注射液联合抗生素治疗,对照组给予单一抗生素治疗,观察两组患者临床疗效及不良反应.结果 观察组发热、咳嗽、咳痰等症状消退或改善时间明显低于对照组(P<0.01);观察组总有效率为100%,明显高于对照组的94.87%,(P<0.05);两组患者均未见明显不良反应.结论 痰热清注射液联合抗生素治疗细菌性肺炎疗效好、见效快,是一种较佳的治疗方案.

  19. Hydrocarbon pneumonia (United States)

    Pneumonia - hydrocarbon ... Coughing Fever Shortness of breath Smell of a hydrocarbon product on the breath Stupor (decreased level of ... Most children who drink or inhale hydrocarbon products and develop ... hydrocarbons may lead to rapid respiratory failure and death.

  20. Efficiency of vanilla, patchouli and ylang ylang essential oils stabilized by iron oxide@C14 nanostructures against bacterial adherence and biofilms formed by Staphylococcus aureus and Klebsiella pneumoniae clinical strains. (United States)

    Bilcu, Maxim; Grumezescu, Alexandru Mihai; Oprea, Alexandra Elena; Popescu, Roxana Cristina; Mogoșanu, George Dan; Hristu, Radu; Stanciu, George A; Mihailescu, Dan Florin; Lazar, Veronica; Bezirtzoglou, Eugenia; Chifiriuc, Mariana Carmen


    Biofilms formed by bacterial cells are associated with drastically enhanced resistance against most antimicrobial agents, contributing to the persistence and chronicization of the microbial infections and to therapy failure. The purpose of this study was to combine the unique properties of magnetic nanoparticles with the antimicrobial activity of three essential oils to obtain novel nanobiosystems that could be used as coatings for catheter pieces with an improved resistance to Staphylococcus aureus and Klebsiella pneumoniae clinical strains adherence and biofilm development. The essential oils of ylang ylang, patchouli and vanilla were stabilized by the interaction with iron oxide@C14 nanoparticles to be further used as coating agents for medical surfaces. Iron oxide@C14 was prepared by co-precipitation of Fe+2 and Fe+3 and myristic acid (C14) in basic medium. Vanilla essential oil loaded nanoparticles pelliculised on the catheter samples surface strongly inhibited both the initial adherence of S. aureus cells (quantified at 24 h) and the development of the mature biofilm quantified at 48 h. Patchouli and ylang-ylang essential oils inhibited mostly the initial adherence phase of S. aureus biofilm development. In the case of K. pneumoniae, all tested nanosystems exhibited similar efficiency, being active mostly against the adherence K. pneumoniae cells to the tested catheter specimens. The new nanobiosystems based on vanilla, patchouli and ylang-ylang essential oils could be of a great interest for the biomedical field, opening new directions for the design of film-coated surfaces with anti-adherence and anti-biofilm properties.

  1. Efficiency of Vanilla, Patchouli and Ylang Ylang Essential Oils Stabilized by Iron Oxide@C14 Nanostructures against Bacterial Adherence and Biofilms Formed by Staphylococcus aureus and Klebsiella pneumoniae Clinical Strains

    Directory of Open Access Journals (Sweden)

    Maxim Bilcu


    Full Text Available Biofilms formed by bacterial cells are associated with drastically enhanced resistance against most antimicrobial agents, contributing to the persistence and chronicization of the microbial infections and to therapy failure. The purpose of this study was to combine the unique properties of magnetic nanoparticles with the antimicrobial activity of three essential oils to obtain novel nanobiosystems that could be used as coatings for catheter pieces with an improved resistance to Staphylococcus aureus and Klebsiella pneumoniae clinical strains adherence and biofilm development. The essential oils of ylang ylang, patchouli and vanilla were stabilized by the interaction with iron oxide@C14 nanoparticles to be further used as coating agents for medical surfaces. Iron oxide@C14 was prepared by co-precipitation of Fe+2 and Fe+3 and myristic acid (C14 in basic medium. Vanilla essential oil loaded nanoparticles pelliculised on the catheter samples surface strongly inhibited both the initial adherence of S. aureus cells (quantified at 24 h and the development of the mature biofilm quantified at 48 h. Patchouli and ylang-ylang essential oils inhibited mostly the initial adherence phase of S. aureus biofilm development. In the case of K. pneumoniae, all tested nanosystems exhibited similar efficiency, being active mostly against the adherence K. pneumoniae cells to the tested catheter specimens. The new nanobiosystems based on vanilla, patchouli and ylang-ylang essential oils could be of a great interest for the biomedical field, opening new directions for the design of film-coated surfaces with anti-adherence and anti-biofilm properties.

  2. Receptor for Advanced Glycation End Products (RAGE) Serves a Protective Role during Klebsiella pneumoniae - Induced Pneumonia. (United States)

    Achouiti, Ahmed; de Vos, Alex F; van 't Veer, Cornelis; Florquin, Sandrine; Tanck, Michael W; Nawroth, Peter P; Bierhaus, Angelika; van der Poll, Tom; van Zoelen, Marieke A D


    Klebsiella species is the second most commonly isolated gram-negative organism in sepsis and a frequent causative pathogen in pneumonia. The receptor for advanced glycation end products (RAGE) is expressed on different cell types and plays a key role in diverse inflammatory responses. We here aimed to investigate the role of RAGE in the host response to Klebsiella (K.) pneumoniae pneumonia and intransally inoculated rage gene deficient (RAGE-/-) and normal wild-type (Wt) mice with K. pneumoniae. Klebsiella pneumonia resulted in an increased pulmonary expression of RAGE. Furthermore, the high-affinity RAGE ligand high mobility group box-1 was upregulated during K. pneumoniae pneumonia. RAGE deficiency impaired host defense as reflected by a worsened survival, increased bacterial outgrowth and dissemination in RAGE-/- mice. RAGE-/- neutrophils showed a diminished phagocytosing capacity of live K. pneumoniae in vitro. Relative to Wt mice, RAGE-/- mice demonstrated similar lung inflammation, and slightly elevated-if any-cytokine and chemokine levels and unchanged hepatocellular injury. In addition, RAGE-/- mice displayed an unaltered response to intranasally instilled Klebsiella lipopolysaccharide (LPS) with respect to pulmonary cell recruitment and local release of cytokines and chemokines. These data suggest that (endogenous) RAGE protects against K. pneumoniae pneumonia. Also, they demonstrate that RAGE contributes to an effective antibacterial defense during K. pneumoniae pneumonia, at least partly via its participation in the phagocytic properties of professional granulocytes. Additionally, our results indicate that RAGE is not essential for the induction of a local and systemic inflammatory response to either intact Klebsiella or Klebsiella LPS.

  3. Carriage of Streptococcus pneumoniae and other respiratory bacterial pathogens in low and lower-middle income countries: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Richard A Adegbola

    Full Text Available BACKGROUND: Infection with Streptococcus pneumoniae is a major cause of childhood morbidity and mortality worldwide, especially in low income countries where pneumococcal conjugate vaccines (PCVs are still underused. In countries where PCVs have been introduced, much of their efficacy has resulted from their impact on nasopharyngeal carriage in vaccinated children. Understanding the epidemiology of carriage for S. pneumoniae and other common respiratory bacteria in developing countries is crucial for implementing appropriate vaccination strategies and evaluating their impact. METHODS AND FINDINGS: We have systematically reviewed published studies reporting nasopharyngeal or oropharyngeal carriage of S. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Neisseria meningitidis in children and adults in low and lower-middle income countries. Studies reporting pneumococcal carriage for healthy children <5 years of age were selected for a meta-analysis. The prevalences of carriage for S. pneumoniae, H. influenzae, and M. catarrhalis were generally higher in low income than in lower-middle income countries and were higher in young children than in adults. The prevalence of S. aureus was high in neonates. Meta-analysis of data from young children before the introduction of PCVs showed a pooled prevalence estimate of 64.8% (95% confidence interval, 49.8%-76.1% in low income countries and 47.8% (95% confidence interval, 44.7%-50.8% in lower-middle income countries. The most frequent serotypes were 6A, 6B, 19A, 19F, and 23F. CONCLUSIONS: In low and lower-middle income countries, pneumococcal carriage is frequent, especially in children, and the spectrum of serotypes is wide. However, because data are limited, additional studies are needed to adequately assess the impact of PCV introduction on carriage of respiratory bacteria in these countries.

  4. Therapeutic effects of garenoxacin in murine experimental secondary pneumonia by Streptococcus pneumoniae after influenza virus infection. (United States)

    Fukuda, Yoshiko; Furuya, Yuri; Nozaki, Yusuke; Takahata, Masahiro; Nomura, Nobuhiko; Mitsuyama, Junichi


    In a pneumococcal pneumonia murine model following influenza virus infection, garenoxacin was more effective than other fluoroquinolones and demonstrated high levels of bacterial eradication in the lung, low mortality, and potent histopathological improvements. Garenoxacin could potentially be used for the treatment of secondary pneumococcal pneumonia following influenza.

  5. Mycoplasma pneumoniae-udløst autoimmun hæmolyse

    DEFF Research Database (Denmark)

    Bohr, Anne Lisbeth; Aagaard, Thomas Granum; Birgens, Henrik;


    Mycoplasma pneumoniae is naturally resistant to betalactamase antibiotics but is sensitive to macrolides. Occasionally, infections with M. pneumoniae can lead to severe anaemia due to its ability to cause haemolysis when cold agglutination occurs. Increasing bacterial resistance to macrolid...

  6. Streptococcus pneumoniae and the host cell

    NARCIS (Netherlands)

    Gradstedt, Per Henrik


    Streptococcus pneumoniae is een bacterie die in de menselijke keel-neusholte voorkomt. Vaak is zij ongevaarlijk, maar soms kan zij van leefomgeving veranderen en zich als invasieve ziekteverwekker door het lichaam verspreiden. Dan kan de bacterie longontsteking, bloedvergiftiging of hersenvliesontst

  7. 不同分期的慢性肾病并发细菌性肺炎的患者降钙素原的表达差异分析%The Analysis of Difference Expression of Procalcitonin in Patients with Different Stages of Chronic Kidney Disease Complicating with Bacterial Pneumonia

    Institute of Scientific and Technical Information of China (English)



    目的:比较慢性肾病( chronic kidney disease,CKD)并发细菌性肺炎患者( bacterial pneumonia,BP)﹑BP患者以及CKD患者的降钙素( procalcitonin,PCT)表达差异,探讨CKD患者的PCT的基础水平及CKD病程对PCT表达水平的影响。方法回顾性分析并比较CKD、BP、CKD并发BP患者PCT的表达水平,不同慢性肾衰竭分期合并细菌性肺炎患者PCT的表达差异。结果 CKD并发BP组与BP组感染细菌类型差异无统计学意义( P>0.05)。 CKD并发BP患者﹑CKD﹑BP患者血清PCT表达差异明显,且明显高于PCT对于细菌感染的阳性临界值0.1ng/mL。 CKD并发BP组与CKD组中的组内PCT表达差异有统计学意义(P0. 05 ); patients with chronic nephropathy complicating bacterial pneumonia, chronic kidney disease, bacterial pneumonia patients serum PCT expression is obviously different,and significantly higher than that of PCT for positive critical value of 0. 1ng/ml bacteriainfection. The expression of PCT 3 CDK compliacting with bacterial pneumonia in patients with chronic ne-phropathy group within the groupdifferences are significant ( P<0. 01 ) . Chronic nephropathy group bacterial pneumonia group, there are differences in the expression level of PCT CKD2period,and the highest expression level in the CKD5 period,chronicne-phropathy group have the same performance. Conclusion Chronic kidney disease on the expression of PCT had a certain influ-ence;chronic kidney disease in patients with bacterial pneumonia,previousPCT diagnosis of bacterial infection of the critical value of the need for appropriate consider raising,avoid excessive use of antibiotics.

  8. Enterobacter Asburiae Pneumonia with Cavitation

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Seung Woo; Heo, Jeong Nam; Park, Choong Ki [Dept. of Radiology, Hanyang University College of Medicine, Guri Hospital, Guri (Korea, Republic of); Choi, Yo Won; Jeon, Seok Chol [Dept. of Radiology, Hanyang University College of Medicine, Seoul Hospital, Seoul (Korea, Republic of)


    Enterobacter species have increasingly been identified as pathogens over the past several decades. These bacterial species have become more important because most are resistant to cephalothin and cefoxitin, and can produce extended-spectrum {beta}-lactamase. Enterobacter asburiae (E. asburiae) is a gram-negative rod of the family Enterobacteriaceae, named in 1986. Since then, there has been only one clinical report of E. asburiae pneumonia. We report a case of E. asburiae pneumonia with cavitation and compare it with the previous case.

  9. Analysis study of bacterial pathogen characteristics of children with community-acquired pneumonia%儿童社区获得性肺炎细菌病原学特点分析研究

    Institute of Scientific and Technical Information of China (English)

    谢庆玲; 李伟伟; 包增兰; 覃敏; 谭颖; 韦玉华; 甄宏; 唐晓燕; 陈泓伶; 温志红; 农生洲; 贺海兰; 庞智东; 梁卓信


    Objective To study the bacterial pathogen characteristics of children with community-acquired pneumonia(CAP) and antimicrobial susceptibility for clinical pneumonia treatment .Methods The clinical features, bacterial pathogen characteristics and microbial sensitivity test of 956 cases of hospitalized children with CAP were systematically analyzed.Results Gram-negative(G-) bacteria was detected in sputum culture from 653 of 956 cases of children with CAP, accounting for 68.3%;Gram-positive(G+) cocci in 303 cases, accounting for 31.7%.A-mong them, E.coli was detected in 253 cases(26.5%), klebsiella pneumoniae in 166 cases(17.4%), haemophilus influenzae in 78 cases(8.2%), acinetobacter baumannii in 53 cases(5.5%), Pseudomonas aeruginosa in 41 cases ( 4.3%), Streptococcus pneumoniae in 47 cases(4.9%) and staphylococcus aureus in 41 cases(4.3%).Common original pathogen of children with CAP in the secondary hospital were haemophilus influenzae , moraxelle catarrhalis and Streptococcus pneumoniae .While those in the tertiary hospitals were E .coli, klebsiella pneumoniae , acineto-bacter baumannii and coagulase negative staphylococcus aureus .Klebsiella pneumoniae were partly resistant to Tien-am and Meiluopeinan , and acinetobacter baumannii were also resistant to Tienam .Streptococcus pneumoniae were generally resistant to penicillin , and sulfamethoxazole , clindamycin and erythromycin and azithromycin .Staphylococ-cus aureus was completely resistant to penicillin and also highly resistant to sulfamethoxazole , ampicillin, erythromy-cin, azithromycin and tetracycline .Conclusion G-bacteria in children with CAP were not uncommon , while there be likely needed to pay seriously attention to higher antimicrobial resistance to bacteria .%目的:探讨儿童社区获得性肺炎( CAP )细菌病原学特点及药敏情况,指导临床肺炎诊治。方法系统分析956例住院CAP患儿的临床特征,细菌病原学特点和微生物

  10. Chlamydia Pneumoniae Pneumonia: An Evolving Clinical Spectrum

    Directory of Open Access Journals (Sweden)

    David Megran


    Full Text Available Chlamydia pneumoniae is a recently recognized respiratory tract pathogen. It accounts for 6 to 10% of all cases of community acquired pneumonia requiring admission to hospital. Two patients hospitalized with C pneumoniae pneumonia are presented to illustrate its range of severity and the extrapulmonary manifestations.

  11. Chlamydia pneumoniae pneumonia: An evolving clinical spectrum (United States)

    Megran, David; Peeling, Rosanna W; Marrie, Thomas J


    Chlamydia pneumoniae is a recently recognized respiratory tract pathogen. It accounts for 6 to 10% of all cases of community acquired pneumonia requiring admission to hospital. Two patients hospitalized with C pneumoniae pneumonia are presented to illustrate its range of severity and the extrapulmonary manifestations. PMID:22514396

  12. 三亚地区儿童社区获得性肺炎病原菌分布及耐药性分析%Pathogenic bacteria distribution of pediatric community acquired pneumonia and bacterial resistance in Sanya

    Institute of Scientific and Technical Information of China (English)

    麦珍; 阮细玲


    目的:了解三亚地区儿童社区获得性肺炎病原菌分布情况及耐药特点,为临床合理使用抗菌药物提供依据。方法回顾分析三亚地区2011年1月至2013年12月确诊的儿童社区获得性肺炎住院患儿阳性痰培养标本485例。结果485株病原菌中,革兰阴性菌占65.36%,革兰阳性菌占29.28%,真菌占5.36%。排名前五位的细菌是肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌、大肠埃希菌、肺炎链球菌。革兰阴性菌对阿米卡星、哌拉西林/他唑巴坦、左氧氟沙星、碳青霉烯类抗菌药物的耐药率均小于20.0%。未发现对万古霉素和利奈唑胺耐药的阳性球菌。结论三亚地区儿童社区获得性肺炎病原菌以革兰阴性菌为主,耐药现象与文献报道存在一定差异,因此临床医生应参照本地区流行病学特点合理使用抗菌药物,以控制细菌耐药率的上升。%Objective To analyze the pathogenic bacteria distribution of pediatric community acquired pneumo‐nia and bacteria resistance in Sanya ,so as to provide a basis for rational use of antibiotics .Methods A total of 485 patients confirmed with community acquired pneumonia were enrolled in this study .The sputum culture results and drug susceptibility test were analyzed .Results In all 485 bacterial isolates ,gram negative bacterium strains accoun‐ted for 65 .36% ,gram positive bacterium strains accounted for 29 .28% ,and fungi were accounted for 5 .36% .Kleb‐siella pneumoniae ,Staphylococcus aureus ,Acinetobacter baumanii ,Escherichia coli and Streptococcus pneumoniae were the most common isolates .Less than 20% gram negative bacterium strains were resistant to amikacin ,piperacil‐lin /tazobactam ,levofloxacin and carbapenem .No vancomycin and linezolid resistant gram positive bacterium strains were found .Conclusion Gram negative bacterium strains were the most common pathogenic bacteria of pediatric community

  13. Influence of Klebsiella pneumoniae CRP protein on bacterial adhesion and virulence in vitro%肺炎克雷伯菌转录调控子CRP对菌株粘附能力及细胞活性的影响

    Institute of Scientific and Technical Information of China (English)

    谭斌; 白群华; 罗美; 杨世亚; 薛健; 周锡鹏; 李迎丽; 邱景富


    Objective To analyze the adhesion and cell virulence of Klebsiella pneumonia wild type (WT) strain,complemented strain c-Δcrp (cAMP receptor protein) and mutant strain Δcrp,in order to investigate crp gene on the adhesion and cell toxicity of Klebsiella pneumonia.Methods After infection of A549 cells by Klebsiella pneumonia WT strain,c-Δcrp strain and Δcrp strain,the cells were lysed and the bacteria were quantified by plating appropriate dilutions on Luria-Bertani agar plates.LDH release was detected to estimate cell activity.Infection time and MOI were optimized.Results The adhesion ability of Klebsiella pneumonia WT (logCFU =5.145) and c-Δcrp strain (logCFU =4.915) was higher than that of Δcrp strain (logCFU =4.122) (P =0.004).The optimal conditions to determinate the LDH release included infected cells incubation for 8 h at 37 ℃,the developing time for 10 min in dark,and 1:10 dilution of the supernatant for test.The virulence of WT strain (70.69%) was significantly higher than that of Δcrp strain (19.54%) (P=0.001).Conclusion Knocking-out of crp gene causes obvious decrease of cellular toxicity and adhesion,comparing with the WT strain and c-Δcrp strain.Klebsiella pneumonia CRP protein positively regulates bacterial virulence and adhesion.%目的 分析肺炎克雷伯菌临床分离株WT(wild type)、回补株(c-Δcrp)和突变株(Δcrp)对人肺癌上皮细胞A549细胞的粘附能力及细胞活性的影响.方法 肺炎克雷伯菌WT株、c-Δcrp株和Δcrp株感染人肺癌上皮细胞A549,经裂解液裂解后平板计数计算粘附的菌量.LDH释放法检测细菌对细胞的毒性,优化感染时间和感染指数.结果 WT株及c-Δcrp株粘附的菌量分别为logCFU=5.145和logCFU=4.915,均高于Δcrp株(logCFU=4.122),差异有统计学意义(F=8.366,P=0.004).以MOI=1 000(细菌∶细胞=1000)的菌量感染靶细胞,37℃孵育8h,加底物液避光显色10 min,离心所得上清稀释10倍进行测定为最佳反应条件.WT

  14. Uncomplicated pneumonia in healthy Canadian children and youth: Practice points for management (United States)

    Le Saux, Nicole; Robinson, Joan L


    Although immunization has decreased the incidence of bacterial pneumonia in vaccinated children, pneumonia remains common in healthy children. Symptoms of bacterial pneumonia frequently overlap those present with viral infections or reactive airway disease. Optimally, the diagnosis of bacterial pneumonia should be supported by a chest radiograph before starting antimicrobials. Factors such as age, vital signs and other measures of illness severity are critical when deciding whether to admit a patient to hospital. Because Streptococcus pneumoniae continues to be the most common cause of bacterial pneumonia in children, prescribing amoxicillin or ampicillin for seven to 10 days remains the mainstay of empirical therapy for nonsevere pneumonia. If improvement does not occur, consideration should be given to searching for complications (empyema or lung abscess). Routine chest radiographs at the end of therapy are not recommended unless clinically indicated. PMID:26744558

  15. Pneumocystis Pneumonia (For Parents) (United States)

    ... Feeding Your 1- to 2-Year-Old Pneumocystis Pneumonia KidsHealth > For Parents > Pneumocystis Pneumonia A A A What's in this article? About PCP Diagnosing PCP Treating PCP Pneumocystis pneumonia (PCP) is an infection caused by Pneumocystis jiroveci , ...

  16. Pneumonia in Immunocompromised People (United States)

    ... Alternative preventive drug treatments are dapsone , atovaquone , and pentamidine (which can be taken as an aerosol, inhaled ... ACZONE trimethoprim No US brand name atovaquone MEPRON pentamidine NEBUPENT Pneumonia Overview of Pneumonia Aspiration Pneumonia and ...

  17. Therapeutic potential of bacteriophage in treating Klebsiella pneumoniae B5055-mediated lobar pneumonia in mice. (United States)

    Chhibber, Sanjay; Kaur, Sandeep; Kumari, Seema


    Klebsiella pneumoniae causes infections in humans especially in immunocompromised patients. About 80 % of nosocomial infections caused by K. pneumoniae are due to multidrug-resistant strains. The emergence of antibiotic-resistant bacterial strains necessitates the exploration of alternative antibacterial therapies, which led our group to study the ability of bacterial viruses (known as bacteriophages or simply phages) to treat mice challenged with K. pneumoniae. Phage SS specific for K. pneumoniae B5055 was isolated and characterized, and its potential as a therapeutic agent was evaluated in an experimental model of K. pneumoniae-mediated lobar pneumonia in mice. Mice were challenged by intranasal (i.n.) inoculation with bacteria (10(8) c.f.u. ml(-1)). A single intraperitoneal injection of 10(10) p.f.u. ml(-1) phage administered immediately after i.n. challenge was sufficient to rescue 100 % of animals from K. pneumoniae-mediated respiratory infections. Administration of the phage preparation 3 h prior to i.n. bacterial challenge provided significant protection in infected mice, while even 6 h delay of phage administration after the induction of infection rendered the phage treatment ineffective. The results of this study therefore suggest that the timing of starting the phage therapy after initiation of infection significantly contributes towards the success of the treatment.

  18. Drop Analysis in Infants with Bacterial Pneumonia in the Diagnosis of Procalcitonin Detection and Blood Culture%降钙素原检测与血培养在婴幼儿细菌性肺炎诊断中的作用分析

    Institute of Scientific and Technical Information of China (English)



    Objective To compare the procalcitonin and blood culture results in the diagnosis of bacterial pneumonia in infants.Methods Choose 36 cases of infants with bacterial pneumonia,fasting blood,for procalcitonin detection,blood culture,the comparison results.Results Procalcitonin blood culture positive rate was 52.78%;the total positive rate was 25%.Conclusion In the diagnosis of infantile bacterial pneumonia,procalcitonin has more advantage.%目的对比降钙素原与血培养在婴幼儿细菌性肺炎诊断中效果。方法选取婴幼儿细菌性肺炎患儿36例,抽取空腹静脉血,行降钙素原、血培养检测,对比结果。结果降钙素原阳性率为52.78%;血培养总阳性率为25.00%。结论在婴幼儿细菌性肺炎诊断中,降钙素原检测具有更大的优势。

  19. Association of Mycoplasma pneumoniae infection and childhood asthma

    Institute of Scientific and Technical Information of China (English)

    YADAV Shakti Nrisingh; GAUTAM Mahesh Kumar; JIANG Li


    Mycoplasma pneumoniae is a frequent cause of acute respiratory infections in both children and adults.It can cause pharyngitis, otitis, tracheobronchitis, or community-acquired pneumonia, but may also remain totally asymptomatic.Mycoplasma pneumoniae is an organism that reportedly has a strong relationship to asthma.The role of atypical bacterial infection in the pathogenesis of asthma is a subject of continuing debate. There is an increasing body of literature concerning the association between Mycoplasma pneumoniae ( M. pneumoniae) and asthma pathogenesis.Moreover, many studies investigating such a link have been uncontrolled and have provided conflicting evidence, in part due to the difficulty in accurately diagnosing infection with these atypical pathogens. Large, general population-based prospective studies are necessary to investigate the development of asthma induced by M. pneumoniae infection in humans. This manuscript will review the relationship between M.pneumoniae infection and childhood asthma.

  20. Pneumonia due to pandemic (H1N1) 2009 influenza virus and Klebsiella pneumoniae capsular serotype K16 in a patient with nasopharyngeal cancer. (United States)

    Lai, Chih-Cheng; Lee, Pei-Lin; Tan, Che-Kim; Huang, Yu-Tsung; Kao, Chiang-Lian; Wang, Jin-Town; Hsueh, Po-Ren


    Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus and group A Streptoccocus, but no Klebsiella pneumoniae were responsible for bacterial coinfections during the 2009 and previous influenza pandemics. We hereby report a case with concurrent bacteremic pneumonia due to an unusual capsular serotype K16 K. pneumoniae and pandemic (H1N1) 2009 influenza in a patient with nasopharyngeal cancer. Such a coinfection has not previously been described.

  1. Infection by Mycoplasma pneumoniae and its importance as an etiological agent in childhood community-acquired pneumonias

    Directory of Open Access Journals (Sweden)

    Letícia Alves Vervloet


    Full Text Available This manuscript reviewed the literature on infection by Mycoplasma pneumoniae with emphasis on etiological aspects of childhood community-acquired pneumonias. Bibliographical research was carried out from Pubmed Medline, MDConsult, HighWire, LILACS, and direct research over the past 10 years with the following keywords: Mycoplasma pneumoniae, pneumonia, and childhood. Fifty-four articles were selected. Mycoplasma pneumoniae has a high incidence in childhood. Clinical presentation includes respiratory and extrarespiratory symptoms. Mycoplasma pneumoniae lung infection can be confused with viral or bacterial pneumonia and is unresponsive to beta-lactams. In addition, co-infections have been reported. Mycoplasma pneumoniae infection occurs in all age groups, being less frequent and more severe in children under the age of five. Its incidence as a causal agent is high. Mycoplasma pneumoniae infections constitute 20%-40% of all community-acquired pneumonias; the severity is highly variable, and this condition may lead to severe sequelae. Mycoplasma pneumoniae frequency is underestimated in clinical practice because of the lack of specific features and a diagnosis that needs serology or PCR. Effective management of M. pneumoniae infections can usually be achieved with macrolides. In Brazil, epidemiological studies are needed in order to assess the incidence of this bacterium.

  2. Granzymes A and B Regulate the Local Inflammatory Response during Klebsiella pneumoniae Pneumonia. (United States)

    García-Laorden, M Isabel; Stroo, Ingrid; Blok, Dana C; Florquin, Sandrine; Medema, Jan Paul; de Vos, Alex F; van der Poll, Tom


    Klebsiella pneumoniae is a common cause of hospital-acquired pneumonia. Granzymes (gzms), mainly found in cytotoxic lymphocytes, have been implicated as mediators of infection and inflammation. We here sought to investigate the role of gzmA and gzmB in the host response to K. pneumoniae-induced airway infection and sepsis. For this purpose, pneumonia was induced in wild-type (WT) and gzmA-deficient (gzmA-/-), gzmB-/- and gzmAxB-/- mice by intranasal infection with K. pneumoniae. In WT mice, gzmA and gzmB were mainly expressed by natural killer cells. Pneumonia was associated with reduced intracellular gzmA and increased intracellular gzmB levels. Gzm deficiency had little impact on antibacterial defence: gzmA-/- and gzmAxB-/- mice transiently showed modestly higher bacterial loads in the lungs but not in distant organs. GzmB-/- and, to a larger extent, gzmAxB-/- mice displayed transiently increased lung inflammation, reflected in the semi-quantitative histology scores and levels of pro-inflammatory cytokines and chemokines. Most differences between gzm-deficient and WT mice had disappeared during late-stage pneumonia. Gzm deficiency did not impact on distant organ injury or survival. These results suggest that gzmA and gzmB partly regulate local inflammation during early pneumonia but eventually play an insignificant role during pneumosepsis by the common human pathogen K. pneumoniae.

  3. Host-pathogen interaction during Streptococcus pneumoniae colonization and infection

    NARCIS (Netherlands)

    D. Bogaert (Debby)


    markdownabstract__Abstract__ Streptococcus pneumoniae was discovered by Sternberg and Pasteur in 1880. It took another six years to discover that this microorganism, called the pneumococcus, was the actual cause of bacterial pneumonia . Subsequently, this bacterium has been shown to provoke an impr

  4. 老年细菌性肺炎患者贫血发生情况及其影响因素的初步分析%Primary Analysis of Incidence of Anemia and Its Related Factors in Eldly Patients with Bacterial Pneumonia

    Institute of Scientific and Technical Information of China (English)



    目的:探讨老年细菌性肺炎患者贫血发生情况及其影响因素。方法回顾性分析61例老年细菌性肺炎患者和100例老年健康体检者实验室检查结果。比较两组血红蛋白(Hgb)水平及贫血发生率。另将老年细菌性肺炎组分为贫血组和非贫血组,比较两组C反应蛋白(CRP)、清蛋白(Alb)水平及体质指数(BMI)。分析老年细菌性肺炎组Hgb与CRP、Alb、BMI及年龄的相关性。结果老年细菌性肺炎组Hgb水平低于健康对照组,贫血率高于健康对照组,差异均有统计学意义(P<0.01);老年细菌性肺炎贫血组CRP高于老年细菌性肺炎非贫血组、而Alb、BMI低于老年细菌性肺炎非贫血组,差异均有统计学意义(P<0.01);细菌性肺炎组Hgb水平与CRP呈负相关(r=-0.258,P<0.05),与Alb呈正相关(r=0.263,P<0.05),与BMI、年龄的相关性均无统计学意义(r分别为0.156、-0.039,P>0.05)。结论老年细菌性肺炎患者贫血发生率较高,营养不良、炎症反应可能是其重要原因。%Objective To investigate the incidence of anemia and its related factors in eldly patients with bacterial pneumo-nia.Methods A retrospective analysis of the results of laboratory tests of 61 cases of elderly patients with bacterial pneumonia and 100 cases of elderly healthy individuals was carried out.The level of hemoglobin(Hgb) and the anemia rate were compared between elderly patients with bacterial pneumonia group and the control group. The elderly patients with bacterial pneumonia group was divided into anemia group and non anemia group,and Creactive protein(CRP),albumin(Alb)and body mass index(BMI) were compared be-tween two groups.The correlation between Hgb and CRP,Alb in the elderly patients with bacterial pneumonia group.Results The level of Hgb of elderly patients with bacterial pneumonia group was significantly lower than the control group,and the anemia rate

  5. Klebsiella pneumoniae capsule expression is necessary for colonization of large intestines of streptomycin-treated mice

    DEFF Research Database (Denmark)

    Favre-Bonte, S.; Licht, Tine Rask; Forestier, C.;


    The role of the Klebsiella pneumoniae capsular polysaccharide (K antigen) during colonization of the mouse large intestine was assessed with mild-type K. pneumoniae LM21 and its isogenic capsule-defective mutant. When bacterial strains were fed alone to mice, the capsulated bacteria persisted....... pneumoniae....

  6. Complete genome sequence of a Klebsiella pneumoniae strain isolated from a known cotton insect boll vector (United States)

    Klebsiella pneumoniae (associated with bacterial pneumonia) was previously isolated from Nezara viridula, a significant vector of cotton boll-rot pathogens. We provide the first annotated genome sequence of the cotton opportunistic strain K. pneumoniae 5-1. This data provides guidance to study the...

  7. Streptococcus pneumoniae DNA Load in Blood as a Marker of Infection in Patients with Community-Acquired Pneumonia

    NARCIS (Netherlands)

    Peters, R.P.H.; Boer, de R.F.; Schuurman, T.; Gierveld, S.; Kooistra-Smid, M.; Agtmael, van M.A.; Vandenbroucke-Grauls, C.M.J.E.; Persoons, M.C.J.; Savelkoul, P.H.M.


    Direct detection of Streptococcus pneumoniae DNA in blood adds to culture results in the etiological diagnosis of patients with community-acquired pneumonia (CAP). Quantification of the amount of DNA, the bacterial DNA load (BDL), provides a measurement of DNAemia that may increase the understanding

  8. 综合 ICU 医院获得性肺炎感染菌株及耐药性分析%Analysis of infected strains and bacterial resistance of hospital acquired pneumonia in general intensive care unit

    Institute of Scientific and Technical Information of China (English)

    成云兰; 朱滨


    目的:分析医院综合重症监护病房(GICU )医院获得性肺炎(HAP)感染菌株特点及耐药情况。方法回顾性分析GICU收治61例 HAP患者的感染菌株及其对抗菌药物耐药性。结果61例H A P患者中,共检出213株菌。革兰阴性杆菌99株(46.5%),以鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌为主;革兰阳性球菌81株(38.0%),以肠球菌、金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌为主;真菌33株(15.5%),以白色念珠菌和非白色念珠菌为主。鲍曼不动杆菌株较多对抗生素多重耐药,未发现耐万古霉素的肠球菌株和葡萄球菌株。结论应根据细菌病原学及抗菌药物耐药性,合理选择抗菌药物,控制GICU内 HAP感染的发生,减少耐药菌的出现。%Objective To analyze the infected strains and bacterial resistance of hospital acquired pneumonia(HAP) in general intensive care unit (GICU ) .Methods Data of isolated infected strains and their resistance to anti‐biotics in 61 patients with HAP in GICU were retrospectively analyzed .Result A total of 213 bacteria strains was isolated in 61 HAP patients ,of which 99 (46.5% ) strains were gram‐negative bacteria ,81(38.0% ) strains were gram‐positive bacteria and 33 (15.5% ) strains were fungus .Gram‐negative bacteria included mainly acinetobacter baumannii , klebsiella pneumoniae ,pseudomonas aeruginosa and escherichia coli .Gram‐positive bacteria included mainly enterococcus ,staphylococcus aureus ,epidermis staphylococcus and hemolytic staphylococci . Fungus included mainly candida albicans and non‐candida albicans .Acinetobacter baumannii strains tended to have multiple drug resistance .No strain of staphylococcus and enterococcus resistant to vancomycin was found . Conclusion According to bacterial etiology characteristics and bacterial resistance ,antibiotics should be reasonably selected to control HAP in

  9. High-throughput sequencing of 16S rDNA amplicons characterizes bacterial composition in bronchoalveolar lavage fluid in patients with ventilator-associated pneumonia

    Directory of Open Access Journals (Sweden)

    Yang XJ


    Full Text Available Xiao-Jun Yang,1,* Yan-Bo Wang,2,3,* Zhi-Wei Zhou,4,* Guo-Wei Wang,2 Xiao-Hong Wang,1 Qing-Fu Liu,1 Shu-Feng Zhou,4 Zhen-Hai Wang2,3 1Department of Intensive Care Unit, 2Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China; 3Key Laboratory of Brain Diseases of Ningxia, Yinchuan, Ningxia, People’s Republic of China; 4Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA *These authors contributed equally to this work Abstract: Ventilator-associated pneumonia (VAP is a life-threatening disease that is associated with high rates of morbidity and likely mortality, placing a heavy burden on an individual and society. Currently available diagnostic and therapeutic approaches for VAP treatment are limited, and the prognosis of VAP is poor. The present study aimed to reveal and discriminate the identification of the full spectrum of the pathogens in patients with VAP using high-throughput sequencing approach and analyze the species richness and complexity via alpha and beta diversity analysis. The bronchoalveolar lavage fluid samples were collected from 27 patients with VAP in intensive care unit. The polymerase chain reaction products of the hypervariable regions of 16S rDNA gene in these 27 samples of VAP were sequenced using the 454 GS FLX system. A total of 103,856 pyrosequencing reads and 638 operational taxonomic units were obtained from these 27 samples. There were four dominant phyla, including Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. There were 90 different genera, of which 12 genera occurred in over ten different samples. The top five dominant genera were Streptococcus, Acinetobacter, Limnohabitans, Neisseria, and Corynebacterium, and the most widely distributed genera were Streptococcus, Limnohabitans, and Acinetobacter in these 27 samples. Of note, the mixed profile of causative pathogens was observed. Taken

  10. Single immunoglobulin interleukin-1 receptor-related molecule impairs host defense during pneumonia and sepsis caused by Streptococcus pneumoniae. (United States)

    Blok, Dana C; van Lieshout, Miriam H P; Hoogendijk, Arie J; Florquin, Sandrine; de Boer, Onno J; Garlanda, Cecilia; Mantovani, Alberto; van't Veer, Cornelis; de Vos, Alex F; van der Poll, Tom


    Streptococcus pneumoniae is a common cause of pneumonia and sepsis. Toll-like receptors (TLRs) play a pivotal role in the host defense against infection. In this study, we sought to determine the role of single immunoglobulin interleukin-1 receptor-related molecule (SIGIRR a.k.a. TIR8), a negative regulator of TLR signaling, in pneumococcal pneumonia and sepsis. Wild-type and SIGIRR-deficient (sigirr-/-) mice were infected intranasally (to induce pneumonia) or intravenously (to induce primary sepsis) with S. pneumoniae and euthanized after 6, 24, or 48 h for analyses. Additionally, survival studies were performed. sigirr-/- mice showed delayed mortality during lethal pneumococcal pneumonia. Accordingly, sigirr-/- mice displayed lower bacterial loads in lungs and less dissemination of the infection 24 h after the induction of pneumonia. SIGIRR deficiency was associated with increased interstitial and perivascular inflammation in lung tissue early after infection, with no impact on neutrophil recruitment or cytokine production. sigirr-/- mice also demonstrated reduced bacterial burdens at multiple body sites during S. pneumoniae sepsis. sigirr-/- alveolar macrophages and neutrophils exhibited an increased capacity to phagocytose viable pneumococci. These results suggest that SIGIRR impairs the antibacterial host defense during pneumonia and sepsis caused by S. pneumoniae.

  11. Seropositivity for Chlamydia Pneumoniae and Mycoplasma Pneumoniae in Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Murat Tutanc


    Full Text Available Acute respiratory tract infections may trigger acute asthma attacks and may be held responsible for etiopathogenesis in children with asthma. Although bacterial infections attract a limited amount of attention, recently Chlamydia pneumoniae (CP and Mycoplasma pneumoniae (MP, in particular, are reported to be the possible factors. IgM and IgG seroprevalence was investigated in 66 children patients with bronchial asthma (between the ages of 3 and 14 for CP and Mycoplasma pneumoniae. In a total of 66 cases, 18 (27.2% patients were detected with IgG positivity for CP whereas 27 of them (40.9% were detected with IgG positivity for MP. IgG positivity was determined in 6 patients (13.0% in the control group for CP, and in 6 patients (10.8% in the control group for MP. The rate of the asthma patients with IgG seropositivity for MP was 4 times higher than that of the control group. It was seen that IgG antibody seropositivity for CP was higher in those with more frequent attacks. No such difference was observed in terms of IgG antibody seropositivity for M. pneumoniae. There are many studies indicating that CP and MP infections take an importance place in the etiology of bronchial asthma and asthma attacks in children. The results obtained reveal the effect of both microorganisms on the etiopathogenesis of the bronchial asthma and the increased number of asthma attacks.

  12. The radiological diagnosis of pneumonia in children

    Directory of Open Access Journals (Sweden)

    Kerry-Ann F O'Grady


    Full Text Available Despite the importance of paediatric pneumonia as a cause of short and long-term morbidity and mortality worldwide, a reliable gold standard for its diagnosis remains elusive. The utility of clinical, microbiological and radiological diagnostic approaches varies widely within and between populations and is heavily dependent on the expertise and resources available in various settings. Here we review the role of radiology in the diagnosis of paediatric pneumonia. Chest radiographs (CXRs are the most widely employed test, however, they are not indicated in ambulatory settings, cannot distinguish between viral and bacterial infections and have a limited role in the ongoing management of disease. A standardised definition of alveolar pneumonia on a CXR exists for epidemiological studies targeting bacterial pneumonias but it should not be extrapolated to clinical settings. Radiography, computed tomography and to a lesser extent ultrasonography and magnetic resonance imaging play an important role in complicated pneumonias but there are limitations that preclude their use as routine diagnostic tools. Large population-based studies are needed in different populations to address many of the knowledge gaps in the radiological diagnosis of pneumonia in children, however, the feasibility of such studies is an important barrier.

  13. Geriatric oral health and pneumonia risk. (United States)

    Terpenning, Margaret


    The oral cavity is a complex microenvironment consisting of multiple bacterial and fungal species, their associated biofilms, and a cytokine milieu influenced by constant inflammatory stimulation. Multiple infectious consequences of poor oral health have been extensively described and primarily affect older adults. Probably the most common sequelae of poor oral health in aged persons is a risk of aspiration pneumonia. The risk of aspiration pneumonia is greatest when periodontal disease, dental caries, and poor oral hygiene are compounded by swallowing disease, feeding problems, and poor functional status. The effectiveness of oral hygiene interventions for preventing aspiration pneumonia and barriers to oral care of nursing home patients require additional study, but the current state of research in these areas is reviewed in this manuscript. The expense of aspiration pneumonia as a nursing home complication makes dental hygiene a potentially cost-saving intervention.

  14. Recurrent Pneumonia due to Double Aortic Arch

    Directory of Open Access Journals (Sweden)

    I. Sedighi


    Full Text Available Introduction: Pneumonia is one of the most common infections during childhood. In children with recurrent bacterial pneumonia complete evaluation for underlying factors is necessary. The most common underlying diseases include: antibody deficiencies , cystic fibrosis , tracheoesophageal fistula and increased pulmonary blood flow. Vascular ring and its pressure effect is a less common cause of stridor and recurrent pneumonia. Congenital abnormalities in aortic arch and main branches which form vascular ring around esophagus and trachea with variable pressure effect cause respiratory symptoms such as stridor , wheezing and recurrent pneumoniaCase Report: A 2 year old boy was admitted in our hospital with respiratory distress and cough . Chest x-Ray demonstrated right lobar pneumonia. He had history of stridor and wheezing from neonatal period and hospitalization due to pneumonia for four times. The patient received appropriate antibiotics. Despite fever and respiratory distress improvement, wheezing continued. Review of his medical documents showed fixed pressure effect on posterior aspect of esophagus in barium swallow. In CT angiography we confirmed double aortic arch.Conclusion: Double aortic arch is one of the causes of persistant respiratory symptom and recurrent pneumonia in children for which fluoroscopic barium swallow is the first non-invasive diagnostic method.(Sci J Hamadan Univ Med Sci 2012;19(1:70-74

  15. Clinical implications and treatment of multiresistant Streptococcus pneumoniae pneumonia. (United States)

    File, T M


    Streptococcus pneumoniae is the leading bacterial cause of community-acquired respiratory tract infections. Prior to the 1970s this pathogen was uniformly susceptible to penicillin and most other antimicrobials. However, since the 1990s there has been a significant increase in drug-resistant Streptococcus pneumoniae (DRSP) due, in large part, to increased use of antimicrobials. The clinical significance of this resistance is not definitely established, but appears to be most relevant to specific MICs for specific antimicrobials. Certain beta-lactams (amoxicillin, cefotaxime, ceftriaxone), the respiratory fluoroquinolones, and telithromycin are among several agents that remain effective against DRSP. Continued surveillance studies, appropriate antimicrobial usage campaigns, stratification of patients based on known risk factors for resistance, and vaccination programmes are needed to appropriately manage DRSP and limit its spread.

  16. How Does Streptococcus pneumoniae Invade the Brain?

    NARCIS (Netherlands)

    Iovino, Federico; Seinen, Jolien; Henriques-Normark, Birgitta; van Dijl, Jan Maarten


    Streptococcus pneumoniae (the pneumococcus) is the major cause of bacterial meningitis. The mechanisms by which pneumococci from the bloodstream penetrate the blood-brain barrier to reach the brain are not fully understood. Receptor-mediated adhesion of the bacteria to the brain endothelium is consi

  17. Clinical analysis of secondary cefoperazone/sulbactam associated diarrhea in children with bacterial pneumonia%细菌性肺炎患儿继发头孢哌酮/舒巴坦相关性腹泻临床分析

    Institute of Scientific and Technical Information of China (English)

    刘勇; 程国平; 戴昕; 汪在华; 蔡萍; 张振


    Objective To investigate the related factors and prognosis of secondary cefoperazone/sulbactam associated diarrhea in children with bacterial pneumonia.Methods Analysis was made on age, gender, white blood cell count, neutrophile granulocyte count, C-reactive protein (CRP), clostridium difficile (CD), antibiotics use time, and hospital stay of 376 children who took cefoperazone/sulbactam. For those who had antibiotic associated diarrhea (AAD), summarization was also made on their first diarrhea start time, diarrhea last time, diarrhea times, probiotics use time, and diarrhea drugs.Results Among 376 children with bacterial pneumonia who took cefoperazone/sulbactam, there were 122 cases of them had AAD. The difference of age, gender, use time of cefoperazone/sulbactam, and hospital stay between children with AAD and those without AAD had statistical significance (P<0.01). Among children with AAD, 73 of them had mild symptom, and 49 had severe symptom. The difference of CD positive rate between severe AAD children and children without AAD had statistical significance (P<0.05). After treatment, there were 17 cases with recurrent diarrhea among 122 AAD children. There were statistically significant differences between relapse AAD children and non-relapse children of CD positive rate, diarrhea time, probiotics use time, antibiotics use time and hospital stays (P<0.05). Conclusion AAD morbidity is high due to cefoperazone/sulbactam treatment for children with bacterial pneumonia. Severe AAD children have high CD positive rate, and relapse AAD children have long antibiotics use time and hospital stay.%目的:探讨细菌性肺炎患儿继发头孢哌酮/舒巴坦相关性腹泻的相关因素及预后。方法分析376例使用过头孢哌酮/舒巴坦患儿的年龄、性别、白细胞数、中性粒细胞数、C反应蛋白(CRP)、难辨梭状芽孢杆菌(CD)、抗生素使用时间和住院时间,发生抗生素相关性腹泻(AAD)的患儿第一次腹泻开始时

  18. Characteristics of Adenovirus Pneumonia in Korean Military Personnel, 2012-2016. (United States)

    Yoon, Hee; Jhun, Byung Woo; Kim, Hojoong; Yoo, Hongseok; Park, Sung Bum


    Adenovirus (AdV) can cause severe pneumonia in non-immunocompromised host, but limited data exist on the distinctive characteristics of AdV pneumonia in non-immunocompromised patients. We evaluated distinctive clinico-laboratory and radiological characteristics and outcomes of AdV pneumonia (n = 179), compared with non-AdV pneumonia (n = 188) in Korean military personnel between 2012 and 2016. AdV pneumonia patients had a higher rate of consolidation with ground-glass opacity (101/152) in lobar distribution (89/152) on computed tomography (CT) (P pneumonia patients. Bacterial co-infection was identified in 28.5% of AdV pneumonia. Most of the AdV isolates typed (69/72, 95.8%) were AdV-55. Patients with a pneumonia severity index ≥ class III were more commonly observed in AdV pneumonia patients compared with non-AdV pneumonia patients (11.2% vs. 2.1%, P pneumonia patients compared with the non-AdV pneumonia patients (3.8 vs. 2.6 days, P pneumonia patients, one of whom died due to AdV-55. Our data showed that AdV pneumonia in non-immunocompromised patients had distinct characteristics and most of the isolates typed in our study were AdV-55. It is suggested that AdV-55 is an important pathogen of pneumonia in Korean military personnel.

  19. A novel method for rapid detection of Streptococcus pneumoniae antigens in blood. (United States)

    Fukushima, Kiyoyasu; Kubo, Toru; Ehara, Naomi; Nakano, Reiji; Matsutake, Toyoshi; Ishimatu, Yuji; Tanaka, Yumi; Akamatsu, Suguru; Izumikawa, Koichi; Kohno, Shigeru


    In this study, we used "RAPIRUN(®)Streptococcus pneumoniae HS (otitis media/sinusitis) (RAPIRUN-HS)," a rapid S. pneumoniae antigen detection kit, to investigate methods for detecting S. pneumoniae antigens in blood of 32 bacterial pneumonia patients. We simultaneously performed PCR to detect S. pneumoniae in blood samples. The results of these tests were compared based on pneumonia severity, determined using the Pneumonia Severity Index (PSI) score classification. Four S. pneumoniae PCR-positive patients of the six severe pneumococcal pneumonia patients (PSI risk class IV/V) also tested positive using RAPIRUN-HS. Twenty-four mild to moderate pneumonia patients (PSI risk class I-III) were S. pneumoniae PCR-negative; of these, 21 tested negative using RAPIRUN-HS. The pneumococcal pneumonia patients testing positive using RAPIRUN-HS had low leukocyte counts and elevated C-reactive protein and procalcitonin levels, indicating that RAPIRUN-HS results were correlated with pneumonia severity. The time course evaluations of the laboratory tests for severe pneumococcal pneumonia patients showed that RAPIRUN-HS and S. pneumoniae PCR yielded positive results earlier than the changes in procalcitonin and IL-6. Thus, concomitant pneumococcal bacteremia was strongly suspected in patients testing positive using RAPIRUN-HS. In conclusion, RAPIRUN-HS may be useful for determining whether to admit patients into hospitals and selecting the appropriate antimicrobial agents.

  20. Female resistance to pneumonia identifies lung macrophage nitric oxide synthase-3 as a therapeutic target

    DEFF Research Database (Denmark)

    Yang, Zhiping; Huang, Yuh-Chin T; Koziel, Henry


    To identify new approaches to enhance innate immunity to bacterial pneumonia, we investigated the natural experiment of gender differences in resistance to infections. Female and estrogen-treated male mice show greater resistance to pneumococcal pneumonia, seen as greater bacterial clearance......). Epidemiologic data show decreased hospitalization for pneumonia in women receiving estrogen or statins (known to activate NOS3). Pharmacologic targeting of NOS3 with statins or another small-molecule compound (AVE3085) enhanced macrophage bacterial killing, improved bacterial clearance, and increased host...... survival in both primary and secondary (post-influenza) pneumonia. The data identify a novel mechanism for host defense via NOS3 and suggest a potential therapeutic strategy to reduce secondary bacterial pneumonia after influenza....

  1. Experimentally produced calf pneumonia. (United States)

    Gourlay, R N; Howard, C J; Thomas, L H; Stott, E J


    Experimental pneumonia was produced in calves by the endobronchial inoculation of pneumonic lung homogenates. Irradiated homogenates produced minimal pneumonia. Ampicillin treatment of the homogenates and the experimental calves reduced the extent of pneumonia. Treatment with tylosin tartrate prevented experimental pneumonia. These results suggest that the total pneumonia was due to organisms susceptible to tylosin tartrate and that the residual pneumonia remaining after ampicillin treatment was due to organisms susceptible to tylosin tartrate but not to ampicillin. Of the organisms isolated from the lungs, the ones in this latter category most likely to be responsible are Mycoplasma dispar and ureaplasmas (T-mycoplasmas).

  2. The Implications of Serum Procalcitonion(PCT) and Blood Normal(BR) Detection in Patients with Bacterial Pneumonia%血清降钙素原和血常规测定对细菌性肺炎的指导意义

    Institute of Scientific and Technical Information of China (English)

    颜鲲; 徐慧兰


    Objective To evaluate the implications of the detection of Serum Procalcitonion (PCT) and BR in patients with Bacterial Pneumonia,and provide theoretical reference for diagnosis and treatment of Bacterial Pneumonia. Methods 64 samples were col ected from patients with Bacterial Pneumonia in respiratory department、ICU and emergency department from January to November 2011,and compared with 32 healthy people .PCT and BR were measured. The PCT level was determined by Brahms PCT-Q method. Results The sensitivities of PCT and BR were 78 %and 63 %,respectively with the sepcificities being 97 %and 70 %.The serum PCT levels of Bacterial Pneumonia group were higher than the healthy group, compared the difference was significant (P<0.05). The serum PCT levels of Bacterial Pneumonia group before using antibiotics were higher than that after effective therapy, compared the difference was significant (P<0.05). Conclusions The serum PCT has diagnostic value for the Bacterial Pneumonia, and it is a useful index to assess the clinical efficacy in patients using antibiotics. It is worthy of clinical application.%目的:探讨血清降钙素原(PCT)和血常规(BR)在细菌性肺炎诊断中的应用价值,旨在为细菌性肺炎的诊治提供理论参考。方法选取中南大学湘雅三医院2011年1月至11月在呼吸、急诊、ICU 住院的细菌性肺炎患者64例,同期健康对照组32例,血清 PCT 采用 Brahms 快速半定量法(PCT-Q)测定,同期检测血常规。结果细菌性肺炎组中,PCT、白细胞计数对诊断的敏感性分别为78%和63%,特异性分别为97%和70%,细菌性肺炎组较健康对照组 PCT 水平显著增高,相比较有显著性差异(P <0.05)。细菌性肺炎组抗生素治疗前和好转后,血清 PCT 水平显著下降,相比较有显著性差异(P <0.05)。结论血清 PCT 的测定对细菌性肺炎有鉴别诊断价值,特别是可反应抗生素治疗效果,值得临床推广应用。

  3. Pneumonia - children - discharge (United States)

    ... this page: // Pneumonia in children - discharge To use the sharing features ... this page, please enable JavaScript. Your child has pneumonia, which is an infection in the lungs. In ...

  4. Pneumonia - adults - discharge (United States)

    ... this page: // Pneumonia in adults - discharge To use the sharing features on this page, please enable JavaScript. You have pneumonia, which is an infection in your lungs. In ...

  5. Pneumocystis jiroveci pneumonia (United States)

    ... Pneumocystis jiroveci pneumonia To use the sharing features on this page, please enable JavaScript. Pneumocystis jiroveci pneumonia is a fungal infection of the lungs. The ...

  6. FastStats: Pneumonia (United States)

    ... this? Submit What's this? Submit Button NCHS Home Pneumonia Recommend on Facebook Tweet Share Compartir Data are ... visits Number of visits to emergency departments with pneumonia as the primary hospital discharge diagnosis: 674,000 ...

  7. Binding and entry of DNA in bacterial transformation

    Energy Technology Data Exchange (ETDEWEB)

    Lacks, S.A.


    Bacterial transformation in relation to DNA transport and competence in Streptococcus pneumoniae (also called Diplococcus pneumoniae) is discussed. This species will serve as a model with which to compare transformation in other bacterial species, particularly Bacillus subtilis and Haemophilus influenzae, with emphasis on the many similarities as well as differences.

  8. Pneumocystis Pneumonia (For Parents) (United States)

    ... Feeding Your 1- to 2-Year-Old Pneumocystis Pneumonia KidsHealth > For Parents > Pneumocystis Pneumonia Print A A A What's in this article? About PCP Diagnosing PCP Treating PCP Pneumocystis pneumonia (PCP) is an infection caused by Pneumocystis jiroveci , ...

  9. Pneumonia (For Parents) (United States)

    ... Old Feeding Your 1- to 2-Year-Old Pneumonia KidsHealth > For Parents > Pneumonia A A A What's in this article? Signs ... Doctor Professional Treatment Home Care en español Neumonía Pneumonia is a general term for lung infections that ...

  10. Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients. (United States)

    de Steenhuijsen Piters, Wouter A A; Huijskens, Elisabeth G W; Wyllie, Anne L; Biesbroek, Giske; van den Bergh, Menno R; Veenhoven, Reinier H; Wang, Xinhui; Trzciński, Krzysztof; Bonten, Marc J; Rossen, John W A; Sanders, Elisabeth A M; Bogaert, Debby


    Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently disease. We compared oropharyngeal microbiota of elderly pneumonia patients (n=100) with healthy elderly (n=91) by 16S-rRNA-based sequencing and verified our findings in young adult pneumonia patients (n=27) and young healthy adults (n=187). Microbiota profiles differed significantly between elderly pneumonia patients and healthy elderly (PERMANOVA, Pdisease was less clear. A decision tree model based on the relative abundance of five bacterial community members in URT microbiota showed high specificity of 95% and sensitivity of 84% (89% and 73%, respectively, after cross-validation) for differentiating pneumonia patients from healthy individuals. These results suggest that pneumonia in elderly and young adults is associated with dysbiosis of the URT microbiome with bacterial overgrowth of single species and absence of distinct anaerobic bacteria. Whether the observed microbiome changes are a cause or a consequence of the development of pneumonia or merely coincide with disease status remains a question for future research.

  11. Identification of putative plant pathogenic determinants from a draft genome sequence of an opportunistic klebsiella pneumoniae strain (United States)

    Klebsiella pneumoniae has been known historically as a causal agent of bacterial pneumonia. More recently, K. pneumoniaerepresentatives have been shown to have a broad ecological distribution and are recognized nitrogen-fixers. Previously, we demonstrated the capacity of K. pneumoniae strain Kp 5-1R...

  12. Role of Nucleotide-Binding Oligomerization Domain-Containing (NOD 2 in Host Defense during Pneumococcal Pneumonia.

    Directory of Open Access Journals (Sweden)

    Tijmen J Hommes

    Full Text Available Streptococcus (S. pneumoniae is the most common causative pathogen in community-acquired pneumonia. Nucleotide-binding oligomerization domain-containing (NOD 2 is a pattern recognition receptor located in the cytosol of myeloid cells that is able to detect peptidoglycan fragments of S. pneumoniae. We here aimed to investigate the role of NOD2 in the host response during pneumococcal pneumonia. Phagocytosis of S. pneumoniae was studied in NOD2 deficient (Nod2-/- and wild-type (Wt alveolar macrophages and neutrophils in vitro. In subsequent in vivo experiments Nod2-/- and Wt mice were inoculated with serotype 2 S. pneumoniae (D39, an isogenic capsule locus deletion mutant (D39Δcps or serotype 3 S. pneumoniae (6303 via the airways, and bacterial growth and dissemination and the lung inflammatory response were evaluated. Nod2-/- alveolar macrophages and blood neutrophils displayed a reduced capacity to internalize pneumococci in vitro. During pneumonia caused by S. pneumoniae D39 Nod2-/- mice were indistinguishable from Wt mice with regard to bacterial loads in lungs and distant organs, lung pathology and neutrophil recruitment. While Nod2-/- and Wt mice also had similar bacterial loads after infection with the more virulent S. pneumoniae 6303 strain, Nod2-/- mice displayed a reduced bacterial clearance of the normally avirulent unencapsulated D39Δcps strain. These results suggest that NOD2 does not contribute to host defense during pneumococcal pneumonia and that the pneumococcal capsule impairs recognition of S. pneumoniae by NOD2.

  13. Copper intoxication inhibits aerobic nucleotide synthesis in Streptococcus pneumoniae (United States)

    Johnson, Michael D. L.; Kehl-Fie, Thomas E.; Rosch, Jason W.


    Copper is universally toxic in excess, a feature exploited by the human immune system to facilitate bacterial clearance. The mechanism of copper intoxication remains unknown for many bacterial species. Here, we demonstrate that copper toxicity in Streptococcus pneumoniae is independent from oxidative stress but, rather, is the result of copper inhibiting the aerobic dNTP biosynthetic pathway. Furthermore, we show that copper-intoxicated S. pneumoniae is rescued by manganese, which is an essential metal in the aerobic nucleotide synthesis pathway. These data provide insight into new targets to enhance copper-mediated toxicity during bacterial clearance. PMID:25730343

  14. Monoclonal Idiotope Vaccine against Streptococcus pneumoniae Infection (United States)

    McNamara, Mary K.; Ward, Ronald E.; Kohler, Heinz


    A monoclonal anti-idiotope antibody coupled to a carrier protein was used to immunize BALB/c mice against a lethal Streptococcus pneumoniae infection. Vaccinated mice developed a high titer of antibody to phosphorylcholine, which is known to protect against infection with Streptococcus pneumoniae. Measurement of the median lethal dose of the bacteria indicated that anti-idiotope immunization significantly increased the resistance of BALB/c mice to the bacterial challenge. Antibody to an idiotope can thus be used as an antigen substitute for the induction of protective immunity.

  15. Mechanisms of interferon-γ production by neutrophils and its function during Streptococcus pneumoniae pneumonia. (United States)

    Gomez, John C; Yamada, Mitsuhiro; Martin, Jessica R; Dang, Hong; Brickey, W June; Bergmeier, Wolfgang; Dinauer, Mary C; Doerschuk, Claire M


    Bacterial pneumonia is a common public health problem associated with significant mortality, morbidity, and cost. Neutrophils are usually the earliest leukocytes to respond to bacteria in the lungs. Neutrophils rapidly sequester in the pulmonary microvasculature and migrate into the lung parenchyma and alveolar spaces, where they perform numerous effector functions for host defense. Previous studies showed that migrated neutrophils produce IFN-γ early during pneumonia induced by Streptococcus pneumoniae and that early production of IFN-γ regulates bacterial clearance. IFN-γ production by neutrophils requires Rac2, Hck/Lyn/Fgr Src family tyrosine kinases, and NADPH oxidase. Our current studies examined the mechanisms that regulate IFN-γ production by lung neutrophils during acute S. pneumoniae pneumonia in mice and its function. We demonstrate that IFN-γ production by neutrophils is a tightly regulated process that does not require IL-12. The adaptor molecule MyD88 is critical for IFN-γ production by neutrophils. The guanine nucleotide exchange factor CalDAG-GEFI modulates IFN-γ production. The CD11/CD18 complex, CD44, Toll-like receptors 2 and 4, TRIF, and Nrf2 are not required for IFN-γ production by neutrophils. The recently described neutrophil-dendritic cell hybrid cell, identified by its expression of Ly6G and CD11c, is present at low numbers in pneumonic lungs and is not a source of IFN-γ. IFN-γ produced by neutrophils early during acute S. pneumoniae pneumonia induces transcription of target genes in the lungs, which are critical for host defense. These studies underline the complexity of the neutrophil responses during pneumonia in the acute inflammatory response and in subsequent resolution or initiation of immune responses.

  16. How Does Streptococcus pneumoniae Invade the Brain? (United States)

    Iovino, Federico; Seinen, Jolien; Henriques-Normark, Birgitta; van Dijl, Jan Maarten


    Streptococcus pneumoniae (the pneumococcus) is the major cause of bacterial meningitis. The mechanisms by which pneumococci from the bloodstream penetrate the blood-brain barrier to reach the brain are not fully understood. Receptor-mediated adhesion of the bacteria to the brain endothelium is considered a key event leading to meningitis development. The aim of this review is to discuss recent advances and perspectives related to the interactions of S. pneumoniae with the blood-brain barrier during the events leading to meningitis. Altogether, the available data suggest that, by precisely defining the pathways and ligands by which S. pneumoniae adheres to specific receptors, it may be possible to interfere with the respective mechanisms and develop strategies to prevent or even cure pneumococcal meningitis.

  17. Development of new synthetic oligosaccharide vaccines : the immunogenicity of oligosaccharide-CRM197 neoconjugates and oligosaccharide/peptide hybrid gold nanoparticles based on the capsular polysaccharide structure of Streptococcus pneumoniae type 14

    NARCIS (Netherlands)

    Safari, D.


    Streptococcus pneumoniae is a leading cause of bacterial pneumonia, meningitis, and sepsis in children worldwide. Nowadays, the antibiotic resistance of S. pneumoniae bacteria has increased worldwide. This makes treatment of S. pneumoniae infections more difficult and stresses the importance of the


    Institute of Scientific and Technical Information of China (English)


    A 22-year-old man underwent bilateral laser in situ keratomileusis and developed Streptococcus pneumoniae keratitis after surgery.This complication occurred one day after the procedure in both eyes.Topical and systemic antibiotics were promptly administered.Bacterial culture was performed following corneal flap lift and scraping of the lesions.Afterwards,the therapeutic regimen was readjusted according to the culture results.Streptococcus pneumoniae was identified from the culture.Three months after the sur...

  19. Oral and airway microbiota in HIV-infected pneumonia patients


    Iwai, S.; Fei, M; Huang, D.; Fong, S.; Subramanian, A.; Grieco, K; Lynch, SV; Huang, L


    Despite the increased frequency of recurrent pneumonia in HIV-infected patients and recent studies linking the airway bacterial community (microbiota) to acute and chronic respiratory infection, little is known of the oral and airway microbiota that exist in these individuals and their propensity to harbor pathogens despite antimicrobial treatment for acute pneumonia. This pilot study compared paired samples of the oral and airway microbiota from 15 hospitalized HIV-infected patients receivin...

  20. Efficacies of colistin and tigecycline in mice with experimental pneumonia due to NDM-1-producing strains of Klebsiella pneumoniae and Escherichia coli. (United States)

    Docobo-Pérez, Fernando; Nordmann, Patrice; Domínguez-Herrera, Juan; López-Rojas, Rafael; Smani, Younes; Poirel, Laurent; Pachón, Jerónimo


    New Delhi metallo-β-lactamase-1 (NDM-1)-producing Enterobacteriaceae have emerged as a global threat. The aim of this study was to assess the efficacies of colistin and tigecycline in an experimental model of pneumonia caused by NDM-1-producing Escherichia coli and Klebsiella pneumoniae. The susceptibilities of K. pneumoniae NDM, E. coli NDM and K. pneumoniae ATCC 29665 were determined using the broth microdilution technique. The pharmacokinetics of colistin and tigecycline in an experimental model of pneumonia were performed using immunocompetent C57BL/6 mice. Mice were treated with colistin (60 mg/kg/day) or tigecycline (10 mg/kg/day). Mortality, bacteraemia and lung bacterial concentrations were recorded. The strains were susceptible to colistin and tigecycline. The ratio of area under the concentration-time curve/minimum inhibitory concentration (AUC/MIC) for colistin was 158.5 (all three strains) and that for tigecycline was 18.5 (K. pneumoniae NDM) and 37 (K. pneumoniae ATCC 29665 and E. coli NDM). In vivo, colistin decreased bacterial lung concentrations of K. pneumoniae NDM and K. pneumoniae ATCC 29665 by 1.16 log colony-forming units (CFU)/g and 2.23 logCFU/g, respectively, compared with controls (not significant). Tigecycline reduced K. pneumoniae NDM and K. pneumoniae ATCC 29665 load by 2.67 logCFU/g and 4.62 logCFU/g (Ppneumonia due to NDM-1-producing K. pneumoniae and its efficacy was suboptimal against NDM-1-producing E. coli. A high tigecycline dose was efficacious for treating experimental pneumonia due to NDM-1-producing E. coli and K. pneumoniae.

  1. Psychosis following mycoplasma pneumonia. (United States)

    Banerjee, Bonita; Petersen, Kyle


    Extrapulmonary manifestations of Mycoplasma pneumoniae are well described, including a subset of central nervous system (CNS)-associated syndromes. In pediatric populations, frequencies of CNS sequelae occur in 0.1% to 7% of patients. Neurologic illness associated with M. pneumoniae, such as meningitis, encephalitis, polyradiculitis, Guillain-Barre, and stroke have been reported; however, the incidence of M. pneumoniae-associated organic brain syndrome is rare. We present the case of a 20-year-old midshipman with acute psychosis following resolution of M. pneumoniae pneumonia and review 6 other adult cases found in the literature. M. pneumoniae remains one of the most common causes of respiratory illnesses in the military recruit setting and therefore should always be suspected as an organic cause of mental status changes in young persons such as recruits, cadets, and midshipmen particularly with antecedent respiratory illnesses.

  2. 培养与聚合酶链反应联合进行住院患儿肺炎细菌病原学检测%Bacterial etiology of pneumonia in hospitalized children:combined detection with culture and polymerase chain reaction

    Institute of Scientific and Technical Information of China (English)

    郑跃杰; 邓继岿; 赵瑞珍


    目的 探讨细菌培养与病原特异性DNA联合检测住院患儿肺炎细菌病原的应用价值.方法对187例肺炎患儿的深部呼吸道吸引物进行肺炎链球菌、流感嗜血杆菌选择性培养和普通培养,并且对同一标本采用靶序列富集多重PCR(Tem-PCB)扩增结合Luminex液态芯片检测平台进行定量测定,检测肺炎链球菌、流感嗜血杆菌、金黄色葡萄球菌、肺炎克雷伯杆菌、大肠杆菌、嗜肺军团菌、绿脓杆菌、鲍曼不动杆菌等14种病原菌的特异性DNA.结果细菌培养的总检出率为40.1%(75/187,含3例检出2种病原菌),病原菌依次为流感嗜血杆菌17.1%、大肠杆菌8.6%、肺炎克雷伯杆菌6.4%、金黄色葡萄球菌4.8%、肺炎链球菌3.7%、绿脓杆菌1.6%、鲍曼不动杆菌1.1%和阴沟肠杆菌1.1%.以细菌培养或Tem-PCR任一阳性为标准,联合检测的总检出率为78.6%(147/187),病原菌依次为流感嗜血杆菌28.9%、肺炎链球菌19.3%、大肠杆菌8.6%、肺炎克雷伯杆菌6.4%、金黄色葡萄球菌5.9%、鲍曼不动杆菌5.9%、绿脓杆菌2.7%和阴沟肠杆菌1.1%.结论 Tem-PCR能提高流感嗜血杆菌、肺炎链球菌、金黄色葡萄球菌、绿脓杆菌和鲍曼不动杆菌的检出例数.细菌培养与病原特异性DNA联合检测应用能显著提高肺炎病原的检出率,可能更真实地反映肺炎的细菌病原学情况.%Objective Bacterial cultures from respiratory aspirate or sputum have been the conventional diagnostic method for neumonia,but the results of culture was often affected by early extensive rise of antibiotics,sample collection and delivery.The objective of this stuay was to explore application of the combined detection of culture and polymerase chain reaction (PCR) assay in hospitalized children with pneumonia.Methods Totally 187 hospitalized children with pneumonia were enrolled.The age of the patients ranged from 1 month to 10 years,124 were male,63 female;175 of the patients receired

  3. Association of Alzheimer's disease and Chlamydophila pneumoniae. (United States)

    Stallings, Tiffany L


    This paper critically reviews the association of infection by Chlamydophila pneumoniae (C. pneumoniae) and Alzheimer's disease (AD). The aging population has increased interest in finding the cause of AD, but studies have yielded contradictory results that are likely due to varying diagnostic tools and different uses of diagnostic tests. Knowledge of AD's characteristics, risk factors, and hypothesized etiologies has expanded since Alois Alzheimer's initial description of AD. Epidemiologic and projection studies provide incidence estimates of AD through a two-stage method: (1) primary diagnosis of dementia by cognitive testing such as Mini-Mental State Examination (MMSE), and (2) clinical diagnosis of AD through criteria such as National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Cross-sectional studies yield prevalence estimates of infection by C. pneumoniae by detecting immunoglobulins through laboratory tests such as microimmunofluorescence (MIF). Studies examining the association of C. pneumoniae and AD are limited, but brain autopsy provides information about presence, proximity to areas associated with AD, and bacterial load. Standardization of diagnostic techniques would allow for better comparability of studies, but uncertainty about the best method of diagnosis of infection by C. pneumoniae and AD may call for revised or novel diagnostic tools.

  4. 白介素17对革兰阴性杆菌肺炎炎症调节作用的研究进展%Progress in researches about inflammatory regulation of interleukin-17 in gram-negative bacterial pneumonia

    Institute of Scientific and Technical Information of China (English)

    赵慧; 刘朝晖


    白介素(interleukin,IL)17是目前新发现的主要由CD4+记忆T细胞、单核细胞分泌的一种前炎性细胞因子.其在细胞增殖分化、生物因子转录与表达及免疫调节方面发挥着重要的作用,与多种炎症尤其是革兰阴性杆菌肺炎的炎症过程密切相关.IL-6、转化生长因子β1、IL-23共同作用激活辅助性17细胞的转录因子信号转导和转录激活因子3、孤儿细胞核受体γt产生IL-17,从而招募中性粒细胞聚集,促进多种细胞因子释放.提高革兰阴性杆菌的清除率,对革兰阴性杆菌肺炎有重要的防御作用.%Interleukin(IL)-17 is a newly founded proinflammatory cytokine,produced by CD4+ T cell and lymphomonocyte. It has significant functions in cell multiplication, biological factor transcription and expression,immunity regulation. It is related with inflammation disease, especially gram-negative bacterial pneumonia. IL-6, transforming growth factor-β1, in combination with IL-23, induced signal transducer and activator of transcription 3 and retinoid-related orphan receptor γt,transcription factor of T help17,to release IL-17,recruit neutrophil,release cytokines and enchance gram-negative bacterial clearance. Local production of IL-17 is a significant factor in effective host defense against gram-negative bacterial pneumonia.

  5. Streptococcus pneumoniae serine protease HtrA, but not SFP or PrtA, is a major virulence factor in pneumonia. (United States)

    de Stoppelaar, Sacha F; Bootsma, Hester J; Zomer, Aldert; Roelofs, Joris J T H; Hermans, Peter W M; van 't Veer, Cornelis; van der Poll, Tom


    Streptococcus (S.) pneumoniae is a common causative pathogen in pneumonia. Serine protease orthologs expressed by a variety of bacteria have been found of importance for virulence. Previous studies have identified two serine proteases in S. pneumoniae, HtrA (high-temperature requirement A) and PrtA (cell wall-associated serine protease A), that contributed to virulence in models of pneumonia and intraperitoneal infection respectively. We here sought to identify additional S. pneumoniae serine proteases and determine their role in virulence. The S. pneumoniae D39 genome contains five putative serine proteases, of which HtrA, Subtilase Family Protein (SFP) and PrtA were selected for insertional mutagenesis because they are predicted to be secreted and surface exposed. Mutant D39 strains lacking serine proteases were constructed by in-frame insertion deletion mutagenesis. Pneumonia was induced by intranasal infection of mice with wild-type or mutant D39. After high dose infection, only D39ΔhtrA showed reduced virulence, as reflected by strongly reduced bacterial loads, diminished dissemination and decreased lung inflammation. D39ΔprtA induced significantly less lung inflammation together with smaller infiltrated lung surface, but without influencing bacterial loads. After low dose infection, D39ΔhtrA again showed strongly reduced bacterial loads; notably, pneumococcal burdens were also modestly lower in lungs after infection with D39Δsfp. These data confirm the important role for HtrA in S. pneumoniae virulence. PrtA contributes to lung damage in high dose pneumonia; it does not however contribute to bacterial outgrowth in pneumococcal pneumonia. SFP may facilitate S. pneumoniae growth after low dose infection.

  6. Symptoms, Diagnosis and Treatment of Pneumonia (United States)

    ... Lung Health and Diseases > Lung Disease Lookup > Pneumonia Pneumonia Symptoms, Causes, and Risk Factors Anyone can get ... risk for pneumonia. What Are the Symptoms of Pneumonia? Pneumonia symptoms can vary from mild to severe, ...

  7. Differential diagnosis value and practiced value of conducting using antibiotics of serum procalcitonin levels among old people with bacterial pneumonia and lung neoplasm%血清降钙素原检测在老年人细菌性肺炎与肺癌的鉴别诊断及指导用药中的价值

    Institute of Scientific and Technical Information of China (English)

    张德文; 何倩; 龙林会


    Objective To study differential diagnosis value and practiced value of conducting using antibiotics of serum procalci-tonin(PCT )levels among old people with bacterial pneumonia and lung neoplasm .Methods From January 2014 to September 2015 , a total of 50 patients with bacterial pneumonia ,40 patients with lung neoplasm ,and 100 healthy person were collected in this study , all the subjects were 60 or more than 60 years old .Chemiluminescence Immune Assay(CLIA)method was used to detect concentra-tions of serum PCT .Meanwhile morning sputum samples were collected and cultured ,then did drug sensitive test .50 patients with bacterial pneumonia were treated with second or third generation of cephalosporin antibiotics in 7 days ,and then detected PCT .Re-sults Serum PCT level in the bacterial pneumonia group before treatment ,after treating 7 days ,lung neoplasm group were (9 .960 ± 8 .540) ,(2 .420 ± 1 .280)and(0 .346 ± 0 .300)ng/mL ,which were all significant higher than(0 .027 ± 0 .010)ng/mL in the control group ,the differences were statistical significant(P< 0 .05) .Serum PCT level in the bacterial pneumonia group before treat-ment was significant higher than that of lung neoplasm group(P< 0 .05) .The serum PCT level of patients after treating 7 days de-creased significantly comparing with before treatment(P < 0 .05) .A total of 21 cases in 50 patients with bacterial pneumonia had positive sputum culture result ,the positive rate was 42 .0% .The serum PCT level of 21 patients with positive sputum culture result before treatment was(17 .620 ± 8 .460)ng/mL ,which increased significantly .Drug sensitive test showed one strain of pseudomonas aeruginosa isolated was multiple drug-resistant bacteria ,which was resistant to the cephalosporin .Conclusion Detecting PCT has value on differential diagnosis between bacterial pneumonia and lung neoplasm among old people ,combining with drug sensitive test is important for conducting the use of antibiotics .%目的:

  8. Evaluation of a multiplex PCR for bacterial pathogens applied to bronchoalveolar lavage. (United States)

    Strålin, K; Korsgaard, J; Olcén, P


    The present study assessed the diagnostic usefulness of a multiplex PCR (mPCR) for Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae and Chlamydophila pneumoniae applied to bronchoalveolar lavage (BAL). Fibreoptic bronchoscopy was performed on 156 hospitalised adult patients with lower respiratory tract infection (LRTI) and 36 controls. BAL fluid was analysed with bacterial culture and mPCR. By conventional diagnostic methods, S. pneumoniae, H. influenzae, M. pneumoniae and C. pneumoniae were aetiological agents in 14, 21, 3.2 and 0% of the LRTI patients, respectively. These pathogens were identified by BAL mPCR in 28, 47, 3.2 and 0.6% of cases, respectively, yielding sensitivities of 86% for S. pneumoniae, 88% for H. influenzae, 100% for M. pneumoniae and 0% for C. pneumoniae, and specificities of 81, 64, 100 and 99% for S. pneumoniae, H. influenzae, M. pneumoniae and C. pneumoniae, respectively. Of the 103 patients who had taken antibiotics prior to bronchoscopy, S. pneumoniae was identified by culture in 2.9% and by mPCR in 31%. Among the controls, mPCR identified S. pneumoniae in 11% and H. influenzae in 39%. In lower respiratory tract infection patients, bronchoalveolar lavage multiplex PCR can be useful for identification of Streptococcus pneumoniae, Mycoplasma pneumoniae and Chlamydophila pneumoniae. The method appears to be particularly useful in patients treated with antibiotics.

  9. Research on Infantile Pneumonia Mycoplasma Infection and Bacterial Infection of the Blood Routine and the Changes of C-Reactive Protein%肺炎支原体感染及细菌感染患儿部分血常规指标及C反应蛋白水平

    Institute of Scientific and Technical Information of China (English)

    古丽比亚·卡合曼; 林磊


    Objective:To compare pediatric pneumonia mycoplasma infection and bacterial infection of the blood routine and the change pattern of c-reactive protein. Methods:160 children with myco-plasma pneumoniae infection and bacterial infection in equal numbers,compared to 80 normal. Testing blood cells,central neutrophils,lymphocytes and mononuclear cell count,and compare three groups of children with red blood cells,hemoglobin. ELISA was adopted to test the C-reactive protein level of three groups. Results:Comparing RBC and PLT counting,difference was not statistically significant (P>0. 05);children with mycoplasma pneumoniae infection of anaemia,the decrement of platelet and leukocyte loss were significantly higher than the control group and bacterial infection group( P0 . 05 );in children with mycoplasma infection group of hemoglobin concentration was lower than that in group a bacterial infection(P0. 05). Conclusion:children with mycoplasma pneumoniae infection and children with bacterial infection could be distinguished by WBC counting,Hb content and CRP level.%目的:比较肺炎支原体感染或细菌感染患儿的血常规及C 反应蛋白( CRP)的变化规律。方法:肺炎支原体感染(支原体感染组)与细菌感染(细菌感染组)患儿各80例,80例正常儿童作为对照组,检测入院或体检时3组儿童血红蛋白( Hb)含量、白细胞( WBC)和红细胞( RBC)及血小板( PLT)计数,中性粒细胞、淋巴细胞及单核细胞分类;采用酶联免疫法( ELISA)法测定3组儿童血清中C反应蛋白( CRP)水平。结果:3组儿童RBC及PLT计数比较,差异无统计学意义( P>0.05);与对照组比较,细菌感染组和支原体感染组WBC计数、中性粒细胞和单核细胞分类及血清CRP水平升高,淋巴细胞分类降低,而Hb含量仅支原体感染组降低,单核细胞分类仅支原体感染组升高,差异有统计学意义( P<0.05);与细菌感

  10. C-type Lectin Mincle Recognizes Glucosyl-diacylglycerol of Streptococcus pneumoniae and Plays a Protective Role in Pneumococcal Pneumonia. (United States)

    Behler-Janbeck, Friederike; Takano, Tomotsugu; Maus, Regina; Stolper, Jennifer; Jonigk, Danny; Tort Tarrés, Meritxell; Fuehner, Thomas; Prasse, Antje; Welte, Tobias; Timmer, Mattie S M; Stocker, Bridget L; Nakanishi, Yoichi; Miyamoto, Tomofumi; Yamasaki, Sho; Maus, Ulrich A


    Among various innate immune receptor families, the role of C-type lectin receptors (CLRs) in lung protective immunity against Streptococcus pneumoniae (S. pneumoniae) is not fully defined. We here show that Mincle gene expression was induced in alveolar macrophages and neutrophils in bronchoalveolar lavage fluids of mice and patients with pneumococcal pneumonia. Moreover, S. pneumoniae directly triggered Mincle reporter cell activation in vitro via its glycolipid glucosyl-diacylglycerol (Glc-DAG), which was identified as the ligand recognized by Mincle. Purified Glc-DAG triggered Mincle reporter cell activation and stimulated inflammatory cytokine release by human alveolar macrophages and alveolar macrophages from WT but not Mincle KO mice. Mincle deficiency led to increased bacterial loads and decreased survival together with strongly dysregulated cytokine responses in mice challenged with focal pneumonia inducing S. pneumoniae, all of which was normalized in Mincle KO mice reconstituted with a WT hematopoietic system. In conclusion, the Mincle-Glc-DAG axis is a hitherto unrecognized element of lung protective immunity against focal pneumonia induced by S. pneumoniae.

  11. The Clinical Observation of Levofloxacin Injection Combined with Cough Syrup Oral Liquid in the Treatment of Bacterial Pneumonia%左氧氟沙星注射液联合咳露口服液治疗细菌性肺炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    史广超; 邢亚恒; 李景钊


    目的:观察左氧氟沙星注射液联合咳露口服液治疗细菌性肺炎的临床疗效。方法:对140例细菌性肺炎患者随机分为治疗组和对照组,每组各70例。两组均给予同种抗生素左氧氟沙星注射液,治疗组加用咳露口服液,疗程均为10 d。结果:治疗组总有效率为100%,对照组总有效率为87%,两组总有效率比较差异有统计学意义(P<0.05)。结论:左氧氟沙星注射液联合咳露口服液治疗细菌性肺炎临床效果明显,且安全性高,无明显不良反应。%Objective:To observe clinical curative effect of levofloxacin injection combined with cough syrup oral liquid in the treatment of bacterial pneumonia.Method:140 bacterial pneumonia patients were randomly divided into treatment group and control group,70 patients in each group.The two groups were given levofloxacin injection,the treatment group was added with cough syrup oral liquid,both groups were treated for 10 days. Result:The total effective rate of treatment group 100%,control group in the total efficiency of 87%,the total effective rate of two groups had significant difference(P<0.05).Conclusion:Levofloxacin injection combined with cough syrup oral liquid in the treatment of bacterial pneumonia have good clinical effect,and high safety,and no obvious adverse reaction.

  12. Bronchitis and Pneumonia (United States)

    ... by a health care provider. How serious are bronchitis and pneumonia? Both conditions are more serious if a child has a chronic health condition or if the condition is caused by a bacteria, in which case antibiotics are the treatment of choice. When pneumonia is caused by bacteria, ...

  13. Pneumocystis jirovecii pneumonia

    DEFF Research Database (Denmark)

    Cordonnier, Catherine; Cesaro, Simone; Maschmeyer, Georg


    Pneumocystis jirovecii can cause life-threatening pneumonia following treatment for haematological malignancies or after HSCT. The mortality rate of P. jirovecii pneumonia (PCP) in these patients is 30%-60%, especially after HSCT. The clinical presentation of PCP in haematology differs from that ...

  14. The gut microbiota plays a protective role in the host defence against pneumococcal pneumonia

    NARCIS (Netherlands)

    Schuijt, T.J.; Lankelma, J.M.; Scicluna, B.P.; Melo, e F.S.; Roelofs, J.J.; Boer, de J.D.; Hoogendijk, A.J.; Beer, de R.; Vos, de A.; Belzer, C.; Vos, de W.M.; Poll, van der T.; Wiersinga, W.J.


    OBJECTIVE: Pneumonia accounts for more deaths than any other infectious disease worldwide. The intestinal microbiota supports local mucosal immunity and is increasingly recognised as an important modulator of the systemic immune system. The precise role of the gut microbiota in bacterial pneumonia,

  15. Draft Genome Sequences of Six Strains of Streptococcus pneumoniae from Serotypes 5, 6A, 6B, 18C, 19A, and 23F (United States)

    Jakobsson, Hedvig E.; Salvà-Serra, Francisco; Karlsson, Roger; Gonzales-Silès, Lucia; Boulund, Fredrik; Engstrand, Lars; Kristiansson, Erik


    ABSTRACT Streptococcus pneumoniae is a pathogenic bacterium found most commonly in the respiratory tract of humans and is a common cause of pneumonia and bacterial meningitis. Here, we report the draft genome sequences of six S. pneumoniae strains: CCUG 1350, CCUG 7206, CCUG 11780, CCUG 33774, CCUG 35180, and CCUG 35272. PMID:28385844

  16. Pneumonia and purulent pericarditis caused by Streptococcus pneumoniae: an uncommon association in the antibiotic era. (United States)

    Flores-González, Jose Carlos; Rubio-Quiñones, Fernando; Hernández-González, Arturo; Rodríguez-González, Moisés; Blanca-García, Jose Antonio; Lechuga-Sancho, Alfonso María; Quintero-Otero, Sebastián


    Bacterial pericarditis in children has become a rare entity in the modern antibiotic era. The most common pathogen is Staphylococcus aureus, being Streptococcus pneumoniae an exceptional cause. We present 2 children, who were diagnosed of pneumonia complicated with a pleural effusion that developed a purulent pericarditis with signs of cardiac tamponade. One of them had received 4 doses of the 7-valent conjugated pneumococcal vaccine. Systemic antibiotics and pericardial and pleural drainages were used. Pneumococcal antigens were positive in pleural and pericardial fluids in both cases, and S. pneumoniae was isolated from pleural effusion in one of them. Both children fully recovered, and none of them developed constrictive pericarditis, although 1 case presented a transient secondary left ventricular dysfunction. Routine immunization with 10- and 13-valent vaccines including a wider range of serotypes should further decrease the already low incidence.

  17. Adult bacteremic pneumococcal pneumonia acquired in the community: A prospective study on 101 patients Neumonía neumocóccica bacteriémica de la comunidad: Un estudio prospectivo en 101 pacientes

    Directory of Open Access Journals (Sweden)

    J. H. Gentile


    Full Text Available Our objective was to describe incidence, clinical, radiographic and microbiological features of bacteremic pneumococcal pneumonia (BPP in our environment. A total of 101 patients (7 were treated as outpatients, older than 18 years of age suffering BPP were prospectively evaluated. The incidence was 2.8 cases per 1000 admissions, 50 were males, mean age was 59.9 years (19-97, mortality was 11.8%. Eighty three percent of fatalities occurred within 3 days of admission. Mortality rate increased with advancing age. Fever, cough and chest pain were the commonest presenting symptoms and 44% of patients had extrapulmonary manifestations. Cigarette smoking, chronic obstructive lung disease, alcoholism and congestive heart failure (CHF were the commonest underlying conditions. CHF was more frequent in non-survivors (p = 0.002. A lobar pattern at chest radiograph predominated in survivors and a diffuse pattern in non-survivors (p = 0.007. Pleural effusion (20.7%, empyema (7.9% and respiratory failure (7.9% were the main complications. Underlying diseases were present in 100% of non-survivors (p = 0.03. Ninety four percent of patients were treated with beta-lactam antibiotics. Streptococcus pneumoniae was isolated from sputum in 6 cases. Three out of 101 S. pneumoniae isolates recovered from blood samples (one from each patient presented organisms resistant to penicillin. We observed an incidence of BPP that is similar to the observed in other countries. There are clinical and radiographic differences between survivors and non-survivors. Penicillin-resistant S. pneumoniae is still an unusual problem in our area.Se evaluaron en forma prospectiva 101 pacientes > 18 años admitidos al hospital con diagnóstico de NNB. El objetivo fue conocer la incidencia y describir las características de la enfermedad, así como la susceptibilidad antibiótica de cepas invasivas de Streptococcus pneumoniae. Se halló una incidencia de 2.8 casos/1000 admisiones; 50 fueron

  18. 脑性瘫痪儿童医院获得性肺炎的病原菌分布及耐药性分析%Pathological bacterial distribution and antibiotic resistance of hospital acquired pneumonia in children with cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    刘常青; 左满凤; 钟新; 杨恩华; 朱木良; 高翠姣


    目的:了解脑性瘫痪(简称脑瘫)儿童医院获得性肺炎( HAP)的病原菌分布及耐药情况。方法收集2012年1月至2015年5月在本院儿童康复科住院期间感染肺炎的脑瘫患儿402例。结果402份痰标本中共分离到菌株291株,检出率72.4%,其中革兰阴性菌259株(89.0%),革兰阳性菌26株(8.9%),真菌6株(2.1%)。革兰阴性菌主要为大肠埃希菌(32.6%)、肺炎克雷伯菌(24.4%)和铜绿假单胞菌(14.4%),其中大肠埃希菌和肺炎克雷伯菌主要产超广谱β内酰胺酶( ESBLs,产酶率分别为58.9%、59.2%),产ESBLs菌的平均耐药率为55.5%,对碳青霉烯类抗生素的平均耐药率为5.0%。铜绿假单胞菌的平均耐药率34.9%,对碳青霉烯类抗生素均敏感。结论脑瘫儿童HAP的病原菌以革兰阴性菌“大肠埃希菌、肺炎克雷伯菌”为主,两者产ESBLs 菌检出率达58%以上,平均耐药率为55.5%,可指导临床首次经验性选药,以提高脑瘫儿童HAP的治疗有效率。%Objective To investigate the pathological bacterial distribution and their antibiotic resistance of hospital acquired pneumonia in children with cerebral palsy. Methods Induced sputum was extracted from 402 ca-ses of hospitalized children with cerebral palsy infected hospital acquired pneumonia in children rehabilitation depart-ment from January 2012 to May 2015. Results A total of 291 (72. 4%) strains of bacteria were isolated from in-duced sputum in the 402 children. The Gram-negative strains were detected in 259 strains (89. 0%), and the Gram-positive strains were found in 26 strains ( 8. 9%) in 291 strains. The others were fungal strains ( 6 strains, 2. 1%) . The Gram-negative bacteria included Escherichia coli ( 32. 6%) , Klebsiella pneumoniae ( 24. 4%) , and Pseudomonas aeruginosa (14. 4%). Escherichia coli and Klebsiella pneumoniae could produce extended-spectrumβ-lactamases ( ESBLs) ( The rates of enzyme production were 58. 9% and 59. 2%) . The

  19. Etiology of severe pneumonia in Ecuadorian children (United States)

    Jonnalagadda, Sivani; Rodríguez, Oswaldo; Estrella, Bertha; Sabin, Lora L.; Sempértegui, Fernando


    Background In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador. Methods This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2–59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated. Results Among 406 children tested, 159 (39.2%) had respiratory syncytial virus (RSV), 71 (17.5%) had human metapneumovirus (hMPV), and 62 (15.3%) had adenovirus. Streptococcus pneumoniae was identified in 37 (9.2%) samples and Mycoplasma pneumoniae in three (0.74%) samples. The yearly circulation pattern of RSV (P = 0.0003) overlapped with S. pneumoniae, (P = 0.03) with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, P = 0.01) and being underweight (aOR = 1.8, P = 0.04). Maternal education (aOR = 0.82, P = 0.003), pulse oximetry (aOR = 0.93, P = 0.005), and rales (aOR = 0.25, P = 0.007) were associated with influenza A. Younger age (aOR = 3.5, P = 0.007) and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, P = 0.03). Conclusion These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available. Trial registration NCT 00513929 PMID:28182741

  20. 血清降钙素原检测对儿童细菌性肺炎抗生素使用的指导研究%Serum Procalcitonin Original Detection of Bacterial Pneumonia in Children Study the Guidance of Antibiotic Use

    Institute of Scientific and Technical Information of China (English)

    杨洪亮; 杨翠珍


    目的:研究儿童细菌性肺炎治疗中利用血清降钙素原水平指导临床抗生素使用的价值。方法将92例儿童细菌性肺炎患儿随机分为对照组和治疗组。对照组给予经验治疗,治疗组应用血清降钙素原含量指导抗生素应用治疗。比较两组抗生素使用时间、抗生素使用费用及细菌耐药率的差异。结果两组患儿在抗生素使用时间上,对照组(6.3±0.4)d与治疗组(3.6±0.5)d相比,差异有统计学意义(P<0.05);两组在抗生素使用费用上,对照组(951±85)元与治疗组(493±66)元相比,差异有统计学意义(P<0.05)。两组在平均细菌耐药率上,对照组平均20.5%与治疗组10.4%相比,差异有统计学意义(P<0.05)。结论儿童细菌性肺炎治疗中参考血清降钙素原水平用药,可以在达到更好治疗效果的同时减少抗生素的使用时间、费用和细菌耐药率。%Objective To study the bacterial pneumonia in children in the use of serum calcitonin original level to guide clinical antibiotics use value.Methods 92 patients with bacterial pneumonia in children were randomly divided into control group and treatment group.The contrd group was given experience treatment.The treatment group application Procalcitonin levels guide the application of antibiotics.Compare two groups of antibiotics use of time, Antibiotic use and bacterial resistance to diference.Results On antibiotic use time, two groups of children patients in the control group(6.3±0.4)d,compared with treatment group(3.6±0.5)d the difference was statisticaly significant(P<0.05);On antibiotic use,control group(951±85)yuan compared with treatment group (493±66) yuan,the difference was statisticaly significant(P<0.05).Two groups on the average bacterial resistance,the control group mas 20.5% compared with treatment group 10.4%,the difference was statisticaly significant(P<0.05).Conclusion Reference of Procalcitonin

  1. The role of influenza in the epidemiology of pneumonia. (United States)

    Shrestha, Sourya; Foxman, Betsy; Berus, Joshua; van Panhuis, Willem G; Steiner, Claudia; Viboud, Cécile; Rohani, Pejman


    Interactions arising from sequential viral and bacterial infections play important roles in the epidemiological outcome of many respiratory pathogens. Influenza virus has been implicated in the pathogenesis of several respiratory bacterial pathogens commonly associated with pneumonia. Though clinical evidence supporting this interaction is unambiguous, its population-level effects-magnitude, epidemiological impact and variation during pandemic and seasonal outbreaks-remain unclear. To address these unknowns, we used longitudinal influenza and pneumonia incidence data, at different spatial resolutions and across different epidemiological periods, to infer the nature, timing and the intensity of influenza-pneumonia interaction. We used a mechanistic transmission model within a likelihood-based inference framework to carry out formal hypothesis testing. Irrespective of the source of data examined, we found that influenza infection increases the risk of pneumonia by ~100-fold. We found no support for enhanced transmission or severity impact of the interaction. For model-validation, we challenged our fitted model to make out-of-sample pneumonia predictions during pandemic and non-pandemic periods. The consistency in our inference tests carried out on several distinct datasets, and the predictive skill of our model increase confidence in our overall conclusion that influenza infection substantially enhances the risk of pneumonia, though only for a short period.

  2. Klebsiella pneumoniae triggers a cytotoxic effect on airway epithelial cells

    Directory of Open Access Journals (Sweden)

    Llobet-Brossa Enrique


    Full Text Available Abstract Background Klebsiella pneumoniae is a capsulated Gram negative bacterial pathogen and a frequent cause of nosocomial infections. Despite its clinical relevance, little is known about the features of the interaction between K. pneumoniae and lung epithelial cells on a cellular level, neither about the role of capsule polysaccharide, one of its best characterised virulence factors, in this interaction. Results The interaction between Klebsiella pneumoniae and cultured airway epithelial cells was analysed. K. pneumoniae infection triggered cytotoxicity, evident by cell rounding and detachment from the substrate. This effect required the presence of live bacteria and of capsule polysaccharide, since it was observed with isolates expressing different amounts of capsule and/or different serotypes but not with non-capsulated bacteria. Cytotoxicity was analysed by lactate dehydrogenase and formazan measurements, ethidium bromide uptake and analysis of DNA integrity, obtaining consistent and complementary results. Moreover, cytotoxicity of non-capsulated strains was restored by addition of purified capsule during infection. While a non-capsulated strain was avirulent in a mouse infection model, capsulated K. pneumoniae isolates displayed different degrees of virulence. Conclusion Our observations allocate a novel role to K. pneumoniae capsule in promotion of cytotoxicity. Although this effect is likely to be associated with virulence, strains expressing different capsule levels were not equally virulent. This fact suggests the existence of other bacterial requirements for virulence, together with capsule polysaccharide.

  3. Signs and symptoms indicative of community-acquired pneumonia in infants under six months

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Bazhuni Pombo March


    Full Text Available OBJECTIVE: Evaluation of the clinical signs and symptoms predicting bacterial and viral pneumonia, in accordance with the Brazilian National Control Program for Acute Respiratory (ARI. METHODS: Observational prospective study. Seventy-six children from birth to six months of age who had pneumonia were studied in the emergency room. The patients were subdivided into two groups, based on radiological findings (gold-standard: 47 had bacterial pneumonia, and 29 had viral pneumonia. The frequencies, sensitivities, and specificities of the signs and symptoms were evaluated. RESULTS: The sensibilities and sensitivities of general findings in bacterial pneumonia were, respectively: fever 53.2%/40.0%; hypoactivity 68.4%/55.6% and prostration detected by the doctor 72.7%/55.0%. The same findings in viral pneumonias showed, respectively: 37.9%/40.0%, 66.7%/55.6% and 66.7%/55.6%. The sensibilities and sensitivities of respiratory findings in bacterial pneumonia were, respectively: coughing 66.0/38.1%, Respiratory rate = 50 ripm 76.6%/38.1%, altered respiratory auscultation 91.3%/10.5%, and chest indrawing 46.7%/80.0%. The same findings in viral pneumonias were, respectively: 69.0%/38.1%, 86.2%/38.1%, 85.7%/10.5% and 44.8%/80.0%. CONCLUSION: Analysis of signs and symptoms in each group did not distinguish bacterial from viral pneumonia. Our findings reinforce the adequacy of the ARI program in Brazil, which gives an early diagnosis of pneumonia, independent of its etiology.

  4. Exogenous Streptococcus pneumoniae Endophthalmitis in Diabetic Rabbits (United States)

    Benton, Angela H.; Fulton, Linda K.; Marquart, Mary E.


    Diabetics are at increased risk for eye infections including bacterial endophthalmitis. It is unclear whether the severity of endophthalmitis is greater in these patients due to confounding factors such as pre-existing ocular diseases in some but not others. Therefore, we tested the hypothesis that disease severity and/or bacterial loads would be significantly higher in a Type I diabetic rabbit model of Streptococcus pneumoniae endophthalmitis. Rabbits were treated with alloxan to destroy pancreatic islet cells, or mock-treated with vehicle, and maintained for 10 days before intravitreal infection with S. pneumoniae E353. Clinical scoring of the eyes was performed 24 and 48 hours after infection, followed by euthanasia and vitreous harvest to quantitate bacterial loads. There were no significant differences in clinical scores (P ≥ 0.440) or bacterial loads (P = 0.736), however, 4/12 (33%) of the diabetic rabbits became bacteremic. This finding not only indicates a breakdown in the blood-ocular barrier, but also prompts further investigation into the exploitation of the diabetic eye by the streptococci. PMID:28387365

  5. Community-acquired pneumonia among smokers. (United States)

    Almirall, Jordi; Blanquer, José; Bello, Salvador


    Recent studies have left absolutely no doubt that tobacco increases susceptibility to bacterial lung infection, even in passive smokers. This relationship also shows a dose-response effect, since the risk reduces spectacularly 10 years after giving up smoking, returning to the level of non-smokers. Streptococcus pneumoniae is the causative microorganism responsible for community-acquired pneumonia (CAP) most frequently associated with smoking, particularly in invasive pneumococcal disease and septic shock. It is not clear how it acts on the progress of pneumonia, but there is evidence to suggest that the prognosis for pneumococcal pneumonia is worse. In CAP caused by Legionella pneumophila, it has also been observed that smoking is the most important risk factor, with the risk rising 121% for each pack of cigarettes smoked a day. Tobacco use may also favor diseases that are also known risk factors for CAP, such as periodontal disease and upper respiratory viral infections. By way of prevention, while giving up smoking should always be proposed, the use of the pneumococcal vaccine is also recommended, regardless of the presence of other comorbidities.

  6. Case Report of Necrotizing Fasciitis Associated with Streptococcus pneumoniae

    Directory of Open Access Journals (Sweden)

    Lei Jiao


    Full Text Available Necrotizing fasciitis, caused by Streptococcus pneumoniae, is an extremely rare and life-threatening bacterial soft tissue infection. We report a case of early necrotizing fasciitis associated with Streptococcus pneumoniae infection in a 26-year-old man who was immunocompromised with mixed connective tissue disease. The patient presented with acute, painful, erythematous, and edematous skin lesions of his right lower back, which rapidly progressed to the right knee. The patient underwent surgical exploration, and a diagnosis of necrotizing fasciitis was confirmed by pathological evidence of necrosis of the fascia and neutrophil infiltration in tissue biopsies. Cultures of fascial tissue biopsies and blood samples were positive for Streptococcus pneumoniae. To our knowledge, this is the first report of necrotizing fasciitis resulting from Streptococcus pneumoniae diagnosed at early phase; the patient recovered well without surgical debridement.

  7. Bacteriophage-loaded nanostructured lipid carrier: improved pharmacokinetics mediates effective resolution of Klebsiella pneumoniae-induced lobar pneumonia. (United States)

    Singla, Saloni; Harjai, Kusum; Katare, Om Prakash; Chhibber, Sanjay


    This study examined the therapeutic and prophylactic potential of bacteriophages in a mouse model of Klebsiella pneumoniae lobar pneumonia. Phages were administered intraperitoneally. Liposome-entrapped phages (LP) were effective in treating infection, even when therapy was delayed by 3 days after the induction of pneumonia. In contrast, nonliposomal phages provided protection when administered 24 hours after infection. Administration of nonliposomal phages 6 hours prior to intranasal bacterial challenge resulted in complete protection, compared with LP, which was effective even when administered 48 hours prior to infection. Increased reduction and a greater increment in the levels of proinflammatory and antiinflammatory cytokines, respectively, in homogenates of lung from LP-treated mice were suggestive of increased efficacy of LP in the treatment of pneumonia. This is the first study to assess liposomes as a delivery vehicle for phage, and the results confirm the superiority of LP for both therapeutic and prophylactic applications.

  8. Pneumonia (For Parents) (United States)

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... to dehydration in extreme cases, bluish or gray color of the lips and fingernails If the pneumonia ...

  9. Hospital-acquired pneumonia (United States)

    ... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

  10. Amoxicillin is effective against penicillin-resistant Streptococcus pneumoniae strains in a mouse pneumonia model simulating human pharmacokinetics. (United States)

    Abgueguen, Pierre; Azoulay-Dupuis, Esther; Noel, Violaine; Moine, Pierre; Rieux, Veronique; Fantin, Bruno; Bedos, Jean-Pierre


    High-dose oral amoxicillin (3 g/day) is the recommended empirical outpatient treatment of community-acquired pneumonia (CAP) in many European guidelines. To investigate the clinical efficacy of this treatment in CAP caused by Streptococcus pneumoniae strains with MICs of amoxicillin > or =2 microg/ml, we used a lethal bacteremic pneumonia model in leukopenic female Swiss mice with induced renal failure to replicate amoxicillin kinetics in humans given 1 g/8 h orally. Amoxicillin (15 mg/kg of body weight/8 h subcutaneously) was given for 3 days. We used four S. pneumoniae strains with differing amoxicillin susceptibility and tolerance profiles. Rapid bacterial killing occurred with an amoxicillin-susceptible nontolerant strain: after 4 h, blood cultures were negative and lung homogenate counts under the 2 log(10) CFU/ml detection threshold (6.5 log(10) CFU/ml in controls, P pneumonia due to S. pneumoniae for which MICs were 2 to 4 microg/ml. The killing rate depends not only on resistance but also on tolerance of the S. pneumoniae strains.

  11. K. pneumoniae: ¿The new “superbacteria”? Pathogenicity, epidemiology and resistance mechanisms K. pneumoniae: ¿la nueva


    Lina María Echeverri Toro; Jaime Alberto López Vargas


    The antimicrobial resistance is an increasing problem of public health. Klebsiella pneumoniae has become one of the most important pathogens because it is a frequent cause of nosocomial and community acquired infections and it has pathogenicity mechanisms like capsules, adhesive properties mediated by specialized estructures (pillis) and siderophores that are capable of taking up iron, an essential factor in bacterial growth. The increase in bacterial resistance to antibiotics has evolved wit...

  12. Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients

    NARCIS (Netherlands)

    Piters, Wouter A. A. de Steenhuijsen; Huijskens, Elisabeth G. W.; Wyllie, Anne L.; Biesbroek, Giske; van den Bergh, Menno R.; Veenhoven, Reinier H.; Wang, Xinhui; Trzcinski, Krzysztof; Bonten, Marc J.; Rossen, John W. A.; Sanders, Elisabeth A. M.; Bogaert, Debby


    Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently disease

  13. Platelets: versatile effector cells in pneumonia and sepsis

    NARCIS (Netherlands)

    S.F. de Stoppelaar


    The role of platelets in infection and immunity is an exciting new theme, which is rapidly evolving. In this thesis we studied the involvement of platelets in the host response to pneumonia and sepsis. We made use of well established mouse models in which mice were infected with a bacterial inoculum

  14. Pathogenicity of Aeromonas hydrophila, Klebsiella pneumoniae, and Proteus mirabilis to brown tree frogs (Litoria ewingii). (United States)

    Schadich, Ermin; Cole, Anthony L J


    Bacterial dermatosepticemia, a systemic infectious bacterial disease of frogs, can be caused by several opportunistic gram-negative bacterial species including Aeromonas hydrophila, Chryseobacterium indologenes, Chryseobacterium meningosepticum, Citrobacter freundii, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Serratia liquifaciens. Here we determined the pathogenicity of 3 bacterial species (Aeromonas hydrophila, Klebsiella pneumoniae, and Proteus mirabilis) associated with an outbreak of fatal dermatosepticemia in New Zealand Litoria ewingii frogs. A bath challenge method was used to expose test frogs to individual bacterial species (2 x 10(7) cfu/mL in pond water); control frogs were exposed to uninfected pond water. None of the control frogs or those exposed to A. hydrophila or P. mirabilis showed any morbidity or mortality. Morbidity and mortality was 40% among frogs exposed to K. pneumonia, and the organism was reisolated from the hearts, spleens, and livers of affected animals.

  15. Mechanisms of dexamethasone-mediated inhibition of Toll-like receptor signaling induced by Neisseria meningitidis and Streptococcus pneumoniae

    DEFF Research Database (Denmark)

    Mogensen, Trine; Berg, Randi S; Paludan, Søren R


    significantly reduces mortality and morbidity from bacterial meningitis. Here we investigate the molecular mechanisms behind the inhibitory effect of dexamethasone upon the inflammatory responses evoked by Neisseria meningitidis and Streptococcus pneumoniae, two of the major causes of bacterial meningitis......B alpha synthesis. Our data also revealed that the timing of steroid treatment relative to infection was important for achieving strong inhibition, particularly in response to S. pneumoniae. Altogether, we describe important targets of dexamethasone in the inflammatory responses evoked by N. meningitidis...... and S. pneumoniae, which may contribute to our understanding of the clinical effect and the importance of timing with respect to corticosteroid treatment during bacterial meningitis. Udgivelsesdato: 2008-Jan...

  16. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care

    DEFF Research Database (Denmark)

    Holm, Anette; Nexoe, Joergen; Bistrup, Lene A


    of pneumonia was low (0.23), but the vital signs, CRP, and leukocyte count had comparably low positive predictive values (0.23-0.30). CONCLUSION: Streptococcus pneumoniae was the most common bacterial pathogen. The risk of hospitalisation was highest among patients with pneumonia or pneumococcal infection......BACKGROUND: Knowledge of predominant pathogens and their association with outcome are of importance for the management of lower respiratory tract infection (LRTI). As antibiotic therapy is indicated in pneumonia and not in acute bronchitis, a predictor of pneumonia is needed. AIM: To describe...... the aetiology and outcome of LRTI in adults with pneumonic and adults with non-pneumonic LRTI treated in general practice and to identify predictors of radiographic pneumonia. DESIGN OF STUDY: Prospective, observational study. SETTING: Forty-two general practices and an outpatient clinic at the Department...

  17. Mycoplasma Pneumoniae and Chlamydophila pneumoniae in hospitalized children with bronchiolitis. (United States)

    Zirakishvili, D; Chkhaidze, I; Barnabishvili, N


    Bronchiolitis is an acute lower respiratory tract infection in early childhood caused mainly by different viruses. Etiology of bronchiolitis have been studied in different environments and populations. Respiratory syncytial virus (RSV), human Metapneumovirus (hMPV), human Bocavirus (hBoV), human Rhinoviruses (hRV) have consistently been shown to predominate. Few studies however have attempted to determine whether other pathogens, particularly Mycoplasma Pneumoniae (MP) and Chlamydophila pneumoniae (CP), are associated with bronchiolitis in children under 2 years of age. The aim of this study was to determine the prevalence and clinical features of MP and CP in children under the age of 2 years presenting to the Iashvili Central Children Hospital in Tbilisi with various severities and clinical manifestations of bronchiolitis. Acute and convalescent serum samples were tested by ELISA for IgM and IgG antibodies to RSV, CP and MP.37 children under two years of age were studied. In 19 patients out of 37 (51.35%) etiological diagnosis were established and in 18 patients (48.65%) no pathogens were found. 11 patients (29.72%) had either CP or MP and 8 patients (21.62%) had RSV. Children infected with CP and MP had less severe bronchiolitis than those infected with RSV. Co-infection was not associated with disease severity. There were no statistically significant differences between groups with respect to length of hospital stay. Our study underlines the importance of atypical bacterial pathogens in acute bronchiolitis in children under 2 years and highlights the complex epidemiology and clinical features of these pathogens in this age group.

  18. Semi-automated method to measure pneumonia severity in mice through computed tomography (CT) scan analysis (United States)

    Johri, Ansh; Schimel, Daniel; Noguchi, Audrey; Hsu, Lewis L.


    Imaging is a crucial clinical tool for diagnosis and assessment of pneumonia, but quantitative methods are lacking. Micro-computed tomography (micro CT), designed for lab animals, provides opportunities for non-invasive radiographic endpoints for pneumonia studies. HYPOTHESIS: In vivo micro CT scans of mice with early bacterial pneumonia can be scored quantitatively by semiautomated imaging methods, with good reproducibility and correlation with bacterial dose inoculated, pneumonia survival outcome, and radiologists' scores. METHODS: Healthy mice had intratracheal inoculation of E. coli bacteria (n=24) or saline control (n=11). In vivo micro CT scans were performed 24 hours later with microCAT II (Siemens). Two independent radiologists scored the extent of airspace abnormality, on a scale of 0 (normal) to 24 (completely abnormal). Using the Amira 5.2 software (Mercury Computer Systems), a histogram distribution of voxel counts between the Hounsfield range of -510 to 0 was created and analyzed, and a segmentation procedure was devised. RESULTS: A t-test was performed to determine whether there was a significant difference in the mean voxel value of each mouse in the three experimental groups: Saline Survivors, Pneumonia Survivors, and Pneumonia Non-survivors. It was found that the voxel count method was able to statistically tell apart the Saline Survivors from the Pneumonia Survivors, the Saline Survivors from the Pneumonia Non-survivors, but not the Pneumonia Survivors vs. Pneumonia Non-survivors. The segmentation method, however, was successfully able to distinguish the two Pneumonia groups. CONCLUSION: We have pilot-tested an evaluation of early pneumonia in mice using micro CT and a semi-automated method for lung segmentation and scoring system. Statistical analysis indicates that the system is reliable and merits further evaluation.

  19. Klebsiella pneumoniae secretes outer membrane vesicles that induce the innate immune response. (United States)

    Lee, Je Chul; Lee, Eun Jeoung; Lee, Jung Hwa; Jun, So Hyun; Choi, Chi Won; Kim, Seung Il; Kang, Sang Sun; Hyun, Sunghee


    Outer membrane vesicles (OMVs) derived from pathogenic Gram-negative bacteria are an important vehicle for delivery of effector molecules to host cells, but the production of OMVs from Klebsiella pneumoniae, an opportunistic pathogen of both nosocomial and community-acquired infections, and their role in bacterial pathogenesis have not yet been determined. In the present study, we examined the production of OMVs from K. pneumoniae and determined the induction of the innate immune response against K. pneumoniae OMVs. Klebsiella pneumoniae ATCC 13883 produced and secreted OMVs during in vitro culture. Proteomic analysis revealed that 159 different proteins were associated with K. pneumoniae OMVs. Klebsiella pneumoniae OMVs did not inhibit cell growth or induce cell death. However, these vesicles induced expression of proinflammatory cytokine genes such as interleukin (IL)-1β and IL-8 in epithelial cells. An intratracheal challenge of K. pneumoniae OMVs in neutropenic mice resulted in severe lung pathology similar to K. pneumoniae infection. In conclusion, K. pneumoniae produces OMVs like other pathogenic Gram-negative bacteria and K. pneumoniae OMVs are a molecular complex that induces the innate immune response.

  20. Prevalence, characterization and clinical significance of Klebsiella pneumoniae carbapenemase (KPC producing Klebsiella pneumoniae

    Directory of Open Access Journals (Sweden)

    : Sarita Nayak, Suman Singh, Soeb Jankhwala, Riddhi Pradhan


    Full Text Available Klebsiella peumoniae, a capsulated gram negative bacillus is responsible for causing life threatening infections in humans. Carbapenems are the drug of choice for serious infection caused by multidrug resistant Klebsiella pneumoniae. The emergence of carbapenem resistance has made it extremely difficult to treat such infections resulting in significant morbidity and mortality. Aims: To study the prevalence of carbapenem resistance using ertapenem as a marker and to detect Klebsiella pneumoniae Carbapenemase (KPC producing Klebsiella pneumoniae as a mechanism of resistance. Material and Methods: The study included 102 patients from which Klebsiella pneumoniae isolated. Identification and antibiotic susceptibility testing of Klebsiella pneumoniae was performed on miniAPI (Analytical Profile Index, Semiautomated bacterial identification system according to Clinical and Laboratory Standards Institute (CLSI guidelines of 2011. The modified Hodge test was performed for detection of Carbapenemase production. Patient’s clinical and demographic details along with risk factors and co-morbid conditions, type of response to antimicrobial therapy and mortality were collected. Results: The prevalence of carbapenem resistance was found to be 30.41% with 16.6% KPC producing Klebsiella pneumoniae. The co-morbid conditions like immunocompromised state (p =0.042, prior antibiotics therapy (p=0.047, previous hospitalization (p =0.021, intensive care unit stay (p=0.047 and use of indwelling devices (p =0.013 were found to be significantly associated with carbapenem resistance. Adverse clinical outcomes (death or worsening among patients infected with ertapenem resistant patients was found to be statistically significant than ertapenem sensitive strains (p =0.008. Conclusions: A high degree of carbapenem resistance in present study is alarming and poses therapeutic dilemmas for clinicians. Initiating timely and appropriate infection control measures along with a

  1. Conventional NK cells can produce IL-22 and promote host defense in Klebsiella pneumoniae pneumonia. (United States)

    Xu, Xin; Weiss, Ido D; Zhang, Hongwei H; Singh, Satya P; Wynn, Thomas A; Wilson, Mark S; Farber, Joshua M


    It was reported that host defense against pulmonary Klebsiella pneumoniae infection requires IL-22, which was proposed to be of T cell origin. Supporting a role for IL-22, we found that Il22(-/-) mice had decreased survival compared with wild-type mice after intratracheal infection with K. pneumoniae. Surprisingly, however, Rag2(-/-) mice did not differ from wild-type mice in survival or levels of IL-22 in the lungs postinfection with K. pneumoniae. In contrast, K. pneumoniae-infected Rag2(-/-)Il2rg(-/-) mice failed to produce IL-22. These data suggested a possible role for NK cells or other innate lymphoid cells in host defense and production of IL-22. Unlike NK cell-like innate lymphoid cells that produce IL-22 and display a surface phenotype of NK1.1(-)NKp46(+)CCR6(+), lung NK cells showed the conventional phenotype, NK1.1(+)NKp46(+)CCR6(-). Mice depleted of NK cells using anti-asialo GM1 showed decreased survival and higher lung bacterial counts, as well as increased dissemination of K. pneumoniae to blood and liver, compared with control-treated mice. NK cell depletion also led to decreased production of IL-22 in the lung. Within 1 d postinfection, although there was no increase in the number of lung NK cells, a subset of lung NK cells became competent to produce IL-22, and such cells were found in both wild-type and Rag2(-/-) mice. Our data suggest that, during pulmonary infection of mice with K. pneumoniae, conventional NK cells are required for optimal host defense, which includes the production of IL-22.

  2. Analysis on Bacterial Drug Resistance of Patients With Ventilator-associated Pneumonia and Nursing Care of Them%呼吸机相关性肺炎的细菌耐药率分析及护理

    Institute of Scientific and Technical Information of China (English)



    呼吸机相关性肺炎(ventilator-associated pneumonia, VAP)是指接受机械通气的急性呼吸衰竭病人发生的一种医源性的,通常是细菌性的肺炎.指病人在接受气管插管时不存在肺炎,也无潜伏性肺炎,而在机械通气后发生的肺炎.伴随着呼吸机在临床越来越广泛的应用,VAP的发生也越来越常见.准确及时地掌握病原学诊断和常见细菌的耐药率,可为临床诊治及护理提供重要依据.

  3. How Can Pneumonia Be Prevented? (United States)

    ... t last as long Fewer serious complications Pneumococcal pneumonia vaccines Two vaccines are available to prevent pneumococcal ... Vaccination Web page. Other ways to help prevent pneumonia You also can take the following steps to ...

  4. Effect of bacterial colony screening on polysaccharide yield of Streptococcus pneumoniae serotype 1%菌种筛选对1型肺炎链球菌产糖量的影响

    Institute of Scientific and Technical Information of China (English)

    黄放; 邓杰; 赵兆; 王智杰; 周宇; 刘威; 张珂; 张伟; 李小波


    目的 用无动物源性培养基筛选高产糖1型肺炎链球菌(Streptococcus pneumoniae serotype 1,PN1).方法 配制无动物源性培养基,并用此培养基进行高产糖PN1单菌落筛选.比较筛选前后PN1在发酵培养中的产糖量.结果 无动物源性培养基筛选前后PN1在发酵培养中的产糖量分别为420和960 mg/L,筛选后PN1的产糖量明显高于筛选前PN1.结论 以无动物源性培养基筛选PN1可使PN1的产糖量明显提高.%Objective To screen a colony of Streptococcus pneumoniae serotype 1(PN1) with high polysaccharide yield using animal-free medium.Methods The animal-free medium was prepared and used to screen a single colony of PN1 with high polysaccharide yield.The polysaccharide yield of PN1 in fermentation culture was compared between before and after screening.Results The polysaccharide yields of PN1 before and after screening with the animal-free medium were 420 and 960 rng/L in fermentation culture,respectively.The polysaccharide yield of PN1 was significantly higher after screening than before screening.Conclusion PN1 screening with animal-free medium can significantly increase polysaccharide yield of PN1.

  5. Bacterial drug resistance analysis of Klebsiella pneumoniae infection in newborn infants%肺炎克雷伯菌属感染新生患儿的细菌耐药性分析

    Institute of Scientific and Technical Information of China (English)

    李际红; 王健; 资捷


    Objective To analyze and research on drug resistance in patients with neonatal pneumonia Klebsiella, to provide a strong basis for early clinical treatment of children with scientific detection, to a certain extent, to ensure the treatment of children, to lay a solid foundation for clinical rational use of antibiotics. Methods From January 2014 to December 2015, 63 patients in our hospital neonatal infection of Klebsiella pneumoniae as the research object of this experiment. Systematically reviewed and studied the specific circumstances of birth and the results of drug resistance test of newborn infants infected with Klebsiella pneumoniae. Results In this study, 63 cases of newborn infants infected with Klebsiella pneumoniae were studied. There were 14 cases of newborn infants with gestational age less than 37 weeks;between 37 weeks and 42 weeks, there were 39 newborn infants; more than 42 weeks of newborn children with 10 cases. 72 strains of Klebsiella pneumoniae were isolated in sputum accounted for 83. 3%, ESBLs positive rate was 37. 5%, ESBLs producing strained to imipenem and levofloxacin, piperacillin, piperacillin / tazobactam and Jotham resistance rate was low (0.0%, 11.1%, 18.5%), strained to penicillin and cephalosporin antibiotics appear to be highly resistant to sulfa antibiotics, aminoglycoside had higher resistance, to ampicillin was 100% resistant. Conclusions The resistance rate of Klebsiella pneumoniae to penicillin and the high rate of antibiotics in newborn infants are higher. The resistance rate of ESBLs producing strains to the tested antibiotics is significantly higher than that of non ESBLs producing strains. The phenomenon of multiple drug resistance of ESBLs producing strains is outstanding. In clinic, we should choose antibiotics rationally according to the results of drug sensitivity test, and actively and effectively control the infection of the newborn.%目的:分析和研究针对新生儿肺炎患者中克雷伯菌的药物的耐

  6. [Management of pneumonia in the elderly]. (United States)

    Piette, François; Bornand, Anne; Cotto, Elise


    Pneumonias in elderly are frequent and severe. They require an accurate assessment following clinical, biological and radiological steps. Each of them can contribute to give answers to the following questions: does this patient need emergency hospitalisation? Is the infection really bacterial and pulmonary? Should antibiotics be started? Which others treatments should be associated for the infection itself and for comorbid conditions? Concerning prevention, every effort must be done to decrease the incidence of these infections, especially vaccination. Pulmonary infections in nursing home need specific attention: cumulation of bad prognosis factors, risk of epidemic propagation, and vaccination of all people caring patients when required.

  7. Contribution of IL-1 to resistance to Streptococcus pneumoniae infection. (United States)

    Kafka, Daniel; Ling, Eduard; Feldman, Galia; Benharroch, Daniel; Voronov, Elena; Givon-Lavi, Noga; Iwakura, Yoichiro; Dagan, Ron; Apte, Ron N; Mizrachi-Nebenzahl, Yaffa


    The role of IL-1 in susceptibility to Streptococcus pneumoniae infection was studied in mice deficient in genes of the IL-1 family [i.e. IL-1alpha-/-, IL-1beta-/-, IL-1alpha/beta-/- and IL-1R antagonist (IL-1Ra)-/- mice] following intra-nasal inoculation. Intra-nasal inoculation of S. pneumoniae of IL-1beta-/- and IL-1alpha/beta-/- mice displayed significantly lower survival rates and higher nasopharyngeal and lung bacterial load as compared with control, IL-1alpha-/- and IL-1Ra-/- mice. Treatment of IL-1beta-/- mice with rIL-1beta significantly improved their survival. A significant increase in blood neutrophils was found in control, IL-1alpha-/- and IL-1Ra-/- but not in IL-1beta-/- and IL-1alpha/beta-/- mice. Local infiltrates of neutrophils and relatively preserved organ architecture were observed in the lungs of IL-1alpha-/- and control mice. However, S. pneumoniae-infected IL-1beta-/-, IL-1alpha/beta-/- and IL-1Ra-/- mice demonstrated diffuse pneumonia and tissue damage. Altogether, all three isoforms contribute to protection against S. pneumoniae; our results point to differential role of IL-1alpha and IL-1beta in the pathogenesis and control of S. pneumoniae infection and suggest that IL-1beta has a major role in resistance to primary pneumococcal infection while the role of IL-1alpha is less important.

  8. [National consensus for management of community acquired pneumonia in adults]. (United States)

    Saldías P, Fernando; Pérez C, Carlos


    Community acquired pneumonia (CAP) is an acute respiratory infection that affects pulmonary parenchyma, and is caused by community acquired microorganisms. In Chile, pneumonia represents the main cause of death due to infectious diseases and is the third specific cause of mortality in adults. In 1999, an experts committee in representation of "Sociedad Chilena de Enfermedades Respiratorias", presented the first National Guidelines for the Treatment of Adult Community Acquired Pneumonia, mainly based in foreign experience and documents, and adapted it to our National Health System Organization. During the last decade, impressive epidemiological and technological changes have occurred, making the update of guidelines for treatment of NAC by several international scientific societies, necessary. These changes include: new respiratory pathogens that are being identified in CAP and affect adult patients (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila); the increasing senescent adult population that carries multiple co-morbidities; the emergence of antimicrobial resistance among respiratory pathogens associated to massive antibiotic prescription; the development by the pharmaceutical industry of new drugs that are effective for pneumonia treatment (macrolides, ketolides and respiratory fluorquinolones); and the development of new diagnostic techniques for detection of antigens, antibodies, and bacterial DNA by molecular biology, useful in respiratory infections. Based on these antecedents, an Advisory Committee of "Sociedad Chilena de Enfermedades Respiratorias" and "Sociedad Chilena de Infectología" has reviewed the national and international evidence about CAP management in adults in order to update clinical recommendations for our country.

  9. Carriage of Mycoplasma pneumoniae in the Upper Respiratory Tract of Symptomatic and Asymptomatic Children: An Observational Study

    NARCIS (Netherlands)

    E.B.M. Spuesens (Emiel); P.L.A. Fraaij (Pieter); E. Visser (Eline); T. Hoogenboezem (Theo); W.C.J. Hop (Wim); L.N.A. van Adrichem (Léon); F. Weber (Frank); H.A. Moll (Henriëtte); B. Broekman (Berth); M.Y. Berger (Marjolein); T. van Rijsoort-Vos (Tineke); A.F. van Belkum (Alex); M. Schutten (Martin); S.D. Pas (Suzan); A.D.M.E. Osterhaus (Albert); N.G. Hartwig (Nico); C. Vink (Cornelis); A.M.C. van Rossum (Annemarie)


    textabstractBackground:Mycoplasma pneumoniae is thought to be a common cause of respiratory tract infections (RTIs) in children. The diagnosis of M. pneumoniae RTIs currently relies on serological methods and/or the detection of bacterial DNA in the upper respiratory tract (URT). It is conceivable,

  10. The pavA gene of Streptococcus pneumoniae encodes a fibronectin-binding protein that is essential for virulence

    NARCIS (Netherlands)

    Holmes, AR; McNab, R; Millsap, KW; Rohde, M; Hammerschmidt, S; Mawdsley, JL; Jenkinson, HF


    Streptococcus pneumoniae colonizes the nasopharynx in up to 40% of healthy subjects, and is a leading cause of middle ear infections (otitis media), meningitis and pneumonia. Pneumococci adhere to glycosidic receptors on epithelial cells and to immobilized fibronectin, but the bacterial adhesins med

  11. Rapid diagnosis of gram negative pneumonia by assay of endotoxin in bronchoalveolar lavage fluid. (United States)

    Pugin, J; Auckenthaler, R; Delaspre, O; van Gessel, E; Suter, P M


    BACKGROUND: Diagnosis of ventilator associated pneumonia can be made by quantitative cultures of bronchoalveolar lavage fluid or of protected specimen brushings, though cultures require 24-48 hours to provide results. In 80% of cases aerobic Gram negative bacteria are the cause. METHODS: A rapid diagnostic method of assessing the endotoxin content of lavage fluid by Limulus assay is described. Forty samples of lavage fluid were obtained from patients with multiple trauma requiring mechanical ventilation for a prolonged period. Pneumonia was diagnosed on the basis of clinical, radiological, and bacteriological findings, including quantitative cultures of lavage fluid. RESULTS: A relation was observed between the concentration of endotoxin in lavage fluid and the quantity of Gram negative bacteria. The median endotoxin content of lavage fluid in Gram negative bacterial pneumonia was 15 endotoxin units (EU)/ml; the range observed in individual patients was 6 to > 150 EU/ml. In patients with pneumonia due to Gram positive cocci and in non-infected patients the median endotoxin level was 0.17 (range < or = 0.06 to 2) EU/ml. An endotoxin level greater than or equal to 6 EU/ml distinguished patients with Gram negative bacterial pneumonia from colonised patients and from those with pneumonia due to Gram positive cocci. CONCLUSION: The measurement of endotoxin in lavage fluid is a rapid (less than two hours) and accurate diagnostic method. It should allow specific and early treatment of Gram negative bacterial pneumonia. PMID:1412100

  12. Bacteremia with Streptococcus pneumoniae

    DEFF Research Database (Denmark)

    Christensen, J S; Jensen, T G; Kolmos, H J


    We conducted a hospital-based cohort study among adult patients with first-time Streptococcus pneumoniae bacteremia (SPB) from 2000 through 2008. Patients were identified in a population-based bacteremia database and followed up for mortality through the Danish Civil Registration System (CRS...... age of the patients was 65 years. The focal diagnosis of the SPB was pneumonia in 381 (79 %) patients, followed in frequency by meningitis in 33 (7 %) patients. Of the 481 patients, 390 (81 %) had community-acquired SPB. Of these, 23 (6 %) did not have sepsis, 132 (34 %) had sepsis, 224 (57 %) had...

  13. Endogenous tissue factor pathway inhibitor has a limited effect on host defence in murine pneumococcal pneumonia. (United States)

    van den Boogaard, Florry E; van 't Veer, Cornelis; Roelofs, Joris J T H; Meijers, Joost C M; Schultz, Marcus J; Broze, George J; van der Poll, Tom


    Streptococcus (S.) pneumoniae is the most common causative pathogen in community-acquired pneumonia. Coagulation and inflammation interact in the host response to infection. Tissue factor pathway inhibitor (TFPI) is a natural anticoagulant protein that inhibits tissue factor (TF), the main activator of inflammation-induced coagulation. It was the objective of this study to investigate the effect of endogenous TFPI levels on coagulation, inflammation and bacterial growth during S. pneumoniae pneumonia in mice. The effect of low endogenous TFPI levels was studied by administration of a neutralising anti-TFPI antibody to wild-type mice, and by using genetically modified mice expressing low levels of TFPI, due to a genetic deletion of the first Kunitz domain of TFPI (TFPIK1(-/-)) rescued with a human TFPI transgene. Pneumonia was induced by intranasal inoculation with S. pneumoniae and samples were obtained at 6, 24 and 48 hours after infection. Anti-TFPI reduced TFPI activity by ~50 %. Homozygous lowTFPI mice and heterozygous controls had ~10 % and ~50 % of normal TFPI activity, respectively. TFPI levels did not influence bacterial growth or dissemination. Whereas lung pathology was unaffected in all groups, mice with ~10 % (but not with ~50 %) of TFPI levels displayed elevated lung cytokine and chemokine concentrations 24 hours after infection. None of the groups with low TFPI levels showed an altered procoagulant response in lungs or plasma during pneumonia. These data argue against an important role for endogenous TFPI in the antibacterial, inflammatory and procoagulant response during pneumococcal pneumonia.

  14. Klebsiella pneumoniae pharyngitis mimicking malignancy: a diagnostic dilemma. (United States)

    Yeh, C-F; Li, W-Y; Hsu, Y-B


    Acute pharyngitis is a common disease. However, acute pharyngitis caused by Klebsiella pneumoniae with a gross appearance mimicking hypopharyngeal malignancy has never previously been reported. We report the case of a 57-year-old man with a right hypopharyngeal tumor which was disclosed by fiberoptic laryngoscopy and computed tomography scan. However, both the frozen and final pathologies showed no evidence of malignant cells, and a bacterial culture revealed the growth of K. pneumoniae. The hypopharyngeal lesion completely regressed after 2 weeks of antibiotic treatment. Clinicians should perform biopsy along with tissue culture for tumor-like lesions because infectious agents can lead to lesions with malignancy-like appearance.

  15. Treatment of Klebsiella pneumoniae septicemia in normal and leukopenic mice by liposome-encapsulated muramyl tripeptide phosphatidylethanolamide

    NARCIS (Netherlands)

    P.M. Melissen (Petronella Maria Bernadette); W. van Vianen (Wim); I.A.J.M. Bakker-Woudenberg (Irma)


    textabstractThe effect of free muramyl tripeptide phosphatidylethanolamide (MTPPE) and liposome-encapsulated MTPPE (LE-MTPPE) on Klebsiella pneumoniae septicemia resulting from intraperitoneal bacterial inoculation was investigated in mice. When administering a single p

  16. Garenoxacin activity against isolates form patients hospitalized with community-acquired pneumonia and multidrug-resistant Streptococcus pneumoniae. (United States)

    Jones, Ronald N; Sader, Helio S; Stilwell, Matthew G; Fritsche, Thomas R


    Community-acquired pneumonia (CAP) continues to cause significant morbidity worldwide, and the principal bacterial pathogens (Streptococcus pneumoniae and Haemophilus influenzae) have acquired numerous resistance mechanisms over the last few decades. CAP treatment guidelines have suggested the use of broader spectrum agents, such as antipneumococcal fluoroquinolones as the therapy for at-risk patient population. In this report, we studied 3087 CAP isolates from the SENTRY Antimicrobial Surveillance Program (1999-2005) worldwide and all respiratory tract infection (RTI) isolate population of pneumococci (14665 strains) grouped by antibiogram patterns against a new des-F(6)-quinolone, garenoxacin. Results indicated that garenoxacin was highly active against CAP isolates of S. pneumoniae (MIC(90), 0.06 microg/mL) and H. influenzae (MIC(90), 99.9% of strains were inhibited at pneumoniae strains to penicillin or erythromycin; however, coresistances were high among the beta-lactams (penicillins and cephalosporins), macrolides, tetracyclines, and trimethoprim/sulfamethoxazole. Analysis of S. pneumoniae isolates with various antimicrobial resistance patterns to 6 drug classes demonstrated that garenoxacin was active against >99.9% (MIC, pneumoniae that have created therapeutic dilemmas for all RTI presentations. Garenoxacin appears to be a welcome addition to the CAP treatment options, particularly for the emerging MDR pneumococci strains.

  17. Evaluation of the Efficacy of a Bacteriophage in the Treatment of Pneumonia Induced by Multidrug Resistance Klebsiella pneumoniae in Mice

    Directory of Open Access Journals (Sweden)

    Fang Cao


    Full Text Available Multidrug-resistant Klebsiella pneumoniae (MRKP has steadily grown beyond antibiotic control. However, a bacteriophage is considered to be a potential antibiotic alternative for treating bacterial infections. In this study, a lytic bacteriophage, phage 1513, was isolated using a clinical MRKP isolate KP 1513 as the host and was characterized. It produced a clear plaque with a halo and was classified as Siphoviridae. It had a short latent period of 30 min, a burst size of 264 and could inhibit KP 1513 growth in vitro with a dose-dependent pattern. Intranasal administration of a single dose of 2 × 109 PFU/mouse 2 h after KP 1513 inoculation was able to protect mice against lethal pneumonia. In a sublethal pneumonia model, phage-treated mice exhibited a lower level of K. pneumoniae burden in the lungs as compared to the untreated control. These mice lost less body weight and exhibited lower levels of inflammatory cytokines in their lungs. Lung lesion conditions were obviously improved by phage therapy. Therefore, phage 1513 has a great effect in vitro and in vivo, which has potential to be used as an alternative to an antibiotic treatment of pneumonia that is caused by the multidrug-resistant K. pneumoniae.

  18. Evaluation of the efficacy of a bacteriophage in the treatment of pneumonia induced by multidrug resistance Klebsiella pneumoniae in mice. (United States)

    Cao, Fang; Wang, Xitao; Wang, Linhui; Li, Zhen; Che, Jian; Wang, Lili; Li, Xiaoyu; Cao, Zhenhui; Zhang, Jiancheng; Jin, Liji; Xu, Yongping


    Multidrug-resistant Klebsiella pneumoniae (MRKP) has steadily grown beyond antibiotic control. However, a bacteriophage is considered to be a potential antibiotic alternative for treating bacterial infections. In this study, a lytic bacteriophage, phage 1513, was isolated using a clinical MRKP isolate KP 1513 as the host and was characterized. It produced a clear plaque with a halo and was classified as Siphoviridae. It had a short latent period of 30 min, a burst size of 264 and could inhibit KP 1513 growth in vitro with a dose-dependent pattern. Intranasal administration of a single dose of 2×10(9) PFU/mouse 2 h after KP 1513 inoculation was able to protect mice against lethal pneumonia. In a sublethal pneumonia model, phage-treated mice exhibited a lower level of K. pneumoniae burden in the lungs as compared to the untreated control. These mice lost less body weight and exhibited lower levels of inflammatory cytokines in their lungs. Lung lesion conditions were obviously improved by phage therapy. Therefore, phage 1513 has a great effect in vitro and in vivo, which has potential to be used as an alternative to an antibiotic treatment of pneumonia that is caused by the multidrug-resistant K. pneumoniae.

  19. Polytrauma Increases Susceptibility to Pseudomonas Pneumonia in Mature Mice. (United States)

    Turnbull, Isaiah R; Ghosh, Sarbani; Fuchs, Anja; Hilliard, Julia; Davis, Christopher G; Bochicchio, Grant V; Southard, Robert E


    Pneumonia is the most common complication observed in patients with severe injuries. Although the average age of injured patients is 47 years, existing studies of the effect of injury on the susceptibility to infectious complications have focused on young animals, equivalent to a late adolescent human. We hypothesized that mature adult animals are more susceptible to infection after injury than younger counterparts. To test this hypothesis, we challenged 6 to 8-month-old mature mice to a polytrauma injury followed by Pseudomonas aeruginosa pneumonia and compared them to young (8-10-week-old) animals. We demonstrate that polytrauma injury increases mortality from pneumonia in mature animals (sham-pneumonia 21% vs. polytrauma-pneumonia 62%) but not younger counterparts. After polytrauma, pneumonia in mature mice is associated with higher bacterial burden in lung, increased incidence of bacteremia, and elevated levels of bacteria in the blood, demonstrating that injury decreases the ability to control the infectious challenge. We further find that polytrauma did not induce elevations in circulating cytokine levels (TNF-alpha, IL-6, KC, and IL-10) 24  h after injury. However, mature mice subjected to polytrauma demonstrated an exaggerated circulating inflammatory cytokine response to subsequent Pseudomonas pneumonia. Additionally, whereas prior injury increases LPS-stimulated IL-6 production by peripheral blood leukocytes from young (8-10-week-old) mice, injury does not prime IL-6 production by cell from mature adult mice. We conclude that in mature mice polytrauma results in increased susceptibility to Pseudomonas pneumonia while priming an exaggerated but ineffective inflammatory response.

  20. Hypervirulent Klebsiella pneumoniae


    Patel, Payal K.; Russo, Thomas A.; Karchmer, Adolf W.


    Hypervirulent strains of Klebsiella pneumoniae are associated with abscess formation, commonly hepatic, and metastatic spread, even in healthy patients. We describe a case of this clinical syndrome, genotypic and phenotypic features of the isolate, and briefly review epidemiology, clinical manifestations, and pathogenesis of this underappreciated syndrome.

  1. Observations on efficacy and safety of linezolid in the treatment of ventilator-associated pneumonia with Gram positive bacterial infection%利奈唑胺治疗革兰阳性菌呼吸机相关性肺炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张谊; 汤杰; 杨佩兰; 钟秀君


    目的 探讨利奈唑胺治疗革兰阳性(G+)菌呼吸机相关性肺炎(VAP)的疗效和安全性.方法 分析2007年6月~2010年7月在我院住院的52例G+菌感染的VAP患者临床资料,分为治疗组25例和对照组27例.所有患者下呼吸道标本中3次以上培养出G+菌.两组分别给予利奈唑胺注射液和万古霉素注射液,治疗疗程为7~14 d.按卫生部颁发的抗菌药物临床研究指导原则判定疗效.结果 治疗组有效率高于对照组(52.0% vs 37.0%);病死率低于对照组(28.0% vs 44.4%);G+菌清除率高于对照组(72.0% vs 55.6%);使用机械通气时间明显短于对照组,差异均有统计学意义(P<0.05).治疗组和对照组的不良反应发生率(16.0% vs 29.6%),差异有统计学意义(P<0.05).结论 利奈唑胺治疗G+的VAP疗效显著,安全性好.%Objective To observe the effect and safety of linesolid in the treatment of ventilator-associated pneumonia(VAP) with Gram positive bacterial( G + ) infection.Methods The clinical data of 52 cases of linezolid or vancomycin treated VAP with Gram positive bacterial infection were analyzed in Shanghai Yueyang Hospital during june 2007 and july 2010.All patients cultred more than 3 times in the G + bacteria.The treatment duration was 7 ~ 14days.The efficacy evaluation was conducted according to the Guidelines on Clinical Trial of Antimicrobial Agents released by Ministry of Health.Results The overall response rate in treatment group was higher than that of control group( 52.0% vs 37.0% ,P < 0.05 ) ,and the mortality was lower in treatment group ( 28.0% vs 44.4%, P < 0.05 ).There were significant difference( P < 0.05 ) in the bacterial clearance rate(72.0% vs 55.6% ).The time of machanical ventilation in treatment group were shorter than control group( P <0.05 ).The two groups also produced significant difference in ADR rate( 16.0% vs 29.6% ).Conclusion Linezotid is effective and safety for the treatment of ventilator

  2. Radiographic and HRCT findings of pneumocystis carinii pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Jin Sam; Kim, Kun Il; Kim, Chang Won; Park, Soon Kew; Cho, Goon Jae [Pusan National Univ. College of Medicine, Seoul (Korea, Republic of)


    To analyze the radiographic and HRCT findings of Pneumocystic carinii pneumonia. We reviewed the medical records and retrospectively analysed the chest radiographs(n=31) and HRCT scans(n=17) of 31 patients with Pneumocystis carinii pneumonia who had been followed up at our institute between, 1993 and March 1998. Pneumocystis carinii pneumonia was confirmed by cytologic evaluation of sputum stained with methenamine silver(n=25) or on the basis of clinical history(n=6). The study group included 17 men and 14 women aged 28-78(average, 53.6) years. Twenty-eight patients had underlying conditions such as hematologic diseases(n=13), AIDS(n=8), malignancy(n=2), DM(n=2) and malnutrition(n=1), and three were free from underlying diseases. Twenty patients had pure Pneumocystis carinii pneumonia and 11 had combined lung diseases, namely pulmonary tuberculosis(n=4), pulmonary metastasis(n=2), bacterial pneumonia(n=2), atypical mycobacterial infection(n=1), pulmonary edema(n=1), and Kaposi' s sarcoma(n=1). Chest radiographic findings of 20 cases of pure Pneumocystis carinii pneumonia included consolidation(n=12), linear-reticular opacity(n=8), ill defined haziness(n=7), and nodules(n=6), with bilaterality in is cases and zonal predominance in ten [central(n=5), lower(n=5)]. Ancillary findings included pleural effusion(n=10), cysts(n=5), lymphadenopathy(n=4) and pneumothorax(n=1). In two patients, findings were entirely normal. HRCT findings in ten cases of pure Pneumocystis carinii pneumonia included ground-glass opacity(n=6), consolidation(n=6), linear-reticular opacity(n=8), and nodules(n=5), with bilaterallity in seven cases and zonal predominance in five [central(n=5), lower(n=2)]. Ancillary findings among these cases included pleural effusion(n=4), lymphadenopathy(n=2), cysts(n=1), and pneumothorax(n=1). HRCT findings in seven cases of Pneumocystis carinii pneumonia combined with other lung diseases included nodules(n=6), ground-glass opacity(n=5), linear

  3. Nasopharyngeal carriage of Streptococcus pneumonia in pneumonia-prone age groups in Semarang, Java Island, Indonesia

    NARCIS (Netherlands)

    H. Farida (Helmia); J.A. Severin (Juliëtte); M.H. Gasem; M. Keuter (Monique); H. Wahyono (Hendro); P. van den Broek (Peterhans); P.W.M. Hermans (Peter); H.A. Verbrugh (Henri)


    textabstractIntroduction: Streptococcus pneumoniae is a worldwide occurring pathogen Nasopharyngeal carriage of Streptococcus pneumoniae precedes pneumonia and other pneumococcal diseases in the community. Little is known about S. pneumoniae carriage in Indonesia, complicating strategies to control

  4. Nasopharyngeal Carriage of Streptococcus pneumonia in Pneumonia-Prone Age Groups in Semarang, Java Island, Indonesia

    NARCIS (Netherlands)

    Farida, H.; Severin, J.A.; Gasem, M.H.; Keuter, M.; Wahyono, H.; Broek, P van den; Hermans, P.W.M.; Verbrugh, H.A.


    INTRODUCTION: Streptococcus pneumoniae is a worldwide occurring pathogen Nasopharyngeal carriage of Streptococcus pneumoniae precedes pneumonia and other pneumococcal diseases in the community. Little is known about S. pneumoniae carriage in Indonesia, complicating strategies to control pneumococcal

  5. Guidelines for prevention of nosocomial pneumonia. Centers for Disease Control and Prevention. (United States)


    This document updates and replaces CDC's previously published "Guideline for Prevention of Nosocomial Pneumonia" (Infect Control 1982;3:327-33, Respir Care 1983;28:221-32, and Am J Infect Control 1983;11:230-44). This revised guideline is designed to reduce the incidence of nosocomial pneumonia and is intended for use by personnel who are responsible for surveillance and control of infections in acute-care hospitals; the information may not be applicable in long-term-care facilities because of the unique characteristics of such settings. This revised guideline addresses common problems encountered by infection-control practitioners regarding the prevention and control of nosocomial pneumonia in U.S. hospitals. Sections on the prevention of bacterial pneumonia in mechanically ventilated and/or critically ill patients, care of respiratory-therapy devices, prevention of cross-contamination, and prevention of viral lower respiratory tract infections (e.g., respiratory syncytial virus [RSV] and influenza infections) have been expanded and updated. New sections on Legionnaires disease and pneumonia caused by Aspergillus sp. have been included. Lower respiratory tract infection caused by Mycobacterium tuberculosis is not addressed in this document. Part I, "An Overview of the Prevention of Nosocomial Pneumonia, 1994, provides the background information for the consensus recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC) in Part II, Recommendations for Prevention of Nosocomial Pneumonia." Pneumonia is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality. Most patients who have nosocomial pneumonia are infants, young children, and persons > 65 years of age; persons who have severe underlying disease, immunosuppression, depressed sensorium, and/or cardiopulmonary disease and persons who have had thoracoabdominal surgery. Although patients receiving mechanically


    Directory of Open Access Journals (Sweden)

    E. N. Romanova


    Full Text Available Abstract. Defensin amounts in severe forms of influenza-associated pneumonia and acute respiratory distresssyndrome is increased to a lesser degree than in pneumonias with milder clinical course. This difference may be determined by selective accumulation of defensins in areas of infectious lesions. Mean content of α-defensins in non-severe pneumonias with influenza А/H1N1 accompanied by normocytosis or leukopenia, is higher than in bacterial pneumonias with leukocytosis. High levels of defensins, along with substantially increased neutrophil counts, associated with normocytosis or leukopenia, reflect a pronounced systemic inflammatory response caused by influenza А/H1N1.

  7. Escherichia fergusonii Associated with Pneumonia in a Beef Cow

    Directory of Open Access Journals (Sweden)

    Guillermo M. Rimoldi


    Full Text Available An adult Angus cow developed hyperthermia, prostration, and respiratory distress, dying 36 hours after the onset of clinical signs. The main finding during postmortem examination was a severe focally extensive pneumonia. Icterus and a chronic mastitis were also noticed. Histologic examination of the lungs detected fibrinonecrotic pneumonia, with large number of oat cells and intralesional Gram-negative bacterial colonies. Samples from lung lesions were collected, and a pure growth of Escherichia fergusonii was obtained. E. fergusonii is a member of Enterobacteriaceae, related to Escherichia coli and Salmonella sp. In veterinary medicine, E. fergusonii has been reported in calves and sheep with clinical cases suggestive of salmonellosis; in a horse and a goat with enteritis and septicemia; and in ostriches with fibrinonecrotic typhlitis. To our knowledge, this report represents the first description of E. fergusonii associated with an acute pneumonia in cattle.

  8. Klebsiella pneumoniae necrotizing fasciitis in a Latin American male. (United States)

    Persichino, Jon; Tran, Richard; Sutjita, Made; Kim, Daniel


    Necrotizing fasciitis, caused by Klebsiella pneumoniae, is a rare and life-threatening bacterial infection. Most documented cases have been reported from Asia, particularly associated with diabetes mellitus. The prevalence of this infection in the USA is rare, especially among persons of non-Asian descent and those without travel to Asia. We report a case of disseminated necrotizing fasciitis, caused by K. pneumoniae, in a Latin American male with diabetes mellitus. Given our review of the literature, this is the only case report, to our knowledge, of a Latin American patient with Klebsiella necrotizing fasciitis in the USA. This case may reflect the geographical spread and emergence of K. pneumoniae infection in the USA. Clinicians need to be aware of the possible relationship between this organism and necrotizing fasciitis in persons of Latin American descent with diabetes mellitus.

  9. Pneumonia in HIV-infected persons: increased risk with cigarette smoking and treatment interruption

    DEFF Research Database (Denmark)

    Gordin, Fred M; Roediger, Mollie P; Girard, Pierre-Marie


    evaluated data from a randomized trial of episodic antiretroviral therapy. The study, Strategies for Management of Antiretroviral Therapy, enrolled 5,472 participants at 318 sites in 33 countries. Study patients had more than 350 CD4 cells at baseline. Diagnosis of bacterial pneumonia was confirmed...... by a blinded clinical-events committee. MEASUREMENTS AND MAIN RESULTS: During a mean follow-up of 16 months, 116 participants (2.2%) developed at least one episode of bacterial pneumonia. Patients randomized to receive episodic antiretroviral therapy were significantly more likely to develop pneumonia than...... patients randomized to receive continuous antiretroviral therapy (hazard ratio, 1.55; 95% confidence interval, 1.07-2.25; P = 0.02). Cigarette smoking was a major risk factor: Current-smokers had more than an 80% higher risk of pneumonia compared with never-smokers (hazard ratio, 1.82; 95% confidence...

  10. The Regulation of Proresolving Lipid Mediator Profiles in Baboon Pneumonia by Inhaled Carbon Monoxide (United States)

    Dalli, Jesmond; Kraft, Bryan D.; Colas, Romain A.; Shinohara, Masakazu; Fredenburgh, Laura E.; Hess, Dean R.; Chiang, Nan; Welty-Wolf, Karen; Choi, Augustine M.; Piantadosi, Claude A.


    Strategies for the treatment of bacterial pneumonia beyond traditional antimicrobial therapy have been limited. The recently discovered novel genus of lipid mediators, coined “specialized proresolving mediators” (SPMs), which orchestrate clearance of recruited leukocytes and restore epithelial barrier integrity, have offered new insight into the resolution of inflammation. We performed lipid mediator (LM) metabololipidomic profiling and identification of LMs on peripheral blood leukocytes and plasma from a baboon model of Streptococcus pneumoniae pneumonia. Leukocytes and plasma were isolated from whole blood of S. pneumoniae–infected (n = 5–6 per time point) and control, uninfected baboons (n = 4 per time point) at 0, 24, 48, and 168 hours. In a subset of baboons with pneumonia (n = 3), we administered inhaled carbon monoxide (CO) at 48 hours (200–300 ppm for 60–90 min). Unstimulated leukocytes from control animals produced a proresolving LM signature with elevated resolvins and lipoxins. In contrast, serum-treated, zymosan-stimulated leukocytes and leukocytes from baboons with S. pneumoniae pneumonia produced a proinflammatory LM signature profile with elevated leukotriene B4 and prostaglandins. Plasma from baboons with S. pneumoniae pneumonia also displayed significantly reduced LM–SPM levels, including eicosapentaenoic acid–derived E-series resolvins (RvE) and lipoxins. CO inhalation increased levels of plasma RvE and lipoxins relative to preexposure levels. These results establish the leukocyte and plasma LM profiles biosynthesized during S. pneumoniae pneumonia in baboons and provide evidence for pneumonia-induced dysregulation of these proresolution programs. Moreover, these SPM profiles are partially restored with inhaled low-dose CO and SPM, which may shorten the time to pneumonia resolution. PMID:25568926

  11. Pneumonia relevant to lung transplantation and pathogen distribution

    Institute of Scientific and Technical Information of China (English)

    HE Xuan; DAI Hua-ping; CHEN Qi-rui; MIAO Jin-bai; SUN Bing; BAO Na; HU Bin


    Background Pneumonia is the most common cause of morbidity and mortality in lung transplant (LT) recipients.The aim of the present study was to evaluate the incidence,etiology,risk factors and prognosis of pneumonia in LT recipients.Methods The LT cohort consisted of 28 recipients receiving LT in Beijing Chao-Yang Hospital from August 2005 to April 2011.Data collected included demographic data,underlying disorders,time and type of transplant,follow-up information,date of last follow-up,and patient status.A retrospective analysis was made of observational data that were prospectively collected.Results Twenty-two patients of 28 LT recipients had 47 episodes of pneumonia throughout the study period.Thirtyeight episodes of pneumonia in 19 recipients occurred post-LT with a median follow-up of 257.5 days (1-2104 days),the incidence of pneumonia was 192.4 episodes per 100 LT/year and its median time of onset was 100.5 days (0-946 days) post-transplantation.Bacteria,virus and fungi accounted for 62%,16% and 15% of the microbial pathogens,respectively.The most frequent were Pseudomonas aeruginosa (20%),cytomegalovirus (CMV) (15%),and Aspergillus fumigatus (10%).A total of 29% (11/38) of pneumonias occurred in the first month post-LT,and then the incidence decreased gradually.The incidence of CMV pneumonia was 25% (7/28) with a median time of 97 days (10-971 days).More than one bacterial infection and CMV infection were independent risk factors for aspergillus infection.The incidence of pulmonary tuberculosis (TB) was 18% (5/28),and the history of TB was a risk factor for TB relapse.There were 58% (7/12) of recipients who died of infection,and 71% (5/7) of these died in the first year after LT.Conclusions Pneumonia is still a major cause of morbidity and mortality in LT recipients.The most frequent microorganisms were Pseudomonas aeruginosa,CMV,and Aspergillus fumigates.The incidence of CMV pneumonia decreases with a delayed median time of onset

  12. TNF-related apoptosis-inducing ligand (TRAIL) exerts therapeutic efficacy for the treatment of pneumococcal pneumonia in mice. (United States)

    Steinwede, Kathrin; Henken, Stefanie; Bohling, Jennifer; Maus, Regina; Ueberberg, Bianca; Brumshagen, Christina; Brincks, Erik L; Griffith, Thomas S; Welte, Tobias; Maus, Ulrich A


    Apoptotic death of alveolar macrophages observed during lung infection with Streptococcus pneumoniae is thought to limit overwhelming lung inflammation in response to bacterial challenge. However, the underlying apoptotic death mechanism has not been defined. Here, we examined the role of the TNF superfamily member TNF-related apoptosis-inducing ligand (TRAIL) in S. pneumoniae-induced macrophage apoptosis, and investigated the potential benefit of TRAIL-based therapy during pneumococcal pneumonia in mice. Compared with WT mice, Trail(-/-) mice demonstrated significantly decreased lung bacterial clearance and survival in response to S. pneumoniae, which was accompanied by significantly reduced apoptosis and caspase 3 cleavage but rather increased necrosis in alveolar macrophages. In WT mice, neutrophils were identified as a major source of intraalveolar released TRAIL, and their depletion led to a shift from apoptosis toward necrosis as the dominant mechanism of alveolar macrophage cell death in pneumococcal pneumonia. Therapeutic application of TRAIL or agonistic anti-DR5 mAb (MD5-1) dramatically improved survival of S. pneumoniae-infected WT mice. Most importantly, neutropenic mice lacking neutrophil-derived TRAIL were protected from lethal pneumonia by MD5-1 therapy. We have identified a previously unrecognized mechanism by which neutrophil-derived TRAIL induces apoptosis of DR5-expressing macrophages, thus promoting early bacterial killing in pneumococcal pneumonia. TRAIL-based therapy in neutropenic hosts may represent a novel antibacterial treatment option.

  13. Rapid urine antigen testing for Streptococcus pneumoniae in adults with community-acquired pneumonia: clinical use and barriers. (United States)

    Harris, Aaron M; Beekmann, Susan E; Polgreen, Philip M; Moore, Matthew R


    Streptococcus pneumoniae (pneumococcus) is the most common bacterial etiology of community-acquired pneumonia (CAP) in adults, a leading cause of death. The majority of pneumococcal CAP is diagnosed by blood culture, which likely underestimates the burden of disease. The 2007 CAP guidelines recommend routine use of the rapid pneumococcal urinary antigen (UAg) test. To assess the how pneumococcal UAg testing is being used among hospitalized adult CAP patients and what barriers restrict its use, a Web-based survey was distributed in 2013 to 1287 infectious disease physician members of the Emerging Infectious disease Network of the Infectious Disease Society of America. Of 493 eligible responses, 65% use the pneumococcal UAg test. The primary barrier to UAg use was availability (46%). UAg users reported ordering fewer other diagnostic tests and tailoring antibiotic therapy. Increased access to UAg tests could improve pneumonia management and pneumococcal CAP surveillance.

  14. Oral and airway microbiota in HIV-infected pneumonia patients. (United States)

    Iwai, Shoko; Fei, Matthew; Huang, Delphine; Fong, Serena; Subramanian, Anuradha; Grieco, Katherine; Lynch, Susan V; Huang, Laurence


    Despite the increased frequency of recurrent pneumonia in HIV-infected patients and recent studies linking the airway bacterial community (microbiota) to acute and chronic respiratory infection, little is known of the oral and airway microbiota that exist in these individuals and their propensity to harbor pathogens despite antimicrobial treatment for acute pneumonia. This pilot study compared paired samples of the oral and airway microbiota from 15 hospitalized HIV-infected patients receiving antimicrobial treatment for acute pneumonia. Total DNA was extracted, bacterial burden was assessed by quantitative PCR, and amplified 16S rRNA was profiled for microbiome composition using a phylogenetic microarray (16S rRNA PhyloChip). Though the bacterial burden of the airway was significantly lower than that of the oral cavity, microbiota in both niches were comparably diverse. However, oral and airway microbiota exhibited niche specificity. Oral microbiota were characterized by significantly increased relative abundance of multiple species associated with the mouth, including members of the Bacteroides, Firmicutes, and TM7 phyla, while airway microbiota were primarily characterized by a relative expansion of the Proteobacteria. Twenty-two taxa were detected in both niches, including Streptococcus bovis and Chryseobacterium species, pathogens associated with HIV-infected populations. In addition, we compared the airway microbiota of five of these patients to those of five non-HIV-infected pneumonia patients from a previous study. Compared to the control population, HIV-infected patients exhibited relative increased abundance of a large number of phylogenetically distinct taxa, which included several known or suspected pathogenic organisms, suggesting that recurrent pneumonia in HIV-infected populations may be related to the presence of these species.

  15. Prevalence and antimicrobial resistance pattern of bacterial meningitis in Egypt

    Directory of Open Access Journals (Sweden)

    Shaban Lamyaa


    Full Text Available Abstract Infectious diseases are the leading cause of morbidity and mortality in the developing world. In Egypt bacterial diseases constitute a great burden, with several particular bacteria sustaining the leading role of multiple serious infections. This article addresses profound bacterial agents causing a wide array of infections including but not limited to pneumonia and meningitis. The epidemiology of such infectious diseases and the prevalence of Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae are reviewed in the context of bacterial meningitis. We address prevalent serotypes in Egypt, antimicrobial resistance patterns and efficacy of vaccines to emphasize the importance of periodic surveillance for appropriate preventive and treatment strategies.

  16. Pneumonia in patients on the background of blood cancer

    Directory of Open Access Journals (Sweden)

    Pertseva T.A.


    Full Text Available Problematic issues of etiologic diagnosis and treatment of community-acquired and nosocomial pneumonia are being studied actively. At the same time specific features of pneumonia in patients with severe immune defects, against blood cancer including are studied insufficiently. By the result of microbiological examinations of 149 patients with pneumonia on the background of blood cancer, who have undergone treatment in hematological center of CE “Dnipropetrovsk local multi-field clinical hospital №4” in 2010-2012, bacterial causative agents were determined in 59,7% of accidents, among which gram-negative microorganisms made up 69,7%, gram-positive – 30,3%. In 63% of accidents the asso¬ciations of causative agents were determined: the combination of fungal flora made up 58, 4% bacterial associations – 25, 8%. Invasive methods of research have demonstrated a considerably bigger informativeness in determination of possible etiological diagnosis of pneumonia. In determination of causative agent in fluid of brochoalveolar lavage the part of positive results made up 77,4% against 30,3% in examination of sputum.

  17. Proteomic analysis of the copper resistance of Streptococcus pneumoniae. (United States)

    Guo, Zhong; Han, Junlong; Yang, Xiao-Yan; Cao, Kun; He, Ke; Du, Gaofei; Zeng, Guandi; Zhang, Liang; Yu, Guangchuang; Sun, Zhenghua; He, Qing-Yu; Sun, Xuesong


    Streptococcus pneumoniae is a Gram-positive bacterial pathogen causing a variety of diseases, including otitis media, bacteraemia and meningitis. Although copper is an essential trace metal for bacterial growth, high intracellular levels of free-copper are toxic. Copper resistance has emerged as an important virulence determinant of microbial pathogens. In this study, we determined the minimum inhibition concentration of copper for the growth inhibition of S. pneumoniae. Two-dimensional-electrophoresis coupled with mass spectrometry was applied to identify proteins involved in copper resistance of S. pneumoniae. In total, forty-four proteins with more than 1.5-fold alteration in expression (p < 0.05) were identified. Quantitative reverse transcription PCR was used to confirm the proteomic results. Bioinformatics analysis showed that the differentially expressed proteins were mainly involved in the cell wall biosynthesis, protein biosynthesis, purine biosynthesis, pyrimidine biosynthesis, primary metabolic process, and the nitrogen compound metabolic process. Many up-regulated proteins in response to the copper treatment directly or indirectly participated in the cell wall biosynthesis, indicating that the cell wall is a critical determinant in copper resistance of S. pneumoniae.

  18. Electrocardiogram in pneumonia. (United States)

    Stein, Paul D; Matta, Fadi; Ekkah, Maan; Saleh, Tarek; Janjua, Muhammad; Patel, Yash R; Khadra, Helmi


    Findings on electrocardiogram may hint that pulmonary embolism (PE) is present when interpreted in the proper context and lead to definitive imaging tests. However, it would be useful to know if electrocardiographic (ECG) abnormalities also occur in patients with pneumonia and whether these are similar to ECG changes with PE. The purpose of this investigation was to determine ECG findings in patients with pneumonia. We retrospectively evaluated 62 adults discharged with a diagnosis of pneumonia who had no previous cardiopulmonary disease and had electrocardiogram obtained during hospitalization. The most prevalent ECG abnormality, other than sinus tachycardia, was minor nonspecific ST-segment or T-wave changes occurring in 13 of 62 (21%). Right atrial enlargement occurred in 4 of 62 (6.5%). QRS abnormalities were observed in 24 of 62 (39%). Right-axis deviation and S(1)S(2)S(3) were the most prevalent QRS abnormalities, which occurred in 6 of 62 (9.7%). Complete right bundle branch block and S(1)Q(3)T(3) pattern occurred in 3 of 62 (4.8%). ECG abnormalities that were not present within 1 month previously or abnormalities that disappeared within 1 month included left-axis deviation, right-axis deviation, right atrial enlargement, right ventricular hypertrophy, S(1)S(2)S(3), S(1)Q(3)T(3), low-voltage QRS complexes, and nonspecific ST-segment or T-wave abnormalities. In conclusion, electrocardiogram in patients with pneumonia often shows QRS abnormalities or nonspecific ST-segment or T-wave changes. ECG findings are similar to ECG abnormalities in PE and electrocardiogram cannot assist in the differential diagnosis.

  19. Guideline for prevention of nosocomial pneumonia. Centers for Disease Control and Prevention. (United States)


    Pneumonia is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality. Most patients with nosocomial pneumonia are those with extremes of age, severe underlying disease, immunosuppression, depressed sensorium, and cardiopulmonary disease, and those who have had thoracoabdominal surgery. Although patients with mechanically assisted ventilation do not comprise a major proportion of patients with nosocomial pneumonia, they have the highest risk of developing the infection. Most bacterial nosocomial pneumonias occur by aspiration of bacteria colonizing the oropharynx or upper gastrointestinal tract of the patient. Intubation and mechanical ventilation greatly increase the risk of nosocomial bacterial pneumonia because they alter first-line patient defenses. Pneumonias due to Legionella spp., Aspergillus spp., and influenza virus are often caused by inhalation of contaminated aerosols. Respiratory syncytial virus (RSV) infection usually follows viral inoculation of the conjunctivae or nasal mucosa by contaminated hands. Traditional preventive measures for nosocomial pneumonia include decreasing aspiration by the patient, preventing cross-contamination or colonization via hands of personnel, appropriate disinfection or sterilization or respiratory therapy devices, use of available vaccines to protect against particular infections, and education of hospital staff and patients. New measures under investigation involve reducing oropharyngeal and gastric colonization by pathogenic microorganisms.

  20. Penicillin resistance and serotyping of Streptococcus pneumoniae in Latin America. (United States)

    Camargos, Paulo; Fischer, Gilberto Bueno; Mocelin, Helena; Dias, Cícero; Ruvinsky, Raúl


    Streptococcus pneumoniae (Strep. pneumoniae) is the main cause of bacterial pneumonia in children less than 5 years of age, with high mortality rates in developing countries. In 1993, the Regional System for Vaccines Group (SIREVA) of the pan-American Health Organisation (PAHO) began a study involving six Latin American countries to identify serotypes and their representativity in the new conjugated vaccines, and to determine the degree of resistance to penicillin. Serotypes 14 (highest resistance level), 5, 1, 6A/B, 23F, 7F, 9V, 19F, 18C, 19A, 9N, were prevalent in the region, with some differences among countries. Although resistance to penicillin ranged from 2% (Brazil) to 21.1% (Mexico), studies have shown that pneumonia caused by Strep. pneumoniae with diminished sensitivity to penillin can be treated with this antibiotic. Only 58% of the serotypes isolated in the region studied were represented in the seven-valent vaccine. Continual surveillance is essential to determine which formulation of conjugated vaccine will be suitable for use in Latin America.

  1. Detection of bacterial antigens and Alzheimer’s disease-like pathology in the central nervous system of BALB/c mice following intranasal infection with a laboratory isolate of Chlamydia pneumoniae

    Directory of Open Access Journals (Sweden)

    Christopher Scott Little


    Full Text Available Pathology consistent with that observed in Alzheimer’s disease (AD has previously been documented following intranasal infection of normal wild-type mice with Chlamydia pneumoniae (Cpn isolated from an AD brain (96-41. In the current study, BALB/c mice were intranasally infected with a laboratory strain of Cpn, AR-39, and brain and olfactory bulbs were obtained at 1-4 months post-infection (pi. Immunohistochemistry for amyloid beta or Cpn antigens was performed on sections from brains of infected or mock-infected mice. Chlamydia-specific immunolabeling was identified in olfactory bulb tissues and in cerebrum of AR-39 infected mice. The Cpn specific labeling was most prominent at 1 month pi and the greatest burden of amyloid deposition was noted at 2 months pi, whereas both decreased at 3 and 4 months. Viable Cpn was recovered from olfactory bulbs of 3 of 3 experimentally infected mice at 1 and 3 months pi, and in 2 of 3 mice at 4 months pi. In contrast, in cortical tissues of infected mice at 1 and 4 months pi no viable organism was obtained. At 3 months pi, only 1 of 3 mice had a measurable burden of viable Cpn from the cortical tissues. Mock-infected mice (0 of 3 had no detectable Cpn in either olfactory bulbs or cortical tissues. These data indicate that the AR-39 isolate of Cpn establishes a limited infection predominantly in the olfactory bulbs of BALB/c mice. Although infection with the laboratory strain of Cpn promotes deposition of amyloid beta, this appears to resolve following reduction of the Cpn antigen burden over time. Our data suggest that infection with the AR-39 laboratory isolate of Cpn results in a different course of amyloid beta deposition and ultimate resolution than that observed following infection with the human AD-brain Cpn isolate, 96-41. These data further support that there may be differences, possibly in virulence factors, between Cpn isolates in the generation of sustainable AD pathology.

  2. Bronchiolitis Obliterans with Organizing Pneumonia (BOOP) (United States)

    ... What can you tell me about cryptogenic organizing pneumonia? Answers from Teng Moua, M.D. Previously called bronchiolitis obliterans with organizing pneumonia, cryptogenic organizing pneumonia (COP) is a rare lung ...

  3. A comparative study of induction of pneumonia in mice with planktonic and biofilm cells of Klebsiella pneumoniae. (United States)

    Sharma, Sonica; Mohan, Harsh; Sharma, Saroj; Chhibber, Sanjay


    In the present study, the course of acute pneumonia in normal BALB/c mice infected by intranasal inoculation of planktonic and preformed biofilm cells (3 days old) of Klebsiella pneumoniae B5055 was studied and compared. With both cell forms the peak of infection was observed on the third post infection day, as assessed on the basis of lung bacterial load and corresponding pathology. There was an intense neutrophil infiltration in bronchoalveolar lavage fluid. Tissue damage was assessed on the basis of increased amounts of nitrite, malondialdehyde and lactate dehydrogenase in lung homogenates. The phagocytic potential of alveolar macrophages was lower in biofilm cell-induced infection than in that induced by planktonic cells. Biofilm cell induced infection generated significantly greater production of tumor necrosis factor-α and interleukin-1β on the third and fifth days of infection, respectively. Production of interleukin-10 was, however, variable. There was no significant difference in the ability of planktonic and biofilm cell forms of K. pneumoniae to induce acute pneumonia in mice in terms of bacterial counts and histopathological changes. However, biofilm cell-induced infection showed delayed clearance as compared to infection induced with the planktonic form.

  4. Pneumonia bacteriana adquirida na comunidade


    Machado, Lais Del Prá Netto


    Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmácia, Florianópolis, 2015. A pneumonia pode ser causada por diversos microrganismos e classificada de forma abrangente, havendo poucos e frágeis estudos clínicos e epidemiológicos sobre pneumonias adquiridas na comunidade (PACs). Os patógenos mais frequentes nas PACs são Streptococcus pneumoniae e Haemophilus influenzae (em pneumonias típicas) e Mycoplasma pneumoni...

  5. Burden of Severe Pneumonia, Pneumococcal Pneumonia and Pneumonia Deaths in Indian States: Modelling Based Estimates. (United States)

    Farooqui, Habib; Jit, Mark; Heymann, David L; Zodpey, Sanjay


    The burden of severe pneumonia in terms of morbidity and mortality is unknown in India especially at sub-national level. In this context, we aimed to estimate the number of severe pneumonia episodes, pneumococcal pneumonia episodes and pneumonia deaths in children younger than 5 years in 2010. We adapted and parameterized a mathematical model based on the epidemiological concept of potential impact fraction developed CHERG for this analysis. The key parameters that determine the distribution of severe pneumonia episode across Indian states were state-specific under-5 population, state-specific prevalence of selected definite pneumonia risk factors and meta-estimates of relative risks for each of these risk factors. We applied the incidence estimates and attributable fraction of risk factors to population estimates for 2010 of each Indian state. We then estimated the number of pneumococcal pneumonia cases by applying the vaccine probe methodology to an existing trial. We estimated mortality due to severe pneumonia and pneumococcal pneumonia by combining incidence estimates with case fatality ratios from multi-centric hospital-based studies. Our results suggest that in 2010, 3.6 million (3.3-3.9 million) episodes of severe pneumonia and 0.35 million (0.31-0.40 million) all cause pneumonia deaths occurred in children younger than 5 years in India. The states that merit special mention include Uttar Pradesh where 18.1% children reside but contribute 24% of pneumonia cases and 26% pneumonia deaths, Bihar (11.3% children, 16% cases, 22% deaths) Madhya Pradesh (6.6% children, 9% cases, 12% deaths), and Rajasthan (6.6% children, 8% cases, 11% deaths). Further, we estimated that 0.56 million (0.49-0.64 million) severe episodes of pneumococcal pneumonia and 105 thousand (92-119 thousand) pneumococcal deaths occurred in India. The top contributors to India's pneumococcal pneumonia burden were Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan in that order. Our results

  6. Silica desiccant packets for storage and transport of Streptococcus pneumoniae and other clinically relevant species.

    Directory of Open Access Journals (Sweden)

    Casey L Pell

    Full Text Available Bacterial isolates are often transported between laboratories for research and diagnostic purposes. Silica desiccant packets (SDPs, which are inexpensive and do not require freezing, were evaluated for storage and recovery of bacterial isolates. Conditions such as inoculum size, swab type and temperature of storage were investigated using ten Streptococcus pneumoniae isolates. The optimized protocol was then tested using 49 additional S. pneumoniae isolates representing 40 serogroups. Overall, S. pneumoniae growth was considered satisfactory (>100 colony forming units for 98/109 (89.9% and 20/20 (100% swabs after 14 days at room temperature or 28 days at 4° C, respectively. Storage in SDPs did not impact on the ability of S. pneumoniae isolates to be subsequently serotyped. When the survival of nine other clinically relevant bacterial species was tested, seven were viable after 28 days at room temperature, the exceptions being Neisseria gonorrhoeae and Haemophilus influenzae. SDPs are suitable for transport and short-term storage of bacterial species including S. pneumoniae.

  7. Bacteremic pneumonia caused by extensively drug-resistant Streptococcus pneumoniae. (United States)

    Kang, Cheol-In; Baek, Jin Yang; Jeon, Kyeongman; Kim, So Hyun; Chung, Doo Ryeon; Peck, Kyong Ran; Lee, Nam Yong; Song, Jae-Hoon


    The emergence of antimicrobial resistance threatens the successful treatment of pneumococcal infections. Here we report a case of bacteremic pneumonia caused by an extremely drug-resistant strain of Streptococcus pneumoniae, nonsusceptible to at least one agent in all classes but vancomycin and linezolid, posing an important new public health threat in our region.

  8. Bacterial coinfections in children with viral wheezing. (United States)

    Lehtinen, P; Jartti, T; Virkki, R; Vuorinen, T; Leinonen, M; Peltola, V; Ruohola, A; Ruuskanen, O


    Bacterial coinfections occur in respiratory viral infections, but the attack rates and the clinical profile are not clear. The aim of this study was to determine bacterial coinfections in children hospitalized for acute expiratory wheezing with defined viral etiology. A total of 220 children aged 3 months to 16 years were investigated. The viral etiology of wheezing was confirmed by viral culture, antigen detection, serologic investigation, and/or PCR. Specific antibodies to common respiratory bacteria were measured from acute and convalescent serum samples. All children were examined clinically for acute otitis media, and subgroups of children were examined radiologically for sinusitis and pneumonia. Rhinovirus (32%), respiratory syncytial virus (31%), and enteroviruses (31%) were the most common causative viruses. Serologic evidence of bacterial coinfection was found in 18% of the children. Streptococcus pneumoniae (8%) and Mycoplasma pneumoniae (5%) were the most common causative bacteria. Acute otitis media was diagnosed in 44% of the children. Chest radiographs showed alveolar infiltrates in 10%, and paranasal radiographs and clinical signs showed sinusitis in 17% of the older children studied. Leukocyte counts and serum C-reactive protein levels were low in a great majority of patients. Viral lower respiratory tract infection in children is often associated with bacterial-type upper respiratory tract infections. However, coexisting bacterial lower respiratory tract infections that induce systemic inflammatory response are seldom detected.

  9. Tobacco use increases susceptibility to bacterial infection

    Directory of Open Access Journals (Sweden)

    Demuth Donald R


    Full Text Available Abstract Active smokers and those exposed to secondhand smoke are at increased risk of bacterial infection. Tobacco smoke exposure increases susceptibility to respiratory tract infections, including tuberculosis, pneumonia and Legionnaires disease; bacterial vaginosis and sexually transmitted diseases, such as chlamydia and gonorrhoea; Helicobacter pylori infection; periodontitis; meningitis; otitis media; and post-surgical and nosocomial infections. Tobacco smoke compromises the anti-bacterial function of leukocytes, including neutrophils, monocytes, T cells and B cells, providing a mechanistic explanation for increased infection risk. Further epidemiological, clinical and mechanistic research into this important area is warranted.

  10. R-roscovitine reduces lung inflammation induced by lipoteichoic acid and Streptococcus pneumoniae. (United States)

    Hoogendijk, Arie J; Roelofs, Joris J T H; Duitman, Janwillem; van Lieshout, Miriam H P; Blok, Dana C; van der Poll, Tom; Wieland, Catharina W


    Bacterial pneumonia remains associated with high morbidity and mortality. The gram-positive pathogen Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. Lipoteichoic acid (LTA) is an important proinflammatory component of the gram-positive bacterial cell wall. R-roscovitine, a purine analog, is a potent cyclin-dependent kinase (CDK)-1, -2, -5 and -7 inhibitor that has the ability to inhibit the cell cycle and to induce polymorphonuclear cell (PMN) apoptosis. We sought to investigate the effect of R-roscovitine on LTA-induced activation of cell lines with relevance for lung inflammation in vitro and on lung inflammation elicited by either LTA or viable S. pneumoniae in vivo. In vitro R-roscovitine enhanced apoptosis in PMNs and reduced tumor necrosis factor (TNF)-α and keratinocyte chemoattractant (KC) production in MH-S (alveolar macrophage) and MLE-12/MLE-15 (respiratory epithelial) cell lines. In vivo R-roscovitine treatment reduced PMN numbers in bronchoalveolar lavage fluid during LTA-induced lung inflammation; this effect was reversed by inhibiting apoptosis. Postponed treatment with R-roscovitine (24 and 72 h) diminished PMN numbers in lung tissue during gram-positive pneumonia; this step was associated with a transient increase in pulmonary bacterial loads. R-roscovitine inhibits proinflammatory responses induced by the gram-positive stimuli LTA and S. pneumoniae. R-roscovitine reduces PMN numbers in lungs upon LTA administration by enhancing apoptosis. The reduction in PMN numbers caused by R-roscovitine during S. pneumoniae pneumonia may hamper antibacterial defense.

  11. Enteral Tube Feeding and Pneumonia (United States)

    Gray, David Sheridan; Kimmel, David


    To determine the effects of enteral tube feeding on the incidence of pneumonia, we performed a retrospective review of all clients at our institution who had gastrostomy or jejunostomy tubes placed over a 10-year period. Ninety-three subjects had a history of pneumonia before feeding tube insertion. Eighty had gastrostomy and 13, jejunostomy…

  12. 老年卒中相关性肺炎病多重耐药菌特点及危险因素分析%Etiology and risk factors of stroke-associated pneumonia in elderly patients with multiple drug-resistant bacterial infections

    Institute of Scientific and Technical Information of China (English)

    莫丽亚; 王翎


    Objective To discuss the etiology and risk factors of stroke⁃associated pneumonia ( SAP ) in elderly patients with multiple drug⁃resistant( MDR) bacterial infections. Methods The data of 132 elderly inpatients with SAP from January 2012 to December 2014 were analyzed retrospectively, and the composition and characteristics of MDR bacteria and the risk factors were observed and analyzed. Results There were 65 MDR strains in 132 patients, and gram⁃negative bacteria was predominated. The top six stains were pseudomonas aeruginosa, staphylococcus aureus, klebsiella pneumonia bacillus, e. coli bacteria, gas enterbacteriaceae and dung enterococcus. Univariate analysis indicated that there was statistical difference between the two groups in age, type of stroke, level of consciousness, feeding way, and mechanical ventilation. Multivariable regression analysis indicated that age, level of consciousness, mechanical ventilation were associated with MDR. Conclusions Gram⁃negative bacillus predominated in MDR, staphylococcus aureus is also an important MDR. Age, level of consciousness, mechanical ventilation are risk factors of MDR bacterial infections in elderly patients.%目的探讨老年卒中相关性肺炎(SAP)多重耐药病原菌(MDR)特点及其危险因素。方法回顾性分析我院老年科2012年1月至2014年12月住院的132例老年SAP患者,了解痰液MDR构成情况及耐药性特点,并分析相关危险因素。结果在132例患者中,分离出65株MRD,其中革兰阴性菌占优势。排名前6位的依次是:铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷白杆菌、大肠埃希氏菌、产气肠杆菌、粪肠球菌。单因素分析显示,年龄、卒中类型、意识水平、喂养方式、机械通气等因素与MDR感染有关( P<0.05),多因素回归分析显示,年龄、意识水平、机械通气是SAP患者发生MDR感染的危险因素。结论老年科病房SAP主要的MDR为革兰阴性

  13. Lymphocytic Interstitial Pneumonia. (United States)

    Panchabhai, Tanmay S; Farver, Carol; Highland, Kristin B


    Lymphocytic interstitial pneumonia (LIP) is a rare lung disease on the spectrum of benign pulmonary lymphoproliferative disorders. LIP is frequently associated with connective tissue diseases or infections. Idiopathic LIP is rare; every attempt must be made to diagnose underlying conditions when LIP is diagnosed. Computed tomography of the chest in patients with LIP may reveal ground-glass opacities, centrilobular and subpleural nodules, and randomly distributed thin-walled cysts. Demonstrating polyclonality with immunohistochemistry is the key to differentiating LIP from lymphoma. The 5-year mortality remains between 33% and 50% and is likely to vary based on the underlying disease process.

  14. Bacterial Invasion of the Inner Ear in Association With Pneumococcal Meningitis

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Brandt, Christian; Østergaard, Christian


    OBJECTIVE: To examine the pathways of bacterial invasion and subsequent spreading in the inner ear during pneumococcal meningitis. STUDY DESIGN: A well-established adult rat model of Streptococcus pneumoniae meningitis was used. METHODS: Thirty rats were inoculated intrathecally with S. pneumoniae...

  15. Significance of anaerobes and oral bacteria in community-acquired pneumonia.

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    Kei Yamasaki

    Full Text Available BACKGROUND: Molecular biological modalities with better detection rates have been applied to identify the bacteria causing infectious diseases. Approximately 10-48% of bacterial pathogens causing community-acquired pneumonia are not identified using conventional cultivation methods. This study evaluated the bacteriological causes of community-acquired pneumonia using a cultivation-independent clone library analysis of the 16S ribosomal RNA gene of bronchoalveolar lavage specimens, and compared the results with those of conventional cultivation methods. METHODS: Patients with community-acquired pneumonia were enrolled based on their clinical and radiological findings. Bronchoalveolar lavage specimens were collected from pulmonary pathological lesions using bronchoscopy and evaluated by both a culture-independent molecular method and conventional cultivation methods. For the culture-independent molecular method, approximately 600 base pairs of 16S ribosomal RNA genes were amplified using polymerase chain reaction with universal primers, followed by the construction of clone libraries. The nucleotide sequences of 96 clones randomly chosen for each specimen were determined, and bacterial homology was searched. Conventional cultivation methods, including anaerobic cultures, were also performed using the same specimens. RESULTS: In addition to known common pathogens of community-acquired pneumonia [Streptococcus pneumoniae (18.8%, Haemophilus influenzae (18.8%, Mycoplasma pneumoniae (17.2%], molecular analysis of specimens from 64 patients with community-acquired pneumonia showed relatively higher rates of anaerobes (15.6% and oral bacteria (15.6% than previous reports. CONCLUSION: Our findings suggest that anaerobes and oral bacteria are more frequently detected in patients with community-acquired pneumonia than previously believed. It is possible that these bacteria may play more important roles in community-acquired pneumonia.

  16. The NOD/RIP2 pathway is essential for host defenses against Chlamydophila pneumoniae lung infection.

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    Kenichi Shimada


    Full Text Available Here we investigated the role of the Nod/Rip2 pathway in host responses to Chlamydophila pneumoniae-induced pneumonia in mice. Rip2(-/- mice infected with C. pneumoniae exhibited impaired iNOS expression and NO production, and delayed neutrophil recruitment to the lungs. Levels of IL-6 and IFN-gamma levels as well as KC and MIP-2 levels in bronchoalveolar lavage fluid (BALF were significantly decreased in Rip2(-/- mice compared to wild-type (WT mice at day 3. Rip2(-/- mice showed significant delay in bacterial clearance from the lungs and developed more severe and chronic lung inflammation that continued even on day 35 and led to increased mortality, whereas WT mice cleared the bacterial load, recovered from acute pneumonia, and survived. Both Nod1(-/- and Nod2(-/- mice also showed delayed bacterial clearance, suggesting that C. pneumoniae is recognized by both of these intracellular receptors. Bone marrow chimera experiments demonstrated that Rip2 in BM-derived cells rather than non-hematopoietic stromal cells played a key role in host responses in the lungs and clearance of C. pneumoniae. Furthermore, adoptive transfer of WT macrophages intratracheally was able to rescue the bacterial clearance defect in Rip2(-/- mice. These results demonstrate that in addition to the TLR/MyD88 pathway, the Nod/Rip2 signaling pathway also plays a significant role in intracellular recognition, innate immune host responses, and ultimately has a decisive impact on clearance of C. pneumoniae from the lungs and survival of the infectious challenge.

  17. The NOD/RIP2 pathway is essential for host defenses against Chlamydophila pneumoniae lung infection. (United States)

    Shimada, Kenichi; Chen, Shuang; Dempsey, Paul W; Sorrentino, Rosalinda; Alsabeh, Randa; Slepenkin, Anatoly V; Peterson, Ellena; Doherty, Terence M; Underhill, David; Crother, Timothy R; Arditi, Moshe


    Here we investigated the role of the Nod/Rip2 pathway in host responses to Chlamydophila pneumoniae-induced pneumonia in mice. Rip2(-/-) mice infected with C. pneumoniae exhibited impaired iNOS expression and NO production, and delayed neutrophil recruitment to the lungs. Levels of IL-6 and IFN-gamma levels as well as KC and MIP-2 levels in bronchoalveolar lavage fluid (BALF) were significantly decreased in Rip2(-/-) mice compared to wild-type (WT) mice at day 3. Rip2(-/-) mice showed significant delay in bacterial clearance from the lungs and developed more severe and chronic lung inflammation that continued even on day 35 and led to increased mortality, whereas WT mice cleared the bacterial load, recovered from acute pneumonia, and survived. Both Nod1(-/-) and Nod2(-/-) mice also showed delayed bacterial clearance, suggesting that C. pneumoniae is recognized by both of these intracellular receptors. Bone marrow chimera experiments demonstrated that Rip2 in BM-derived cells rather than non-hematopoietic stromal cells played a key role in host responses in the lungs and clearance of C. pneumoniae. Furthermore, adoptive transfer of WT macrophages intratracheally was able to rescue the bacterial clearance defect in Rip2(-/-) mice. These results demonstrate that in addition to the TLR/MyD88 pathway, the Nod/Rip2 signaling pathway also plays a significant role in intracellular recognition, innate immune host responses, and ultimately has a decisive impact on clearance of C. pneumoniae from the lungs and survival of the infectious challenge.

  18. 环介导等温扩增技术在检测细菌性肺炎常见致病菌中的应用%Value of loop-mediated isothermal amplification in detection of common pathogens of bacterial pneumonia

    Institute of Scientific and Technical Information of China (English)

    戴然然; 刘嘉琳; 万欢英


    Objective To investigate the value of loop-mediated isothermal amplification (LAMP) assay in the etiology diagnosis of bacterial pnuemonia through nucleic acid detection of common pathogens in pneumonia patients by LAMP method. Methods Sputum DNA was extracted from 75 pneumonia patients. DNA was amplified by LAMP. The fluorescence signals of products were detected by real-time PCR. The quantitative results were qualitatively analyzed at different cutoff values, and the data were compared with the results of sputum culture. Results The positive ratio of amplified products with LAMP assay at the cutoff value of 1 × 104 was 68.0% ,and the coincidence rate between LAMP assay and sputum culture was 56.0%. The positive ratio of amplified products with LAMP assay at the cutoff value of 1× 105 was 50.7%, and the coincidence rate between LAMP assay and sputum culture was 58.7%.The positive ratio of amplified products with LAMP assay at the cutoff value of 1 × 106 was 30.7%, and the coincidence rate between LAMP assay and sputum culture was 53.3%. There was no statistical significance on the positive rate between sputum culture and LAMP results at the cutoff value of 1 × 105.The detection rate of parts of bacteria by LAMP assay is higher than that by sputum culture at the cutoff value of 1 × 105 ,especially for the harsh bacteria. Conclusions DNA of common pathogens in sputum of patients with bacterial pneumonia can be easily and quickly amplified by LAMP method to identify pathogenic bacteria types. Compared with sputum culture, the bacterial detection rate is higher by LAMP assay at the cutoff value of 1 × 105. Especially for the harsh bacteria, LAMP method has significant advantages.%目的 应用环介导等温扩增(LAMP)方法对肺炎患者痰液常见致病菌进行核酸检测,研究LAMP方法在细菌性肺炎病原学诊断中的价值.方法 抽提75例肺炎患者痰液细菌DNA,根据肺炎常见8种致病细菌设计引物,应用LAMP技术扩增DNA,实

  19. Management of Rhodococcus equi pneumonia in foals

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    Johns I


    Full Text Available Imogen Johns Department of Clinical Sciences and Services, Royal Veterinary College, North Mymms, UK Abstract: Rhodococcus equi, a gram-positive facultative intracellular bacterial pathogen, is the most important cause of pneumonia in foals aged 3 weeks to 5 months. The disease occurs worldwide, resulting in significant morbidity and mortality on endemically affected farms. Foals appear to become infected early in life, but clinical signs are typically delayed until 1–3 months of age because of the insidious nature of the disease. Although pneumonia is the most common clinical manifestation, up to 74% of foals may concurrently have extrapulmonary disorders, including both extrapulmonary infections (abdominal abscessation, colitis, osteomyelitis and immune-mediated disorders (nonseptic synovitis, uveitis. Diagnosis is based on the combination of clinical signs and abnormalities on hematologic screening and thoracic imaging in an appropriately aged foal and is confirmed by bacteriologic culture of the organism. Management of R. equi infections, in particular on farms with endemic disease, combines appropriate treatment of affected foals with preventative measures targeted at preventing infection and identifying foals before the development of severe disease. The combination of rifampin and a macrolide antimicrobial is recommended for treatment, as the combination is synergistic, reaches high intracellular concentrations, and should minimize the development of antimicrobial resistance. The prognosis for survival for foals with R. equi pneumonia is good, especially in foals mildly or subclinically affected, as is the prognosis for future athletic performance. Screening for early identification before the development of clinical signs has been advocated on endemically affected farms, although the most appropriate method, the timing of screening, and the selection of foals requiring treatment have yet to be determined. Recent evidence suggests that

  20. Etiology of acute otitis media and serotype distribution of Streptococcus pneumoniae and Haemophilus influenzae in Chilean children <5 years of age (United States)

    Rosenblut, Andres; Napolitano, Carla; Pereira, Angelica; Moreno, Camilo; Kolhe, Devayani; Lepetic, Alejandro; Ortega-Barria, Eduardo


    Abstract The impact of bacterial conjugate vaccines on acute otitis media (AOM) is affected by several factors including population characteristics, bacterial etiology and vaccine conjugation method, carrier, and coverage. This study estimated the baseline etiology, distribution, and antibiotic susceptibility of bacterial serotypes that causes AOM in children aged Streptococcus pneumoniae (41.7% [58/139]) and Haemophilus influenzae (40.3% [56/139]) were predominant among the cultures that showed bacterial growth (85% [139/164]). All Streptococcus pneumoniae positive episodes were serotyped, 19F (21%) and 14 (17%) were the predominant serotypes; all Haemophilus influenzae strains were nontypeable. Streptococcus pneumoniae were resistant to penicillin (5%) and erythromycin (33%); Haemophilus influenzae were resistant to ampicillin (14%) and cefuroxime and cefotaxime (2% each). AOM in Chilean children is predominantly caused by Streptococcus pneumoniae and nontypeable Haemophilus influenzae. Use of a broad spectrum vaccine against these pathogens might aid the reduction of AOM in Chile. PMID:28178138

  1. Bacterial Vaginosis (United States)

    ... Issues > Conditions > Sexually Transmitted > Bacterial Vaginosis Health Issues Listen Español Text Size Email Print Share Bacterial Vaginosis Page Content Bacterial vaginosis (BV) is the most common vaginal infection in sexually active teenaged girls . It appears to be caused by ...

  2. Antimicrobial Resistant Streptococcus pneumoniae

    Directory of Open Access Journals (Sweden)

    B Khanal


    Full Text Available Introduction: Pneumococcal infections are important cause of morbidity and mortality. Knowledge of antimicrobial susceptibility patterns plays important role in the selection of appropriate therapy. Present study was undertaken to analyze the susceptibility patterns of pneumococcal isolates against commonly used antimicrobials with special reference to determination of minimum inhibitory concentration (MIC of penicillin in a tertiary care hospital in eastern Nepal. Methods: Twenty-six strains of S. pneumoniae isolated from various clinical specimens submitted to microbiology laboratory were evaluated. All isolates were tested for antimicrobial susceptibility by disk diffusion method. MIC of penicillin was tested by broth dilution method. Results: Of the total isolates 19 (73% were from invasive infections. Seven isolates were resistant to cotrimoxazole. No resistance to penicillin was seen in disk diffusion testing. Less susceptibility to penicillin (MIC 0.1-1.0 mg/L was observed in five (17% isolates. High level resistance to penicillin was not detected. One isolate was multidrug resistant. Conclusions: S. pneumoniaeisolates with intermediate resistance to penicillin prevail in Tertiary Care Hospital in eastern Nepal, causing invasive and noninvasive infections. As intermediate resistance is not detected in routine susceptibility testing, determination of MIC is important. It helps not only in the effective management of life threatening infections but is also essential in continuous monitoring and early detection of resistance. In addition, further study on pneumococcal infections, its antimicrobial resistance profile and correlation with clinical and epidemiological features including serotypes and group prevalence is recommended in future. Keywords: antimicrobial susceptibility pattern, penicillin, Streptococcus pneumoniae.

  3. Pneumoniae in immunocompromised patients; Pneumonien bei Immunsuppression

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    Jacobi, Volkmar; Lehnert, Thomas; Thalhammer, Axel [Klinikum der Johann-Wolfgang-Goethe-Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie


    Due to the large surface area, heat, high humidity and high oxygen supply in the lung makes an ideal environment for the propagation of germs. The purpose of the immune system is to establish and maintain the balance between saprophytes and immune defense so as to depress and ultimately kill germs as they infiltrate the body. This usually is achieved by the use of a highly complex immune system. It is a perfect combination of non-specific, cellular and humoral immune mechanisms with very specific immune cells and antibodies, which are specialized on particular pathogens. The specific defenses potentiate the effect of the nonspecific defense in a large extent so as to prevent re-infection and ultimately eliminate recognized pathogens. The causes of immune deficiency can be related to either the cellular or humoral level and affect both the specific and nonspecific defenses. There is a different excitation spectrum depending on the type of immune deficiency. Immune deficiency can prevalently cause complications in the course of infections, decelerate the healing and allow the occurrence of rare pathogens. In particular, the radiological characteristics of typical and atypical pneumonia in immunocompromised patients will be discussed. Particular emphasis is placed on the appearance of bacterial infections, mycobacterioses, PCP, CMV, and laid fungual pneumonia. Even it is not possible to identify certain pathogens radiologically, it is often possible to narrow the spectrum of germs causing pulmonary infections significantly by comparing with other pulmonary complications such as lymphoma or kaposisarcomas. (orig.)

  4. Purpura Fulminans Secondary to Streptococcus pneumoniae Meningitis

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    Erick F. Alvarez


    Full Text Available Purpura fulminans (PF is a rare skin disorder with extensive areas of blueblack hemorrhagic necrosis. Patients manifest typical laboratory signs of disseminated intravascular coagulation (DIC. Our case describes a 37-year-old previously healthy man who presented with 3 days of generalized malaise, headache, vomiting, photophobia, and an ecchymotic skin rash. Initial laboratory workup revealed DIC without obvious infectious trigger including unremarkable cerebrospinal fluid (CSF biochemical analysis. There was further progression of the skin ecchymosis and multiorgan damage consistent with PF. Final CSF cultures revealed Streptococcus pneumoniae. Despite normal initial CSF biochemical analysis, bacterial meningitis should always be considered in patients with otherwise unexplained DIC as this may be an early manifestation of infection. PF is a clinical diagnosis that requires early recognition and prompt empirical treatment, especially, in patients with progressive altered mental status, ecchymotic skin rash, and DIC.

  5. Klebsiella pneumoniae alleviates influenza-induced acute lung injury via limiting NK cell expansion. (United States)

    Wang, Jian; Li, Fengqi; Sun, Rui; Gao, Xiang; Wei, Haiming; Tian, Zhigang


    A protective effect induced by bacterial preinfection upon a subsequent lethal influenza virus infection has been observed, but the underlying immune mechanisms have not yet been fully elucidated. In this study, we used a mouse model of Klebsiella pneumoniae preinfection to gain insight into how bacterial preinfection influences the subsequent lethal influenza virus infection. We found that K. pneumoniae preinfection significantly attenuated lung immune injury and decreased mortality during influenza virus infection, but K. pneumoniae-specific immunity was not involved in this cross-protection against influenza virus. K. pneumoniae preinfection limited NK cell expansion, which was involved in influenza-induced immune injury and death. Furthermore, K. pneumoniae preinfection could not control NK cell expansion and death during influenza virus infection in Rag1(-/-) mice, but adoptive transfer of T cells from wild-type mice was able to restore this protective effect. Our data suggest that the adaptive immune response activated by bacterial infection limits the excessive innate immune response induced by a subsequent influenza infection, ultimately protecting mice from death.

  6. Streptococcus pneumoniae synergizes with nontypeable Haemophilus influenzae to induce inflammation via upregulating TLR2

    Directory of Open Access Journals (Sweden)

    Kweon Soo-Mi


    Full Text Available Abstract Background Toll-like receptor 2 (TLR2 plays a critical role in mediating inflammatory/immune responses against bacterial pathogens in lung. Streptococcus pneumoniae (S. pneumoniae and nontypeable Haemophilus influenzae (NTHi were previously reported to synergize with each other to induce inflammatory responses. Despite the relatively known intracellular signaling pathways involved in the synergistic induction of inflammation, it is still unclear if both bacterial pathogens also synergistically induce expression of surface TLR2. Results Here we provide direct evidence that S. pneumoniae synergizes with NTHi to upregulate TLR2 expression in lung and middle ear of the mice. Pneumolysin (PLY appears to be the major virulence factor involved in this synergism. Moreover, S. pneumoniae PLY induces TLR2 expression via a TLR4-MyD88-NF-κB-dependent signaling pathway. Interestingly, tumor suppressor CYLD acts as a negative regulator of S. pneumoniae-induced TLR2 up-regulation via negative-crosstalk with NF-κB signaling. Conclusion Our study thus provides novel insights into the regulation of TLR2 expression in mixed bacterial infections.

  7. Pherotypes are driving genetic differentiation within Streptococcus pneumoniae

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    Ramirez Mario


    Full Text Available Abstract Background The boundaries of bacterial species and the mechanisms underlying bacterial speciation are matters of intense debate. Theoretical studies have shown that recombination acts as a strong cohesive force preventing divergence in bacterial populations. Streptococcus pneumoniae populations have the telltale signs of high recombination with competence implicated as the major driving force behind gene exchange. Competence in S. pneumoniae is triggered by a quorum-sensing mechanism controlled by the competence-stimulating peptide pheromone. Results We studied the distribution of the two major pherotypes in the pneumococcal population and their association with serotype, antimicrobial resistance and genetic lineage. Using multilocus sequence data we evaluated pherotype influence on the dynamics of horizontal gene transfer. We show that pherotype is a clonal property of pneumococci. Standard population genetic analysis and multilocus infinite allele model simulations support the hypothesis that two genetically differentiated populations are defined by the major pherotypes. Conclusion Severe limitations to gene flow can therefore occur in bacterial species in the absence of geographical barriers and within highly recombinogenic populations. This departure from panmixia can have important consequences for our understanding of the response of pneumococci to human imposed selective pressures such as vaccination and antibiotic use.

  8. [The role of trovafloxacin in the treatment of nosocomial pneumonia]. (United States)

    Mandell, L A


    In order to understand the role of trovafloxacin in the treatment of nosocomial pneumonia, the nature and characteristics of this infection have to be first reviewed. During the first part of this revision the principal aspects of the epidemiology are reviewed, some concepts which take part in the pathogenia of the illness and the immunology of these patients are analysed and the microbiological characteristics of nosocomial pneumonia are evaluated. In the second part of the revision the bacterial resistance to the main groups of antibiotics is considered, listing the different mechanisms used by the bacteria to develop this resistance. They are: production of enzymes which inactivate the antibiotic, access reduction of the drug to the target site, increase of the antibiotic efflux or changes in the target site. Current controversies concerning diagnostic methods and some controversial issues regarding this pathology are here discussed. Finally, the proposed guidelines for the treating hospital acquired pneumonia are revised as well as the role of special new antibiotics. In this sense special reference is made to trovafloxacin, listing its principal characteristics, as its broad spectrum of activity, its excellent pharmacokinetic properties, its availability in i.v. and oral formulations and its good tolerance, which makes trovafloxacin a very interesting option for treatment of hospital acquired pneumonia.

  9. What Are the Signs and Symptoms of Pneumonia? (United States)

    ... Home » Health Information for the Public » Health Topics » Pneumonia » Signs, Symptoms, and Complications Explore Pneumonia Pneumonia Causes Risk Factors Signs, Symptoms, and Complications ...

  10. Non-Intensive Care Unit Acquired Pneumonia: A New Clinical Entity?

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    Marta Di Pasquale


    Full Text Available Hospital-acquired pneumonia (HAP is a frequent cause of nosocomial infections, responsible for great morbidity and mortality worldwide. The majority of studies on HAP have been conducted in patients hospitalized in the intensive care unit (ICU, as mechanical ventilation represents a major risk factor for nosocomial pneumonia and specifically for ventilator-associated pneumonia. However, epidemiological data seem to be different between patients acquiring HAP in the ICU vs. general wards, suggesting the importance of identifying non ICU-acquired pneumonia (NIAP as a clinical distinct entity in terms of both etiology and management. Early detection of NIAP, along with an individualized management, is needed to reduce antibiotic use and side effects, bacterial resistance and mortality. The present article reviews the pathophysiology, diagnosis, treatment and prevention of NIAP.

  11. Stress ulcer prophylaxis and ventilation pneumonia: prevention by antibacterial cytoprotective agents? (United States)

    Daschner, F; Kappstein, I; Engels, I; Reuschenbach, K; Pfisterer, J; Krieg, N; Vogel, W


    The gastric and tracheal flora of 142 consecutive patients receiving stress ulcer prophylaxis were investigated, identifying identical isolates by typing. Furthermore, the growth pattern of normal respiratory bacteria and organisms causing ventilation pneumonia at different pH values and the in vitro effect of sucralfate and bismuth subsalicylate on these bacteria in simulated gastric fluid were studied. The results obtained were as follows: (1) with rising gastric pH bacterial counts in gastric aspirates, especially gram-negatives, increased significantly; (2) in 45 (31.7%) of the patients identical organisms were first isolated in gastric samples and one to two days later in tracheal secretions; (3) ventilation pneumonia was significantly more frequent in patients with high gastric pH; (4) pathogens causing ventilation pneumonia grew well in simulated gastric fluid at higher pH values, unlike normal respiratory organisms; and (5) sucralfate and bismuth subsalicylate showed antibacterial activity against frequent causative organisms of ventilation pneumonia.

  12. Clinical and microbiological characteristics of Klebsiella pneumoniae from community-acquired recurrent urinary tract infections. (United States)

    Lin, W H; Kao, C Y; Yang, D C; Tseng, C C; Wu, A B; Teng, C H; Wang, M C; Wu, J J


    Understanding the pathogenesis of recurrent urinary tract infection (RUTI) and whether it is attributable to reinfection with a new strain or relapse with the primary infecting strain is of considerable importance. Because previous studies regarding community-acquired Klebsiella pneumoniae RUTI are inconclusive, we undertook this study to evaluate the characteristics of the host and the bacterial agent K. pneumoniae in RUTI. A prospective study was designed, using consecutive patients diagnosed with community-acquired K. pneumoniae-related UTI from January 2007 to December 2009. Of the total 468 consecutive episodes, we found 7 patients with RUTI. All the patients with RUTI were elderly (median, 74 years), with diabetes (100 %, 7 out of 7). Clinical K. pneumoniae isolates derived from the same patients with RUTI revealed identical genomic fingerprints, indicating that K. pneumoniae UTI relapsed despite appropriate antibiotic therapy. The antimicrobial resistance, growth curve and biofilm formation of the recurrent isolates did not change. K. pneumoniae strains causing RUTI had more adhesion and invasiveness than the colonization strains (p recurrent strains with the community-acquired UTI strains, the prevalence of diabetes mellitus was significant (100 % vs 53.7 %, p = 0.03) in the RUTI group. Our data suggest that K. pneumoniae strains might be able to persist within the urinary tract despite appropriate antibiotic treatment, and the greater adhesion and invasiveness in the recurrent strains may play an important role in recurrent infections.

  13. Structure and Inhibition of Quorum Sensing Target from Streptococcus pneumoniae

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    Singh,V.; Shi, W.; Almo, S.; Evans, G.; Furneaux, R.; Tyler, P.; Painter, G.; Lenz, D.; Mee, S.; et al.


    Streptococcus pneumoniae 5'-methylthioadenosine/S-adenosylhomocysteine hydrolase (MTAN) catalyzes the hydrolytic deadenylation of its substrates to form adenine and 5-methylthioribose or S-ribosylhomocysteine (SRH). MTAN is not found in mammals but is involved in bacterial quorum sensing. MTAN gene disruption affects the growth and pathogenicity of bacteria, making it a target for antibiotic design. Kinetic isotope effects and computational studies have established a dissociative S{sub N}1 transition state for Escherichia coli MTAN, and transition state analogues resembling the transition state are powerful inhibitors of the enzyme [Singh, V., Lee, J. L., Nunez, S., Howell, P. L., and Schramm, V. L. (2005) Biochemistry 44, 11647-11659]. The sequence of MTAN from S. pneumoniae is 40% identical to that of E. coli MTAN, but S. pneumoniae MTAN exhibits remarkably distinct kinetic and inhibitory properties. 5'-Methylthio-Immucillin-A (MT-ImmA) is a transition state analogue resembling an early S{sub N}1 transition state. It is a weak inhibitor of S. pneumoniae MTAN with a K{sub i} of 1.0 {mu}M. The X-ray structure of S. pneumoniae MTAN with MT-ImmA indicates a dimer with the methylthio group in a flexible hydrophobic pocket. Replacing the methyl group with phenyl (PhT-ImmA), tolyl (p-TolT-ImmA), or ethyl (EtT-ImmA) groups increases the affinity to give K{sub i} values of 335, 60, and 40 nM, respectively. DADMe-Immucillins are geometric and electrostatic mimics of a fully dissociated transition state and bind more tightly than Immucillins. MT-DADMe-Immucillin-A inhibits with a K{sub i} value of 24 nM, and replacing the 5'-methyl group with p-Cl-phenyl (p-Cl-PhT-DADMe-ImmA) gave a K{sub i}* value of 0.36 nM. The inhibitory potential of DADMe-Immucillins relative to the Immucillins supports a fully dissociated transition state structure for S. pneumoniae MTAN. Comparison of active site contacts in the X-ray crystal structures of E. coli and S. pneumoniae

  14. CXCR1/CXCR2 antagonism is effective in pulmonary defense against Klebsiella pneumoniae infection. (United States)

    Wei, Jing; Peng, Jing; Wang, Bing; Qu, Hong; Wang, Shiyi; Faisal, Aziz; Cheng, Jia-Wei; Gordon, John R; Li, Fang


    Klebsiella pneumoniae-associated pathology is largely mediated by neutrophilic inflammation. In this study, we administered Klebsiella pneumoniae to experimental guinea pig groups and the ELR-CXC chemokine antagonist CXCL8(3-72), ceftazidime, and dexamethasone to different groups, respectively. After 24 h, we assessed the animal's pulmonary inflammatory levels, including gross histopathology, airway neutrophilia, lung myeloperoxidase levels, expressions of CXCL8 and TNF, and airway bacterial loads. Compared with ceftazidime and dexamethasone treatments, the administration of the ELR-CXC chemokine antagonist CXCL8(3-72) alone was more effective than other methods, although it did not markedly attenuate the bacterial load. These results suggest new methods for the treatment of Klebsiella pneumoniae pathology.

  15. Total synthesis of a Streptococcus pneumoniae serotype 12F CPS repeating unit hexasaccharide (United States)

    Pereira, Claney L; Govindan, Subramanian


    The Gram-positive bacterium Streptococcus pneumoniae causes severe disease globally. Vaccines that prevent S. pneumoniae infections induce antibodies against epitopes within the bacterial capsular polysaccharide (CPS). A better immunological understanding of the epitopes that protect from bacterial infection requires defined oligosaccharides obtained by total synthesis. The key to the synthesis of the S. pneumoniae serotype 12F CPS hexasaccharide repeating unit that is not contained in currently used glycoconjugate vaccines is the assembly of the trisaccharide β-D-GalpNAc-(1→4)-[α-D-Glcp-(1→3)]-β-D-ManpNAcA, in which the branching points are equipped with orthogonal protecting groups. A linear approach relying on the sequential assembly of monosaccharide building blocks proved superior to a convergent [3 + 3] strategy that was not successful due to steric constraints. The synthetic hexasaccharide is the starting point for further immunological investigations.

  16. A protein-based pneumococcal vaccine protects rhesus macaques from pneumonia after experimental infection with Streptococcus pneumoniae. (United States)

    Denoël, Philippe; Philipp, Mario T; Doyle, Lara; Martin, Dale; Carletti, Georges; Poolman, Jan T


    Infections caused by Streptococcus pneumoniae are a major cause of mortality throughout the world. Protein-based pneumococcal vaccines are envisaged to replace or complement the current polysaccharide-based vaccines. In this context, detoxified pneumolysin (dPly) and pneumococcal histidine triad protein D (PhtD) are two potential candidates for incorporation into pneumococcal vaccines. In this study, the protective efficacy of a PhtD-dPly vaccine was evaluated in a rhesus macaque (Macaca mulatta) model of pneumonia. The animals were immunized twice with 10 μg of PhtD and 10 μg of dPly formulated in the Adjuvant System AS02 or with AS02 alone, before they were challenged with a 19F pneumococcal strain. The survival was significantly higher in the protein-vaccinated group and seemed to be linked to the capacity to greatly reduce bacterial load within the first week post-challenge. Vaccination elicited high concentrations of anti-PhtD and anti-Ply antibodies and a link was found between survival and antibody levels. In conclusion, AS02-adjuvanted PhtD-dPly vaccine protects against S. pneumoniae-induced pneumonia. It is probable that the protection is at least partially mediated by PhtD- and Ply-specific antibodies.

  17. CNS Complications of Mycoplasma Pneumoniae

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Three cases of acute central nervous system disease occurring subsequent to infection with M pneumoniae are reported from University College, Institute of Child Health, and Great Ormond Street Hospital, London, UK.

  18. [Idiopathic interstitial pneumonias in 2016]. (United States)

    Debray, M-P; Borie, R; Danel, C; Khalil, A; Majlath, M; Crestani, B


    Idiopathic interstitial pneumonias comprise 8 clinicopathological entities, most of them with a chronic course and various prognosis. Idiopathic pulmonary fibrosis is the most frequent and most severe of these. Computed tomography has an important role for its diagnosis. It can identify the corresponding pathological pattern of usual interstitial pneumonia in about 50 percent of cases. It can suggest differential diagnosis in other cases, most frequently fibrosing nonspecific interstitial pneumonia and chronic hypersensitivity pneumonitis. Imaging features should be integrated to clinical and available pathologic data during multidisciplinary team meetings involving physicians with a good knowledge of interstitial diseases. Some cases may be unclassifiable, but these could later be reclassified as new data may occur or imaging features may change. Surgical lung biopsy is being less frequently performed and an emerging less invasive technique, lung cryobiopsy, is under evaluation. Pleuroparenchymal fibroelastosis is a distinct entity only recently described, with uncertain prevalence and prognosis that seems being quite often associated to another pattern of interstitial pneumonia.

  19. Temporary increase of invasive infection due to Streptococcus pneumoniae in the Netherlands.

    NARCIS (Netherlands)

    Neeling, A.J. de; Pelt, W. van; Hol, C.; Ligtvoet, E.E.J.; Sabbe, L.J.M.; Bartelds, A.; Embden, J.D.A. van


    In 1996 and 1997, the Netherlands Reference Laboratory for Bacterial Meningitis (Amsterdam) noted an increase in Streptococcus pneumoniae isolates from blood but not from CSF. To find an explanation for this increase, we determined the incidence of invasive pneumococcal disease detected in the perio

  20. Dissecting the energy metabolism in Mycoplasma pneumoniae through genome-scale metabolic modeling

    NARCIS (Netherlands)

    Wodke, J.A.; Puchalka, J.; Lluch-Senar, M.; Marcos, J.; Yus, E.; Godinho, M.; Gutierrez-Gallego, R.; Martins Dos Santos, V.A.P.; Serrano, L.; Klipp, E.; Maier, T.


    Mycoplasma pneumoniae, a threatening pathogen with a minimal genome, is a model organism for bacterial systems biology for which substantial experimental information is available. With the goal of understanding the complex interactions underlying its metabolism, we analyzed and characterized the met

  1. Aetiology and resistance patterns of community-acquired pneumonia in León, Nicaragua

    NARCIS (Netherlands)

    Matute, A J; Brouwer, W P; Hak, E; Delgado, E; Alonso, E; Hoepelman, I M


    We conducted a prevalence study to gain greater insight into the aetiology, bacterial resistance and risk factors for community-acquired pneumonia (CAP) in the region of León, Nicaragua. During the period from July 2002 to January 2005, all consecutive patients with signs and symptoms suggestive of

  2. Identification and Characterization of Imipenem-Resistant Klebsiella pneumoniae and Susceptible Klebsiella variicola Isolates Obtained from the Same Patient. (United States)

    Garza-Ramos, Ulises; Moreno-Dominguez, Stephania; Hernández-Castro, Rigoberto; Silva-Sanchez, Jesús; Barrios, Humberto; Reyna-Flores, Fernando; Sanchez-Perez, Alejandro; Carrillo-Casas, Erika M; Sanchez-León, María Carmen; Moncada-Barron, David


    Klebsiella variicola, a bacterium closely genetically related to Klebsiella pneumoniae, is commonly misidentified as K. pneumoniae by biochemical tests. To distinguish between the two bacteria, phylogenetic analysis of the rpoB gene and the identification of unique genes in both bacterial species by multiplex-polymerase chain reaction (PCR) provide the means to reliably identify and genotype K. variicola. In recent years, K. variicola has been described both as the cause of an intrahospital outbreak in a pediatric hospital, which resulted in sepsis in inpatients, and as a frequent cause of bloodstream infections. In the present study, K. pneumoniae and K. variicola were isolated from a unique patient displaying different antimicrobial susceptibility phenotypes and different genotypes of virulence determinants. Eight clinical isolates were obtained at different time intervals; all during a 5-month period. The isolates were identified as K. pneumoniae by an automated identification system. The clinical (biochemical test) and molecular (multiplex-PCR and rpoB gene) characterization identified imipenem resistance in the first six K. pneumoniae ST258 isolates, which encode the SHV-12 cephalosporinase and KPC-3 carbapenemase genes. The two last remaining isolates corresponded to susceptible K. variicola. The bacterial species showed a specific profile of virulence-associated determinants, specifically the fimA, fimH, and ecpRAB fimbrial-encoding genes identified only in K. pneumoniae isolates. However, the entb (enterobactin), mrkD (fimbrial adhesin), uge (epimerase), ureA (urease), and wabG (transferase) genes were shared between both bacterial species. Recent studies attribute a higher mortality rate to K. variicola than to K. pneumonia. This work highlights the identification of K. pneumoniae and the closely related K. variicola isolated from the same patient. The value of distinguishing between these two bacterial species is in their clinical significance, their

  3. Clinical behavior of Streptococcus pneumoniae meningoencephalitis Comportamiento clinico y terapéutico de la meningoencefalitis por Streptococcus pneumoniae

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    Raisa Bu-Coifiu Fanego


    Full Text Available OBJECTIVE: There was an increased number of cases of meningoencephalitis caused by Streptococcus pneumoniae, after the successful vaccination campaigns against Neisseria meningitidis and Haemophilus influenzae. This paper aims at describing the clinical characteristics, the laboratory findings, the complications, and the therapeutic management of these patients, who have been suffering from this disease since 1993 to 2006. METHOD: Twelve children with Streptococcus pneumoniae meningoencephalitis admitted to the pediatric hospital of San Miguel del Padron, City of Havana in this period were assessed. RESULTS: Children under one year are the most frequently affected. Septic shock and brain edema were the most severe complications. Three patients died, implying that this disease has a serious course. Early treatment of brain edema is very important to reduce mortality. The elective drugs for treatment of these cases of Streptococcus pneumoniae meningoencephalitis were vancomycin combined with cephalosporin, cefotaxime or ceftriaxone type. CONCLUSION: Patients with Streptococcus pneumoniae meningoencephalitis show clinical characteristics, complications, and sequels that are different to other bacterial meningoencephalitis, meaning that they could be helpful for physicians considering the differential diagnosis of meningoencephalitis.OBJETIVO: Existe un incremento de la meningoencefalitis producida por Streptococcus pneumoniae, después de las campañas exitosas de vacunación contra Neisseria meningitidis y Haemophilus influenzae. El objetivo de este trabajo es describir las caracteristicas clinicas, los hallazgos de laboratorio, las complicaciones y el manejo terapéutico de los pacientes que sufrieron esta enfermedad desde 1993 a 2006. MÉTODO: Se estudiaron doce niños con meningoencefalitis por Streptococcus pneumoniae ingresados en el Hospital Pediátrico de San Miguel del Padrón, Ciudad de La Habana en este periodo. RESULTADOS: Los ni

  4. The roentgenological study of measles pneumonia

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    Shin, U.; Song, C. H.; Lee, H. Y.; Chung, H. K.; Joo, K. B. [Han Gang Sacred Heart Hospital, Hallym College, Seoul (Korea, Republic of)


    Measles is important infectious disease of pediatrics and pneumonia is the most commonest complication of measles. We have experienced 20 cases of pneumonia among 31 cases of measles in infant nursing home of Chae Chun during of December. 1981. The results a are as follows; 1. The incidence of measles pneumonia is 64.5%. 2. The patterns of pneumonic infiltration is : The pneumonia may have a bronchopneumonia (60%), Lobar pneumonia (15%), or combined form (35%). 3. Both lungs are involved by measles pneumonia: Right lung only (30%), Left lung only (5%), or Bilateral (65%). 4. Hilar lymphadenopathy (51.6%). Hilar lymphadenopathy with pneumonia (82.2%) and hilar lymphadenopathy without pneumonia (17.8%). 5. There is no pulmonary nodule which is noted frequently in atypical measles pneumonia as a seguale.

  5. Cavity Forming Pneumonia Due to Staphylococcus aureus Following Dengue Fever. (United States)

    Miyata, Nobuyuki; Yoshimura, Yukihiro; Tachikawa, Natsuo; Amano, Yuichiro; Sakamoto, Yohei; Kosuge, Youko


    While visiting Malaysia, a 22-year-old previously healthy Japanese man developed myalgia, headache, and fever, leading to a diagnosis of classical dengue fever. After improvement and returning to Japan after a five day hospitalization, he developed productive cough several days after defervescing from dengue. Computed tomography (CT) thorax scan showed multiple lung cavities. A sputum smear revealed leukocytes with phagocytized gram-positive cocci in clusters, and grew an isolate Staphylococcus aureus sensitive to semi-synthetic penicillin; he was treated successfully with ceftriaxone and cephalexin. This second reported case of pneumonia due to S. aureus occurring after dengue fever, was associated both with nosocomial exposure and might have been associated with dengue-associated immunosuppression. Clinicians should pay systematic attention to bacterial pneumonia following dengue fever to establish whether such a connection is causally associated.

  6. Microbial Etiology of Community-Acquired Pneumonia Among Infants and Children Admitted to the Pediatric Hospital, Ain Shams University (United States)

    El Seify, Magda Yehia; Fouda, Eman Mahmoud; Ibrahim, Hanan Mohamed; Fathy, Maha Muhammad; Husseiny Ahmed, Asmaa Al; Khater, Walaa Shawky; El Deen, Noha Nagi Mohammed Salah; Abouzeid, Heba Galal Mohamed; Hegazy, Nancy Riyad Ahmed; Elbanna, Heba Salah Sayed


    Background While recognizing the etiology of community-acquired pneumonia is necessary for formulating local antimicrobial guidelines, limited data is published about this etiology in Egyptian pediatric patients. Objectives To determine the frequency of bacterial and viral pathogens causing community-acquired pneumonia (CAP) among immunocompetent Egyptian infants and preschool children. Methods Ninety infants and preschool-age children admitted to our hospital with CAP were prospectively included in the study. Etiological agents were identified using conventional bacteriological identification methods and IgM antibodies detection against common atypical respiratory bacteria and viruses. Results An etiology was identified in 59 patients (65.5%). Bacterial pathogens were detected in 43 (47.8%) of the cases while viral pathogens were detected in 23 (25.5%). Coinfection with more than one etiologic agent was evident in seven patients (7.8%). The most common typical bacterial cause of pneumonia was Staphylococcus aureus (n = 12, 13.3%), followed by Streptococcus pneumoniae and Klebsiella pneumoniae (n = 7, 7.8%, each). The commonest atypical bacterium was Mycoplasma pneumoniae (n = 10, 11.1%), whereas the commonest viral etiology was influenza viruses (n = 11, 12.2%). Conclusion Although we could not determine the causative agent in some studied cases, this study provides preliminary data regarding the spectrum and frequency of microorganisms causing CAP in Egyptian infants and preschool children.

  7. Effects of Chinese herbal medicine Dusuqing Granule on toll-like receptor 4 signaling in multiple organ injury induced by bacterial pneumonia in aged rats%毒素清对多器官损伤细菌性肺炎老龄大鼠Toll样受体4信号转导的影响

    Institute of Scientific and Technical Information of China (English)

    王守富; 张慧俭; 李建生; 秦金利; 李素云; 余海滨; 王峰; 李亚; 刘四化


    目的:从脏器组织Toll样受体4(toll-like receptor 4,TLR4)信号转导相关分子表达变化方面揭示毒素清颗粒对老年细菌性肺炎大鼠多器官损伤的保护作用机制.方法:将55只老龄大鼠随机分为对照组、模型组、毒素清组和洛美沙星组,模型组25只,其余3组均为10只.气管插管,注入肺炎克雷伯杆菌,由肺炎导致多器官损伤;采用免疫组织化学法、逆转录聚合酶链反应法检测肺、心、小肠组织TLR4信号转导通路主要相关分子表达变化.结果:与对照组比较,模型组肺、心、小肠组织内毒素结合蛋白(lipopolysaccharide-binding protein,LBP)、CD14、TLR4、白细胞介素1受体相关激酶1(interleukin-1 receptor-associated kinase-1,IRAK-1)mRNA和TLR4、肿瘤坏死因子受体相关因子6(tumor necrosis factor receptor-associated factor 6,TRAF6)、核因子κB(nuclear factor-κB,NF-κB)蛋白表达明显增强(P<0.01,P<0.05).与模型组比较,毒素清组肺、心、小肠组织LBP、CD14、TLR mRNA表达和TLR4、TRAF6、NF-κB蛋白表达显著减弱(P<0.01,P<0.05).结论:毒素清可能通过降低TLR4信号转导活性,进而减少细胞因子分泌以减轻脏器组织损伤.毒素清可降低Toll样受体信号转导途径多种分子LBP、CD14、TLR4、IRAK-1、TRAF6和NF-κB活性,这与单一一种抑制剂仅作用于某个环节不同.%To study the protective mechanism of Dusuqing Granule, a compound Chinese herbal medicine, on the senile multiple organ injury caused by bacterial pneumonia by observing the expression changes of molecules related to toll-like receptor 4 (TLR4) signaling. Methods: A total of 55 male Sprague-Dawley aged rats were divided into control group, untreated group, Dusuqing group and Iomefloxacin group. There were 25 rats in the untreated group and 10 rats in each of the other three groups. Multiple organ injury in a rat model of pneumonia was induced by injection of Klebsiella pneumoniae through tracheal

  8. Clinical Practice Guidelines for Bacterial Meningoencephalitis.

    Directory of Open Access Journals (Sweden)

    Belkys Rodríguez Llerena


    Full Text Available Clinical Practice Guidelines for Bacterial Meningoencephalitis. It has been defined as an acute inflammatory process caused by bacteria, often purulent, which involves the meninges, subarachnoid space around the brain, spinal cord and usually includes the ventricles. It is caused in the 80% of the patients by three bacteria: Haemophilus influenzae, Neisseria meningitides and Streptococcus pneumonia. Concepts, classification, diagnosis and treatment were reviewed. It includes assessment guidelines focused on the most important aspects to be accomplished.

  9. [Interstitial Pneumonia and Emphysema]. (United States)

    Sawa, Teiji; Kato, Yuko; Ishii, Sachiyo


    Interstitial pneumonia (IP) and chronic obstructive pulmonary disease (COPD) are representative diseases of restrictive pulmonary dysfunction and obstructive pulmonary dysfunction, respectively. In the preoperative anesthesia clinic, anesthesiologists are frequently asked to assess the anesthesia management of patients with these diseases. In respiratory function tests, IP is detected as a decrease in % vital capacity (< 80%), and COPD as a decrease in % FEV1.0 (< 70%). Other key factors which affect the assessment are; 1) severity assessment that affects the safety of anesthesia management, 2) prognostic evaluation including the acute exacerbation in the postoperative period, and 3) patient-related factors (age, life degree of autonomy, other comorbidities, surgery-related factors, and anesthesia method). In the patients in the disease stage I or II, anesthesia management is relatively safe. On the other hand, the patients in the disease stage IV have no surgical indication except life-saving emergent situation. In another words, anesthesiologists are required to make the judgment for the anesthesia management of the patient in the disease stage III, based on the assessment of patient-related factors, surgery-related factors, and prognosis.

  10. Dietary supplementation with omega-3 polyunsaturated fatty acids ameliorates acute pneumonia induced by Klebsiella pneumoniae in BALB/c mice. (United States)

    Sharma, Sonica; Chhibber, Sanjay; Mohan, Harsh; Sharma, Saroj


    The immune benefits associated with the optimal intake of dietary fatty acids are widely known. The objective of the present investigation was to elucidate the role of omega-3 polyunsaturated fatty acids (n-3 PUFA) food source on acute pneumonia induced by Klebsiella pneumoniae. Three different n-3 PUFA preparations (cod liver oil, Maxigard, and flaxseed oil) were orally supplemented and infection was induced in different groups of experimental mice. Mice fed olive oil and normal saline served as oil and saline controls, respectively. After 2 weeks of fatty acid feeding, no effect on the establishment of infection was observed when acute pneumonia was induced in animals. On the other hand, 6 weeks of n-3 PUFA administration was found to improve resistance in mice, as reduced lung bacterial load coupled with significant improvement in pathology was seen in infected mice. Alveolar macrophages collected from all 3 groups of mice fed n-3 PUFA exhibited a significant decrease in the level of apoptosis following infection with K. pneumoniae and an enhanced in vitro phagocytic potential for the pathogen. Lower lung levels of nitric oxide, malondialdehyde, and lactate dehydrogenase were associated with a decrease in the severity of tissue damage. There was a significant increase in the lung levels of pro-inflammatory cytokines (tumor necrosis factor alpha (TNF-α) and interleukin-1 beta (IL-1β)). No significant change was observed in the levels of interleukin-10 (IL-10). This study highlights that dietary n-3 PUFA supplementation exerts an overall beneficial effect against acute experimental pneumonia. This mechanism is operative through upregulation of nonspecific and specific immune defenses of the host.

  11. [Fatal pneumonia caused by carbapenem resistant Klebsiella pneumoniae]. (United States)

    van Apeldoorn, Marjan; Lettinga, Kamilla; Bernards, Alexandra; Paltansing, Sunita; alNaiemi, Nashwan; Kalpoe, Jayant


    A 63-year-old Dutch man became colonized with a carbapenem resistant Klebsiella pneumoniae during a period of hospitalization in India. His recovery in the Netherlands was complicated by pneumonia due to this difficult-to-control multiresistant bacteria to which he eventually succumbed. Carbapenem resistance in Enterobacteriaceae, such as K. pneumoniae, is usually caused by carbapenemase (a betalactamase) production. Carbapenemase producing Enterobacteriaceae (CPE) are spreading throughout the world and cause difficult-to-treat infections that are associated with high mortality. This case report illustrates the clinical challenges associated with infection with these multiresistant Enterobacteriaceae. In the Netherlands, there are no guidelines for detection of CPE and carbapenemase production can frequently go undetected in clinical microbiology laboratories. As a consequence, adequate treatment of CPE infections and infection control measures to prevent the spread of CPE can be delayed. Expeditious development and implementation of existing Dutch draft guidelines for detection methods of CPE is therefore warranted.

  12. The clinical characteristics,treatment and outcome of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the drug resistance of My-coplasma pneumoniae among children with community-acquired pneumonia (CAP) ,and to explore the clinical and radiological characteristics of and the role of azithromycin in the treatment of of macrolide-resistant (MR) Mycoplasma pneumoniae pneumonia.Methods Cases of CAP in children (n=179) were prospectively enrolled in

  13. Heterogeneity of lung mononuclear phagocytes during pneumonia: contribution of chemokine receptors. (United States)

    Chen, Lanlin; Zhang, Zhimin; Barletta, Kathryn E; Burdick, Marie D; Mehrad, Borna


    Bacterial pneumonia is a common and dangerous illness. Mononuclear phagocytes, which comprise monocyte, resident and recruited macrophage, and dendritic cell subsets, are critical to antimicrobial defenses, but the dynamics of their recruitment to the lungs in pneumonia is not established. We hypothesized that chemokine-mediated traffic of mononuclear phagocytes is important in defense against bacterial pneumonia. In a mouse model of Klebsiella pneumonia, circulating Ly6C(hi) and, to a lesser extent, Ly6C(lo) monocytes expanded in parallel with accumulation of inflammatory macrophages and CD11b(hi) dendritic cells and plasmacytoid dendritic cells in the lungs, whereas numbers of alveolar macrophages remained constant. CCR2 was expressed by Ly6C(hi) monocytes, recruited macrophages, and airway dendritic cells; CCR6 was prominently expressed by airway dendritic cells; and CX3CR1 was ubiquitously expressed by blood monocytes and lung CD11b(hi) dendritic cells during infection. CCR2-deficient, but not CCL2-, CX3CR1-, or CCR6-deficient animals exhibited worse outcomes of infection. The absence of CCR2 had no detectable effect on neutrophils but resulted in reduction of all subsets of lung mononuclear phagocytes in the lungs, including alveolar macrophages and airway and plasmacytoid dendritic cells. In addition, absence of CCR2 skewed the phenotype of lung mononuclear phagocytes, abrogating the appearance of M1 macrophages and TNF-producing dendritic cells in the lungs. Taken together, these data define the dynamics of mononuclear phagocytes during pneumonia.

  14. Therapeutic effect of the YH6 phage in a murine hemorrhagic pneumonia model. (United States)

    Yang, Mei; Du, Chongtao; Gong, Pengjuan; Xia, Feifei; Sun, Changjiang; Feng, Xin; Lei, Liancheng; Song, Jun; Zhang, Lei; Wang, Bin; Xiao, Feng; Yan, Xinwu; Cui, Ziyin; Li, Xinwei; Gu, Jingmin; Han, Wenyu


    The treatment, in farmed mink, of hemorrhagic pneumonia caused by multidrug-resistant Pseudomonas aeruginosa strains has become increasingly difficult. This study investigated the potential use of phages as a therapy against hemorrhagic pneumonia caused by P. aeruginosa in a murine hemorrhagic pneumonia model. An N4-like phage designated YH6 was isolated using P. aeruginosa strain D9. YH6 is a virulent phage with efficient and broad host lytic activity against P. aeruginosa. No bacterial virulence- or lysogenesis-related ORF is present in the YH6 genome, making it eligible for use in phage therapy. In our murine experiments, a single intranasal administration of YH6 (2 × 10(7) PFU) 2 h after D9 intranasal injections at double minimum lethal dose was sufficient to protect mice against hemorrhagic pneumonia. The bacterial load in the lungs of YH6-protected mice was less than 10(3) CFU/g within 24 h after challenge and ultimately became undetectable, whereas the amount of bacteria in the lung tissue derived from unprotected mice was more than 10(8) CFU/g within 24 h after challenge. In view of its protective efficacy in this murine hemorrhagic pneumonia model, YH6 may serve as an alternative treatment strategy for infections caused by multidrug-resistant P. aeruginosa.

  15. Development of a new trend conjugate vaccine for the prevention of Klebsiella pneumoniae

    Directory of Open Access Journals (Sweden)

    Tarek A. Ahmad


    Full Text Available Klebsiella pneumoniae is a major cause of nosocomial pneumonia, septicemia and urinary tract infections, especially in newborns, blood cancer patients, and other immunocompromised candidates. The control of K. pneumoniae is a complicated issue due to its tight pathogenesis. Immuno-prophylactic preparations, especially those directed toward the bacterium O-antigen, showed to be the most successful way to prevent the infection incidence. However, all previously proposed preparations were either of limited spectrum or non-maternal, and hence not targeting the main Klebsiella patients. Moreover, all preparations were directed only to prevent the respiratory diseases due to that pathogen. This article addresses the development of a method originally used to purify the non-capsular bacterial- endotoxins, as a new and easy method for vaccine production against K. pneumoniae. The application of this method was preceded by a biotechnological control of capsular polysaccharide production in K. pneumoniae. The new produced natural conjugate between the bacterial O-antigen and its outer membrane proteins was evaluated by physicochemical and immunological methods to investigate its purity, integrity, safety and immunogenicity. It showed to be pure, stable, safe for use, and able to elicit a protective immunoglobulin titer against different Klebsiella infections. This immune-response proved to be transferable to the offspring of the vaccinated experimental rabbits via placenta.

  16. Pneumonia Can Be Prevented -- Vaccines Can Help (United States)

    ... What's this? Submit Button Past Emails CDC Features Pneumonia Can Be Prevented—Vaccines Can Help Language: English ... treatment (like antibiotics and antivirals). Save the Date: Pneumonia Twitter Chat on November 15 CDC experts will ...

  17. Heteroresistance to penicillin in Streptococcus pneumoniae. (United States)

    Morand, Brigitte; Mühlemann, Kathrin


    Heteroresistance to beta-lactam antibiotics has been mainly described for staphylococci, for which it complicates diagnostic procedures and therapeutic success. This study investigated whether heteroresistance to penicillin exists in Streptococcus pneumoniae. Population analysis profile (PAP) showed the presence of subpopulations with higher penicillin resistance in four of nine clinical pneumococcal strains obtained from a local surveillance program (representing the multiresistant clones ST179, ST276, and ST344) and in seven of 16 reference strains (representing the international clones Spain(23F)-1, Spain(9V)-3, Spain(14)-5, Hungary(19A)-6, South Africa(19A)-13, Taiwan(23F)-15, and Finland(6B)-12). Heteroresistant strains had penicillin minimal inhibitory concentrations (MICs) (for the majority of cells) in the intermediate- to high-level range (0.19-2.0 mug/ml). PAP curves suggested the presence of subpopulations also for the highly penicillin-resistant strains Taiwan(19F)-14, Poland(23F)-16, CSR(19A)-11, and CSR(14)-10. PAP of bacterial subpopulations with higher penicillin resistance showed a shift toward higher penicillin-resistance levels, which reverted upon multiple passages on antibiotic-free media. Convergence to a homotypic resistance phenotype did not occur. Comparison of two strains of clone ST179 showed a correlation between the heteroresistant phenotype and a higher-penicillin MIC and a greater number of altered penicillin-binding proteins (PBP1a, -2b, and -2x), respectively. Therefore, heteroresistance to penicillin occurs in international multiresistant clones of S. pneumoniae. Pneumococci may use heteroresistance to penicillin as a tool during their evolution to high penicillin resistance, because it gives the bacteria an opportunity to explore growth in the presence of antibiotics before acquisition of resistance genes.

  18. Outbreak of Pneumonia in the Setting of Fatal Pneumococcal Meningitis among US Army Trainees: Potential Role of Chlamydia pneumoniae Infection (United States)


    physical stress may contribute to an increased risk for infections with Streptococcus pneumoniae , Streptococcus pyogenes, Mycoplasma pneumoniae ...Chlamydia pneumoniae , Mycoplasma pneumoniae , Streptococcus pneumoniae , Bordetella pertussis, and Legionella pneumophila[10] in addition to undergoing...postexposure chemoprophylaxis. Mil Med 2003;168:1-6 7. Balicer RD, Zarka S, Levine H, et al. Control of Streptococcus pneumoniae serotype 5 epidemic of

  19. PEGylated liposomal vancomycin: a glimmer of hope for improving treatment outcomes in MRSA pneumonia. (United States)

    Pumerantz, Andrew S


    Methicillin-resistant Staphylococcus aureus (MRSA) plays a significant role in the pandemic of multidrug resistant bacterial infections and is a major cause of hospital-acquired pneumonia. MRSA pneumonia carries a high morbidity and mortality rate especially in elderly diabetics with chronic kidney disease. S. aureus is highly virulent and successful respiratory pathogen. Vancomycin and linezolid are the only two antimicrobial agents FDA-approved to treat MRSA pneumonia. Standard vancomycin dosing is associated with high clinical failure rates and higher dosages are associated with increased nephrotoxicity. Pharmacokinetic and pharmacodynamic limitations are major contributors to poor outcomes with vancomycin. New agents are needed to improve treatment outcomes with MRSA pneumonia. Recently released antimicrobials with in vitro activity are not FDA-approved for treating MRSA pneumonia. Other novel agents are being investigated though none are in late-stage development. Pharmaceutical industry perception of low returns on investment, a Sisyphean regulatory environment, and obstacles to patentability have contributed to declining interest in both the development of novel antibiotics and the improvement of existing generic formulations. Despite decades of investigation into liposomal encapsulation as a drug delivery system that would increase efficacy and decrease toxicity, only liposomal amphotericin B and doxorubicin are commercially available. In this article, the pharmacokinetics and biodistribution of a novel PEGylated liposomal vancomycin formulation along with passive targeting and the enhanced permeability and retention effect of liposomal drug delivery; the pathogenesis of MRSA pneumonia; and recent patents of novel anti-MRSA agents, including inhalational liposomal vancomycin, are reviewed.

  20. Inhibition of Phosphodiesterase-4 during Pneumococcal Pneumonia Reduces Inflammation and Lung Injury in Mice. (United States)

    Tavares, Luciana P; Garcia, Cristiana C; Vago, Juliana P; Queiroz-Junior, Celso M; Galvão, Izabela; David, Bruna A; Rachid, Milene A; Silva, Patrícia M R; Russo, Remo C; Teixeira, Mauro M; Sousa, Lirlândia P


    Pneumococcal pneumonia is a leading cause of mortality worldwide. The inflammatory response to bacteria is necessary to control infection, but it may also contribute to tissue damage. Phosphodiesterase-4 inhibitors, such as rolipram (ROL), effectively reduce inflammation. Here, we examined the impact of ROL in a pneumococcal pneumonia murine model. Mice were infected intranasally with 10(5)-10(6) CFU of Streptococcus pneumoniae, treated with ROL in a prophylactic or therapeutic schedule in combination, or not, with the antibiotic ceftriaxone. Inflammation and bacteria counts were assessed, and ex vivo phagocytosis assays were performed. ROL treatment during S. pneumoniae infection decreased neutrophil recruitment into lungs and airways and reduced lung injury. Prophylactic ROL treatment also decreased cytokine levels in the airways. Although modulation of inflammation by ROL ameliorated pneumonia, bacteria burden was not reduced. On the other hand, antibiotic therapy reduced bacteria without reducing neutrophil infiltration, cytokine level, or lung injury. Combined ROL and ceftriaxone treatment decreased lethality rates and was more efficient in reducing inflammation, by increasing proresolving protein annexin A1 (AnxA1) expression, and bacterial burden by enhancing phagocytosis. Lack of AnxA1 increased inflammation and lethality induced by pneumococcal infection. These data show that immunomodulatory effects of phosphodiesterase-4 inhibitors are useful during severe pneumococcal pneumonia and suggest their potential benefit as adjunctive therapy during infectious diseases.

  1. Ethanol-induced alcohol dehydrogenase E (AdhE) potentiates pneumolysin in Streptococcus pneumoniae. (United States)

    Luong, Truc Thanh; Kim, Eun-Hye; Bak, Jong Phil; Nguyen, Cuong Thach; Choi, Sangdun; Briles, David E; Pyo, Suhkneung; Rhee, Dong-Kwon


    Alcohol impairs the host immune system, rendering the host more vulnerable to infection. Therefore, alcoholics are at increased risk of acquiring serious bacterial infections caused by Streptococcus pneumoniae, including pneumonia. Nevertheless, how alcohol affects pneumococcal virulence remains unclear. Here, we showed that the S. pneumoniae type 2 D39 strain is ethanol tolerant and that alcohol upregulates alcohol dehydrogenase E (AdhE) and potentiates pneumolysin (Ply). Hemolytic activity, colonization, and virulence of S. pneumoniae, as well as host cell myeloperoxidase activity, proinflammatory cytokine secretion, and inflammation, were significantly attenuated in adhE mutant bacteria (ΔadhE strain) compared to D39 wild-type bacteria. Therefore, AdhE might act as a pneumococcal virulence factor. Moreover, in the presence of ethanol, S. pneumoniae AdhE produced acetaldehyde and NADH, which subsequently led Rex (redox-sensing transcriptional repressor) to dissociate from the adhE promoter. An increase in AdhE level under the ethanol condition conferred an increase in Ply and H2O2 levels. Consistently, S. pneumoniae D39 caused higher cytotoxicity to RAW 264.7 cells than the ΔadhE strain under the ethanol stress condition, and ethanol-fed mice (alcoholic mice) were more susceptible to infection with the D39 wild-type bacteria than with the ΔadhE strain. Taken together, these data indicate that AdhE increases Ply under the ethanol stress condition, thus potentiating pneumococcal virulence.

  2. Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil

    Directory of Open Access Journals (Sweden)

    Thiago Pavoni Gomes Chagas


    Full Text Available OBJECTIVE: The present study was undertaken to characterize CTX-M ESBL-producing Klebsiella pneumoniae collected from hospitals in different cities of Brazil. MATERIAL AND METHODS: Eighty-five K. pneumoniae strains isolated from hospitalized patients in six different hospitals of three cities of Brazil were analyzed. ESBL production was confirmed by the standard double-disk synergy test and the Etest®. The MIC50 and MIC90 for ESBL-producing isolates were determined by the Etest® method. The antimicrobial susceptibilities of bacterial isolates were determined using the agar diffusion method according to the CLSI. Screening for blaTEM, blaSHV, blaCTX-M genes and class 1 integron was performed by PCR amplification. To determine the genomic diversity of CTX-M-producers, isolates were analyzed by macrorestriction profile analysis following PFGE. RESULTS AND DISCUSSION: Seventy-one K. pneumoniae isolates were ESBL-producing. PCR and sequencing experiments detected 38 CTX-M-producing K. pneumoniae belonged to groups CTX-M 1, CTX-M 2, CTX-M 8 and CTX-M 9. The association of different types ESBL (CTX-M, SHV and TEM was frequent. All K. pneumoniae isolates carried class 1 integron. PFGE analysis revealed thirty-one clonal types among CTX-M-producing isolates. The data presented herein illustrate the diversity of genotypes of CTX-M producing K. pneumoniae among Brazilians hospitals.

  3. The Lignan-containing Extract of Schisandra chinensis Berries Inhibits the Growth of Chlamydia pneumonia. (United States)

    Hakala, Elina; Hanski, Leena L; Yrjönen, Teijo; Vuorela, Heikki J; Vuorela, Pia M


    The purpose of this study was to investigate the effect and selectivity of an extract of Schisandra chinensis berries against Chlamydia pneumoniae and C. trachomatis. Among the ethnopharmacological uses of the extract from Schisandrae fructus are cough and pneumonia. Therefore we focused on respiratory pathogens. The extract completely inhibited the growth of C. pneumoniae strain CV6 at 250 μg/mL concentration. The inhibition of C. pneumoniae and C. trachomatis growth was dose dependent and established with three different strains. The extract inhibited C. pneumoniae production of infectious progeny in a dose dependent manner. Chlamydia selectivity was elucidated with growth inhibition measurements of three other respiratory bacterial species. A pure compound found in Schisandra chinensis berries, schisandrin B at 20.0 μg/mL concentration inhibited the growth of both C. pneumoniae and C. trachomatis. The extract was found to be non-toxic to the human host cells. These findings highlight the potential of the extract from Schisandra chinensis berries as a source for antichlamydial compounds.

  4. Childhood pneumonia and vitamin A

    Directory of Open Access Journals (Sweden)

    Farhad Heidarian


    Full Text Available One of the major causes of mortality in children younger than 5 years old is acute lower respiratory tract infections (ALRI. ALRI clinical features are cough, tachypnea, fever, coryza, chest retraction, crackles and wheeze. Increased white blood cell count with left shift might happen in pneumonia. C-reactive protein (CRP and erythrocyte sedimentation rate (ESR might rise in children with respiratory tract infections. Vitamin A deficiency is associated with severe childhood infections. The effect of vitamin A supplementation in childhood pneumonia depends on the prevalence and the level of vitamin A deficiency in the population. Some studies confirmed that retinol levels were significantly higher after recovery from acute pneumonia compared to acute phase. But there were no significant association between serum retinol level and the clinical manifestation.

  5. Nursing home-acquired pneumonia. (United States)

    El Solh, Ali A


    Nursing home-acquired pneumonia (NHAP) was first described in 1978. Since then there has been much written regarding NHAP and its management despite the lack of well-designed studies in this patient population. The most characteristic features of patients with NHAP are the atypical presentation, which may lead to delay in diagnosis and therapy. The microbial etiology of pneumonia encompasses a wide spectrum that spans microbes recovered from patients with community-acquired pneumonia to organisms considered specific only to nosocomial settings. Decision to transfer a nursing home patient to an acute care facility depends on a host of factors, which include the level of staffing available at the nursing home, patients' advance directives, and complexity of treatment. The presence of risk factors for multidrug-resistant pathogens dictates approach to therapy. Prevention remains the cornerstone of reducing the incidence of disease. Despite the advance in medical services, mortality from NHAP remains high.

  6. Bacterial gastroenteritis (United States)

    Bacterial gastroenteritis is present when bacteria cause an infection of the stomach and intestines ... has not been treated Many different types of bacteria can cause ... Campylobacter jejuni E coli Salmonella Shigella Staphylococcus ...

  7. Viruses and bacteria in sputum samples of children with community-acquired pneumonia. (United States)

    Honkinen, M; Lahti, E; Österback, R; Ruuskanen, O; Waris, M


    Few comprehensive studies have searched for viruses and bacteria in children with community-acquired pneumonia (CAP). We identified 76 children hospitalized for pneumonia. Induced sputum samples were analysed for 18 viruses by antigen detection and PCR, and for six bacteria by culture and PCR. Viruses were found in 72% of samples, bacteria in 91%, and both in 66%. Rhinovirus (30%), human bocavirus (18%) and human metapneumovirus (14%) were the most commonly detected viruses. Two viruses were found in 22% of samples and three in 8%. The most common bacteria found were Streptococcus pneumoniae (50%), Haemophilus influenzae (38%), and Moraxella catarrhalis (28%). Rhinovirus-S. pneumoniae was the most commonly found combination of virus and bacterium (16%). All six children with treatment failure had both viruses and bacteria detected in the sputum. Otherwise, we found no special clinical characteristics in those with mixed viral-bacterial detections. With modern molecular diagnostic techniques, there are high rates of both viral and bacterial identification in childhood CAP. The clinical significance of mixed viral-bacterial infections remains unclear, although we found a potential association between them and treatment failure.

  8. Linezolid has unique immunomodulatory effects in post-influenza community acquired MRSA pneumonia.

    Directory of Open Access Journals (Sweden)

    Urvashi Bhan

    Full Text Available Post influenza pneumonia is a leading cause of mortality and morbidity, with mortality rates approaching 60% when bacterial infections are secondary to multi-drug resistant (MDR pathogens. Staphylococcus aureus, in particular community acquired MRSA (cMRSA, has emerged as a leading cause of post influenza pneumonia.Linezolid (LZD prevents acute lung injury in murine model of post influenza bacterial pneumonia.Mice were infected with HINI strain of influenza and then challenged with cMRSA at day 7, treated with antibiotics (LZD or Vanco or vehicle 6 hours post bacterial challenge and lungs and bronchoalveolar lavage fluid (BAL harvested at 24 hours for bacterial clearance, inflammatory cell influx, cytokine/chemokine analysis and assessment of lung injury.Mice treated with LZD or Vanco had lower bacterial burden in the lung and no systemic dissemination, as compared to the control (no antibiotic group at 24 hours post bacterial challenge. As compared to animals receiving Vanco, LZD group had significantly lower numbers of neutrophils in the BAL (9×10(3 vs. 2.3×10(4, p < 0.01, which was associated with reduced levels of chemotactic chemokines and inflammatory cytokines KC, MIP-2, IFN-γ, TNF-α and IL-1β in the BAL. Interestingly, LZD treatment also protected mice from lung injury, as assessed by albumin concentration in the BAL post treatment with H1N1 and cMRSA when compared to vanco treatment. Moreover, treatment with LZD was associated with significantly lower levels of PVL toxin in lungs.Linezolid has unique immunomodulatory effects on host inflammatory response and lung injury in a murine model of post-viral cMRSA pneumonia.

  9. Risk factors for community-acquired bacterial meningitis

    DEFF Research Database (Denmark)

    Lundbo, Lene Fogt; Benfield, Thomas


    of these are pathogen-specific, while some are shared between different bacteria. METHODS: We searched the database PubMed to identify host risk factors for bacterial meningitis caused by the pathogens Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b, because they are three most common...

  10. Clusters of Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Helweg-Larsen, J; Tsolaki, A G; Miller, Raymonde


    Genotyping at the internal transcribed spacer (ITS) regions of the nuclear rRNA operon was performed on isolates of P. carinii sp. f. hominis from three clusters of P. carinii pneumonia among eight patients with haematological malignancies and six with HIV infection. Nine different ITS sequence...... types of P. carinii sp. f. hominis were identified in the samples from the patients with haematological malignancies, suggesting that this cluster of cases of P. carinii pneumonia was unlikely to have resulted from nosocomial transmission. A common ITS sequence type was observed in two of the patients...

  11. Pneumonia acquired in the Community

    Directory of Open Access Journals (Sweden)

    María Caridad Fragoso Marchante


    Full Text Available A bibliographical revision of the main aspects in the diagnosis and treatment of the patients suffering from pneumonia acquired in the community is carried out. Microorganisms responsible for this type of pneumonia are mention in this paper as well as the available diagnostic methods for germs isolation. Different guidelines for diagnosis and treatment of this disease published by several medical societies and scientific institutions are analyzed by means of a review of the stratification index of the patients used in each of them. Aspects related to the duration of the treatment and the possible causes associated with the unfavorable evolution are stated.

  12. Cisplatin-Induced Eosinophilic Pneumonia

    Directory of Open Access Journals (Sweden)

    Hideharu Ideguchi


    Full Text Available A 67-year-old man suffering from esophageal cancer was admitted to our hospital complaining of dyspnea and hypoxemia. He had been treated with cisplatin, docetaxel, and fluorouracil combined with radiotherapy. Chest computed tomography revealed bilateral ground-glass opacity, and bronchoalveolar lavage fluid showed increased eosinophils. Two episodes of transient eosinophilia in peripheral blood were observed after serial administration of anticancer drugs before the admission, and drug-induced lymphocyte stimulation test to cisplatin was positive. Thus cisplatin-induced eosinophilic pneumonia was suspected, and corticosteroid was effectively administered. To our knowledge, this is the first reported case of cisplatin-induced eosinophilic pneumonia.

  13. Impact of oral simvastatin therapy on acute lung injury in mice during pneumococcal pneumonia

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    Boyd Angela R


    Full Text Available Abstract Background Recent studies suggest that the reported protective effects of statins (HMG-CoA reductase inhibitors against community-acquired pneumonia (CAP and sepsis in humans may be due to confounders and a healthy user-effect. To directly test whether statins are protective against Streptococcus pneumoniae, the leading cause of CAP, we examined the impact of prolonged oral simvastatin therapy at physiologically relevant doses in a mouse model of pneumococcal pneumonia. BALB/c mice were placed on rodent chow containing 0 mg/kg (control, 12 mg/kg (low simvastatin diet [LSD]; corresponds to 1.0 mg/kg/day, or 120 mg/kg (high simvastatin diet [HSD]; corresponds to 10 mg/kg/day simvastatin for four weeks, infected intratracheally with S. pneumoniae serotype 4 strain TIGR4, and sacrificed at 24, 36, or 42 h post-infection for assessment of lung histology, cytokine production, vascular leakage and edema, bacterial burden and bloodstream dissemination. Some mice received ampicillin at 12-h intervals beginning at 48 h post-infection and were monitored for survival. Immunoblots of homogenized lung samples was used to assess ICAM-1 production. Results Mice receiving HSD had reduced lung consolidation characterized by less macrophage and neutrophil infiltration and a significant reduction in the chemokines MCP-1 (P = 0.03 and KC (P = 0.02 and ICAM-1 in the lungs compared to control mice. HSD mice also had significantly lower bacterial titers in the blood at 36 (P = 0.007 and 42 (P = 0.03 hours post-infection versus controls. LSD had a more modest effect against S. pneumoniae but also resulted in reduced bacterial titers in the lungs and blood of mice after 42 h and a reduced number of infiltrated neutrophils. Neither LSD nor HSD mice had reduced mortality in a pneumonia model where mice received ampicillin 48 h after challenge. Conclusions Prolonged oral simvastatin therapy had a strong dose-dependent effect on protection

  14. Etiology of acute otitis media and serotype distribution of Streptococcus pneumoniae and Haemophilus influenzae in Chilean children <5 years of age. (United States)

    Rosenblut, Andres; Napolitano, Carla; Pereira, Angelica; Moreno, Camilo; Kolhe, Devayani; Lepetic, Alejandro; Ortega-Barria, Eduardo


    The impact of bacterial conjugate vaccines on acute otitis media (AOM) is affected by several factors including population characteristics, bacterial etiology and vaccine conjugation method, carrier, and coverage. This study estimated the baseline etiology, distribution, and antibiotic susceptibility of bacterial serotypes that causes AOM in children aged Haemophilus influenzae (40.3% [56/139]) were predominant among the cultures that showed bacterial growth (85% [139/164]). All Streptococcus pneumoniae positive episodes were serotyped, 19F (21%) and 14 (17%) were the predominant serotypes; all Haemophilus influenzae strains were nontypeable. Streptococcus pneumoniae were resistant to penicillin (5%) and erythromycin (33%); Haemophilus influenzae were resistant to ampicillin (14%) and cefuroxime and cefotaxime (2% each).AOM in Chilean children is predominantly caused by Streptococcus pneumoniae and nontypeable Haemophilus influenzae. Use of a broad spectrum vaccine against these pathogens might aid the reduction of AOM in Chile.

  15. Risk factors for KPC-producing Klebsiella pneumoniae: watch out for surgery. (United States)

    da Silva, Kesia Esther; Maciel, Wirlaine Glauce; Sacchi, Flávia Patussi Correia; Carvalhaes, Cecilia Godoy; Rodrigues-Costa, Fernanda; da Silva, Ana Carolina Ramos; Croda, Mariana Garcia; Negrão, Fábio Juliano; Croda, Julio; Gales, Ana Cristina; Simionatto, Simone


    This study describes the molecular characteristics and risk factors associated with carbapenem-resistant Klebsiella pneumoniae strains. Risk factors associated with KPC-producing K. pneumoniae strains were investigated in this case-control study from May 2011 to May 2013. Bacterial identification was performed by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility was determined by broth microdilution. Carbapenemase production was assessed by both modified Hodge test (MHT) and ertapenem hydrolysis using MALDI-TOF MS. The presence of β-lactamase-encoding genes was evaluated by PCR and DNA sequencing. Alterations in genes encoding K. pneumoniae outer membrane proteins were analysed by PCR and DNA sequencing as well as SDS-PAGE. Genetic relatedness among strains was determined by pulsed-field gel electrophoresis. This study included 94 patients. Longer hospitalisation, mechanical ventilation, catheters, and previous surgery were associated with KPC-producing K. pneumoniae. Sixty-eight strains showed resistance to carbapenems. Carbapenemase production was detected by MHT in 67 K. pneumoniae strains and by MALDI-TOF MS in 57. The presence of the blaKPC-2 gene was identified in 57 strains. The blaKPC-2 gene was not found in 11 carbapenem-resistant K. pneumoniae; instead, the blaCTX-M-1-like, blaCTX-M-2-like, blaCTX-M-8 like, blaCTX-M-14-like and blaSHV- like genes associated with OmpK35 and OmpK36 alterations were observed. Thirty-three KPC-producing K. pneumoniae strains were clonally related, and patients infected with these strains had a higher mortality rate (78.78 %). Our results show that KPC-producing K. pneumoniae was associated with several healthcare-related risk factors, including recent surgery.

  16. Immunization with LytB protein of Streptococcus pneumoniae activates complement-mediated phagocytosis and induces protection against pneumonia and sepsis. (United States)

    Corsini, Bruno; Aguinagalde, Leire; Ruiz, Susana; Domenech, Mirian; Antequera, María Luisa; Fenoll, Asunción; García, Pedro; García, Ernesto; Yuste, Jose


    The cell wall glucosaminidase LytB of Streptococcus pneumoniae is a surface exposed protein involved in daughter cell separation, biofilm formation and contributes to different aspects of the pathogenesis process. In this study we have characterized the antibody responses after immunization of mice with LytB in the presence of alhydrogel as an adjuvant. Enzyme-linked immunosorbent assays measuring different subclasses of immunoglobulin G, demonstrated that the antibody responses to LytB were predominantly IgG1 and IgG2b, followed by IgG3 and IgG2a subclasses. Complement-mediated immunity against two different pneumococcal serotypes was investigated using sera from immunized mice. Immunization with LytB increased the recognition of S. pneumoniae by complement components C1q and C3b demonstrating that anti-LytB antibodies trigger activation of the classical pathway. Phagocytosis assays showed that serum containing antibodies to LytB stimulates neutrophil-mediated phagocytosis against S. pneumoniae. Animal models of infection including invasive pneumonia and sepsis were performed with two different clinical isolates. Vaccination with LytB increased bacterial clearance and induced protection demonstrating that LytB might be a good candidate to be considered in a future protein-based vaccine against S. pneumoniae.

  17. The Most Common Detected Bacteria in Sputum of Patients with Community Acquired Pneumonia (CAP) Treated In Hospital (United States)

    Cukic, Vesna; Hadzic, Armin


    Introduction: Community acquired pneumonia (CAP) is the most common infective pulmonary disease. Objective: To show the most common detected bacteria in bacterial culture of sputum in patients with CAP hospitalized in Clinic for Pulmonary Diseases and TB “Podhrastovi” in four-year period: from 2012 to 2015. Material and methods: This is the retrospective analysis. Each patient gave sputum 3 days in a row when admitted to hospital. Sputum has been examined: bacterial culture with antibiotics sensitivity, Gram stain, Mycobacterium tuberculosis; in cases with high temperature blood cultures were done; when we were suspicious about bronchial carcinoma bronchoscopy with BAL (bronchoalveolar lavage) was done. We show analyzed patients according to age, sex, whether they had pneumonia or bronchopneumonia, bacteria isolated in sputum and in BAL. Results: 360 patients with CAP were treated in four-year period (247 males and 113 females). 167 or 43, 39 % had pneumonia (119 males and 48 females). Number of males was significantly bigger (χ2 = 30,186; p<0,001). 193 or 53, 61 % had bronchopneumonia (128 males and 65 females). Number of males was significantly bigger (χ2 = 20,556; p<0,001). Number of patients with negative bacterial culture of sputum (131–78, 44%) was significantly bigger than number of patients with positive culture (36–21, 56%) (χ2 = 50,042; p<0,001) in pneumonia. Number of patients with negative bacterial culture of sputum (154- 79, 79%) was significantly bigger than number of patients with positive culture (39- 20, 21%) (χ2 = 68,523; p<0,001) in bronchopneumonia. Streptococcus pneumoniae was significantly most common detected bacterium compared with the number of other isolated bacteria; in pneumonia (χ2 =33,222; p<0,001) and in bronchopneumonia (χ2 =51,231; p<0,001). Conclusion: It is very important to detect the bacterial cause of CAP to administrate the targeted antibiotic therapy. PMID:27994296

  18. Fusobacterium necrophorum in North American Bighorn Sheep ( Ovis canadensis ) Pneumonia. (United States)

    Shanthalingam, Sudarvili; Narayanan, Sanjeevkumar; Batra, Sai Arun; Jegarubee, Bavananthasivam; Srikumaran, Subramaniam


    Fusobacterium necrophorum has been detected in pneumonic bighorn sheep (BHS; Ovis canadensis ) lungs, in addition to the aerobic respiratory pathogens Mannheimia haemolytica , Bibersteinia trehalosi , Pasteurella multocida , and Mycoplasma ovipneumoniae . Similar to M. haemolytica , F. necrophorum produces a leukotoxin. Leukotoxin-induced lysis and degranulation of polymorphonuclear leukocytes (PMNs) and macrophages are responsible for acute inflammation and lung tissue damage characteristic of M. haemolytica -caused pneumonia. As one approach in elucidating the role of F. necrophorum in BHS pneumonia, we determined the frequency of the presence of F. necrophorum in archived pneumonic BHS lung tissues, and susceptibility of BHS leukocytes to F. necrophorum leukotoxin. A species-specific PCR assay detected F. necrophorum in 37% of pneumonic BHS lung tissues (total tested n=70). Sequences of PCR amplicons were similar to the less virulent F. necrophorum subsp. funduliforme. Fusobacterium necrophorum leukotoxin exhibited cytotoxicity to BHS PMNs and peripheral blood mononuclear cells. As with the M. haemolytica leukotoxin, F. necrophorum leukotoxin was more toxic to BHS PMNs than domestic sheep PMNs. It is likely that F. necrophorum enters the lungs after M. haemolytica and other aerobic respiratory pathogens enter the lungs and initiate tissue damage, thereby creating a microenvironment that is conducive for anaerobic bacterial growth. In summary, Fusobacterium leukotoxin is highly toxic for BHS leukocytes; however, based on the PCR findings, it is unlikely to play a direct role in the development of BHS pneumonia.

  19. Childhood Pneumonia Screener: a concept

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    Jukka Räsänen


    Full Text Available Childhood pneumonia continues to be the number one cause of death in children under five years of age in developing countries. In addition to mortality, pneumonia constitutes an enormous economic and social burden because late diagnosis is associated with high cost of treatment and often leads to chronic health problems. There are several bottlenecks in developing countries in the case flow of a child with lung infection: 1 recognising the symptoms as a reason to seek care, 2 getting the patient to a first-tier health facility, 3 scarcity of trained healthcare personnel who can diagnose the condition and its severity, 4 access to a second-tier facility in severe cases. These factors are commonly present in rural areas but even in more urban settings, access to a physician is often delayed. The Childhood Pneumonia Screener project aims at bridging the diagnostic gap using emerging technology. Mobile “smart” phone communication with several inexpensive dedicated sensors is proposed as a rapid data-collection and transmission unit that is connected to a central location where trained personnel assisted by sophisticated signal processing algorithms, evaluate the data and determine if the child is likely to have pneumonia and what the level and urgency of care should be.

  20. Streptococcus pneumoniae proteomics: determinants of pathogenesis and vaccine development. (United States)

    Bittaye, Mustapha; Cash, Phil


    Streptococcus pneumoniae is a major pathogen that is responsible for a variety of invasive diseases. The bacteria gain entry initially by establishing a carriage state in the nasopharynx from where they migrate to other sites in the body. The worldwide distribution of the bacteria and the severity of the diseases have led to a significant level of interest in the development of vaccines against the bacteria. Current vaccines, based on the bacterial polysaccharide, have a number of limitations including poor immunogenicity and limited effectiveness against all pneumococcal serotypes. There are many challenges in developing vaccines that will be effective against the diverse range of isolates and serotypes for this highly variable bacterial pathogen. This review considers how proteomic technologies have extended our understanding of the pathogenic mechanisms of nasopharyngeal colonization and disease development as well as the critical areas in developing protein-based vaccines.

  1. Evaluation of different nucleic acid amplification techniques for the detection of M. pneumoniae, C. pneumoniae and Legionella spp. in respiratory specimens from patients with community-acquired pneumonia

    NARCIS (Netherlands)

    Loens, K; Beck, T; Ursi, D; Overdijk, M; Sillekens, P; Goossens, H; Ieven, M; Niesters, Bert


    The number of pathogens involved in community-acquired pneumonia, with varying susceptibilities to antimicrobials, is numerous constituting an enormous challenge for diagnostic microbiology. Differentiation of infections due to Streptococcus pneumoniae and those due to Mycoplasma pneumoniae, Chlamyd

  2. Molecular characterization of multidrug-resistant Klebsiella pneumoniae isolates

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    Xiang-hua Hou


    Full Text Available Klebsiella pneumoniae is an important cause of healthcare-associated infections worldwide. Selective pressure, the extensive use of antibiotics, and the conjugational transmission of antibiotic resistance genes across bacterial species and genera facilitate the emergence of multidrug-resistant (MDR K. pneumoniae. Here, we examined the occurrence, phenotypes and genetic features of MDR K. pneumoniae isolated from patients in intensive care units (ICUs at the First Affiliated Hospital of Xiamen University in Xiamen, China, from January to December 2011. Thirty-eight MDR K. pneumoniae strains were collected. These MDR K. pneumoniae isolates possessed at least seven antibiotic resistance determinants, which contribute to the high-level resistance of these bacteria to aminoglycosides, macrolides, quinolones and β-lactams. Among these isolates, 24 strains were extended-spectrum β-lactamase (ESBL producers, 2 strains were AmpC producers, and 12 strains were both ESBL and AmpC producers. The 38 MDR isolates also contained class I (28/38 and class II integrons (10/38. All 28 class I-positive isolates contained aacC1, aacC4, orfX, orfX’ and aadA1 genes. β-lactam resistance was conferred through blaSHV (22/38, blaTEM (10/38, and blaCTX-M (7/38. The highly conserved blaKPC-2 (37/38 and blaOXA-23(1/38 alleles were responsible for carbapenem resistance, and a gyrAsite mutation (27/38 and the plasmid-mediated qnrB gene (13/38 were responsible for quinolone resistance. Repetitive-sequence-based PCR (REP-PCR fingerprinting of these MDR strains revealed the presence of five groups and sixteen patterns. The MDR strains from unrelated groups showed different drug resistance patterns; however, some homologous strains also showed different drug resistance profiles. Therefore, REP-PCR-based analyses can provide information to evaluate the epidemic status of nosocomial infection caused by MDR K. pneumoniae; however, this test lacks the power to discriminate some

  3. Molecular characterization of multidrug-resistant Klebsiella pneumoniae isolates. (United States)

    Hou, Xiang-hua; Song, Xiu-yu; Ma, Xiao-bo; Zhang, Shi-yang; Zhang, Jia-qin


    Klebsiella pneumoniae is an important cause of healthcare-associated infections worldwide. Selective pressure, the extensive use of antibiotics, and the conjugational transmission of antibiotic resistance genes across bacterial species and genera facilitate the emergence of multidrug-resistant (MDR) K. pneumoniae. Here, we examined the occurrence, phenotypes and genetic features of MDR K. pneumoniae isolated from patients in intensive care units (ICUs) at the First Affiliated Hospital of Xiamen University in Xiamen, China, from January to December 2011. Thirty-eight MDR K. pneumoniae strains were collected. These MDR K. pneumoniae isolates possessed at least seven antibiotic resistance determinants, which contribute to the high-level resistance of these bacteria to aminoglycosides, macrolides, quinolones and β-lactams. Among these isolates, 24 strains were extended-spectrum β-lactamase (ESBL) producers, 2 strains were AmpC producers, and 12 strains were both ESBL and AmpC producers. The 38 MDR isolates also contained class I (28/38) and class II integrons (10/38). All 28 class I-positive isolates contained aacC1, aacC4, orfX, orfX' and aadA1 genes. β-lactam resistance was conferred through bla SHV (22/38), bla TEM (10/38), and bla CTX-M (7/38). The highly conserved bla KPC-2 (37/38) and bla OXA-23(1/38) alleles were responsible for carbapenem resistance, and a gyrAsite mutation (27/38) and the plasmid-mediated qnrB gene (13/38) were responsible for quinolone resistance. Repetitive-sequence-based PCR (REP-PCR) fingerprinting of these MDR strains revealed the presence of five groups and sixteen patterns. The MDR strains from unrelated groups showed different drug resistance patterns; however, some homologous strains also showed different drug resistance profiles. Therefore, REP-PCR-based analyses can provide information to evaluate the epidemic status of nosocomial infection caused by MDR K. pneumoniae; however, this test lacks the power to discriminate some

  4. Effect of radiation processing in elimination of Klebsiella pneumoniae from food (United States)

    Gautam, Raj Kamal; Nagar, Vandan; Shashidhar, Ravindranath


    Klebsiella pneumoniae has been considered as an important foodborne pathogen which causes severe infections that include meningitis, bronchitis, bacteremia, pneumonia, and urinary tract infections in humans and animals. It is well known to most clinicians as a cause of community-acquired bacterial pneumonia. Klebsiella is an opportunistic pathogen, that primarily attacks neonates, infants, elderly and immuno-compromised patients and therefore impose a serious, emerging public health hazard globally. Contaminated sprouts, vegetables, seafood and other animal meat products are considered as main sources of Klebsiella infection. In the current study, radiation sensitivity of K. pneumoniae MTCC 109 was determined in different food samples. The decimal reduction dose (D10) values of K. pneumoniae MTCC 109 in saline and nutrient broth at 0-4 °C were 0.116±0.009, 0.136±0.005 kGy, respectively. The mixed sprouts, fish and poultry samples were inoculated with K. pneumoniae MTCC 109 and exposed to gamma radiation to evaluate the effectiveness of radiation treatment in the elimination of K. pneumoniae. D10 values of K. pneumoniae in mixed sprouts, poultry and fish samples were found to be 0.142±0.009, 0.125±0.0004 and 0.277±0.012 kGy, respectively. Radiation treatment with a 1.5 kGy dose resulted in the complete elimination of 3.1±1.8×105 CFU/g of K. pneumoniae from these food samples. No recovery of K. pneumoniae was observed in the 1.5 kGy treated samples stored at 4 °C up to 12 days, even after enrichment and selective plating. This study shows that a 1.5 kGy dose of irradiation treatment could lead to the complete elimination of 3.1±1.8×105 CFU/g of K. pneumoniae from mixed sprouts, poultry and fish samples.

  5. Identification of Antigenic Proteins of the Nosocomial Pathogen Klebsiella pneumoniae (United States)

    Hoppe, Sebastian; Bier, Frank F.; von Nickisch-Rosenegk, Markus


    The continuous expansion of nosocomial infections around the globe has become a precarious situation. Key challenges include mounting dissemination of multiple resistances to antibiotics, the easy transmission and the growing mortality rates of hospital-acquired bacterial diseases. Thus, new ways to rapidly detect these infections are vital. Consequently, researchers around the globe pursue innovative approaches for point-of-care devices. In many cases the specific interaction of an antigen and a corresponding antibody is pivotal. However, the knowledge about suitable antigens is lacking. The aim of this study was to identify novel antigens as specific diagnostic markers. Additionally, these proteins might be aptly used for the generation of vaccines to improve current treatment options. Hence, a cDNA-based expression library was constructed and screened via microarrays to detect novel antigens of Klebsiella pneumoniae, a prominent agent of nosocomial infections well-known for its extensive antibiotics resistance, especially by extended-spectrum beta-lactamases (ESBL). After screening 1536 clones, 14 previously unknown immunogenic proteins were identified. Subsequently, each protein was expressed in full-length and its immunodominant character examined by ELISA and microarray analyses. Consequently, six proteins were selected for epitope mapping and three thereof possessed linear epitopes. After specificity analysis, homology survey and 3d structural modelling, one epitope sequence GAVVALSTTFA of KPN_00363, an ion channel protein, was identified harboring specificity for K. pneumoniae. The remaining epitopes showed ambiguous results regarding the specificity for K. pneumoniae. The approach adopted herein has been successfully utilized to discover novel antigens of Campylobacter jejuni and Salmonella enterica antigens before. Now, we have transferred this knowledge to the key nosocomial agent, K. pneumoniae. By identifying several novel antigens and their linear

  6. [The effect of stress ulcer prevention on the incidence of pneumonia in artificial respiration]. (United States)

    Daschner, F; Reuschenbach, K; Pfisterer, J; Kappstein, I; Vogel, W; Krieg, N; Just, H


    The role of stress ulcer prophylaxis in increasing the risk of pneumonia in ventilator patients was analyzed prospectively in 142 artificially ventilated patients at a medical and surgical intensive care unit (104 males, 38 females, mean time of ventilation 7.9 days, mean age 46.5 years). The pH of gastric aspirate and bacterial counts in gastric fluid and tracheal secretions were investigated daily. Identical isolates from gastric aspirates and tracheal secretions were typed by agglutination, bacteriocin, or phage typing. An average of 2.1 bacterial species were isolated in 80.5% of all gastric aspirates. Bacterial counts increased with rising gastric aspirate pH, which was especially true for Gram-negative and less so for Gram-positive organisms; colony counts of Candida sp. decreased slightly. In 31.6% of patients identical bacterial species were first isolated from gastric aspirates and 1 to 2 days later from tracheal secretions. Of these microbes that were first isolated from gastric aspirate and later from tracheal secretions, 50.3% were Gram-negative, 37.5% Gram-positive, and only 4.2% Candida sp. One-half of all bacterial aspirations occurred between the 2nd and 7th day of ventilation; 80% occurred within 11 days of ventilation. Only 20% of all migrations of Gram-positive organisms from stomach to respiratory tract lead to pneumonia, as compared with 60% of Gram-negatives. At a gastric pH below 3.4 the incidence of ventilation pneumonia was 40.6%; above pH 5.0 the incidence was 69.2% (P less than or equal to 0.05). As pH increased, the organism causing pneumonia was significantly more often isolated first from the gastric aspirate and 1 to 2 days later from the tracheal secretion of the same patient.

  7. Trends in mortality from septicaemia and pneumonia with economic development: an age-period-cohort analysis.

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    Irene O L Wong

    Full Text Available BACKGROUND: Hong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong's unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community reaching "first world" status over the last 60 years (i.e., in two or three generations, we examined the longitudinal trends in infection related mortality including septicemia compared to trends in non-bacterial pneumonia to generate hypotheses for further testing in other recently transitioned economies and to provide generalized aetiological insights on how economic transition affects infection-related mortality. METHODS: We used deaths from septicemia and pneumonia not specified as bacterial, and population figures in Hong Kong from 1976-2005. We fitted age-period-cohort models to decompose septicemia and non-bacterial pneumonia mortality rates into age, period and cohort effects. RESULTS: Septicaemia-related deaths increased exponentially with age, with a downturn by period. The birth cohort curves had downward inflections in both sexes in the 1940s, with a steeper deceleration for women. Non-bacterial pneumonia-related deaths also increased exponentially with age, but the birth cohort patterns showed no downturns for those born in the 1940s. CONCLUSION: The observed changes appeared to suggest that better early life conditions may enable better development of adaptive immunity, thus enhancing immunity against bacterial infections, with greater benefits for women than men. Given the interaction between the immune system and the gonadotropic axis, these observations are compatible with the hypothesis that upregulation of the gonadotropic axis underlies some of the changes in disease patterns with economic development.

  8. Mycoplasma pneumoniae associated organising pneumonia in a 10 year old boy. (United States)

    Wachowski, O; Demirakça, S; Müller, K-M; Scheurlen, W


    We describe a 10 year old boy with organising pneumonia associated with acute Mycoplasma pneumoniae infection. The diagnosis of organising pneumonia was made by open lung biopsy and the M pneumoniae infection was proven serologically. Antibiotic and long term corticosteroid treatment resulted in steadily improving pulmonary function monitored by spirometry. The introduction of anti-inflammatory treatment with NSAIDs/immunosuppressive agents in order to spare steroids was well tolerated and resulted in further improvement of the pulmonary function. To our knowledge this is the first documented case of Mycoplasma pneumoniae associated organising pneumonia to be reported in a child.

  9. Prevalence of Streptococcus Pneumoniae, Haemophilus Influenzae and Moraxella Catarrhalis in Adenoid Tissues of Children with Adenoid Hypertrophy

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    SS Khoramrooz


    Full Text Available Background & aim: Chronic infection of the adenoid tissue is one of the causes of hypertrophy. Adenoids are considered to be as reservoirs of pathogenic bacteria such as Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae. The aim of this study was to determine the prevalence of mentioned bacteria in children with adenoid hypertrophy. Methods: A total of 113 children with adenoid hypertrophy who underwent adenoidectomy were included in this study. Subsequently, adenoidectomy was performed under general anesthesia. All of the adenoid samples were evaluated for bacterial infection by culture and PCR methods. Results: Streptococcus. pneumoniae was the most common (33.6% bacteria isolated by culture followed by H. influenzae (22.9% and M. catarrhalis (9.7%. PCR method detected S. pneumoniae, H. influenzae and M. catarrhalis in 31%, 29.2% and 9.7% of samples respectively. Conclusion: Streptococcus. Pneumonia, H. influenzae and M. catarrhalis are isolated with different frequency in patients with adenoid hypertrophy.

  10. [Emergence of new pneumonia: besides severe acute respiratory syndrome]. (United States)

    Mangiarotti, P; Pozzi, E


    Important epidemiological modifications have been registered in respiratory infections, both in immunocompetent and immunocompromised hosts. Pathogens with modified antibiotic susceptibility patterns have emerged, which display an increased antibiotic resistance, such as S. pneumoniae, S. aureus, H. influenzae. This trait has a strong impact on the therapeutic choices, particularly when an empiric antibiotic treatment is selected. The prevalence of bacterial species showing non-susceptibility to the most common prescribed antibiotics (betalactams, macrolides etc.) follows a different geographic distribution. Some pathogens have acquired a new epidemiological role in patients affected with immune deficiencies: among them P. carinii and other bacterial, fungal and viral pathogens. The emergence of new, previously unknown, species, has been registered, both bacteria (C. pneumoniae) and viruses (Metapneumovirus, Hantavirus etc.). Such aspects must be considered in the diagnosis of respiratory infections, which should include diagnostic tests for the identification of such pathogens. Among the new respiratory infections severe acute respiratory syndrome (SARS) has quickly become a health care emergency, so that efforts have been made to identify the aetiological agent as well as the main epidemiological and clinical characteristics of the disease. Avian influenza has raised great interest immediately after the first cases of human infection caused by the avian virus, especially after the outbreaks in Asian countries and in the Netherlands. A crucial step in containing infection is the prevention of the disease; efforts are directed toward this endpoint.

  11. Effect of Streptococcus pneumoniae on human respiratory epithelium in vitro. (United States)

    Steinfort, C; Wilson, R; Mitchell, T; Feldman, C; Rutman, A; Todd, H; Sykes, D; Walker, J; Saunders, K; Andrew, P W


    A total of 11 of 15 Streptococcus pneumoniae culture filtrates and all five bacterial autolysates produced by cell death in the stationary phase caused slowed ciliary beating and disruption of the surface integrity of human respiratory epithelium in organ culture. This effect was inhibited by cholesterol and was heat labile and reduced by standing at room temperature but was stable at -40 degrees C. The activity was detected at the late stationary phase of culture and was associated with the presence of hemolytic activity. Gel filtration of a concentrated culture filtrate and autolysate both yielded a single fraction of approximately 50 kilodaltons which slowed ciliary beating and were the only fractions with hemolytic activity. Rabbit antiserum to pneumolysin, a sulfhydryl-activated hemolytic cytotoxin released by S. pneumoniae during autolysis, neutralized the effect of the culture filtrate on respiratory epithelium. Both native and recombinant pneumolysin caused ciliary slowing and epithelial disruption. Electron microscopy showed a toxic effect of pneumolysin on epithelial cells: cytoplasmic blebs, mitochondrial swelling, cellular extrusion, and cell death, but no change in ciliary ultrastructure. Recombinant pneumolysin (10 micrograms/ml) caused ciliary slowing in the absence of changes in cell ultrastructure. Release of pneumolysin in the respiratory tract during infection may perturb host defenses, allowing bacterial proliferation and spread.

  12. How recent advances in molecular tests could impact the diagnosis of pneumonia. (United States)

    Murdoch, David R


    Molecular diagnostic tests have been the single major development in pneumonia diagnostics over recent years. Nucleic acid detection tests (NATs) have greatly improved the ability to detect respiratory viruses and bacterial pathogens that do not normally colonize the respiratory tract. In contrast, NATs do not yet have an established role for diagnosing pneumonia caused by bacteria that commonly colonize the nasopharynx due to difficulties discriminating between pathogens and coincidental carriage strains. New approaches are needed to distinguish infection from colonization, such as through use of quantitative methods and identification of discriminating cut-off levels. The recent realization that the lung microbiome exists has provided new insights into the pathogenesis of pneumonia involving the interaction between multiple microorganisms. New developments in molecular diagnostics must account for this new paradigm.

  13. Fluoroquinolones in the management of community-acquired pneumonia in primary care. (United States)

    Wispelwey, Brian; Schafer, Katherine R


    A literature search was conducted to evaluate the pharmacokinetic and pharmacodynamic profile of the respiratory fluoroquinolones (gemifloxacin, levofloxacin and moxifloxacin) and their efficacy and safety in the management of community-acquired pneumonia (CAP). Data show that CAP is a common presentation in primary care practice, and is associated with high rates of morbidity and mortality, particularly in the elderly. Although the causative pathogens differ depending on treatment setting and patient factors, Streptococcus pneumoniae is the primary pathogen in all treatment settings. As a class, the respiratory fluoroquinolones have a very favorable pharmacokinetic and pharmacodynamic profile. Pharmacodynamic criteria suggest that moxifloxacin and gemifloxacin are more potent against S. pneumoniae, which may have the added benefit of reducing resistance selection and enhancing bacterial eradication. The respiratory fluoroquinolones are also generally well tolerated, and are first-line options for outpatient treatment of CAP in patients with comorbidities or previous antibiotic use.

  14. Streptococcus pneumoniae Supragenome Hybridization Arrays for Profiling of Genetic Content and Gene Expression. (United States)

    Kadam, Anagha; Janto, Benjamin; Eutsey, Rory; Earl, Joshua P; Powell, Evan; Dahlgren, Margaret E; Hu, Fen Z; Ehrlich, Garth D; Hiller, N Luisa


    There is extensive genomic diversity among Streptococcus pneumoniae isolates. Approximately half of the comprehensive set of genes in the species (the supragenome or pangenome) is present in all the isolates (core set), and the remaining is unevenly distributed among strains (distributed set). The Streptococcus pneumoniae Supragenome Hybridization (SpSGH) array provides coverage for an extensive set of genes and polymorphisms encountered within this species, capturing this genomic diversity. Further, the capture is quantitative. In this manner, the SpSGH array allows for both genomic and transcriptomic analyses of diverse S. pneumoniae isolates on a single platform. In this unit, we present the SpSGH array, and describe in detail its design and implementation for both genomic and transcriptomic analyses. The methodology can be applied to construction and modification of SpSGH array platforms, as well to other bacterial species as long as multiple whole-genome sequences are available that collectively capture the vast majority of the species supragenome.

  15. Phagocytosis and Killing of Carbapenem-Resistant ST258 Klebsiella pneumoniae by Human Neutrophils. (United States)

    Kobayashi, Scott D; Porter, Adeline R; Dorward, David W; Brinkworth, Amanda J; Chen, Liang; Kreiswirth, Barry N; DeLeo, Frank R


    Carbapenem-resistant Klebsiella pneumoniae strains classified as multilocus sequence type 258 (ST258) are among the most widespread multidrug-resistant hospital-acquired pathogens. Treatment of infections caused by these organisms is difficult, and mortality is high. The basis for the success of ST258, outside of antibiotic resistance, remains incompletely determined. Here we tested the hypothesis that ST258K. pneumoniae has enhanced capacity to circumvent killing by human neutrophils, the primary cellular defense against bacterial infections. There was limited binding and uptake of ST258 by human neutrophils, and correspondingly, there was limited killing of bacteria. On the other hand, transmission electron microscopy revealed that any ingested organisms were degraded readily within neutrophil phagosomes, thus indicating that survival in the neutrophil assays is due to limited phagocytosis, rather than to microbicide resistance after uptake. Our findings suggest that enhancing neutrophil phagocytosis is a potential therapeutic approach for treatment of infection caused by carbapenem-resistant ST258K. pneumoniae.

  16. A type IV pilus mediates DNA binding during natural transformation in Streptococcus pneumoniae.

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    Raphaël Laurenceau

    Full Text Available Natural genetic transformation is widely distributed in bacteria and generally occurs during a genetically programmed differentiated state called competence. This process promotes genome plasticity and adaptability in Gram-negative and Gram-positive bacteria. Transformation requires the binding and internalization of exogenous DNA, the mechanisms of which are unclear. Here, we report the discovery of a transformation pilus at the surface of competent Streptococcus pneumoniae cells. This Type IV-like pilus, which is primarily composed of the ComGC pilin, is required for transformation. We provide evidence that it directly binds DNA and propose that the transformation pilus is the primary DNA receptor on the bacterial cell during transformation in S. pneumoniae. Being a central component of the transformation apparatus, the transformation pilus enables S. pneumoniae, a major Gram-positive human pathogen, to acquire resistance to antibiotics and to escape vaccines through the binding and incorporation of new genetic material.

  17. Combined effects of lactoferrin and lysozyme on Streptococcus pneumoniae killing. (United States)

    André, G O; Politano, W R; Mirza, S; Converso, T R; Ferraz, L F C; Leite, L C C; Darrieux, M


    Streptococcus pneumoniae is a common colonizer of the human nasopharynx, which can occasionally spread to sterile sites, causing diseases such as otitis media, sinusitis, pneumonia, meningitis and bacteremia. Human apolactoferrin (ALF) and lysozyme (LZ) are two important components of the mucosal innate immune system, exhibiting lytic effects against a wide range of microorganisms. Since they are found in similar niches of the host, it has been proposed that ALF and LZ could act synergistically in controlling bacterial spread throughout the mucosa. The combination of ALF and LZ has been shown to enhance killing of different pathogens in vitro, with ALF facilitating the latter action of LZ. The aim of the present work was to investigate the combined effects of ALF and LZ on S pneumoniae. Concomitant addition of ALF and LZ had a synergistic killing effect on one of the pneumococci tested. Furthermore, the combination of ALF and ALZ was more bactericidal than lysozyme alone in all pneumococcal strains. Pneumococcal surface protein A (PspA), an important vaccine candidate, partially protects pneumococci from ALF mediated killing, while antibodies against one PspA enhance killing of the homologous strain by ALF. However, the serological variability of this molecule could limit the effect of anti-PspA antibodies on different pneumococci. Therefore, we investigated the ability of anti-PspA antibodies to increase ALF-mediated killing of strains that express different PspAs, and found that antisera to the N-terminal region of PspA were able to increase pneumococcal lysis by ALF, independently of the sequence similarities between the molecule expressed on the bacterial surface and that used to produce the antibodies. LF binding to the pneumococcal surface was confirmed by flow cytometry, and found to be inhibited in presence of anti-PspA antibodies. On a whole, the results suggest a contribution of ALF and LZ to pneumococcal clearance, and confirm PspA's ability to interact

  18. Infection Route Analysis of Ventilator Associated Pneumonia

    Institute of Scientific and Technical Information of China (English)

    Wei; Guo; Jie; Zhang; Jing-yun; Li; Yue; Ma; Sheng-hui; Cui


    Objective A prospective study was conducted in a tertiary care center to identify the risk factors of ventilator associated pneumonia(VAP) through phenotypic and molecular biological methods. Methods The patients who were mechanically ventilated in the respiratory intensive care unit(RICU) and the neurological internal intensive care unit(NICU) were enrolled in our study, and samples were collected from the lower respiratory tract, oropharynx and stomach. Other samples, including the environmental air, swabs of nurses’ hands, subglottic secretion and ventilator circuit, were also collected. Microorganisms in the collected samples were recovered and identified at species level by biochemical detection. Genetic relationship of dominant species was further characterized by pulsed field gel electrophoresis(PFGE). Results Out of 48 enrolled patients, 22 cases developed VAP and bacterial cultures were recovered from the lower respiratory tract samples of 14 cases. The average hospitalization time with VAP was significantly longer than that of patients without VAP(P < 0.05). Among the recovered bacteria cultures, multidrug-resistant Pseudomonas aeruginosa and Stenotrophomonas maltophilia were dominant. It was more likely that subglottic secretion and gastric juice samples contained the same isolates as recovered in the lower respiratory tract by PFGE analysis. Conclusions Mechanical ventilation in RICU and NICU was a high risk factor for VAP development. Special emphasis of VAP prophylaxis should be paid on subglottic secretion and gastric juice reflux.

  19. Evolution of Bacterial Suicide (United States)

    Tchernookov, Martin; Nemenman, Ilya


    While active, controlled cellular suicide (autolysis) in bacteria is commonly observed, it has been hard to argue that autolysis can be beneficial to an individual who commits it. We propose a theoretical model that predicts that bacterial autolysis is evolutionarily advantageous to an individualand would fixate in physically structured environments for stationary phase colonies. We perform spatially resolved agent-based simulations of the model, which predict that lower mixing in the environment results in fixation of a higher autolysis rate from a single mutated cell, regardless of the colony's genetic diversity. We argue that quorum sensing will fixate as well, even if initially rare, if it is coupled to controlling the autolysis rate. The model does not predict a strong additional competitive advantage for cells where autolysis is controlled by quorum sensing systems that distinguish self from nonself. These predictions are broadly supported by recent experimental results in B. subtilisand S. pneumoniae. Research partially supported by the James S McDonnell Foundation grant No. 220020321 and by HFSP grant No. RGY0084/2011.

  20. Community-onset Klebsiella pneumoniae pneumonia in Taiwan: clinical features of the disease and associated microbiological characteristics of isolates from pneumonia and nasopharynx. (United States)

    Lin, Yi-Tsung; Wang, Yu-Ping; Wang, Fu-Der; Fung, Chang-Phone


    Klebsiella pneumoniae is an important cause of community-onset pneumonia in Asian countries and South Africa. We investigated the clinical characteristics of K. pneumoniae causing community-onset pneumonia, and the associated microbiological features between K. pneumoniae isolates from pneumonia and those from the nasopharynx in Taiwan. This study was conducted at the Taipei Veterans General Hospital during July, 2012 to February, 2014. The clinical characteristics in patients with community-onset K. pneumoniae pneumonia were analyzed. K. pneumoniae isolates from the nasopharynx of adults attending otorhinolaryngology outpatient clinics were collected to compare their microbiological features with those from pneumonia. Capsular genotypes, antimicrobial susceptibility, and multilocus sequence type (MLST) were determined among these strains. Ninety-one patients with community-onset K. pneumoniae pneumonia were enrolled. We found a high mortality (29.7%) among these patients. Capsular types K1, K2, K5, K20, K54, and K57 accounted for ∼70% of the K. pneumoniae isolates causing pneumonia, and ∼70% of all the K. pneumoniae strains isolated from the nasopharynx of patients in outpatient clinics. The MLST profiles further demonstrated the genetic relatedness between most pneumonia isolates and those from the nasopharynx. In conclusion, our results show that community-onset pneumonia caused by K. pneumoniae was associated with high mortality and could have a reservoir in the nasopharynx. To tackle this high-mortality disease, the distribution of capsular types in the nasopharynx might have implications for future vaccine development.

  1. Bacterial Adhesion & Blocking Bacterial Adhesion

    DEFF Research Database (Denmark)

    Vejborg, Rebecca Munk


    tract to the microbial flocs in waste water treatment facilities. Microbial biofilms may however also cause a wide range of industrial and medical problems, and have been implicated in a wide range of persistent infectious diseases, including implantassociated microbial infections. Bacterial adhesion...... is the first committing step in biofilm formation, and has therefore been intensely scrutinized. Much however, still remains elusive. Bacterial adhesion is a highly complex process, which is influenced by a variety of factors. In this thesis, a range of physico-chemical, molecular and environmental parameters......, which influence the transition from a planktonic lifestyle to a sessile lifestyle, have been studied. Protein conditioning film formation was found to influence bacterial adhesion and subsequent biofilm formation considerable, and an aqueous extract of fish muscle tissue was shown to significantly...

  2. Bacterial lipases

    NARCIS (Netherlands)

    Jaeger, Karl-Erich; Ransac, Stéphane; Dijkstra, Bauke W.; Colson, Charles; Heuvel, Margreet van; Misset, Onno


    Many different bacterial species produce lipases which hydrolyze esters of glycerol with preferably long-chain fatty acids. They act at the interface generated by a hydrophobic lipid substrate in a hydrophilic aqueous medium. A characteristic property of lipases is called interfacial activation, mea

  3. Bacterial Ecology

    DEFF Research Database (Denmark)

    Fenchel, Tom


    Bacterial ecology is concerned with the interactions between bacteria and their biological and nonbiological environments and with the role of bacteria in biogeochemical element cycling. Many fundamental properties of bacteria are consequences of their small size. Thus, they can efficiently exploit...

  4. [Efficacy and safety of azithromycin infusion in patients with mild or moderate community-acquired pneumonia]. (United States)

    Noguchi, Shingo; Yatera, Kazuhiro; Kawanami, Toshinori; Yamasaki, Kei; Uchimura, Keigo; Hata, Ryosuke; Tachiwada, Takashi; Oda, Keishi; Hara, Kanako; Suzuki, Yu; Akata, Kentarou; Ogoshi, Takaaki; Tokuyama, Susumu; Inoue, Naoyuki; Nishida, Chinatsu; Orihashi, Takeshi; Yoshida, Yugo; Kawanami, Yukiko; Taura, Yusuke; Ishimoto, Hiroshi; Obata, Hideto; Tsuda, Toru; Yoshii, Chiharu; Mukae, Hiroshi


    Azithromycin (AZM) is one of 15-membered rings macrolide antibiotics with wide spectrum of antimicrobial efficacy for Gram-positive and -negative bacteria and also atypical bacteria. So far, there had been no reports of the prospective studies evaluating efficacy and safety of AZM infusion in patients with mild or moderate community-acquired pneumonia (CAP). This study was conducted to evaluate prospectively the efficacy and safety of AZM in patients with mild or moderate CAP. AZM 500 mg was intravenously administered once daily, and the clinical efficacy were evaluated by clinical symptoms, peripheral blood laboratory findings and chest X-rays. Sixty-four patients were firstly registered, and eventually 61 and 62 patients were enrolled for the evaluation of clinical efficacy and safety of AZM, respectively. The efficacy of AZM in 61 patients evaluated was 88.5%. In addition, the efficacies of AZM in each pneumonia severity index by A-DROP system by the Japanese Respiratory Society (JRS) guideline in CAP were 85.2% in mild and 91.2% in moderate. Furthermore, the efficacy of AZM in each differentiation between suspicion of bacterial pneumonia and that of atypical pneumonia by JRS guideline in CAP were 91.7% in suspicion of atypical pneumonia, and its efficacy was high than that of bacterial pneumonia. Nineteen patients (20 cases; 15 with liver dysfunction, 4 with diarrhea, 1 with vascular pain) out of 62 patients were reported to have possible adverse effects of AZM. All of the patients with these adverse effects demonstrated mild dysfunction and continued AZM treatment, and these dysfunctions normalized soon after cessation of AZM. In conclusion, AZM is effective drug for patients with mild or moderate CAP, and we believe that it may be one of effective choice in the treatment of CAP patients who need hospitalization.

  5. Membrane topology of the Na+/citrate transporter CitS of Klebsiella pneumoniae by insertion mutagenesis

    NARCIS (Netherlands)

    Geest, Marleen van; Lolkema, Juke S.


    The sodium ion dependent citrate transporter of Klebsiella pneumoniae (CitS) is a member of the bacterial 2-hydroxycarboxylate transporter family. Membrane topology models of the protein. largely based on reporter molecule fusions to C-terninally truncated CitS molecules, indicate that the protein t

  6. Treatment of pneumonia in infants with daily single oral dose of cefixime Tratamiento de la neumonía del lactante con cefixima en dosis única diaria



    Treatment of pneumonia in infants with dail y single oral dose of cefixime Twenty five male and female Infants aged two to twenty-three months suffering from bacterial pneumonia were treated with cefixime in order to evaluate clinical efficiency and tolerance. A daily single oral dose of 8 mg kg was given for fourteen days. Clinical status and radiologic and laboratory findings improved during the course of therapy. A case of gastrointestinal intolerance (4%) and twelve (48%) of high levels o...

  7. Comparison of hospital-wide and age and location - stratified antibiograms of S. aureus, E. coli, and S. pneumoniae: age- and location-stratified antibiograms



    Background Antibiograms created by aggregating hospital-wide susceptibility data from diverse patients can be misleading. To demonstrate the utility of age- and location-stratified antibiograms, we compared stratified antibiograms for three common bacterial pathogens, E. coli, S. aureus, and S. pneumoniae. We created stratified antibiograms based on patient age (/=65 years), and inpatient or outpatient location using all 2009 E. coli and S. aureus, and all 2008–2009 S. pneumoniae isolates sub...

  8. A Multiplex PCR for Detection of Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, and Bordetella pertussis in Clinical Specimens (United States)


    NAVAL HEALTH RESEARCH CENTER A MULTIPLEX PCR FOR DETECTION OF Mycoplasma pneumoniae,Chlamydophila pneumoniae, Legionella pneumophila, AND Bordetella...5300 2 A Multiplex PCR for Detection of Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, and Bordetella pertussis in Clinical...Chlamydophila pneumoniae, Legionella pneumophila, and Bordetella pertussis in uncultured patient specimens. These organisms cause similar symptomologies

  9. Persistent Pneumonia in an Infant. (United States)

    Padilla, Kristen; Logan, Latania; Codispoti, Christopher; Jones, Carolyn; Van Opstal, Elizabeth


    A 4-month-old boy with past medical history of eczema presented with fever and cough; a chest radiograph showed lung consolidation, and he was initially treated with amoxicillin for presumed community-acquired pneumonia. After several days, his fever persisted. He was also profoundly anemic. Antibiotic coverage was broadened because of the concern for resistant organisms; he began to improve and was discharged from the hospital. However, at 5 months of age, his fever returned, and he continued to demonstrate lung consolidation on chest radiograph. Additionally, he had lost weight and continued to be anemic. Splenic cysts were noted on abdominal ultrasound. He was diagnosed with an unusual etiology for his pneumonia and improved with the appropriate therapy. An underlying immunodeficiency was suspected, but initial testing was nondiagnostic. At 12 months of age, he presented with another infection, and the final diagnosis was made.

  10. Comprehensive methylome characterization of Mycoplasma genitalium and Mycoplasma pneumoniae at single-base resolution.

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    Maria Lluch-Senar

    Full Text Available In the bacterial world, methylation is most commonly associated with restriction-modification systems that provide a defense mechanism against invading foreign genomes. In addition, it is known that methylation plays functionally important roles, including timing of DNA replication, chromosome partitioning, DNA repair, and regulation of gene expression. However, full DNA methylome analyses are scarce due to a lack of a simple methodology for rapid and sensitive detection of common epigenetic marks (ie N(6-methyladenine (6 mA and N(4-methylcytosine (4 mC, in these organisms. Here, we use Single-Molecule Real-Time (SMRT sequencing to determine the methylomes of two related human pathogen species, Mycoplasma genitalium G-37 and Mycoplasma pneumoniae M129, with single-base resolution. Our analysis identified two new methylation motifs not previously described in bacteria: a widespread 6 mA methylation motif common to both bacteria (5'-CTAT-3', as well as a more complex Type I m6A sequence motif in M. pneumoniae (5'-GAN(7TAY-3'/3'-CTN(7ATR-5'. We identify the methyltransferase responsible for the common motif and suggest the one involved in M. pneumoniae only. Analysis of the distribution of methylation sites across the genome of M. pneumoniae suggests a potential role for methylation in regulating the cell cycle, as well as in regulation of gene expression. To our knowledge, this is one of the first direct methylome profiling studies with single-base resolution from a bacterial organism.

  11. [Specificities of pneumonia in geriatrics]. (United States)

    Pepersack, T


    Pneumonia is a major cause of morbidity and mortality leading to a high rate of hospitalization especially in theelderly. It is often a sign of frailty and is associated with a poor prognosis. However, taking into account the geriatric specificities (risk factors, atypical clinical presentations with "geriatric syndromes", ethical debate) using an interdisciplinary and a comprehensive geriatric approach remains an important responsibility of the general practitionner. This article summarizes these specificities and offers interventions targeted on the characteristics of elderly patients.

  12. Population variability of the FimH type 1 fimbrial adhesin in Klebsiella pneumoniae. (United States)

    Stahlhut, Steen G; Chattopadhyay, Sujay; Struve, Carsten; Weissman, Scott J; Aprikian, Pavel; Libby, Stephen J; Fang, Ferric C; Krogfelt, Karen Angeliki; Sokurenko, Evgeni V


    FimH is an adhesive subunit of type 1 fimbriae expressed by different enterobacterial species. The enteric bacterium Klebsiella pneumoniae is an environmental organism that is also a frequent cause of sepsis, urinary tract infection (UTI), and liver abscess. Type 1 fimbriae have been shown to be critical for the ability of K. pneumoniae to cause UTI in a murine model. We show here that the K. pneumoniae fimH gene is found in 90% of strains from various environmental and clinical sources. The fimH alleles exhibit relatively low nucleotide and structural diversity but are prone to frequent horizontal-transfer events between different bacterial clones. Addition of the fimH locus to multiple-locus sequence typing significantly improved the resolution of the clonal structure of pathogenic strains, including the K1 encapsulated liver isolates. In addition, the K. pneumoniae FimH protein is targeted by adaptive point mutations, though not to the same extent as FimH from uropathogenic Escherichia coli or TonB from the same K. pneumoniae strains. Such adaptive mutations include a single amino acid deletion from the signal peptide that might affect the length of the fimbrial rod by affecting FimH translocation into the periplasm. Another FimH mutation (S62A) occurred in the course of endemic circulation of a nosocomial uropathogenic clone of K. pneumoniae. This mutation is identical to one found in a highly virulent uropathogenic strain of E. coli, suggesting that the FimH mutations are pathoadaptive in nature. Considering the abundance of type 1 fimbriae in Enterobacteriaceae, our present finding that fimH genes are subject to adaptive microevolution substantiates the importance of type 1 fimbria-mediated adhesion in K. pneumoniae.

  13. Pneumonia Outbreak Caused by Chlamydophila pneumoniae Among US Air Force Academy Cadets, Colorado, USA (United States)


    Article 3. DATES COVERED (From – To) Sep 2013 – May 2014 4. TITLE AND SUBTITLE Pneumonia Outbreak Caused by Chlamydophila pneumoniae among US Air Force...October 2013–May 2014, there were 102 cases of pneumonia diagnosed in US Air Force Academy cadets. A total of 73% of tested nasal washes contained...Chlamydophila pneumoniae . This agent can be considered to be present on campus settings during outbreaks with numerous, seemingly disconnected cases of

  14. Severe community-acquired pneumonia caused by Mycoplasma pneumoniae in young female patient

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    Milačić Nena


    Full Text Available Mycoplasma pneumonia is common agent causing community acquired pneumonia in younger population. However, the course of illness is usually benign and is rarely associated with pulmonary complications. We report a 27 years old female patient with unilateral pneumonia followed by pleural effusion and adhesions on the same side. This potential source of infection should be considered in young patients where resolution of symptoms from pneumonia is delayed.

  15. Therapeutic effect of Pseudomonas aeruginosa phage YH30 on mink hemorrhagic pneumonia. (United States)

    Gu, Jingmin; Li, Xinwei; Yang, Mei; Du, Chongtao; Cui, Ziyin; Gong, Pengjuan; Xia, Feifei; Song, Jun; Zhang, Lei; Li, Juecheng; Yu, Chuang; Sun, Changjiang; Feng, Xin; Lei, Liancheng; Han, Wenyu


    Hemorrhagic pneumonia caused by Pseudomonas aeruginosa remains one of the most costly infectious diseases among farmed mink and commonly leads to large economic losses during mink production. The objective of this study was to investigate the potential of using phages as a therapy against hemorrhagic pneumonia in mink. A broad-host-range phage from the Podoviridae family, YH30, was isolated using the mink-originating P. aeruginosa (serotype G) D7 strain as a host. The genome of YH30 was 72,192bp (54.92% G+C), contained 86 open reading frames and lacked regions encoding known virulence factors, integration-related proteins or antibiotic resistance determinants. These characteristics make YH30 eligible for use in phage therapy. The results of a curative treatment experiment demonstrated that a single intranasal administration of YH30 was sufficient to cure hemorrhagic pneumonia in mink. The mean colony count of P. aeruginosa in the blood and lung of YH30-protected mink was less than 10(3) CFU/mL (g) within 24h of bacterial challenge and ultimately became undetectable, whereas that in unprotected mink reached more than 10(8) CFU/mL (g). Additionally, YH30 dramatically improved the pathological manifestations of lung injury in mink with hemorrhagic pneumonia. Our work demonstrates the potential of phages to treat P. aeruginosa-caused hemorrhagic pneumonia in mink.

  16. KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil

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    Camila Arguelo Biberg


    Full Text Available The emergence of β-lactamase-producing Enterobacteriaceae in the last few decades has become major challenge faced by hospitals. In this study, isolates of Klebsiella pneumoniae carbapenemase-2 (KPC-2-producing K. pneumoniae from a tertiary hospital in Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was performed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF; Bruker Daltonics, Germany mass spectrometry. The minimum inhibitory concentrations of carbapenems were determined using the agar dilution method as recommended by the Clinical Laboratory Standards Institute guidelines. Carbapenemase production was detected using the modified Hodge test (MHT and polymerase chain reaction (PCR, followed by DNA sequencing. Of 360 (12.2% K. pneumoniae isolates obtained between May 2009 and May 2010, 44 (12.2% were carbapenem nonsusceptible. Of these 44 isolates, thirty-six K. pneumoniae isolates that were positive by MHT and PCR carried the blaKPC-2 gene. Thus, KPC-2producing Klebsiella pneumoniae has been present in a Brazilian hospital located in the Midwest region since at least 2009.

  17. KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil (United States)

    Biberg, Camila Arguelo; Rodrigues, Ana Claudia Souza; do Carmo, Sidiane Ferreira; Chaves, Claudia Elizabeth Volpe; Gales, Ana Cristina; Chang, Marilene Rodrigues


    The emergence of β-lactamase-producing Enterobacteriaceae in the last few decades has become major challenge faced by hospitals. In this study, isolates of Klebsiella pneumoniae carbapenemase-2 (KPC-2)-producing K. pneumoniae from a tertiary hospital in Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was performed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF; Bruker Daltonics, Germany) mass spectrometry. The minimum inhibitory concentrations of carbapenems were determined using the agar dilution method as recommended by the Clinical Laboratory Standards Institute guidelines. Carbapenemase production was detected using the modified Hodge test (MHT) and polymerase chain reaction (PCR), followed by DNA sequencing. Of 360 (12.2%) K. pneumoniae isolates obtained between May 2009 and May 2010, 44 (12.2%) were carbapenem nonsusceptible. Of these 44 isolates, thirty-six K. pneumoniae isolates that were positive by MHT and PCR carried the bla KPC-2 gene. Thus, KPC-2producing Klebsiella pneumoniae has been present in a Brazilian hospital located in the Midwest region since at least 2009. PMID:26273265

  18. Potential Usefulness of Streptococcus pneumoniae Extracellular Membrane Vesicles as Antibacterial Vaccines (United States)

    Choi, Chi-Won; Park, Edmond Changkyun; Yun, Sung Ho; Lee, Sang-Yeop


    The secretion of extracellular membrane vesicles (EMVs) is a common phenomenon that occurs in archaea, bacteria, and mammalian cells. The EMVs of bacteria play important roles in their virulence, biogenesis mechanisms, and host cell interactions. Bacterial EMVs have recently become the focus of attention because of their potential as highly effective vaccines that cause few side effects. Here, we isolated the EMVs of Streptococcus pneumoniae and examined their potential as new vaccine candidates. Although the S. pneumoniae bacteria were highly pathogenic in a mouse model, the EMVs purified from these bacteria showed low pathological activity both in cell culture and in mice. When mice were injected intraperitoneally with S. pneumoniae EMVs and then challenged, they were protected from both the homologous strain and another pathogenic serotype of S. pneumoniae. We also identified a number of proteins that may have immunogenic activity and may be responsible for the immune responses by the hosts. These results suggest that S. pneumoniae EMVs or their individual immunogenic antigens may be useful as new vaccine agents.

  19. Evaluation and selection of tandem repeat loci for Streptococcus pneumoniae MLVA strain typing

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    Valjevac Samina


    Full Text Available Abstract Background Precise identification of bacterial pathogens at the strain level is essential for epidemiological purposes. In Streptococcus pneumoniae, the existence of 90 different serotypes makes the typing particularly difficult and requires the use of highly informative tools. Available methods are relatively expensive and cannot be used for large-scale or routine typing of any new isolate. We explore here the potential of MLVA (Multiple Loci VNTR Analysis; VNTR, Variable Number of Tandem Repeats, a method of growing importance in the field of molecular epidemiology, for genotyping of Streptococcus pneumoniae. Results Available genome sequences were searched for polymorphic tandem repeats. The loci identified were typed across a collection of 56 diverse isolates and including a group of serotype 1 isolates from Africa. Eventually a set of 16 VNTRs was proposed for MLVA-typing of S. pneumoniae. These robust markers were sufficient to discriminate 49 genotypes and to aggregate strains on the basis of the serotype and geographical origin, although some exceptions were found. Such exceptions may reflect serotype switching or horizontal transfer of genetic material. Conclusion We describe a simple PCR-based MLVA genotyping scheme for S. pneumoniae which may prove to be a powerful complement to existing tools for epidemiological studies. Using this technique we uncovered a clonal population of strains, responsible for infections in Burkina Faso. We believe that the proposed MLVA typing scheme can become a standard for epidemiological studies of S. pneumoniae.

  20. Sinergismo in vitro tra rokitamicina e cotrimossazolo in S. pyogenes e S. pneumoniae

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    Simona Roveta


    Full Text Available Background: Synergism between cotrimoxazole (SXT and rokitamycin (ROK was observed carrying out antimicrobial susceptibility tests on S. pyogenes and S. pneumoniae with the disk diffusion method (CLSI, 2005. The aim of this study was to confirm this phenomenon on a large number of isolates displaying different macrolide resistance phenotypes. Methods: Synergism between SXT and ROK on 104 S. pyogenes and 102 S. pneumoniae recently isolated was detected by a double-disk screening test.Time kill experiments were also performed on representative strains adopting standard procedures (CLSI 2005. Results: The combination of SXT plus ROK was synergistic against 93% S. pyogenes strains and 51% S. pneumoniae strains. On pneumococci SXT-S this percentage arise to 64%, while, on SXT-R it was 29%. In no instances antagonism was demonstrated. Synergism was not observed against S. pyogenes strains showing cMLSB phenotype. In S. pneumoniae no relationship between different mechanisms of macrolide resistance and the results of interactions was found. Results of time-kill experiments confirmed those obtained with double-disk assay in all the strains tested. Conclusion: Synergism between SXT and ROK was more frequently encountered among S. pyogenes than S. pneumoniae strains.This drug association may be synergistic or not when acting on different strains of the same bacterial species. Different macrolide-resistance mechanisms (reduced binding due to modification of the 50S subunit or efflux pump among the various bacteria may eplain the observed differences.

  1. KPC-2-producing Klebsiella pneumoniae in a hospital in the Midwest region of Brazil. (United States)

    Biberg, Camila Arguelo; Rodrigues, Ana Claudia Souza; do Carmo, Sidiane Ferreira; Chaves, Claudia Elizabeth Volpe; Gales, Ana Cristina; Chang, Marilene Rodrigues


    The emergence of β-lactamase-producing Enterobacteriaceae in the last few decades has become major challenge faced by hospitals. In this study, isolates of Klebsiella pneumoniae carbapenemase-2 (KPC-2)-producing K. pneumoniae from a tertiary hospital in Mato Grosso do Sul, Brazil, were characterized. Bacterial identification was performed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF; Bruker Daltonics, Germany) mass spectrometry. The minimum inhibitory concentrations of carbapenems were determined using the agar dilution method as recommended by the Clinical Laboratory Standards Institute guidelines. Carbapenemase production was detected using the modified Hodge test (MHT) and polymerase chain reaction (PCR), followed by DNA sequencing. Of 360 (12.2%) K. pneumoniae isolates obtained between May 2009 and May 2010, 44 (12.2%) were carbapenem nonsusceptible. Of these 44 isolates, thirty-six K. pneumoniae isolates that were positive by MHT and PCR carried the bla KPC-2 gene. Thus, KPC-2producing Klebsiella pneumoniae has been present in a Brazilian hospital located in the Midwest region since at least 2009.

  2. Non-typeable Haemophilus influenzae and Streptococcus pneumoniae as primary causes of acute otitis media in colombian children: a prospective study

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    Castrejon Maria M


    Full Text Available Abstract Background Acute otitis media (AOM is one of the most frequently encountered bacterial infections in children aged Streptococcus pneumoniae (S. pneumoniae and non-typeable Haemophilus influenzae (NTHi are historically identified as primary AOM causes. Nevertheless, recent data on bacterial pathogens causing AOM in Latin America are limited. This prospective study aimed to identify and characterize bacterial etiology and serotypes of AOM cases including antimicrobial susceptibility in Methods From February 2008 to January 2009, children ≥3 months and Results Of the 106 enrolled children, 99 were included in the analysis. Bacteria were cultured from 62/99 (63% of samples with S. pneumoniae, H. influenzae, or S. pyogenes. The most commonly isolated bacteria were H. influenzae in 31/99 (31% and S. pneumoniae in 30/99 (30% of samples. The majority of H. influenzae episodes were NTHi (27/31; 87%. 19F was the most frequently isolated pneumococcal serotype (10/30; 33%. Of the 30 S. pneumoniae positive samples, 8/30 (27% were resistant to tetracycline, 5/30 (17% to erythromycin and 8/30 (27% had intermediate resistance to penicillin. All H. influenzae isolates tested were negative to beta-lactamase. Conclusions NTHi and S. pneumoniae are the leading causes of AOM in Colombian children. A pneumococcal conjugate vaccine that prevents both pathogens could be useful in maximizing protection against AOM.

  3. Cytotoxicity of Mycoplasma pneumoniae Membranes (United States)

    Gabridge, Michael G.; Johnson, Cynthia K.; Cameron, Alexander M.


    Organ cultures of adult hamster trachea were used to evaluate the cytotoxic potential of cell fractions of Mycoplasma pneumoniae. Cytoplasm was essentially devoid of activity, whereas viable cells and membrane preparations, at a level of 25 μg of protein per ml, induced necrosis. Damage, as revealed by light and electron microscopy, included ciliostasis, vacuolization, loss of ciliated respiratory epithelial cells, disorganization, and a loss of polarity. Dose response data indicated that the speed and degree of cytotoxicity was directly related to the concentration of membranes. Doses of 30 to 60 μg of protein per ml could reduce relative ciliary activity to 20% of the control level within 4 days. Membranes prepared after freeze-thaw lysis of cells were almost twice as active as those isolated after a combination of osmotic and sonic shock. Membranes of M. fermentans were inactive, though both the FH and M129 strains of M. pneumoniae were toxic. These data indicate that the toxic factor responsible for M. pneumoniae may be located in the cell membrane. Images PMID:16558100

  4. Biosynthesis of selenium nanoparticles using Klebsiella pneumoniae and their recovery by a simple sterilization process

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    Parisa Jafari Fesharaki


    Full Text Available The use of biologically derived metal nanoparticles for various proposes is going to be an issue of considerable importance; thus, appropriate methods should be developed and tested for the biological synthesis and recovery of these nanoparticles from bacterial cells. In this research study, a strain of Klebsiella pneumoniae was tested for its ability to synthesize elemental selenium nanoparticles from selenium chloride. A broth of Klebsiella pneumoniae culture containing selenium nanoparticles was subjected to sterilization at 121ºC and 17 psi for 20 minutes. Released selenium nanoparticles ranged in size from 100 to 550 nm, with an average size of 245 nm. Our study also showed that no chemical changes occurred in selenium nanoparticles during the wet heat sterilization process. Therefore, the wet heat sterilization process can be used successfully to recover elemental selenium from bacterial cells.

  5. Causes of Pneumonia Epizootics among Bighorn Sheep, Western United States, 2008–2010 (United States)

    Highland, Margaret A.; Baker, Katherine; Cassirer, E. Frances; Anderson, Neil J.; Ramsey, Jennifer M.; Mansfield, Kristin; Bruning, Darren L.; Wolff, Peregrine; Smith, Joshua B.; Jenks, Jonathan A.


    Epizootic pneumonia of bighorn sheep is a devastating disease of uncertain etiology. To help clarify the etiology, we used culture and culture-independent methods to compare the prevalence of the bacterial respiratory pathogens Mannheimia haemolytica, Bibersteinia trehalosi, Pasteurella multocida, and Mycoplasma ovipneumoniae in lung tissue from 44 bighorn sheep from herds affected by 8 outbreaks in the western United States. M. ovipneumoniae, the only agent detected at significantly higher prevalence in animals from outbreaks (95%) than in animals from unaffected healthy populations (0%), was the most consistently detected agent and the only agent that exhibited single strain types within each outbreak. The other respiratory pathogens were frequently but inconsistently detected, as were several obligate anaerobic bacterial species, all of which might represent secondary or opportunistic infections that could contribute to disease severity. These data provide evidence that M. ovipneumoniae plays a primary role in the etiology of epizootic pneumonia of bighorn sheep. PMID:22377321

  6. Causes of pneumonia epizootics among bighorn sheep, Western United States, 2008-2010. (United States)

    Besser, Thomas E; Highland, Margaret A; Baker, Katherine; Cassirer, E Frances; Anderson, Neil J; Ramsey, Jennifer M; Mansfield, Kristin; Bruning, Darren L; Wolff, Peregrine; Smith, Joshua B; Jenks, Jonathan A


    Epizootic pneumonia of bighorn sheep is a devastating disease of uncertain etiology. To help clarify the etiology, we used culture and culture-independent methods to compare the prevalence of the bacterial respiratory pathogens Mannheimia haemolytica, Bibersteinia trehalosi, Pasteurella multocida, and Mycoplasma ovipneumoniae in lung tissue from 44 bighorn sheep from herds affected by 8 outbreaks in the western United States. M. ovipneumoniae, the only agent detected at significantly higher prevalence in animals from outbreaks (95%) than in animals from unaffected healthy populations (0%), was the most consistently detected agent and the only agent that exhibited single strain types within each outbreak. The other respiratory pathogens were frequently but inconsistently detected, as were several obligate anaerobic bacterial species, all of which might represent secondary or opportunistic infections that could contribute to disease severity. These data provide evidence that M. ovipneumoniae plays a primary role in the etiology of epizootic pneumonia of bighorn sheep.

  7. Reação leucemoide e anemia hemolítica grave causada por Mycoplasma pneumoniae Leukemoid reaction and severe hemolytic anemia due to Mycoplasma pneumoniae

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    Kléber G. Luz


    Full Text Available Hemólise massiva é uma manifestação rara da infecção por Mycoplasma pneumoniae.É desencadeada por crioaglutininas, anticorpos IgM, que surgem sete a dez dias após a infecção em cerca de 50% a 75% dos casos. Hiperleucocitose é também evento incomum e orienta o diagnóstico para etiologia bacteriana ou neoplásica. Relatamos um caso de um homem de 67 anos com pneumonia por Mycoplasma pneumoniae, que apresentou anemia grave e reação leucemoide, diagnosticada por meio do teste de crioaglutininas à beira do leito e dosagem do título de anticorpo anti-mycoplasma. Após início do tratamento adequado, houve melhora importante da anemia e a leucometria foi reduzida de 56.100/mm³ para valores próximos do normal.Massive hemolysis, a rare manifestation of Mycoplasma pneumoniae infection, is due to cold agglutinins (IgM antibodies that appear seven to ten days after the infection in around 50% to 70% of cases. Hyperleukocytosis, suggestive of bacterial or neoplastic etiologies, is also an uncommon event. We report here on the case of a 67-year-old man with Mycoplasma pneumoniae pneumonia who presented with severe anemia and leukemoid reaction as diagnosed by the bedside cold agglutinin test and measurement of anti-mycoplasma antibodies. After beginning appropriate treatment, the anemia improved significantly and the leukocyte count reduced from 56100 /mm³ to close to normal level.

  8. Reflections on pneumonia in the tropics


    Alpers, Michael P.


    This review of pneumonia in the tropics is based on experience with respiratory infections in Papua New Guinea since the 1970s. It discusses ideas, principles, historical aspects of pneumonia research and the need to work with people in the community. In order to understand pneumonia in a tropical setting and evaluate new interventions it is essential to study the ecosystem of the causative infections, within the host and the community and between interacting microorganisms. Vaccines are much...

  9. Treatment Failure and Mortality amongst Children with Severe Acute Malnutrition Presenting with Cough or Respiratory Difficulty and Radiological Pneumonia.

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    Mohammod Jobayer Chisti

    Full Text Available Appropriate intervention is critical in reducing deaths among under-five, severe acutely malnourished (SAM children with danger signs of severe pneumonia; however, there is paucity of data on outcome of World Health Organisation (WHO recommended interventions of SAM children with severe pneumonia. We sought to evaluate outcome of the interventions in such children.We prospectively enrolled SAM children aged 0-59 months, admitted to the Intensive Care Unit (ICU or Acute Respiratory Infection (ARI ward of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b, between April 2011 and June 2012 with cough or respiratory difficulty and radiological pneumonia. All the enrolled children were treated with ampicillin and gentamicin, and micronutrients as recommended by the WHO. Comparison was made among pneumonic children with (n = 111 and without WHO defined danger signs of severe pneumonia (n = 296. The outcomes of interest were treatment failure (if a child required changing of antibiotics and deaths during hospitalization. Further comparison was also made among those who developed treatment failure and who did not and among the survivors and deaths.SAM children with danger signs of severe pneumonia more often experienced treatment failure (58% vs. 20%; p<0.001 and fatal outcome (21% vs. 4%; p<0.001 compared to those without danger signs. Only 6/111 (5.4% SAM children with danger signs of severe pneumonia and 12/296 (4.0% without danger signs had bacterial isolates from blood. In log-linear binomial regression analysis, after adjusting for potential confounders, danger signs of severe pneumonia, dehydration, hypocalcaemia, and bacteraemia were independently associated both with treatment failure and deaths in SAM children presenting with cough or respiratory difficulty and radiological pneumonia (p<0.01.The result suggests that SAM children with cough or respiratory difficulty and radiologic pneumonia who

  10. The natural cytotoxicity receptor 1 contribution to early clearance of Streptococcus pneumoniae and to natural killer-macrophage cross talk.

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    Shirin Elhaik-Goldman

    Full Text Available Natural killer (NK cells serve as a crucial first line of defense against tumors, viral and bacterial infections. We studied the involvement of a principal activating natural killer cell receptor, natural cytotoxicity receptor 1 (NCR1, in the innate immune response to S. pneumoniae infection. Our results demonstrate that the presence of the NCR1 receptor is imperative for the early clearance of S. pneumoniae. We tied the ends in vivo by showing that deficiency in NCR1 resulted in reduced lung NK cell activation and lung IFNγ production at the early stages of S. pneumoniae infection. NCR1 did not mediate direct recognition of S. pneumoniae. Therefore, we studied the involvement of lung macrophages and dendritic cells (DC as the mediators of NK-expressed NCR1 involvement in response to S. pneumoniae. In vitro, wild type BM-derived macrophages and DC expressed ligands to NCR1 and co-incubation of S. pneumoniae-infected macrophages/DC with NCR1-deficient NK cells resulted in significantly lesser IFNγ levels compared to NCR1-expressing NK cells. In vivo, ablation of lung macrophages and DC was detrimental to the early clearance of S. pneumoniae. NCR1-expressing mice had more potent alveolar macrophages as compared to NCR1-deficient mice. This result correlated with the higher fraction of NCR1-ligand(high lung macrophages, in NCR1-expressing mice, that had better phagocytic activity compared to NCR1-ligand(dull macrophages. Overall, our results point to the essential contribution of NK-expressed NCR1 in early response to S. pneumoniae infection and to NCR1-mediated interaction of NK and S. pneumoniae infected-macrophages and -DC.

  11. Frequently Asked Questions about Ventilator-Associated Pneumonia (United States)

    ... Submit Button Frequently Asked Questions about Ventilator-associated Pneumonia Recommend on Facebook Tweet Share Compartir What is a Ventilator-associated Pneumonia (VAP)? Ventilator-associated pneumonia (VAP) is a lung ...

  12. [Bacterial vaginosis]. (United States)

    Romero Herrero, Daniel; Andreu Domingo, Antonia


    Bacterial vaginosis (BV) is the main cause of vaginal dysbacteriosis in the women during the reproductive age. It is an entity in which many studies have focused for years and which is still open for discussion topics. This is due to the diversity of microorganisms that cause it and therefore, its difficult treatment. Bacterial vaginosis is probably the result of vaginal colonization by complex bacterial communities, many of them non-cultivable and with interdependent metabolism where anaerobic populations most likely play an important role in its pathogenesis. The main symptoms are an increase of vaginal discharge and the unpleasant smell of it. It can lead to serious consequences for women, such as an increased risk of contracting sexually transmitted infections including human immunodeficiency virus and upper genital tract and pregnancy complications. Gram stain is the gold standard for microbiological diagnosis of BV, but can also be diagnosed using the Amsel clinical criteria. It should not be considered a sexually transmitted disease but it is highly related to sex. Recurrence is the main problem of medical treatment. Apart from BV, there are other dysbacteriosis less characterized like aerobic vaginitis of which further studies are coming slowly but are achieving more attention and consensus among specialists.

  13. Effects of PM2 5 exposure on Klebsiella pneumoniae clearance in the lungs of rats

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the effects of PM2.5 exposure on susceptibility to Klebsiella infection and bacterial clearance,and to discuss its possible mechanisms.Methods Eighty-six healthy male SD rats were randomly divided into 4 groups:a control group,a Klebsiella pneumoniae infection group(infection group),a PM2.5 group and a PM2.5

  14. [Pneumonia: The urgent problem of 21st century medicine]. (United States)

    Chuchalin, A G


    The paper analyzes the systematic reviews and meta-analyses on the strategic issues of pneumonia, which have been published in the past 3 years. It discusses the prevalence and mortality rates of acquired pneumonia, hospital-acquired (nosocomial) pneumonia, healthcare-associated pneumonia, ventilator-associated pneumonia, and Mycoplasma pneumonia, and the specific features of their etiology, diagnosis, and treatment. A large number of investigations emphasize the relevance of this problem in current clinical practice.

  15. TRAIL+ monocytes and monocyte-related cells cause lung damage and thereby increase susceptibility to influenza-Streptococcus pneumoniae coinfection. (United States)

    Ellis, Gregory T; Davidson, Sophia; Crotta, Stefania; Branzk, Nora; Papayannopoulos, Venizelos; Wack, Andreas


    Streptococcus pneumoniae coinfection is a major cause of influenza-associated mortality; however, the mechanisms underlying pathogenesis or protection remain unclear. Using a clinically relevant mouse model, we identify immune-mediated damage early during coinfection as a new mechanism causing susceptibility. Coinfected CCR2(-/-) mice lacking monocytes and monocyte-derived cells control bacterial invasion better, show reduced epithelial damage and are overall more resistant than wild-type controls. In influenza-infected wild-type lungs, monocytes and monocyte-derived cells are the major cell populations expressing the apoptosis-inducing ligand TRAIL. Accordingly, anti-TRAIL treatment reduces bacterial load and protects against coinfection if administered during viral infection, but not following bacterial exposure. Post-influenza bacterial outgrowth induces a strong proinflammatory cytokine response and massive inflammatory cell infiltrate. Depletion of neutrophils or blockade of TNF-α facilitate bacterial outgrowth, leading to increased mortality, demonstrating that these factors aid bacterial control. We conclude that inflammatory monocytes recruited early, during the viral phase of coinfection, induce TRAIL-mediated lung damage, which facilitates bacterial invasion, while TNF-α and neutrophil responses help control subsequent bacterial outgrowth. We thus identify novel determinants of protection versus pathology in influenza-Streptococcus pneumoniae coinfection.

  16. Growth of the Pittsburgh Pneumonia Agent in Animal Cell Cultures


    Rinaldo, Charles R.; Pasculle, A. William; Myerowitz, Richard L.; Gress, Francis M.; Dowling, John N.


    Pittsburgh pneumonia agent (Legionella micdadei) grew in monkey, chicken, and human cell cultures. Pittsburgh pneumonia agent grew predominantly in the cytoplasm, resulting in a nonfocal, mild cytopathic effect.

  17. IL-22 Defect During Streptococcus pneumoniae Infection Triggers Exacerbation of Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Muriel Pichavant


    Full Text Available Progression of chronic obstructive pulmonary disease (COPD is linked to episodes of exacerbations caused by bacterial infections due to Streptococcus pneumoniae. Our objective was to identify during COPD, factors of susceptibility to bacterial infections among cytokine network and their role in COPD exacerbations. S. pneumoniae was used to sub-lethally challenge mice chronically exposed to air or cigarette smoke (CS and to stimulate peripheral blood mononuclear cells (PBMC from non-smokers, smokers and COPD patients. The immune response and the cytokine production were evaluated. Delayed clearance of the bacteria and stronger lung inflammation observed in infected CS-exposed mice were associated with an altered production of IL-17 and IL-22 by innate immune cells. This defect was related to a reduced production of IL-1β and IL-23 by antigen presenting cells. Importantly, supplementation with recombinant IL-22 restored bacterial clearance in CS-exposed mice and limited lung alteration. In contrast with non-smokers, blood NK and NKT cells from COPD patients failed to increase IL-17 and IL-22 levels in response to S. pneumoniae, in association with a defect in IL-1β and IL-23 secretion. This study identified IL-17 and IL-22 as susceptibility factors in COPD exacerbation. Therefore targeting such cytokines could represent a potent strategy to control COPD exacerbation.

  18. Enhanced inflammation in aged mice following infection with Streptococcus pneumoniae is associated with decreased IL-10 and augmented chemokine production. (United States)

    Williams, Andrew E; José, Ricardo J; Brown, Jeremy S; Chambers, Rachel C


    Streptococcus pneumoniae is the most common cause of severe pneumonia in the elderly. However, the impact of aging on the innate inflammatory response to pneumococci is poorly defined. We compared the innate immune response in old vs. young adult mice following infection with S. pneumoniae. The accumulation of neutrophils recovered from bronchoalveolar lavage fluid and lung homogenates was increased in aged compared with young adult mice, although bacterial outgrowth was similar in both age groups, as were markers of microvascular leak. Aged mice had similar levels of IL-1β, TNF, IFN-γ, IL-17, and granulocyte colony-stimulating factor following S. pneumoniae infection, compared with young mice, but increased levels of the chemokines CXCL9, CXCL12, CCL3, CCL4, CCL5, CCL11, and CCL17. Moreover, levels of IL-10 were significantly lower in aged animals. Neutralization of IL-10 in infected young mice was associated with increased neutrophil recruitment but no decrease in bacterial outgrowth. Furthermore, IL-10 neutralization resulted in increased levels of CCL3, CCL5, and CXCL10. We conclude that aging is associated with enhanced inflammatory responses following S. pneumoniae infection as a result of a compromised immunomodulatory cytokine response.

  19. Pneumonia and empyema caused by Streptococcus intermedius that shows the diagnostic importance of evaluating the microbiota in the lower respiratory tract. (United States)

    Noguchi, Shingo; Yatera, Kazuhiro; Kawanami, Toshinori; Yamasaki, Kei; Fukuda, Kazumasa; Naito, Keisuke; Akata, Kentarou; Nagata, Shuya; Ishimoto, Hiroshi; Taniguchi, Hatsumi; Mukae, Hiroshi


    The bacterial species in the Streptococcus anginosus group (S. constellatus, S. anginosus, S. intermedius) are important causative pathogens of bacterial pneumonia, pulmonary abscesses and empyema. However, the bacteria in this group are primarily oral resident bacteria and unable to grow significantly on ordinary aerobic culture media. We experienced a case of pneumonia and empyema caused by Streptococcus intermedius detected using a 16S rRNA gene sequencing analysis of bronchoalveolar lavage fluid and pleural effusion, but not sputum. Even when applying the molecular method, sputum samples are occasionally unsuitable for identifying the causative pathogens of lower respiratory tract infections.

  20. Causative agent distribution and antibiotic therapy assessment among adult patients with community acquired pneumonia in Chinese urban population

    Directory of Open Access Journals (Sweden)

    Liu Yong


    Full Text Available Abstract Background Knowledge of predominant microbial patterns in community-acquired pneumonia (CAP constitutes the basis for initial decisions about empirical antimicrobial treatment, so a prospective study was performed during 2003–2004 among CAP of adult Chinese urban populations. Methods Qualified patients were enrolled and screened for bacterial, atypical, and viral pathogens by sputum and/or blood culturing, and by antibody seroconversion test. Antibiotic treatment and patient outcome were also assessed. Results Non-viral pathogens were found in 324/610 (53.1% patients among whom M. pneumoniae was the most prevalent (126/610, 20.7%. Atypical pathogens were identified in 62/195 (31.8% patients carrying bacterial pathogens. Respiratory viruses were identified in 35 (19% of 184 randomly selected patients with adenovirus being the most common (16/184, 8.7%. The nonsusceptibility of S. pneumoniae to penicillin and azithromycin was 22.2% (Resistance (R: 3.2%, Intermediate (I: 19.0% and 79.4% (R: 79.4%, I: 0%, respectively. Of patients (312 from whom causative pathogens were identified and antibiotic treatments were recorded, clinical cure rate with β-lactam antibiotics alone and with combination of a β-lactam plus a macrolide or with fluoroquinolones was 63.7% (79/124 and 67%(126/188, respectively. For patients having mixed M. pneumoniae and/or C. pneumoniae infections, a better cure rate was observed with regimens that are active against atypical pathogens (e.g. a β-lactam plus a macrolide, or a fluoroquinolone than with β-lactam alone (75.8% vs. 42.9%, p = 0.045. Conclusion In Chinese adult CAP patients, M. pneumoniae was the most prevalent with mixed infections containing atypical pathogens being frequently observed. With S. pneumoniae, the prevalence of macrolide resistance was high and penicillin resistance low compared with data reported in other regions.

  1. Ekstrapulmonale komplikationer ved mycoplasma pneumoniae-infektioner

    DEFF Research Database (Denmark)

    Bjørn, Anne-Mette Bay; Lebech, Anne-Mette K


    Mycoplasma pneumoniae is a common cause of atypical pneumonia in children and young adults. The infection is generally mild and only a very few patients are admitted to hospital. However, extrapulmonary complications are well recognised--mostly as manifestations from the central nervous system (CNS)....

  2. Seeing Streptococcus pneumoniae, a Common Killer Bacteria

    DEFF Research Database (Denmark)

    Kjærgaard, Rikke Schmidt; Andersen, Ebbe Sloth


    of the bacteria Streptococcus pneumoniae by use of ink, watercolours and computer graphics. We propose a novel artistic visual rendering of Streptococcus pneumoniae and ask what the value of these kind of representations are compared to traditional scientific data. We ask if drawings and computer...

  3. Necrotizing Pneumonia Caused by Penicillium chrysogenum


    D’Antonio, Domenico; Violante, Beatrice; Farina, Claudio; Sacco, Rocco; Angelucci, Domenico; Masciulli, Maurizio; Iacone, Antonio; Romano, Ferdinando


    We report a case of necrotizing pneumonia due to Penicillium chrysogenum in a 57-year-old woman operated on for lung cancer. The residual right lower pulmonary lobe was infiltrated by Penicillium chrysogenum. The patient underwent a second pulmonary right lobectomy and was successfully treated with oral itraconazole. To our knowledge, this is the first case of pneumonia due to P. chrysogenum.

  4. Pneumonia of lambs in the Abruzzo region of Italy: anatomopathological and histopathological studies and localisation of Mycoplasma ovipneumoniae. (United States)

    Ettorre, Chiara; Sacchini, Flavio; Scacchia, Massimo; Della Salda, Leonardo


    The most common forms of inflammation of the lower respiratory tract in lambs are acute enzootic pneumonia, caused mainly by Mannheimia haemolytica, chronic enzootic pneumonia (defined as 'atypical' in lambs), the aetiological of which is Mycoplasma ovipneumoniae and viral inflammation principally caused by parainfluenza virus type 3. The authors conducted anatomopathological and histopathological studies of the most commonly encountered spontaneous lung inflammations in lambs slaughtered in the Abruzzo region of Italy, with special attention to 'atypical pneumonia'. Microbiological isolations and a histopathological and immunohistochemical analysis were performed to reveal any possible correlations between causal agents and lesion patterns. Positive results for M. ovipneumoniae were compared to those for Mycoplasma isolation to evaluate the sensitivity of the two techniques. Of a total of 156 samples, 31 (19.8%) demonstrated involvement of M. ovipneumoniae, 15 (9.6%) were positive on microbiological isolation confirmed by typing with biomolecular methods and, finally, histological lesions (atypical pneumonia) were observed in the remaining 16 cases (10.2%). Of these 31 samples, 23 (14.7% of the total) demonstrated postive antigen in alveolar macrophages and giant cells on immunohistochemical testing. These data revealed the presence of chronic enzootic pneumonia in the Abruzzo area and the importance of immunohistochemistry (in combination with isolation and anatomopathological and histopathological examination) for the diagnosis of pneumonia caused by M. ovipneumoniae, as well as the high sensitivity shown by antigen marker expression, even in samples where bacterial load was limited.

  5. Systems Biology Approaches for the Prediction of Possible Role of Chlamydia pneumoniae Proteins in the Etiology of Lung Cancer. (United States)

    Khan, Shahanavaj; Imran, Ahamad; Khan, Abdul Arif; Abul Kalam, Mohd; Alshamsan, Aws


    Accumulating evidence has recently supported the association of bacterial infection with the growth and development of cancers, particularly in organs that are constantly exposed to bacteria such as the lungs, colon, cervical cancer etc. Our in silico study on the proteome of Chlamydia pneumoniae suggests an unprecedented idea of the etiology of lung cancer and have revealed that the infection of C. pneumoniae is associated with lung cancer development and growth. It is reasonable to assume that C. pneumoniae transports its proteins within host-intracellular organelles during infection, where they may work with host-cell proteome. The current study was performed for the prediction of nuclear targeting protein of C. pneumoniae in the host cell using bioinformatics predictors including ExPASy pI/Mw tool, nuclear localization signal (NLS) mapper, balanced sub cellular localization predictor (BaCeILo), and Hum-mPLoc 2.0. We predicted 47/1112 nuclear-targeting proteins of C. pneumoniae connected with several possible alterations in host replication and transcription during intracellular infection. These nuclear-targeting proteins may direct to competitive interactions of host and C. pneumoniae proteins with the availability of same substrate and may be involved as etiological agents in the growth and development of lung cancer. These novel findings are expected to access in better understanding of lung cancer etiology and identifying molecular targets for therapy.

  6. Photodynamic inactivation of Klebsiella pneumoniae biofilms and planktonic cells by 5-aminolevulinic acid and 5-aminolevulinic acid methyl ester. (United States)

    Liu, Chengcheng; Zhou, Yingli; Wang, Li; Han, Lei; Lei, Jin'e; Ishaq, Hafiz Muhammad; Nair, Sean P; Xu, Jiru


    The treatment of Klebsiella pneumoniae, particularly extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae, is currently a great challenge. Photodynamic antimicrobial chemotherapy is a promising approach for killing antibiotic-resistant bacteria. The aim of this study was to evaluate the capacity of 5-aminolevulinic acid (5-ALA) and its derivative 5-ALA methyl ester (MAL) in the presence of white light to cause photodynamic inactivation (PDI) of K. pneumoniae planktonic and biofilm cells. In the presence of white light, 5-ALA and MAL inactivated planktonic cells in a concentration-dependent manner. Biofilms were also sensitive to 5-ALA and MAL-mediated PDI. The mechanisms by which 5-ALA and MAL caused PDI of ESBL-producing K. pneumonia were also investigated. Exposure of K. pneumonia to light in the presence of either 5-ALA or MAL induced cleavage of genomic DNA and the rapid release of intracellular biopolymers. Intensely denatured cytoplasmic contents and aggregated ribosomes were also detected by transmission electron microscopy. Scanning electron microscopy showed that PDI of biofilms caused aggregated bacteria to detach and that the bacterial cell envelope was damaged. This study provides insights into 5-ALA and MAL-mediated PDI of ESBL-producing K. pneumoniae.

  7. Uji Daya Hambat Ekstrak Buah Belimbing Manis (Averrhoa carambola terhadap Pertumbuhan Bakteri Streptococcus pneumoniae secara In Vitro

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    Rita Risandi


    Full Text Available AbstrakBuah belimbing manis (Averrhoa carambola merupakan salah satu tanaman Indonesia yang diyakini memiliki khasiat obat. Salah satu manfaat yang dapat diambil dari sari buah belimbing manis (Averrhoa carambola adalah dapat mengobati radang tenggorokan. Radang tenggorokan merupakan salah satu infeksi yang disebabkan oleh bakteri Streptococcus pneumoniae. Tujuan penelitian ini adalah menentukan daya hambat ekstrak buah belimbing manis (Averrhoa carambola terhadap pertumbuhan bakteri Streptococcus pneumoniae  secara in vitro. Metode studi ini ialah eksperimental dengan desain postest only control group design yang dilakukan di Laboratorium Biota Sumatera Universitas Andalas dan Laboratorium Mikrobiologi Fakultas Kedokteran Universitas Andalas dari Agustus sampai Oktober 2014. Hasil penelitian menunjukkan bahwa ekstrak buah belimbing manis (Averrhoa carambola dengan konsentrasi yaitu 5%, 10%, 15% dan 20% tidak memiliki daya hambat terhadap pertumbuhan bakteri Streptococcus pneumoniae.  Hal ini terbukti karena tidak terbentuk zona hambat pada agar darah dan tidak terdapat pengaruh lama kontak ekstrak buah belimbing manis (Averrhoa carambola  terhadap pertumbuhan bakteri Streptococcus pneumoniae secara in vitro. Ekstrak buah belimbing manis tidak memiliki efek antibakteri terhadap pertumbuhan bakteri Streptococcus pneumoniae.Kata kunci: ekstrak buah belimbing manis, Streptococcus pneumoniae, daya hambat Abstract             Star fruit (Averrhoa carambola is a Indonesian plant that is believed to have medicinal properties. One of the benefits that can be drawn from the juice of star fruit (Averrhoa carambola is the ability to treat strep throat. Strep throat is a bacterial infection caused by Streptococcus pneumoniae. The objective of this study was to determine the inhibitory extract of star fruit (Averrhoa carambola on the growth of the bacterium Streptococcus pneumoniae in vitro. This was an experimental  research  with design

  8. Recognising and managing community-acquired pneumonia. (United States)

    Gibson, Vanessa


    Pneumonia remains a significant cause of morbidity and mortality in the UK and yet the seriousness of the disease is underestimated. Pneumonia can be life-threatening because the delicate tissues of the alveoli and pulmonary capillaries are susceptible to damage from the inflammatory response. This damage leads to consolidation that prevents the diffusion of oxygen and carbon dioxide, and this in turn can lead to respiratory failure. This article summarises guidance on the diagnosis and management of community-acquired pneumonia, and also includes information on the prevention of pneumonia. This information should be valuable to nurses working in a variety of clinical areas since patients with community-acquired pneumonia are encountered in primary, intermediate, secondary and critical care.

  9. Pathogenicity ofKlebsiella pneumonia(KpC4) infecting maize and mice

    Institute of Scientific and Technical Information of China (English)

    HUANG Min; HE Yue-qiu; LIN Li; WU Yi-xin; Honhing Ho; HE Peng-fei; LI Guo-zhi; HE Peng-bo; XIONG Guo-ru; YUAN Yuan


    Recently, a new bacterial top rot disease of maize has frequently appeared in many areas of Yunnan Province, China. The pathogen of the disease was identiifed asKlebsiela pneumoniae(KpC4), which is wel known to cause pulmonary and urinary diseases in humans and animals and occasionaly exists as a harmless endophyte in plants. To evaluate the viru-lence of the maize pathogen to maize and mice, we inoculated maize and mice with routine inoculation and intraperitoneal injection respectively according to Koch’s postulates. The results showed that KpC4 and the clinical strainK. pneumoniae 138 (Kp138) were al highly pathogenic to maize and mice and the strain re-isolated from diseased mice also caused typical top rot symptoms on maize by artiifcial inoculation. It is highlighting that a seemingly dedicated human/animal pathogen could cause plant disease. This is the ifrst report ofK. pneumoniae, an opportunistic pathogen of human/animal , could infect maize and mice. The ifndings serve as an alert to plant, medical and veterinarian scientists regarding a potentialy dangerous bacterial pathogen infecting both plants and animals/humans. The maize plants in the ifeld could serve as a reservoir forK. pneumoniae which might infect animals and probably humans when conditions are favorable. The new ifndings not only are signiifcant in the developing control strategy for the new disease in Yunnan, but also serve as a starting point for further studies on the mechanism of pathogenesis and epidemiology ofK. pneumoniae.

  10. Thalidomide treatment modulates macrophage pro-inflammatory function and cytokine levels in Klebsiella pneumoniae B5055 induced pneumonia in BALB/c mice. (United States)

    Kumar, Vijay; Harjai, Kusum; Chhibber, Sanjay


    Lung innate immune response plays an important role in the clearance of pathogens from lungs, however, profound activation of innate immune cells (alveolar macrophages or neutrophils) can lead to development of acute lung inflammation or injury by producing various pro-inflammatory molecules (IL-1, TNF-alpha and H2O2 etc.). Present study is designed to investigate the immunomodulatory action of thalidomide in Klebsiella pneumoniae B5055 induced acute lung infection in BALB/c mice. Acute lung inflammation was induced by intranasal instillation of K. pneumoniae B5055 into mice without any anaesthesia and treated with thalidomide (30 mg/kg/day/po) or normal saline orally using a treatment schedule shown to modulate pro-inflammatory innate immune response. Thalidomide treatment modulated pro-inflammatory function of alveolar macrophages by significantly (ppneumonia caused by gram negative bacterial infection.

  11. Acute Chlamydia pneumoniae and Mycoplasma pneumoniae infections in community-acquired pneumonia and exacerbations of COPD or asthma: therapeutic considerations. (United States)

    Meloni, F; Paschetto, E; Mangiarotti, P; Crepaldi, M; Morosini, M; Bulgheroni, A; Fietta, A


    Rates of acute Chlamydia pneumoniae and Mycoplasma pneumoniae infections were determined in 115 adults hospitalized for community-acquired pneumonia (CAP), purulent exacerbations of COPD and acute exacerbations of bronchial asthma, by means of serology and molecular methods. Results were compared with those obtained in a matched control group. Common respiratory pathogens were isolated by cultures in 22.5% and 22.2% of CAP and exacerbated COPD patients, respectively. Cultures from exacerbated asthma patients were always negative. Serological and molecular evidence of current C. pneumoniae infection was obtained in 10.0%, 8.9% and 3.3% of CAP, COPD and asthma cases. The corresponding rates of acute M. pneumoniae infection were 17.5%, 6.7% and 3.3%, respectively. Finally, no difference was found between typical and atypical pathogen rates. These findings highlight the importance of taking into account C. pneumoniae and M. pneumoniae infections in guiding the choice of empirical antibacterial treatment for CAP and purulent exacerbations of COPD.

  12. Pneumonia grave por "Chlamydia psittaci"

    Directory of Open Access Journals (Sweden)



    Full Text Available A psitacose, também conhecida como ornitose, é causada pela Chlamydia psittaci; caracteriza-se por doença de início insidioso, sintomas brandos e inespecíficos, lembrando infecção de vias aéreas superiores. Acomete principalmente o pulmão, sendo raramente doença sistêmica e fatal. Descreve-se um caso raro de pneumonia por Chlamydia psittaci que evoluiu para insuficiência respiratória aguda, necessitando de ventilação mecânica. Destaca-se a importância em considerar o diagnóstico, especialmente em casos de pneumonia comunitária que evolui de modo insatisfatório, que não responde à terapia antimicrobiana e cuja epidemiologia é positiva para exposição às aves. O diagnóstico precoce é fundamental devido à excelente resposta terapêutica. O diagnóstico tardio pode levar a curso grave e fatal da doença.

  13. Clinical manifestations of organizing pneumonia

    Directory of Open Access Journals (Sweden)

    Martín Hunter


    Full Text Available Organizing pneumonia is a clinical entity asociated with nonspecific symptoms and radiological findings and abnormalities in pulmonary function tests. It is defined by the characteristic histopathological pattern: filling of alveoli and respiratory bronchioles by plugs of granulation tissue. It can be idiopathic (COP or secondary to other causes (SOP. It is an unusual finding and the clinical and radiographic findings are nonspecific. For specific diagnosis an invasive procedure has to be done, but often empirical treatment is started when there's a clinical suspicion. We describe the clinical characteristics of 13 patients with histological diagnosis of organizing pneumonia. Data was obtained from their medical records. The median age was 76 years and the median time to diagnosis from the onset of symptoms was 31 days. In 10 cases the diagnosis was made by transbronchial biopsy. 8 patients required hospitalization, 4 of them received high doses of steroids and 3 required ventilatory support. One patient died from a cause attributable to this entity and 5 relapsed. Dyspnea, cough and fever were the most frequent symptoms. Most patients had more than one tomographic pattern being the most common ground glass opacities and alveolar consolidation. Nine patients were diagnosed with COP and 4 with SOP. The most frequent underlying cause of SOP was drug toxicity. The clinical characteristics of the reported cases are consistent with previously published series. As an interesting feature, there was a group of patients that needed high doses of steroids and ventilatory support.

  14. In vivo evolution of tigecycline-non-susceptible Klebsiella pneumoniae strains in patients: relationship between virulence and resistance. (United States)

    Lin, Yi-Tsung; Huang, Yi-Wei; Huang, Hsin-Hui; Yang, Tsuey-Ching; Wang, Fu-Der; Fung, Chang-Phone


    Tigecycline resistance among Klebsiella pneumoniae isolates has been increasingly reported. We aimed to investigate the relationship among in vivo acquisition of tigecycline resistance in K. pneumoniae clinical isolates, the underlying molecular mechanisms and bacterial virulence. Clinical isolates of K. pneumoniae from the same patient in a medical centre in Taiwan that were initially tigecycline-susceptible (TS) and then became tigecycline-non-susceptible (TNS) were identified. Clinical data were collected. All isolates were subjected to MIC determination by Etest, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), virulence factor determination, and growth rate and mouse lethality studies. Quantitative RT-PCR was performed to analyse acrA, oqxA, ramA and rarA expressions. The presence of mutations in acrR, ramR, oqxR and rpsJ were analysed by DNA sequencing. Five isogenic paired isolates were determined by PFGE fingerprinting. TNS K. pneumoniae appeared after treatment with a variety of antibiotics among patients infected with TS K. pneumoniae. TNS K. pneumoniae isolates were associated with upregulation of RamA and/or RarA and the corresponding AcrAB and/or OqxAB efflux pump(s), respectively. Various mutations in negative regulatory genes (ramR and oqxR) accounted for overexpression of ramA and rarA, respectively. Three of the five paired isolates showed similar growth rates and virulence between TS and TNS isolates. Two TNS K. pneumoniae strains belonging to capsular types K1 and K20 retained their high virulence. In conclusion, some TNS K. pneumoniae strains derived from TS isolates did not compromise their virulence. Dissemination of these highly pathogenic and resistant strains would be of major concern in the future.

  15. Disentangling competence for genetic transformation and virulence in Streptococcus pneumoniae. (United States)

    Lin, Jingjun; Zhu, Luchang; Lau, Gee W


    Horizontal gene transfer mediated by the competence regulon is a major driver of genome plasticity in Streptococcus pneumoniae. When pneumococcal cells enter the competent state, about 6% of the genes in the genome are up-regulated. Among these, some genes are essential for genetic transformation while others are dispensable for the process. Exhaustive deletion analyses show that some up-regulated genes dispensable for genetic transformation contribute to pneumococcal-mediated pneumonia and bacteremia infections. Interestingly, virulence functions of such genes are either dependent or independent of the competent state. Among the competent-state-dependent genes are those mediating allolysis, a process where small fraction of non-competent cells within the pneumococcal population are lysed by their competent counterparts, releasing DNA presumably for transformation. Inadvertently, the pore-forming toxin pneumolysin is also released during allolysis, contributing to virulence. In this review, we discuss recent advances in our understanding of pneumococcal virulence processes mediated by the competence regulon. We proposed that coupling of competence induction and bacterial fitness drives the natural selection to favor an intact competence regulon, which in turn, provides the long-term benefits of genetic plasticity.

  16. Macrolide resistance determination and molecular typing of Mycoplasma pneumoniae by pyrosequencing. (United States)

    Spuesens, Emiel B M; Hoogenboezem, Theo; Sluijter, Marcel; Hartwig, Nico G; van Rossum, Annemarie M C; Vink, Cornelis


    The first choice antibiotics for treatment of Mycoplasma pneumoniae infections are macrolides. Several recent studies, however, have indicated that the prevalence of macrolide (ML)-resistance, which is determined by mutations in the bacterial 23S rRNA, is increasing among M. pneumoniae isolates. Consequently, it is imperative that ML-resistance in M. pneumoniae is rapidly detected to allow appropriate and timely treatment of patients. We therefore set out to determine the utility of pyrosequencing as a convenient technique to assess ML-resistance. In addition, we studied whether pyrosequencing could be useful for molecular typing of M. pneumoniae isolates. To this end, a total of four separate pyrosequencing assays were developed. These assays were designed such as to determine a short genomic sequence from four different sites, i.e. two locations within the 23S rRNA gene, one within the MPN141 (or P1) gene and one within the MPN528a gene. While the 23S rRNA regions were employed to determine ML-resistance, the latter two were used for molecular typing. The pyrosequencing assays were performed on a collection of 108 M. pneumoniae isolates. The ML-resistant isolates within the collection (n=4) were readily identified by pyrosequencing. Moreover, each strain was correctly typed as either a subtype 1 or subtype 2 strain by both the MPN141 and MPN528a pyrosequencing test. Interestingly, two recent isolates from our collection, which were identified as subtype 2 strains by the pyrosequencing assays, were found to carry novel variants of the MPN141 gene, having rearrangements in each of the two repetitive elements (RepMP4 and RepMP2/3) within the gene. In conclusion, pyrosequencing is a convenient technique for ML-resistance determination as well as molecular typing of M. pneumoniae isolates.

  17. Structural and functional analysis of fucose-processing enzymes from Streptococcus pneumoniae. (United States)

    Higgins, Melanie A; Suits, Michael D; Marsters, Candace; Boraston, Alisdair B


    Fucose metabolism pathways are present in many bacterial species and typically contain the central fucose-processing enzymes fucose isomerase (FcsI), fuculose kinase (FcsK), and fuculose-1-phosphate aldolase (FcsA). Fucose initially undergoes isomerization by FcsI producing fuculose, which is then phosphorylated by FcsK. FcsA cleaves the fuculose-1-phosphate product into lactaldehyde and dihydroxyacetone phosphate, which can be incorporated into central metabolism allowing the bacterium to use fucose as an energy source. Streptococcus pneumoniae has fucose-processing operons containing homologs of FcsI, FcsK, and FcsA; however, this bacterium appears unable to utilize fucose as an energy source. To investigate this contradiction, we performed biochemical and structural studies of the S. pneumoniae fucose-processing enzymes SpFcsI, SpFcsK, and SpFcsA. These enzymes are demonstrated to act in a sequential manner to ultimately produce dihydroxyacetone phosphate and have structural features entirely consistent with their observed biochemical activities. Analogous to the regulation of the Escherichia coli fucose utilization operon, fuculose-1-phosphate appears to act as an inducing molecule for activation of the S. pneumoniae fucose operon. Despite our evidence that S. pneumoniae appears to have the appropriate regulatory and biochemical machinery for fucose metabolism, we confirmed the inability of the S. pneumoniae TIGR4 strain to grow on fucose or on the H-disaccharide, which is the probable substrate of the transporter for the pathway. On the basis of these observations, we postulate that the S. pneumoniae fucose-processing pathway has a non-metabolic role in the interaction of this bacterium with its human host.

  18. Bacterial hydrodynamics

    CERN Document Server

    Lauga, Eric


    Bacteria predate plants and animals by billions of years. Today, they are the world's smallest cells yet they represent the bulk of the world's biomass, and the main reservoir of nutrients for higher organisms. Most bacteria can move on their own, and the majority of motile bacteria are able to swim in viscous fluids using slender helical appendages called flagella. Low-Reynolds-number hydrodynamics is at the heart of the ability of flagella to generate propulsion at the micron scale. In fact, fluid dynamic forces impact many aspects of bacteriology, ranging from the ability of cells to reorient and search their surroundings to their interactions within mechanically and chemically-complex environments. Using hydrodynamics as an organizing framework, we review the biomechanics of bacterial motility and look ahead to future challenges.

  19. Comparison of high-resolution computed tomography findings between Pseudomonas aeruginosa pneumonia and Cytomegalovirus pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Omeri, Ahmad Khalid; Okada, Fumito; Takata, Shoko; Ono, Asami; Sato, Haruka; Mori, Hiromu [Oita University Faculty of Medicine, Department of Radiology, Yufu, Oita (Japan); Nakayama, Tomoko [Oita Red Cross Hospital, Department of Radiology, Oita (Japan); Ando, Yumiko [Oita Nishibeppu National Hospital, Department of Radiology, Oita (Japan); Hiramatsu, Kazufumi [Oita University Hospital, Hospital Infection Control Center, Oita (Japan)


    To compare pulmonary high-resolution CT (HRCT) findings in patients with Pseudomonas aeruginosa pneumonia to HRCT findings in patients with Cytomegalovirus (CMV) pneumonia. We studied 124 patients (77 men, 47 women; age range, 20-89 years; mean age, 65.4 years) with P. aeruginosa pneumonia and 44 patients (22 men, 22 women; age range, 36-86 years; mean age, 63.2 years) with CMV pneumonia. CT findings of consolidation (p < 0.005), bronchial wall thickening (p < 0.001), cavity (p < 0.05), and pleural effusion (p < 0.001) were significantly more frequent in patients with P. aeruginosa pneumonia than in those with CMV pneumonia. Centrilobular nodules, a crazy-paving appearance, and nodules were significantly more frequent in patients with CMV pneumonia than in those with P. aeruginosa pneumonia (all p < 0.001). Pulmonary HRCT findings, such as bronchial wall thickening, crazy-paving appearance, and nodules may be useful in distinguishing between P. aeruginosa pneumonia and CMV pneumonia. (orig.)

  20. Influenza virus induces bacterial and nonbacterial otitis media. (United States)

    Short, Kirsty R; Diavatopoulos, Dimitri A; Thornton, Ruth; Pedersen, John; Strugnell, Richard A; Wise, Andrew K; Reading, Patrick C; Wijburg, Odilia L


    Otitis media (OM) is one of the most common childhood diseases. OM can arise when a viral infection enables bacteria to disseminate from the nasopharynx to the middle ear. Here, we provide the first infant murine model for disease. Mice coinfected with Streptococcus pneumoniae and influenza virus had high bacterial load in the middle ear, middle ear inflammation, and hearing loss. In contrast, mice colonized with S. pneumoniae alone had significantly less bacteria in the ear, minimal hearing loss, and no inflammation. Of interest, infection with influenza virus alone also caused some middle ear inflammation and hearing loss. Overall, this study provides a clinically relevant and easily accessible animal model to study the pathogenesis and prevention of OM. Moreover, we provide, to our knowledge, the first evidence that influenza virus alone causes middle ear inflammation in infant mice. This inflammation may then play an important role in the development of bacterial OM.

  1. The pneumococcal serine-rich repeat protein is an intra-species bacterial adhesin that promotes bacterial aggregation in vivo and in biofilms.

    NARCIS (Netherlands)

    Sanchez, C.J.; Shivshankar, P.; Stol, K.; Trakhtenbroit, S.; Sullam, P.M.; Sauer, K.; Hermans, P.W.M.; Orihuela, C.J.


    The Pneumococcal serine-rich repeat protein (PsrP) is a pathogenicity island encoded adhesin that has been positively correlated with the ability of Streptococcus pneumoniae to cause invasive disease. Previous studies have shown that PsrP mediates bacterial attachment to Keratin 10 (K10) on the surf

  2. Time to positivity in blood cultures of adults with Streptococcus pneumoniae bacteremia

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    Ansorena Luis


    Full Text Available Abstract Background previous studies have established that bacterial blood concentration is related with clinical outcome. Time to positivity of blood cultures (TTP has relationship with bacterial blood concentration and could be related with prognosis. As there is scarce information about the usefulness of TTP, we study the relationship of TTP with clinical parameters in patients with Streptococcus pneumoniae bacteremia. Methods TTP of all cases of Streptococcus pneumoniae bacteremia, detected between January 1995 and December 2004 using the BacT/Alert automated blood culture system in a teaching community hospital was analyzed. When multiple cultures were positive only the shortest TTP was selected for the analysis. Results in the study period 105 patients with Streptococcus pneumoniae bacteremia were detected. Median TTP was 14.1 hours (range 1.2 h to 127 h. Immunosuppressed patients (n = 5, patients with confusion (n = 19, severe sepsis or shock at the time of blood culture extraction (n = 12, those with a diagnosis of meningitis (n = 7 and those admitted to the ICU (n = 14 had lower TTP. Patients with TTP in the first quartile were more frequently hospitalized, admitted to the ICU, had meningitis, a non-pneumonic origin of the bacteremia, and a higher number of positive blood cultures than patients with TTP in the fourth quartile. None of the patients with TTP in the 90th decile had any of these factors associated with shorter TTP, and eight out of ten patients with TTP in the 10th decile had at least one of these factors. The number of positive blood cultures had an inverse correlation with TTP, suggesting a relationship of TTP with bacterial blood concentration. Conclusion Our data support the relationship of TTP with several clinical parameters in patients with Streptococcus pneumoniae bacteremia, and its potential usefulness as a surrogate marker of outcome.

  3. Community-Acquired Pneumonia in Children: A Multidisciplinary Consensus Review

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    Donald E Low


    Full Text Available Community-acquired pneumonia (CAP is common among children and may have viral, bacterial or, occasionally, other causes. The etiology is complex, with age-related trends, and differs from that in adult CAP, necessitating different management guidelines. There is an absence of current guidelines for the management of pediatric CAP (PCAP that take into account changing etiologies, antimicrobial-resistance issues and the use of newly licensed antimicrobials. The present review does not provide specific guidelines, but it reviews the literature and presents currrent approaches to the treatment of PCAP. To compile the review, an expert panel was convened to provide a consensus. The review discusses the etiology, diagnosis and antimicrobial treatment of PCAP as well as indications for referral to a hospital emergency department. The goal of the review is to provide those involved with treatment of PCAP in the community setting with information that can be used to make effective treatment choices.

  4. Aromatic Esters of Bicyclic Amines as Antimicrobials against Streptococcus pneumoniae. (United States)

    de Gracia Retamosa, María; Díez-Martínez, Roberto; Maestro, Beatriz; García-Fernández, Esther; de Waal, Bas; Meijer, E W; García, Pedro; Sanz, Jesús M


    A double approach was followed in the search of novel inhibitors of the surface choline-binding proteins (CBPs) of Streptococcus pneumoniae (pneumococcus) with antimicrobial properties. First, a library of 49 rationally-designed esters of alkyl amines was screened for their specific binding to CBPs. The best binders, being esters of bicyclic amines (EBAs), were then tested for their in vitro effect on pneumococcal growth and morphology. Second, the efficiency of EBA-induced CBP inhibition was enhanced about 45,000-fold by multivalency effects upon synthesizing a poly(propylene imine) dendrimer containing eight copies of an atropine derivative. Both approaches led to compounds that arrest bacterial growth, dramatically decrease cell viability, and exhibit a protection effect in animal disease models, demonstrating that the pneumococcal CBPs are adequate targets for the discovery of novel antimicrobials that overcome the currently increasing antimicrobial resistance issues.

  5. High-mobility group nucleosome-binding domain 2 protein inhibits the invasion of Klebsiella pneumoniae into mouse lungs in vivo. (United States)

    Zheng, Shuang; Ren, Laibin; Li, Heng; Shen, Xiaofei; Yang, Xiaolong; Li, Na; Wang, Xinyuan; Guo, Xiaojuan; Wang, Xiaoying; Huang, Ning


    Since bacterial invasion into host cells is a critical step in the infection process and the predominance of multiple-antibiotic-resistant Klebsiella (K.) pneumoniae strains, using molecular agents to interfere with K. pneumoniae invasion is an attractive approach for the prevention of infection and suppress the immune inflammatory response. In previous studies by our group, high-mobility group nucleosome-binding domain 2 (HMGN2) protein was shown to exhibit anti-bacterial activity in vitro. The objective of the present study was to investigate the effects of HMGN2 protein on the invasion of K. pneumoniae 03183 in vivo. The results showed that pre-treatment with 128 µg/ml HMGN2 significantly reduced K. pneumoniae 03183 invasion into mouse lungs and increased the mRNA expression of CXCL1 and LCN2 within 2 h. Immunohistochemical staining showed that F-actin expression was significantly decreased, and fluorescence microscopy and western blot analysis further demonstrated that HMGN2 significantly blocked K. pneumoniae 03183-induced actin polymerization. These changes implied that HMGN2 may provide protection against K. pneumoniae 03183 infection in vivo.

  6. Alveolar damage in AIDS-related Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Benfield, T L; Prentø, P; Junge, Jette


    OBJECTIVE: Pneumocystis carinii pneumonia is the most common and serious of the pulmonary complications of AIDS. Despite this, many basic aspects in the pathogenesis of HIV-associated P carinii pneumonia are unknown. We therefore undertook a light and electron microscopic study of transbronchial...... biopsy specimens to compare pathologic features of P carinii pneumonia and other HIV-related lung diseases. DESIGN AND PATIENTS: Thirty-seven consecutive HIV-infected patients undergoing a diagnostic bronchoscopy. RESULTS: P carinii pneumonia was characterized by an increase in inflammation, edema...... with P carinii pneumonia, whereas none without P carinii pneumonia had this finding (p pneumonia. The changes may form...

  7. Comparison of Biofilm and Attachment Mechanisms of a Phytopathological and Clinical Isolate of Klebsiella pneumoniae Subsp. pneumoniae

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    Adriana Marcia Nicolau Korres


    Full Text Available Some bacterial species can colonize humans and plants. It is almost impossible to prevent the contact of clinically pathogenic bacteria with food crops, and if they can persist there, they can reenter the human food chain and cause disease. On the leaf surface, microorganisms are exposed to a number of stress factors. It is unclear how they survive in such different environments. By increasing adhesion to diverse substrates, minimizing environmental differences, and providing protection against defence mechanisms, biofilms could provide part of the answer. Klebsiella pneumoniae subsp. pneumoniae is clinically important and also associated with fruit diseases, such as “pineapple fruit collapse.” We aimed to characterize biofilm formation and adhesion mechanisms of this species isolated from pineapple in comparison with a clinical isolate. No differences were found between the two isolates quantitatively or qualitatively. Both tested positive for capsule formation and were hydrophobic, but neither produced adherence fibres, which might account for their relatively weak adhesion compared to the positive control Staphylococcus epidermidis ATCC 35984. Both produced biofilms on glass and polystyrene, more consistently at 40°C than 35°C, confirmed by atomic force and high-vacuum scanning electron microscopy. Biofilm formation was maintained in an acidic environment, which may be relevant phytopathologically.

  8. Bacterial biofilms investigated by atomic force microscopy and electrochemistry

    DEFF Research Database (Denmark)

    Hu, Yifan

    thesis, Atomic Force Microscopy (AFM) and electrochemistry have been applied to investigate three pathogenic medically important bacterial biofilms, i.e. Pseudomonas aeruginosa (cystic fibrosis pneumonia), Staphylococcus epidermidis (contamination of surgical catheters and indwelling equipment...... attachment on the surface. High-resolution AFM imaging showed no detectable differences among the four strains. Adhesion maps using hydrophobically modified tips compared with bare hydrophilic silicon nitride tips also showed small differences only. This indicates that hydrophobic effects are not the primary...

  9. Chylothorax in dermatomyositis complicated with interstitial pneumonia. (United States)

    Isoda, Kentaro; Kiboshi, Takao; Shoda, Takeshi


    Chylothorax is a disease in which chyle leaks and accumulates in the thoracic cavity. Interstitial pneumonia and pneumomediastinum are common thoracic manifestations of dermatomyositis, but chylothorax complicated with dermatomyositis is not reported. We report a case of dermatomyositis with interstitial pneumonia complicated by chylothorax. A 77-year-old woman was diagnosed as dermatomyositis with Gottron's papules, skin ulcers, anti-MDA5 antibody and rapid progressive interstitial pneumonia. Treatment with betamethasone, tacrolimus and intravenous high-dose cyclophosphamide was initiated, and her skin symptoms and interstitial pneumonia improved once. However, right-sided chylothorax began to accumulate and gradually increase, and at the same time, her interstitial pneumonia began to exacerbate, and skin ulcers began to reappear on her fingers and auricles. Although her chylothorax improved by fasting and parenteral nutrition, she died due to further exacerbations of dermatomyositis and interstitial pneumonia in spite of steroid pulse therapy, increase in the betamethasone dosage, additional intravenous high-dose cyclophosphamide and plasma pheresis. An autopsy showed no lesions such as malignant tumors in the thoracic cavity. This is the first report of chylothorax complicated by dermatomyositis with interstitial pneumonia.

  10. Prophage spontaneous activation promotes DNA release enhancing biofilm formation in Streptococcus pneumoniae.

    Directory of Open Access Journals (Sweden)

    Margarida Carrolo

    Full Text Available Streptococcus pneumoniae (pneumococcus is able to form biofilms in vivo and previous studies propose that pneumococcal biofilms play a relevant role both in colonization and infection. Additionally, pneumococci recovered from human infections are characterized by a high prevalence of lysogenic bacteriophages (phages residing quiescently in their host chromosome. We investigated a possible link between lysogeny and biofilm formation. Considering that extracellular DNA (eDNA is a key factor in the biofilm matrix, we reasoned that prophage spontaneous activation with the consequent bacterial host lysis could provide a source of eDNA, enhancing pneumococcal biofilm development. Monitoring biofilm growth of lysogenic and non-lysogenic pneumococcal strains indicated that phage-infected bacteria are more proficient at forming biofilms, that is their biofilms are characterized by a higher biomass and cell viability. The presence of phage particles throughout the lysogenic strains biofilm development implicated prophage spontaneous induction in this effect. Analysis of lysogens deficient for phage lysin and the bacterial major autolysin revealed that the absence of either lytic activity impaired biofilm development and the addition of DNA restored the ability of mutant strains to form robust biofilms. These findings establish that limited phage-mediated host lysis of a fraction of the bacterial population, due to spontaneous phage induction, constitutes an important source of eDNA for the S. pneumoniae biofilm matrix and that this localized release of eDNA favors biofilm formation by the remaining bacterial population.

  11. Bacterial vaginosis -- aftercare (United States)

    ... this page: // Bacterial vaginosis - aftercare To use the sharing features on this ... to back after you use the bathroom. Preventing Bacterial Vaginosis You can help prevent bacterial vaginosis by: Not ...

  12. Pregnancy Complications: Bacterial Vaginosis (United States)

    ... Complications & Loss > Pregnancy complications > Bacterial vaginosis and pregnancy Bacterial vaginosis and pregnancy E-mail to a friend Please ... this page It's been added to your dashboard . Bacterial vaginosis (also called BV or vaginitis) is an infection ...

  13. First report of an outbreak of pneumonia caused by Streptococcus pneumoniae serotype 6A. (United States)

    Prebil, Karla; Beović, Bojana; Paragi, Metka; Seme, Katja; Kastrin, Tamara; Plesničar, Blanka Kores; Petek, Bojana; Martinčič, Žiga


    Five patients in a geropsychiatric unit of a psychiatric hospital became abruptly ill with pneumonia caused by Streptococcus pneumoniae serotype 6A. Four other residents were colonized with the same serotype, which has previously not been reported in association with pneumonia outbreaks. Furthermore, serotype 6A is not included in all vaccine types, which may be important for the choice of vaccine in some settings. All isolates showed identical pulsed-field gel electrophoresis restriction patterns.

  14. Genotyping Klebsiella pneumoniae isolated from hepatic abscesses in three patients from Bogota, Colombia

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    Dora I. Ríos


    Full Text Available Pyogenic liver abscess caused by Klebsiella pneumoniae represents an ever increasing entity which has mainly been described as occurring in Asia, even though, on a smaller scale, cases are being more frequently described from the USA and Europe, 13% overall mortality being reached worldwide. Affected patients are severely sick, suffering from fever, sweating, having increased acute phase reactants and risk factors such as Diabetes Mellitus, alcoholism and the inherent characteristics of the bacteria causing the disease. Objective: in this work we used a Multilocus Sequencing Typing (MLST, a nucleotide sequence-based method in order to characterize the genetic relationships among bacterial isolates. Materials and methods: the report is focused on three cases involving patients suffering from pyogenic liver abscess caused by Klebsiella pneumoniae in two hospitals in Bogota, Colombia, where phenotyping and hypermucoviscosity studies were carried out, as well as the genotyping of cultured Klebsiella isolates. Reults: it was found that the isolated microorganism in cases I and II corresponded to the same K. pneumoniae strain, having 100% sequence identity for the 5 genes being studied while the strain in Case III was genotypically different. Conclusion: it is important to carry out multidisciplinary studies allowing all pyogenic liver abscess cases reported in Colombia to be complied to ascertain the frequency of microorganisms causing this pathology in our country, as well as a genotyping study of different K. pneumoniae strains to compare them and confirm clonal and pathogenicity relationships through housekeeping gene analysis.

  15. Requirement for Serratia marcescens cytolysin in a murine model of hemorrhagic pneumonia. (United States)

    González-Juarbe, Norberto; Mares, Chris A; Hinojosa, Cecilia A; Medina, Jorge L; Cantwell, Angelene; Dube, Peter H; Orihuela, Carlos J; Bergman, Molly A


    Serratia marcescens, a member of the carbapenem-resistant Enterobacteriaceae, is an important emerging pathogen that causes a wide variety of nosocomial infections, spreads rapidly within hospitals, and has a systemic mortality rate of ≤41%. Despite multiple clinical descriptions of S. marcescens nosocomial pneumonia, little is known regarding the mechanisms of bacterial pathogenesis and the host immune response. To address this gap, we developed an oropharyngeal aspiration model of lethal and sublethal S. marcescens pneumonia in BALB/c mice and extensively characterized the latter. Lethal challenge (>4.0 × 10(6) CFU) was characterized by fulminate hemorrhagic pneumonia with rapid loss of lung function and death. Mice challenged with a sublethal dose (marcescens strains that failed to cause profound weight loss, extended illness, hemorrhage, and prolonged lung pathology in mice. This study describes a model of S. marcescens pneumonia that mimics known clinical features of human illness, identifies neutrophils and the toxin ShlA as a key factors important for defense and infection, respectively, and provides a solid foundation for future studies of novel therapeutics for this important opportunistic pathogen.

  16. Hyperoxia accelerates Fas-mediated signaling and apoptosis in the lungs of Legionella pneumophila pneumonia

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    Tanabe Yoshinari


    Full Text Available Abstract Background Oxygen supplementation is commonly given to the patients with severe pneumonia including Legionella disease. Recent data suggested that apoptosis may play an important role, not only in the pathogenesis of Legionella pneumonia, but also in oxygen-induced tissue damage. In the present study, the lethal sensitivity to Legionella pneumonia were compared in the setting of hyperoxia between wild-type and Fas-deficient mice. Findings C57BL/6 mice and B6.MRL-Faslpr mice characterized with Fas-deficiency were used in this study. After intratracheal administration of L. pneumophila, mice were kept in hyperoxic conditions (85-90% O2 conc. in an airtight chamber for 3 days. Bone-marrow derived macrophages infected with L. pneumophila were also kept in hyperoxic conditions. Caspase activity and cytokine production were determined by using commercially available kits. Smaller increases of several apoptosis markers, such as caspase-3 and -8, were demonstrated in Fas-deficient mice, even though the bacterial burdens in Fas-deficient and wild type mice were similar. Bone-marrow derived macrophages from Fas-deficient mice were shown to be more resistant to Legionella-induced cytotoxicity than those from wild-type mice under hyperoxia. Conclusions These results demonstrated that Fas-mediated signaling and apoptosis may be a crucial factor in the pathogenesis of Legionella pneumonia in the setting of hyperoxia.

  17. Impact of Hfq on global gene expression and virulence in Klebsiella pneumoniae.

    Directory of Open Access Journals (Sweden)

    Ming-Ko Chiang

    Full Text Available Klebsiella pneumoniae is responsible for a wide range of clinical symptoms. How this bacterium adapts itself to ever-changing host milieu is still a mystery. Recently, small non-coding RNAs (sRNAs have received considerable attention for their functions in fine-tuning gene expression at a post-transcriptional level to promote bacterial adaptation. Here we demonstrate that Hfq, an RNA-binding protein, which facilitates interactions between sRNAs and their mRNA targets, is critical for K. pneumoniae virulence. A K. pneumoniae mutant lacking hfq (Δhfq failed to disseminate into extra-intestinal organs and was attenuated on induction of a systemic infection in a mouse model. The absence of Hfq was associated with alteration in composition of envelope proteins, increased production of capsular polysaccharides, and decreased resistance to H(2O(2, heat shock, and UV irradiation. Microarray-based transcriptome analyses revealed that 897 genes involved in numerous cellular processes were deregulated in the Δhfq strain. Interestingly, Hfq appeared to govern expression of many genes indirectly by affecting sigma factor RpoS and RpoE, since 19.5% (175/897 and 17.3% (155/897 of Hfq-dependent genes belong to the RpoE- and RpoS-regulon, respectively. These results indicate that Hfq regulates global gene expression at multiple levels to modulate the physiological fitness and virulence potential of K. pneumoniae.

  18. Automated glycan assembly of a S. pneumoniae serotype 3 CPS antigen (United States)

    Weishaupt, Markus W; Matthies, Stefan; Hurevich, Mattan; Pereira, Claney L; Hahm, Heung Sik


    Summary Vaccines against S. pneumoniae, one of the most prevalent bacterial infections causing severe disease, rely on isolated capsular polysaccharide (CPS) that are conjugated to proteins. Such isolates contain a heterogeneous oligosaccharide mixture of different chain lengths and frame shifts. Access to defined synthetic S. pneumoniae CPS structures is desirable. Known syntheses of S. pneumoniae serotype 3 CPS rely on a time-consuming and low-yielding late-stage oxidation step, or use disaccharide building blocks which limits variability. Herein, we report the first iterative automated glycan assembly (AGA) of a conjugation-ready S. pneumoniae serotype 3 CPS trisaccharide. This oligosaccharide was assembled using a novel glucuronic acid building block to circumvent the need for a late-stage oxidation. The introduction of a washing step with the activator prior to each glycosylation cycle greatly increased the yields by neutralizing any residual base from deprotection steps in the synthetic cycle. This process improvement is applicable to AGA of many other oligosaccharides. PMID:27559395

  19. Use of Multiplex PCR for Diagnosis of Bacterial Infection Respiratory Mixed

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    Al-ssum, R. M.


    Full Text Available Atypical bacteria grow very slowly in culture or they do not grow at all leading to delays in detection and diagnosis. PCR multiplex was performed on template DNAs extracted from seventy three collected specimens. Thirty seven showed positive indication for the presence of bacterial infection. The incidence of Mycoplasma pneumoniae, Chlamydia pneumonia and Legionella pneumophila as a single infecting agent was 31.5%, 27.5% and 20 % respectively. Dual agent infection caused by Mycoplasma + Chlamydia, Mycoplasma + Legionella and Legionella + Chlamydia was 24%, 20% and 15% respectively. Triple agent infection caused by Legionella + Mycoplasma + Chlamydia was 17.5%. The etiology of the infection was M. pneumoniae, L. pneumophila or C. pneumoniae as a single etiology or in combination of two or three organisms.

  20. Idiopathic interstitial pneumonias: Classification revision

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    Demosthenes Bouros MD, PhD, FCCP


    Full Text Available The American Thoracic Society (ATS, the European Respiratory Society (ERS and the Japan Respiratory Society (JRS are planning a revision of the 2002 ATS/ERS International Multidisciplinary Classification of Idiopathic Interstitial Pneumonias (IIPs1. In two years’ time it will be 10 years since its publication and with a view to publishing the revision after 10 years (i.e., in 2012, a steering committee has been established, which met in New Orleans during ATS congress in May 2010 and more recently in Barcelona during the ERS congress (Photo. The committee will meet again during the ATS and the ERS congresses that will be held in the next two years, with an additional meeting in Modena, Italy, in Αpril 2011.

  1. 肺炎克雷伯杆菌疫苗中试生产中细菌培养工艺的改进及优化%Improvement and optimization of bacterial culture process in Klebsiella pneumoniae vaccine pilot scale production

    Institute of Scientific and Technical Information of China (English)

    徐道俊; 郑鑫; 柴俊东; 普明祥; 陈南萍; 李永贵; 奚树花; 潘继菊; 左智洁


    Objective To improve the cultural process and select the optimity for producing Klebsiella pneumoniae vaccine . Methods The integrated liquid medium was instead of semi-integrated medium for inoculating Klebsiella pneumoniae in bioreactor (10 L and 100 L of volume), and the effects of various factors (such as medium formulation, pH, culture tem-perature, stirring speed, oxygen concentration , supplemented glucose content and its supplementing time pon ) on the growth and polysaccharide yield were detected in bioreactor .Results The results showed that the integrated liquid medium can be used for inoculating Klebsiella pneumoniae to substitute for semi-synthetic medium .The optimum culture conditions are as follows:pH 7.2, temperature at 37℃, stirring speed at 250 r/m, 60 L/h ventilation, and supplementing 3 000 mL of 40%glucose solution into 100 L medium after inoculating two hours , and then continuously cultured for three hours , by this time the growth state of the bacteria is the best , polysaccharrde content is the highest .Conclusion Stable Klebsiella pneumonia fermentation for producing vaccine has been established by several validated test with 100 L bioreactor .%目的:中试生产中对肺炎克雷伯杆菌培养工艺进行改进及优化。方法采用液体综合培养基代替半综合培养基在10 L和100 L中国丽生物反应器中对肺炎克雷伯杆菌进行培养,在10 L中国丽生物反应器探讨不同的培养基配方、pH值、培养温度、搅拌转速、溶氧,工艺参数稳定后,扩大培养到100 L中国丽生物反应器,并探讨培养过程中补加葡萄糖的浓度及补加方式等对细菌浓度及荚膜多糖含量的影响。结果肺炎克雷伯杆菌液体综合培养基可代替半综合培养基用于该菌的培养,培养过程中维持pH值7.2、温度37℃、通气60 L/h、搅拌转速250 r/min、培养到2 h时开始以恒速补加30 mL/L 40%葡萄糖溶液、培养时间为5 h,细菌长势

  2. In vivo and in vitro studies on the roles of neutrophil extracellular traps during secondary pneumococcal pneumonia after primary pulmonary influenza infection

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    Anandi eNarayana Moorthy


    Full Text Available Seasonal influenza virus infections may lead to debilitating disease, and account for significant fatalities annually worldwide. Most of these deaths are attributed to the complications of secondary bacterial pneumonia. Evidence is accumulating to support the notion that neutrophil extracellular traps (NETs harbor several antibacterial proteins, and trap and kill bacteria. We have previously demonstrated the induction of NETs that contribute to lung tissue injury in severe influenza pneumonia. However, the role of these NETs in secondary bacterial pneumonia is unclear. In this study, we explored whether NETs induced during pulmonary influenza infection have functional significance against infections with Streptococcus pneumoniae and other bacterial and fungal species. Our findings revealed that NETs do not participate in killing of Streptococcus pneumoniae in vivo and in vitro. Dual viral and bacterial infection elevated the bacterial load compared to animals infected with bacteria alone. Concurrently, enhanced lung pathogenesis was observed in dual-infected mice compared to those challenged with influenza virus or bacteria alone. The intensified NETs in dual-infected mice often appeared as clusters that were frequently filled with partially degraded DNA, as evidenced by punctate histone protein staining. The severe pulmonary pathology and excessive NETs generation in dual infection correlated with exaggerated inflammation and damage to the alveolar-capillary barrier. NETs stimulation in vitro did not significantly alter the gene expression of several antimicrobial proteins, and these NETs did not exhibit any bactericidal activity. Fungicidal activity against Candida albicans was observed at similar levels both in presence or absence of NETs. These results substantiate that the NETs released by primary influenza infection do not protect against secondary bacterial infection, but may compromise lung function.

  3. Wzy-dependent bacterial capsules as potential drug targets. (United States)

    Ericsson, Daniel J; Standish, Alistair; Kobe, Bostjan; Morona, Renato


    The bacterial capsule is a recognized virulence factor in pathogenic bacteria. It likely works as an antiphagocytic barrier by minimizing complement deposition on the bacterial surface. With the continual rise of bacterial pathogens resistant to multiple antibiotics, there is an increasing need for novel drugs. In the Wzy-dependent pathway, the biosynthesis of capsular polysaccharide (CPS) is regulated by a phosphoregulatory system, whose main components consist of bacterial-tyrosine kinases (BY-kinases) and their cognate phosphatases. The ability to regulate capsule biosynthesis has been shown to be vital for pathogenicity, because different stages of infection require a shift in capsule thickness, making the phosphoregulatory proteins suitable as drug targets. Here, we review the role of regulatory proteins focusing on Streptococcus pneumoniae, Staphylococcus aureus, and Escherichia coli and discuss their suitability as targets in structure-based drug design.

  4. Streptococcus pneumoniae TIGR4 Flavodoxin: Structural and Biophysical Characterization of a Novel Drug Target (United States)

    Rodríguez-Cárdenas, Ángela; Rojas, Adriana L.; Conde-Giménez, María; Velázquez-Campoy, Adrián; Hurtado-Guerrero, Ramón; Sancho, Javier


    Streptococcus pneumoniae (Sp) strain TIGR4 is a virulent, encapsulated serotype that causes bacteremia, otitis media, meningitis and pneumonia. Increased bacterial resistance and limited efficacy of the available vaccine to some serotypes complicate the treatment of diseases associated to this microorganism. Flavodoxins are bacterial proteins involved in several important metabolic pathways. The Sp flavodoxin (Spfld) gene was recently reported to be essential for the establishment of meningitis in a rat model, which makes SpFld a potential drug target. To facilitate future pharmacological studies, we have cloned and expressed SpFld in E. coli and we have performed an extensive structural and biochemical characterization of both the apo form and its active complex with the FMN cofactor. SpFld is a short-chain flavodoxin containing 146 residues. Unlike the well-characterized long-chain apoflavodoxins, the Sp apoprotein displays a simple two-state thermal unfolding equilibrium and binds FMN with moderate affinity. The X-ray structures of the apo and holo forms of SpFld differ at the FMN binding site, where substantial rearrangement of residues at the 91–100 loop occurs to permit cofactor binding. This work will set up the basis for future studies aiming at discovering new potential drugs to treat S. pneumoniae diseases through the inhibition of SpFld. PMID:27649488

  5. Identification of pneumococcal surface protein A as a lactoferrin-binding protein of Streptococcus pneumoniae. (United States)

    Hammerschmidt, S; Bethe, G; Remane, P H; Chhatwal, G S


    Lactoferrin (Lf), an iron-sequestering glycoprotein, predominates in mucosal secretions, where the level of free extracellular iron (10(-18) M) is not sufficient for bacterial growth. This represents a mechanism of resistance to bacterial infections by prevention of colonization of the host by pathogens. In this study we were able to show that Streptococcus pneumoniae specifically recognizes and binds the iron carrier protein human Lf (hLf). Pretreatment of pneumococci with proteases reduced hLf binding significantly, indicating that the hLf receptor is proteinaceous. Binding assays performed with 63 clinical isolates belonging to different serotypes showed that 88% of the tested isolates interacted with hLf. Scatchard analysis showed the existence of two hLf-binding proteins with dissociation constants of 5.7 x 10(-8) and 2.74 x 10(-7) M. The receptors were purified by affinity chromatography, and internal sequence analysis revealed that one of the S. pneumoniae proteins was homologous to pneumococcal surface protein A (PspA). The function of PspA as an hLf-binding protein was confirmed by the ability of purified PspA to bind hLf and to competitively inhibit hLf binding to pneumococci. S. pneumoniae may use the hLf-PspA interaction to overcome the iron limitation at mucosal surfaces, and this might represent a potential virulence mechanism.

  6. Differential Recognition and Hydrolysis of Host Carbohydrate Antigens by Streptococcus pneumoniae Family 98 Glycoside Hydrolases

    Energy Technology Data Exchange (ETDEWEB)

    Higgins, M.; Whitworth, G; El Warry, N; Randriantsoa, M; Samain, E; Burke, R; Vocadlo, D; Boraston, A


    The presence of a fucose utilization operon in the Streptococcus pneumoniae genome and its established importance in virulence indicates a reliance of this bacterium on the harvesting of host fucose-containing glycans. The identities of these glycans, however, and how they are harvested is presently unknown. The biochemical and high resolution x-ray crystallographic analysis of two family 98 glycoside hydrolases (GH98s) from distinctive forms of the fucose utilization operon that originate from different S. pneumoniae strains reveal that one enzyme, the predominant type among pneumococcal isolates, has a unique endo-{beta}-galactosidase activity on the LewisY antigen. Altered active site topography in the other species of GH98 enzyme tune its endo-{beta}-galactosidase activity to the blood group A and B antigens. Despite their different specificities, these enzymes, and by extension all family 98 glycoside hydrolases, use an inverting catalytic mechanism. Many bacterial and viral pathogens exploit host carbohydrate antigens for adherence as a precursor to colonization or infection. However, this is the first evidence of bacterial endoglycosidase enzymes that are known to play a role in virulence and are specific for distinct host carbohydrate antigens. The strain-specific distribution of two distinct types of GH98 enzymes further suggests that S. pneumoniae strains may specialize to exploit host-specific antigens that vary from host to host, a factor that may feature in whether a strain is capable of colonizing a host or establishing an invasive infection.

  7. Predicting the presence of bacterial pathogens in the airways of primary care patients with acute cough (United States)

    Teepe, Jolien; Broekhuizen, Berna D.L.; Loens, Katherine; Lammens, Christine; Ieven, Margareta; Goossens, Herman; Little, Paul; Butler, Chris C.; Coenen, Samuel; Godycki-Cwirko, Maciek; Verheij, Theo J.M.


    BACKGROUND: Bacterial testing of all patients who present with acute cough is not feasible in primary care. Furthermore, the extent to which easily obtainable clinical information predicts bacterial infection is unknown. We evaluated the diagnostic value of clinical examination and testing for C-reactive protein and procalcitonin for bacterial lower respiratory tract infection. METHODS: Through a European diagnostic study, we recruited 3104 adults with acute cough (≤ 28 days) in primary care settings. All of the patients underwent clinical examination, measurement of C-reactive protein and procalcitonin in blood, and chest radiography. Bacterial infection was determined by conventional culture, polymerase chain reaction and serology, and positive results were defined by the presence of Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Bordetella pertussis or Legionella pneumophila. Using multivariable regression analysis, we examined the association of diagnostic variables with the presence of bacterial infection. RESULTS: Overall, 539 patients (17%) had bacterial lower respiratory tract infection, and 38 (1%) had bacterial pneumonia. The only item with diagnostic value for lower respiratory tract infection was discoloured sputum (area under the receiver operating characteristic [ROC] curve 0.56, 95% confidence interval [CI] 0.54–0.59). Adding C-reactive protein above 30 mg/L increased the area under the ROC curve to 0.62 (95% CI 0.59–0.65). For bacterial pneumonia, comorbidity, fever and crackles on auscultation had diagnostic value (area under ROC curve 0.68, 95% CI 0.58–0.77). Adding C-reactive protein above 30 mg/L increased the area under the ROC curve to 0.79 (95% CI 0.71–0.87). Procalcitonin did not add diagnostic information for any bacterial lower respiratory tract infection, including bacterial pneumonia. INTERPRETATION: In adults presenting with acute lower respiratory tract infection, signs, symptoms and C

  8. Influenza Alone and in Sequence with Pneumonia Due to ’Streptococcus pneumoniae’ in the Squirrel Monkey (United States)


    rights reserved. . . . . t Influenza Alone and In Sequence with Pneumonia Due to-, Streptococcus pneumoniae in the Squirrel Monkey VI / !.llendt, G.G...rhesus drome of sequential respiratory infections. monkeys with the virus alone or in sequence with Streptococcus pneumoniae I1 l. Since that report...were also BC 0 0 observed in the glomeruli of the kidney. S 0 1027 S. pneumoniae-induced pathology. The results Streptococcus pneumoniae obtained in

  9. Decreased Streptococcus pneumoniae susceptibility to oral antibiotics among children in rural Vietnam: a community study

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    Phuc Ho D


    Full Text Available Abstract Background Streptococcus pneumoniae is the most significant bacterial cause of community-acquired pneumonia among children under five years worldwide. Updated resistance information of S. pneumoniae among children is essential to adjust the recommendations for empirical treatment of community-acquired pneumonia, which will have immense implications for local and global health. This study investigated the prevalence of antibiotic resistance in isolated strains of S. pneumoniae and relationship with antibiotic use and demographic factors of children under five in rural Vietnam in 2007. Methods In Bavi district, 847 children 6 to 60 months were selected from 847 households. The main child-caregivers in the households were interviewed weekly using structured questionnaires to collect information of daily illness symptoms and drug use for the selected child over a four-week period (from March through June 2007. In the 3rd week, the children were invited for a clinical examination and to collect nasopharyngeal samples for S. pneumoniae identification. Etest and disk diffusion were used to test antibiotic susceptibility. Results Of 818 participating children, 258 (32% had ongoing respiratory infections, 421 (52% carried S. pneumoniae, and 477 (58% had used antibiotics within the previous three weeks. Of the 421 isolates, 95% were resistant to at least one antibiotic (401/421. Resistance to co-trimoxazole, tetracycline, phenoxymethylpenicillin, erythromycin and ciprofloxacin was 78%, 75%, 75%, 70% and 28%, respectively. Low resistance was noted for amoxicillin (4%, benzylpenicillin (4%, and cefotaxime (2%. The intermediate resistance to amoxicillin was 32%. Multidrug-resistance was seen in 60%. The most common pattern was co-resistance to co-trimoxazole, tetracycline and erythromycin. The proportion of children carrying resistant bacteria was higher among the children who had used antibiotics in the previous three weeks. Conclusions Resistance

  10. Detection of Streptococcus pneumoniae from Different Types of Nasopharyngeal Swabs in Children.

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    Felix S Dube

    Full Text Available A better understanding of the epidemiology of nasopharyngeal carriage of Streptococcus pneumoniae is important to assess the impact of vaccination and the pathogenesis of pneumococcal disease. We compared the recovery of S. pneumoniae from nylon flocked, Dacron and rayon swabs.The recovery of S. pneumoniae from mocked specimens using flocked, Dacron and rayon swabs were compared by culture. The yield from paired nasopharyngeal (NP samples obtained from healthy children sampled with flocked and Dacron swabs was also determined using culture and lytA-targeted real-time polymerase chain reaction (qPCR.Using mock specimen, the percentage recovery of S. pneumoniae ATCC 49619 (serotype 19F strain from the flocked swabs was 100%, while it was 41% from Dacron swabs and 7% from rayon swabs. Similar results were observed for S. pneumoniae serotypes 1 and 5. S. pneumoniae was cultured from 18 of 42 (43% paired NP samples from the healthy children (median age 8 [interquartile range (IQR 5-16] months. The median number of colony-forming units (CFU recovered from flocked swabs was two-fold higher (8.8×10(4 CFU/mL [IQR, 2.0×10(2 - 4.0×10(5 CFU/mL] than Dacron swabs (3.7×10(4 CFU/mL [IQR, 4.0×10(2-3.2×10(5 CFU/mL], p = 0.17. Using lytA-targeted qPCR from paired NP samples, the median copy number of S. pneumoniae detected from flocked swabs was significantly higher than from Dacron swabs (3.0×10(5 genome copies/mL [IQR, 1.3×10(2-1.8×10(6] vs. 9.3×10(4 genome copies/mL [IQR, 7.0×10(1-1.1×10(6]; p = 0.005.Flocked swabs released more S. pneumoniae compared to both Dacron and rayon swabs from mock specimens. Similarly, higher bacterial loads were detected by qPCR from flocked swabs compared with Dacron swabs from healthy children.

  11. Candida pneumonia in intensive care unit?

    NARCIS (Netherlands)

    Schnabel, Ronny M; Linssen, Catharina F; Guion, Nele; van Mook, Walther N; Bergmans, Dennis C


    It has been questioned if Candida pneumonia exists as a clinical entity. Only histopathology can establish the definite diagnosis. Less invasive diagnostic strategies lack specificity and have been insufficiently validated. Scarcity of this pathomechanism and nonspecific clinical presentation make v

  12. A review of Chlamydia pneumoniae and atherosclerosis

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Fasting, H; Henneberg, E W;


    Chlamydia pneumoniae is a Gram-negative obligate intracellular bacterium that causes acute upper and lower respiratory infections. Its distribution is worldwide. Seroepidemiological studies have shown an association between C. pneumoniae and atherosclerosis, and the risk of acute myocardial infar...... individuals who are or are not infected with C. pneumoniae. The latter are needed in order to clarify the impact of the presence of C. pneumoniae and to avoid indiscriminate use of antimicrobials....... of viable organisms. However, the pathogenicity is unknown, and the significance of detecting the organism is unresolved. In two minor controlled clinical trials, patients with ischaemic heart disease were randomised into antibiotic-treated and placebo groups. Both trials showed a significant reduction...

  13. Mycoplasma pneumoniae meningoencephalitis: a case report

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    Mehmet Selçuk Bektaş


    Full Text Available Nervous system is the most affected area in mycoplasma pneumoniae infections with exception of respiratory system. It is an important agent of childhood acute encephalitis and respiratory system infections in school-age children and young adults. Routine clinical and laboratory findings to identify spesific diagnosis is limited. Twelve-year-old female patient was admitted with fever, fatigue, sore throat, slipping the right eye, withdrawal of the mouth from the right and right hemiclonic seizures. Test of anti-Mycoplasma pneumoniae (M. pneumoniae IgM was positive and IgG antibodies were found to be 4-fold increase in the sera of follow-up. This article was presented with the aim of remembering M. pneumoniae to be an differential diagnosis in children with acute encephalitis.

  14. Mapping the Evolution of Hypervirulent Klebsiella pneumoniae

    DEFF Research Database (Denmark)

    Struve, Carsten; Roe, Chandler C; Stegger, Marc;


    UNLABELLED: Highly invasive, community-acquired Klebsiella pneumoniae infections have recently emerged, resulting in pyogenic liver abscesses. These infections are caused by hypervirulent K. pneumoniae (hvKP) isolates primarily of capsule serotype K1 or K2. Hypervirulent K1 isolates belong...... of this important clonal lineage. IMPORTANCE: During the last 3 decades, hypervirulent Klebsiella pneumoniae (hvKP) isolates have emerged, causing severe community-acquired infections primarily in the form of pyogenic liver abscesses. This syndrome has so far primarily been found in Southeast Asia, but increasing...... to clonal complex 23 (CC23), indicating that this clonal lineage has a specific genetic background conferring hypervirulence. Here, we apply whole-genome sequencing to a collection of K. pneumoniae isolates to characterize the phylogenetic background of hvKP isolates with an emphasis on CC23. Most of the hv...

  15. [Thousand faces of Streptococcus pneumonia (pneumococcus) infections]. (United States)

    Szabó, Bálint Gergely; Lénárt, Katalin Szidónia; Kádár, Béla; Gombos, Andrea; Dezsényi, Balázs; Szanka, Judit; Bobek, Ilona; Prinz, Gyula


    Incidence and mortality rates of infections caused by Streptococcus pneumoniae (pneumococcus) are high worldwide and in Hungary among paediatric as well as adult populations. Pneumococci account for 35-40% of community acquired adult pneumonias requiring hospitalization, while 25-30% of Streptococcus pneumoniae pneumonias are accompanied by bacteraemia. 5-7% of all infections are fatal but this rate is exponentially higher in high risk patients and elderly people. Mortality could reach 20% among patients with severe invasive pneumococcal infections. Complications may develop despite administration of adequate antibiotics. The authors summarize the epidemiology of pneumococcal infections, pathogenesis of non-invasive and invasive disease and present basic clinical aspects through demonstration of four cases. Early risk stratification, sampling of hemocultures, administration of antibiotics and wider application of active immunization could reduce the mortality of invasive disease. Anti-pneumococcal vaccination is advisable for adults of ≥50 years and high risk patients of ≥18 years who are susceptible to pneumococcal disease.

  16. Chlamydia pneumoniae and Atherosclerosis: The End?

    Directory of Open Access Journals (Sweden)

    LE Nicolle


    Full Text Available In this issue of the Journal, Patrick et al (pages 298-300 report on the results of a pilot study testing the hypothesis that seropositivity to Chlamydia pneumoniae together with a specific bacteriophage protein is associated with first-episode myocardial infarction or unstable angina. The study evolved from an earlier report suggesting that C pneumoniae with phage seropositivity was strongly associated with the presence of abdominal aortic aneurysm. The phage association suggested a potential explanation for some of the variability in previous studies exploring C pneumoniae as a cause for atherosclerosis (ie, only selected strains of C pneumoniae were pathogenic. Patrick et al found no significant association or trend, and the authors concluded that the negative findings in their pilot study did not support further studies to address this potential association.

  17. Crystal structures of Mycobacteria tuberculosis and Klebsiella pneumoniae UDP-galactopyranose mutase in the oxidised state and Klebsiella pneumoniae UDP-galactopyranose mutase in the (active) reduced state



    Uridine diphosphogalactofuranose (UDP-Galf) is the precursor of the D-galactofuranose sugar found in bacterial and parasitic cell walls, including those of many pathogens. UDP-Galf is made from UDP-galactopyranose by the enzyme UDP-galactopyranose mutase. The enzyme requires the reduced FADH− co-factor for activity. The structure of the Mycobacterium tuberculosis mutase with FAD has been determined to 2.25Å. The structures of Klebsiella pneumoniae mutase with FAD and with FADH− bound have bee...

  18. K. pneumoniae: ¿The new “superbacteria”? Pathogenicity, epidemiology and resistance mechanisms K. pneumoniae: ¿la nueva

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    Lina María Echeverri Toro


    Full Text Available The antimicrobial resistance is an increasing problem of public health. Klebsiella pneumoniae has become one of the most important pathogens because it is a frequent cause of nosocomial and community acquired infections and it has pathogenicity mechanisms like capsules, adhesive properties mediated by specialized estructures (pillis and siderophores that are capable of taking up iron, an essential factor in bacterial growth. The increase in bacterial resistance to antibiotics has evolved with the use of these in patients treatments, being increasingly wide the spectrum that they include, happening from the resistance to ampicillin by the production of betalactamase SHV-1 to carbapenems resistance by diverse mechanisms, from the production of extendedspectrum betalactamases (ESBL that are associated with hydrolysis of extended-spectrum cephalosporins and aztreonam. Microbiology laboratory should follow international recommendations to detect and confirm the presence of this resistance mechanism in bacteria and the clinicians should make a suitable interpretation of the results to make the better choice of the antibiotic therapy. ----- La resistencia de los microorganismos a los antibióticos es un problema cada vez creciente en salud pública. Entre estos, Klebsiella pneumoniae es un representante importante no sólo por su frecuencia como causa de infecciones asociadas al cuidado de la salud y de la comunidad, sino por los mecanismos patogénicos que posee, como la capacidad de producir cápsula, la presencia de estructuras especializadas que le permiten adherirse a las células del hospedero (pilis, y de sideróforos que le permiten obtener el hierro necesario para su desarrollo. La resistencia de Klebsiella pneumoniae a los antimicrobianos ha evolucionado de acuerdo con la aparición y uso de estas moléculas en el tratamiento de los pacientes, siendo cada vez más amplio el espectro que abarcan, el cual va desde la resistencia a la ampicilina

  19. Regulation of virulence gene expression resulting from Streptococcus pneumoniae and nontypeable Haemophilus influenzae interactions in chronic disease.

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    Emily K Cope

    Full Text Available Chronic rhinosinusitis (CRS is a common inflammatory disease of the sinonasal cavity mediated, in part, by polymicrobial communities of bacteria. Recent molecular studies have confirmed the importance of Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi in CRS. Here, we hypothesize that interaction between S. pneumoniae and NTHi mixed-species communities cause a change in bacterial virulence gene expression. We examined CRS as a model human disease to validate these polymicrobial interactions. Clinical strains of S. pneumoniae and NTHi were grown in mono- and co-culture in a standard biofilm assay. Reverse transcriptase real-time PCR (RTqPCR was used to measure gene expression of key virulence factors. To validate these results, we investigated the presence of the bacterial RNA transcripts in excised human tissue from patients with CRS. Consequences of physical or chemical interactions between microbes were also investigated. Transcription of NTHi type IV pili was only expressed in co-culture in vitro, and expression could be detected ex vivo in diseased tissue. S. pneumoniae pyruvate oxidase was up-regulated in co-culture, while pneumolysin and pneumococcal adherence factor A were down-regulated. These results were confirmed in excised human CRS tissue. Gene expression was differentially regulated by physical contact and secreted factors. Overall, these data suggest that interactions between H. influenzae and S. pneumoniae involve physical and chemical mechanisms that influence virulence gene expression of mixed-species biofilm communities present in chronically diseased human tissue. These results extend previous studies of population-level virulence and provide novel insight into the importance of S. pneumoniae and NTHi in CRS.

  20. Klebsiella pneumoniae KPC: first isolations in Italy


    Carla Fontana; Marco Favaro; Loredana Sarmati; Silvia Natoli; Anna Altieri; Maria Cristina Bossa; Silvia Minelli; Cartesio Favalli


    Klebsiella pneumoniae carbapenemase (KPC) was detected in two isolates of carbapenem-resistant K. pneumoniae in an italian teaching hospital. This is the first report of a KPC-producing isolates in our country. The first strain was isolated from a urine sample collected from a indwelling urinary catheter in a ICU-patient with subdural haematoma, while the second was from the culture of the central venous catheter (CVC) in a patient affected by Crohn’s disease admitted in gastroenterology ward...

  1. Perianal Abscess and Proctitis by Klebsiella pneumoniae


    Jeong, Woo Shin; Choi, Sung Youn; Jeong, Eun Haeng; Bang, Ki Bae; Park, Seung Sik; Lee, Dae Sung; Park, Dong Il; Jung, Yoon Suk


    Klebsiella pneumoniae (K. pneumoniae) can at times cause invasive infections, especially in patients with diabetes mellitus and a history of alcohol abuse. A 61-year-old man with diabetes mellitus and a history of alcohol abuse presented with abdominal and anal pain for two weeks. After admission, he underwent sigmoidoscopy, which revealed multiple ulcerations with yellowish exudate in the rectum and sigmoid colon. The patient was treated with ciprofloxacin and metronidazole. After one week, ...

  2. Chlamydia pneumoniae and atherosclrerosis: pathogenic ways


    Woolcott, Orison; Facultad de Medicina, Universidad Nacional Mayor de San Marcos; Sánchez, Luis; Facultad de Medicina, Universidad Nacional Mayor de San Marcos


    Atherosclerosis is a chronic inflammatory process in which macrophages, smooth muscle cells, T lymphocytes, and several chemical mediators intervene. In recent years, the finding of Chlamydia pneumoniae in arterial atherosclerotic plaques has suggested an etiological role; however, whether C. pneumoniae causes atherosclerosis or precipitates or favors atheroesclerosis progression remains uncertain. We review studies published on-line or available in Lima specialized libraries regarding C. pne...

  3. Opposing Signals from Pathogen-Associated Molecular Patterns and IL-10 Are Critical for Optimal Dendritic Cell Induction of In Vivo Humoral Immunity to Streptococcus pneumoniae (United States)


    patterns and IL-10 for optimization of DC induction of an in vivo humoral immune response. Bone marrow-derived, CD8 DC pulsed with Streptococcus ... pneumoniae in vitro induce in vivo protein- and polysaccharide-specific Ig isotype responses upon adoptive transfer into naive mice. Following bacterial

  4. Acute bacterial infections of the lower respiratory tract in children from low-income countries

    NARCIS (Netherlands)

    Fleer, A; Wolf, B.H.M.


    Acute bacterial infection of the lower respiratory tract is a major cause of morbidity and mortality in children and is responsible for 4 million childhood deaths each year. Most of these deaths are caused by pneumonia and occur in the youngest children in the poorest parts of the world. Severe pneu

  5. Mycoplasma pneumoniae pneumonia in hospitalized children diagnosed at acute stage by paired sera

    Institute of Scientific and Technical Information of China (English)

    LIU Chun-ling; WEI Ming; LIU Zhen-ye; WANG Gui-qiang; ZHANG Bo; XU Hua; HU Liang-ping; HE Xiao-feng; WANG Jun-hua; ZHANG Jun-hong; LIU Xiao-yu


    Background Mycoplasma pneumoniae (M. pneumoniae) is a frequent cause of respiratory tract infections. However,there is deficient knowledge about the clinical manifestations of M. pneumoniae infection. We described the clinical and laboratory findings of M. pneumoniae pneumonia in hospitalized children who were all diagnosed by a ≥ fourfold increase in antibody titer.Methods M. pneumoniae antibodies were routinely detected in children admitted with acute respiratory infection during a one-year period. The medical history was re-collected from children whose M. pneumoniae antibody titer increased≥fourfold at the bedside by a single person, and their frozen paired serum samples were measured again for the M.pneumoniae antibody titer.Results Of the 635 children whose sera were detected for the M. pneumoniae antibody, paired sera were obtained from 82 and 29.3% (24/82) showed a ≥ fourfold increase in antibody titer. There were 24 cases, nine boys and 15 girls, aged from two to 14 years, whose second serum samples were taken on day 9 at the earliest after symptom onset; the shortest interval was three days. All children presented with a high fever (≥38.5℃) and coughing. Twenty-one had no nasal obstruction or a runny nose, and five had mild headaches which all were associated with the high fever. The disease was comparatively severe if the peak temperature was >39.5℃. All were diagnosed as having pneumonia through chest X-rays. Four had bilateral or multilobar involvement and their peak temperatures were all ≤ 39.5℃. None of the children had difficulty in breathing and all showed no signs of wheezing.Conclusions The second serum sample could be taken on day 9 at the earliest after symptom onset meant that paired sera could be used for the clinical diagnosis of M. pneumoniae pneumonia in children at the acute stage. M. pneumoniae is a lower respiratory tract pathogen. Extrapulmonary complications were rare and minor in our study. High peak temperature (

  6. Mast cells play an important role in chlamydia pneumoniae lung infection by facilitating immune cell recruitment into the airway. (United States)

    Chiba, Norika; Shimada, Kenichi; Chen, Shuang; Jones, Heather D; Alsabeh, Randa; Slepenkin, Anatoly V; Peterson, Ellena; Crother, Timothy R; Arditi, Moshe


    Mast cells are known as central players in allergy and anaphylaxis, and they play a pivotal role in host defense against certain pathogens. Chlamydia pneumoniae is an important human pathogen, but it is unclear what role mast cells play during C. pneumoniae infection. We infected C57BL/6 (wild-type [WT]) and mast cell-deficient mice (Kit(W-sh/W-sh) [Wsh]) with C. pneumoniae. Wsh mice showed improved survival compared with WT mice, with fewer cells in Wsh bronchoalveolar lavage fluid (BALF), despite similar levels of cytokines and chemokines. We also found a more rapid clearance of bacteria from the lungs of Wsh mice compared with WT mice. Cromolyn, a mast cell stabilizer, reduced BALF cells and bacterial burden similar to the levels seen in Wsh mice; conversely, Compound 48/80, a mast cell degranulator, increased the number of BALF cells and bacterial burden. Histology showed that WT lungs had diffuse inflammation, whereas Wsh mice had patchy accumulations of neutrophils and perivascular accumulations of lymphocytes. Infected Wsh mice had reduced amounts of matrix metalloprotease-9 in BALF and were resistant to epithelial integral membrane protein degradation, suggesting that barrier integrity remains intact in Wsh mice. Mast cell reconstitution in Wsh mice led to enhanced bacterial growth and normal epithelial integral membrane protein degradation, highlighting the specific role of mast cells in this model. These data suggest that mast cells play a detrimental role during C. pneumoniae infection by facilitating immune cell infiltration into the airspace and providing a more favorable replicative environment for C. pneumoniae.

  7. Clinical analysis of ventilator-associated pneumonia

    Institute of Scientific and Technical Information of China (English)

    Bing-Qu Deng; Yong Liang


    Objective:To investigate the clinical analysis associated pneumonia in elderly ventilator. Methods:Through January 2011 to December 2013 in our hospital 165 cases of ventilator therapy in elderly patients with clinical data were retrospectively analyzed, discussed ventilator-associated pneumonia in the elderly risk factors, clinical symptoms, and the distribution of pathogens analysis of drug resistance.Results: The patient's age, sex, APACHE score, the incidence of aspiration, sedation and antacids, ventilator time were higher in patients (P<0.05); pathogens of ventilator-associated pneumonia in the elderly by high to low order of Pseudomonas aerations, Acinetobacter sop, etc.; pathogens commonly used in clinical antimicrobial drug resistance is higher.Conclusion:Take the risk factors associated pneumonia ventilator for elderly corresponding measures to reduce the incidence of ventilator-associated pneumonia, which Gram-negative bacteria as cause of ventilator-associated pneumonia in the elderly is an important pathogen occurs, the clinical course of treatment should be combined with a reasonable choice of antimicrobial susceptibility testing.

  8. Vector promoters used in Klebsiella pneumoniae. (United States)

    Jiang, Xiao; Zhu, Chengqian; Lin, Jie; Li, Jingkang; Fu, Shuilin; Gong, Heng


    Much effort has been devoted to the metabolic engineering of Klebsiella pneumoniae; however, our knowledge of the actual expression level of promoters used in K. pneumoniae is limited. In this study, the expression levels of three promoters were compared systematically by using the lacZ reporter gene with different carbon sources in K. pneumoniae. The results showed that, although promoters PT5 and Ptac designed for Escherichia coli were functional, PT5 appeared more efficient and the induction/repression ratio of Ptac was decreased extremely in K. pneumoniae. The basal level of Ptac for lacZ expression reached 396.5 U/mg, which was 9.5-fold higher compared with PT5 in LB medium, indicating Ptac can be used as an efficient "constitutive" promoter as well as an efficient induced promoter in K. pneumoniae. In different carbon sources medium, a newly constructed endogenous constitutive Pbud proved to be a stable and weak promoter. On the basis of our data, a set of Pbud and Ptac promoters could meet the broad range (about 1,000 orders of magnitude) of gene expression needed for engineered K. pneumoniae in glycerol-based medium.

  9. Acute and subacute idiopathic interstitial pneumonias. (United States)

    Taniguchi, Hiroyuki; Kondoh, Yasuhiro


    Idiopathic interstitial pneumonias (IIPs) may have an acute or subacute presentation, or acute exacerbation may occur in a previously subclinical or unrecognized chronic IIP. Acute or subacute IIPs include acute interstitial pneumonia (AIP), cryptogenic organizing pneumonia (COP), nonspecific interstitial pneumonia (NSIP), acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) and AE-NSIP. Interstitial lung diseases (ILDs) including connective tissue disease (CTD) associated ILD, hypersensitivity pneumonitis, acute eosinophilic pneumonia, drug-induced lung disease and diffuse alveolar haemorrhage need to be differentiated from acute and subacute IIPs. Despite the severe lack of randomized controlled trials for the treatment of acute and subacute IIPs, the mainstream treatment remains corticosteroid therapy. Other potential therapies reported in the literature include corticosteroids and immunosuppression, antibiotics, anticoagulants, neutrophil elastase inhibitor, autoantibody-targeted treatment, antifibrotics and hemoperfusion therapy. With regard to mechanical ventilation, patients in recent studies with acute and subacute IIPs have shown better survival than those in previous studies. Therefore, a careful value-laden decision about the indications for endotracheal intubation should be made for each patient. Noninvasive ventilation may be beneficial to reduce ventilator associated pneumonia.

  10. The crystal structure of alanine racemase from Streptococcus pneumoniae, a target for structure-based drug design

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    Davlieva Milya


    Full Text Available Abstract Background Streptococcus pneumoniae is a globally important pathogen. The Gram-positive diplococcus is a leading cause of pneumonia, otitis media, bacteremia, and meningitis, and antibiotic resistant strains have become increasingly common over recent years.Alanine racemase is a ubiquitous enzyme among bacteria and provides the essential cell wall precursor, D-alanine. Since it is absent in humans, this enzyme is an attractive target for the development of drugs against S. pneumoniae and other bacterial pathogens. Results Here we report the crystal structure of alanine racemase from S. pneumoniae (AlrSP. Crystals diffracted to a resolution of 2.0 Å and belong to the space group P3121 with the unit cell parameters a = b = 119.97 Å, c = 118.10 Å, α = β = 90° and γ = 120°. Structural comparisons show that AlrSP shares both an overall fold and key active site residues with other bacterial alanine racemases. The active site cavity is similar to other Gram positive alanine racemases, featuring a restricted but conserved entryway. Conclusions We have solved the structure of AlrSP, an essential step towards the development of an accurate pharmacophore model of the enzyme, and an important contribution towards our on-going alanine racemase structure-based drug design project. We have identified three regions on the enzyme that could be targeted for inhibitor design, the active site, the dimer interface, and the active site entryway.

  11. Aeromonas dhakensis pneumonia and sepsis in a neonate Risso's dolphin Grampus griseus from the Mediterranean Sea. (United States)

    Pérez, Lola; Abarca, M Lourdes; Latif-Eugenín, Fadua; Beaz-Hidalgo, Roxana; Figueras, M José; Domingo, Mariano


    A neonate Risso's dolphin Grampus griseus was found stranded alive on a beach in Catalonia, Spain. Rehabilitation attempts were unsuccessful and it died 2 d later, showing pneumonia and sepsis. A pure bacterial culture was obtained from all tissues and blood and identified as Aeromonas hydrophila using the API 20NE. However, sequencing the rpoD gene showed that the strain in fact belongs to A. dhakensis, making this the first report of fatal haemorrhagic-necrotizing pneumonia and sepsis due to this species in a marine mammal. The A. dhakensis strain GMV-704 produced β-haemolysis, possessed several virulence genes and showed sensitivity to several antimicrobials. This study provides a new potential host for A. dhakensis, and its potential virulence in dolphins and its presence in the marine environment may warrant considering this species a potential threat to marine mammals.

  12. Nutritional status and diarrheal illness as independent risk factors for alveolar pneumonia. (United States)

    Coles, Christian L; Fraser, Drora; Givon-Lavi, Noga; Greenberg, David; Gorodischer, Raphael; Bar-Ziv, Jacob; Dagan, Ron


    Community-acquired alveolar pneumonia (CAAP) is typically associated with bacterial infections and is especially prevalent in vulnerable populations worldwide. The authors studied nutritional status and diarrheal history as risk factors for CAAP in Bedouin children pneumonia with regard to nutritional status and diarrhea history. Controls were frequency matched to cases on age and enrollment month. Logistic regression models were used to evaluate associations of CAAP with nutritional status and recent diarrhea experience. Anemia (adjusted odds ratio (AOR) = 3.32, 95% confidence interval (CI): 2.24, 4.94; p or =1 diarrhea episodes within 31 days prior to enrollment (AOR = 2.30, 95% CI: 1.26, 4.19; p = 0.007) were identified as risk factors for CAAP. Results suggest that improving antenatal care and the nutritional status of infants may reduce the risk of CAAP in Bedouin children. Furthermore, they suggest that vaccines developed to prevent diarrhea may also lower the risk of CAAP.

  13. A case series of urticaria multiforme: Its association with Mycoplasma pneumoniae infection?

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    Yakup Canıtez


    Full Text Available Urticaria multiforme is a rare clinical and morphological subtype of acute urticaria in childhood. Clinical features include acute onset of blanchable, annular, polycyclic, erythematous wheals with dusky or ecchymotic centers (target lesion-like. Pruritus in nearly all and edema on the face, hand and foot in the majority of cases are seen. Urticaria multiforme known as a cutaneous hypersensitivity reaction can often be misdiagnosed as erythema multiforme and serum-sickness-like reaction. Although the majority of cases have been related with viral or bacterial infections and drug use, the exact etiopathogenesis of the disease is yet unclear. Association of Mycoplasma pneumoniae infection and urticaria multiforme have been reported in only two cases in the literature. In this article, a total of four cases diagnosed as urticaria multiforme two of whom had clinical and serological proof of Mycoplasma pneumoniae infection has been presented, and diagnostic criteria, differential diagnosis, etiopathogenesis and treatment of urticaria multiforme have been reviewed.

  14. Prevalence and antibiotic resistance of commensal Streptococcus pneumoniae in nine European countries. (United States)

    Yahiaoui, Rachid Y; den Heijer, Casper Dj; van Bijnen, Evelien Me; Paget, W John; Pringle, Mike; Goossens, Herman; Bruggeman, Cathrien A; Schellevis, François G; Stobberingh, Ellen E


    The human microbiota represents an important reservoir of antibiotic resistance. Moreover, the majority of antibiotics are prescribed in primary care. For this reason, we assessed the prevalence and antibiotic resistance of nasal carriage strains of Streptococcus pneumoniae, the most prevalent bacterial causative agent of community-acquired respiratory tract infections, in outpatients in nine European countries. Nasal swabs were collected between October 2010 and May 2011, from 32,770 patients, recruited by general practices in nine European countries. Overall prevalence of S. pneumoniae nasal carriage in the nine countries was 2.9%. The carriage was higher in men (3.7%) than in women (2.7%). Children (4-9 years) had a higher carriage prevalence (27.2%) compared with those older than 10 years (1.9%). The highest resistance observed was to cefaclor. The highest prevalence of multidrug resistance was found in Spain and the lowest prevalence was observed in Sweden.

  15. Neutral red-mediated microbial electrosynthesis by Escherichia coli, Klebsiella pneumoniae, and Zymomonas mobilis. (United States)

    Harrington, Timothy D; Mohamed, Abdelrhman; Tran, Vi N; Biria, Saeid; Gargouri, Mahmoud; Park, Jeong-Jin; Gang, David R; Beyenal, Haluk


    The aim of this work was to compare the effects of electrosynthesis on different bacterial species. The effects of neutral red-mediated electrosynthesis on the metabolite profiles of three microorganisms: Escherichia coli, Klebsiella pneumoniae, and Zymomonas mobilis, were measured and compared and contrasted. A statistically comprehensive analysis of neutral red-mediated electrosynthesis is presented using the analysis of end-product profiles, current delivered, and changes in cellular protein expression. K. pneumoniae displayed the most dramatic response to electrosynthesis of the three bacteria, producing 93% more ethanol and 76% more lactate vs. control fermentation with no neutral red and no electron delivery. Z. mobilis showed no response to electrosynthesis except elevated acetate titers. Stoichiometric comparison showed that NAD(+) reduction by neutral red could not account for changes in metabolites during electrosynthesis. Neutral red-mediated electrosynthesis was shown to have multifarious effects on the three species.

  16. Tylosin tartrate and tiamutilin effects on experimental piglet pneumonia induced with pneumonic pig lung homogenate containing mycoplasmas, bacteria and viruses. (United States)

    Hannan, P C; Bhogal, B S; Fish, J P


    The effects of tylosin tartrate and tiamutilin were examined in pneumonias induced experimentally in neonatal piglets with a homogenate of pneumonic pig lung, obtained from pigs with naturally acquired enzootic pneumonia. The homogenate contained mycoplasmas, including Mycoplasma hyopneumoniae (M suipneumoniae) and M hyorhinis, and certain bacteria and viruses. The experimental pneumonias generally resembled mycoplasmal pneumonia histologically but were complicated by aspiration pneumonia in some animals. both tylosin tartrate (50 mg/kg) and tiamutilin (10 mg/kg) administered orally twice daily for 10 days, beginning 14 days after intranasal infection, significantly reduced the incidence and severity of macroscopical pneumonic lung lesions. M hyopneumoniae could be isolated from the lungs of the unmedicated piglets, but not from drug-treated piglets. The numbers of M hyorhinis, Acholeplasma granularum, Haemophilus parasuis, Pasteurella multocida and P haemolytica in the lung tissue of the infected piglets were significantly reduced by drug therapy. The role of bacterial in the experimental infection appeared to be that of secondary invaders.

  17. Absence of capsule reveals glycan-mediated binding and recognition of salivary mucin MUC7 by Streptococcus pneumoniae. (United States)

    Thamadilok, S; Roche-Håkansson, H; Håkansson, A P; Ruhl, S


    Salivary proteins modulate bacterial colonization in the oral cavity and interact with systemic pathogens that pass through the oropharynx. An interesting example is the opportunistic respiratory pathogen Streptococcus pneumoniae that normally resides in the nasopharynx, but belongs to the greater Mitis group of streptococci, most of which colonize the oral cavity. Streptococcus pneumoniae also expresses a serine-rich repeat (SRR) adhesin, PsrP, which is a homologue to oral Mitis group SRR adhesins, such as Hsa of Streptococcus gordonii and SrpA of Streptococcus sanguinis. As the latter bind to salivary glycoproteins through recognition of terminal sialic acids, we wanted to determine whether S. pneumoniae also binds to salivary proteins through possibly the same mechanism. We found that only a capsule-free mutant of S. pneumoniae TIGR4 binds to salivary proteins, most prominently to mucin MUC7, but that this binding was not mediated through PsrP or recognition of sialic acid. We also found, however, that PsrP is involved in agglutination of human red blood cells (RBCs). After removal of PsrP, an additional previously masked lectin-like adhesin activity mediating agglutination of sialidase-treated RBCs becomes revealed. Using a custom-spotted glycoprotein and neoglycoprotein dot blot array, we identify candidate glycan motifs recognized by PsrP and by the putative S. pneumoniae adhesin that could perhaps be responsible for pneumococcal binding to salivary MUC7 and glycoproteins on RBCs.

  18. [Clinical characteristics and geriatric evaluation of elderly patients with pneumonia in a hospital in Buenos Aires, Argentina]. (United States)

    Regueiro, Martín; Homar, Cecilia; Ovejero, Ricardo; Liu, Antonio; Pieroni, Tomás; Basilico, Romina


    In order to determine the clinical and geriatric characteristics of elderly adults with pneumonia in a hospital in Buenos Aires, Argentina, a cross-sectional study was carried out in 2010, included 66 patients hospitalized for pneumonia. The mean age of the study subjects was 82, 54.5% of whom were men. 47.0% of the hospitalizations were due to community-acquired pneumonia. As for the functional evaluation, 31.8% showed dependence in performing basic activities of daily living and 69.4% presented dependence in instrumental activities of daily living. The most frequent clinical characteristics observed were fever, cough, dyspnea and expectoration. The causative agent of pneumonia was identified in 34.8% of the cases, 18 of which were bacterial (27.2%) and 5 viral (7.5%). The crude mortality rate was 28.8%, but was close to 50% in those patients having confusional syndrome. We conclude that pneumonia in elderly patients has special characteristics, which can be observed with a proper diagnostic and geriatric evaluation.

  19. Clinical and pulmonary thin-section CT findings in acute Klebsiella Pneumoniae pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Fumito [Oita University Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Oita (Japan); Oita University Faculty of Medicine, Department of Radiology, Oita (Japan); Ando, Yumiko; Honda, Koichi; Nakayama, Tomoko; Kiyonaga, Maki; Ono, Asami; Tanoue, Shuichi; Maeda, Toru; Mori, Hiromu [Oita University Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Oita (Japan)


    The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia. We retrospectively evaluated thin-section CT examinations performed between January 1991 and December 2007 from 962 patients with acute Klebsiella pneumoniae pneumonia. Seven hundred and sixty-four cases with concurrent infectious diseases were excluded. Thus, our study group comprised 198 patients (118 male, 80 female; age range 18-97 years, mean age 61.5). Underlying diseases and clinical findings were assessed. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusion. CT findings in patients with acute Klebsiella pneumoniae pneumonia consisted mainly of ground-glass attenuation (100%), consolidation (91.4%), and intralobular reticular opacity (85.9%), which were found in the periphery (96%) of both sides of the lungs (72.2%) and were often associated with pleural effusion (53%). The underlying conditions in patients with Klebsiella pneumoniae pneumonia were alcoholism or smoking habit. (orig.)

  20. Pneumomediastinum and pneumothorax as presenting signs in severe Mycoplasma pneumoniae pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Vazquez, Jose L.; Vazquez, Ignacio; Garcia-Tejedor, Jose L. [Complejo Hospitalario Universitario de Vigo, Department of Radiology, Vigo (Spain); Gonzalez, Maria L.; Reparaz, Alfredo [Complejo Hospitalario Universitario de Vigo, Department of Pediatrics, Vigo (Spain)


    We present a 3-year-old child with severe extensive Mycoplasma pneumoniae pneumonia complicated with pneumomediastinum and pneumothorax. Pneumothorax and pneumomediastinum have only exceptionally been described in mild cases of the disease. The radiological findings, differential diagnosis and clinical course are discussed. (orig.)

  1. Adenovirus Type 7 Pneumonia in Children Who Died from Measles-Associated Pneumonia, Hanoi, Vietnam, 2014. (United States)

    Hai, Le Thanh; Thach, Hoang Ngoc; Tuan, Ta Anh; Nam, Dao Huu; Dien, Tran Minh; Sato, Yuko; Kumasaka, Toshio; Suzuki, Tadaki; Hanaoka, Nozomu; Fujimoto, Tsuguto; Katano, Harutaka; Hasegawa, Hideki; Kawachi, Shoji; Nakajima, Noriko


    During a 2014 measles outbreak in Vietnam, postmortem pathologic examination of hospitalized children who died showed that adenovirus type 7 pneumonia was a contributory cause of death in children with measles-associated immune suppression. Adenovirus type 7 pneumonia should be recognized as a major cause of secondary infection after measles.

  2. Relationship Between the Inoculum Dose of Streptococcus pneumoniae and Pneumonia Onset in a Rabbit Model (United States)


    White rabbits (mean + or - SD + or - 4.75 + or - 0.25 kg (n = 27)). Rabbits were endobronchially inoculated with increasing doses of Streptococcus ... pneumoniae and pneumonia onset was observed over the following 96 h. The diagnostic approach was based on the Clinical Pulmonary Infection Score

  3. Preliminary investigation of a mice model of Klebsiella pneumoniae subsp. ozaenae induced pneumonia. (United States)

    Renois, Fanny; Jacques, Jérôme; Guillard, Thomas; Moret, Hélène; Pluot, Michel; Andreoletti, Laurent; de Champs, Christophe


    In the present study, we comparatively assessed the pathophysiological mechanisms developed during lung infection of BALB/C female mice infected by an original wild type Klebsiella pneumoniae subsp. ozaenae strain (CH137) or by a referent subspecies K. pneumoniae. subsp. pneumoniae strain (ATCC10031). The mice infected with 2.10⁶ CFU K. p. subsp. pneumoniae (n = 10) showed transient signs of infection and all of them recovered. All of those infected with 1.10⁶ CFU K. p. subsp. ozaenae (n = 10) developed pneumonia within 24 h and died between 48 and 72 h. Few macrophages, numerous polymorphonuclear cells and lymphocytes were observed in their lungs in opposite to K. p. subsp. pneumoniae. In bronchoalveolar lavage, a significant increase in MIP-2, IL-6, KC and MCP-1 levels was only observed in K. p. subsp. ozaenae infected mice whereas high levels of TNF-α were evidenced with the two subspecies. Our findings indicated a lethal effect of a wild type K. p. subsp. ozaenae strain by acute pneumonia reflecting an insufficient alveolar macrophage response. This model might be of a major interest to comparatively explore the pathogenicity of K. p. subsp ozaenae strains and to further explore the physiopathological mechanisms of gram-negative bacteria induced human pneumonia.

  4. Clinical and pulmonary thin-section CT findings in acute Klebsiella pneumoniae pneumonia. (United States)

    Okada, Fumito; Ando, Yumiko; Honda, Koichi; Nakayama, Tomoko; Kiyonaga, Maki; Ono, Asami; Tanoue, Shuichi; Maeda, Toru; Mori, Hiromu


    The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia. We retrospectively evaluated thin-section CT examinations performed between January 1991 and December 2007 from 962 patients with acute Klebsiella pneumoniae pneumonia. Seven hundred and sixty-four cases with concurrent infectious diseases were excluded. Thus, our study group comprised 198 patients (118 male, 80 female; age range 18-97 years, mean age 61.5). Underlying diseases and clinical findings were assessed. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusion. CT findings in patients with acute Klebsiella pneumoniae pneumonia consisted mainly of ground-glass attenuation (100%), consolidation (91.4%), and intralobular reticular opacity (85.9%), which were found in the periphery (96%) of both sides of the lungs (72.2%) and were often associated with pleural effusion (53%). The underlying conditions in patients with Klebsiella pneumoniae pneumonia were alcoholism or smoking habit.

  5. Ceftobiprole medocaril (BAL5788) treatment of experimental Haemophilus influenzae, Enterobacter cloacae, and Klebsiella pneumoniae murine pneumonia. (United States)

    Rouse, Mark S; Hein, Melanie M; Anguita-Alonso, Paloma; Steckelberg, James M; Patel, Robin


    Ceftobiprole (BAL9141) is an investigational cephalosporin active against methicillin- and vancomycin-resistant staphylococci administered as a water-soluble prodrug, ceftobiprole medocaril (BAL5788). Using an immunocompetent murine pneumonia model of Haemophilus influenzae, Enterobacter cloacae, or extended-spectrum beta-lactamase (ESBL) nonproducing or producing Klebsiella pneumoniae pneumonia, we compared results of treatment with ceftobiprole medocaril (71 mg/kg, sc, qid), ceftriaxone (50 mg/kg, im, bid), or cefepime (50 mg/kg, ip, q.i.d.). Results were expressed as median and 25th to 75th percentile log10 colony forming units per gram of lung tissue. Ceftobiprole, ceftriaxone, and cefepime were each more active than was no treatment and were equally active for treatment of experimental H. influenzae, E. cloacae, or ESBL-nonproducing K. pneumoniae pneumonia. For ESBL-producing K. pneumoniae, no differences were detected between no treatment and treatment with ceftobiprole, ceftriaxone, or cefepime. Ceftobiprole is active against H. influenzae, E. cloacae, and ESBL-nonproducing K. pneumoniae in an immunocompetent experimental murine pneumonia model.

  6. Capsule Switching and Antimicrobial Resistance Acquired during Repeated Streptococcus pneumoniae Pneumonia Episodes. (United States)

    Chang, Bin; Nariai, Akiyoshi; Sekizuka, Tsuyoshi; Akeda, Yukihiro; Kuroda, Makoto; Oishi, Kazunori; Ohnishi, Makoto


    Streptococcus pneumoniae colonizes the nasopharyngeal mucus in healthy people and causes otitis media, pneumonia, bacteremia, and meningitis. In this study, we analyzed an S. pneumoniae strain that caused 7 repeated pneumonia episodes in an 80-month-old patient with cerebral palsy during a period of 25 months. A total of 10 S. pneumoniae strains were obtained from sputum samples, and serotype 6B was isolated from samples from the first 5 episodes, whereas serotype 6A was isolated from samples from the last 2. Whole-genome sequencing showed clonality of the 10 isolates with 10 single nucleotide polymorphisms (SNPs) in the genomes. Among these SNPs, one single point mutation in the wciP gene was presumed to relate to the serotype switching from 6B to 6A, and the other mutations in parC and gyrA were related to fluoroquinolone resistance. These results suggested that an S. pneumoniae strain, which asymptomatically colonized the patient's nasopharynx or was horizontally transmitted from an asymptomatic carrier, caused the repeated pneumonia events. Phenotypic variations in the capsule type and antimicrobial susceptibility occurred during the carrier state. Hyporesponsiveness to serotypes 6B and 6A of S. pneumoniae was found even after vaccination with the 7-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine. After an additional vaccination with the 13-valent pneumococcal conjugate vaccine, opsonic activities for both serotypes 6A and 6B significantly increased and are expected to prevent relapse by the same strain.

  7. Characterization of the inflammatory infiltrate in Streptococcus pneumoniae pneumonia in young and elderly patients. (United States)

    Menter, Thomas; Giefing-Kroell, Carmen; Grubeck-Loebenstein, Beatrix; Tzankov, Alexandar


    There is an increased susceptibility and mortality in the elderly due to pneumonia caused by Streptococcus pneumoniae. We aimed to assess the inflammatory cell composition with respect to age in pneumococcal pneumonia patients. Neutrophilic granulocytes and various lymphocyte and macrophage subpopulations were immunohistochemically quantified on lung tissue specimens of young (n = 5; mean age 8.4 years), middle-aged (n = 8; mean age 55.9 years) and elderly (n = 9; mean age 86.6 years) pneumonia patients with microbiologically proven S. pneumoniae pneumonia. We discovered a higher percentage of neutrophilic granulocytes in elderly as opposed to young patients (95 vs. 75%, p = 0.012). Conversely, young patients versus elderly patients had more alveolar macrophages (CD11c+: 20 vs. 9%, p = 0.029) and M1 macrophages (CD14+: 30 vs. 10%, p = 0.012 and HLA-DR+: 52 vs. 11%, p = 0.019). There was no significant difference concerning M2 macrophages and lymphocytes. Comparison of young patients with middle-aged patients showed similar significant results for alveolar macrophages (p = 0.019) and subsignificant results for M1 macrophages and neutrophilic granulocytes (p pneumonia in situ. Our observations improve the understanding of the innate immune mechanisms of pneumococcal lung infection and point at the potential of therapies for restoring macrophage function and decreasing neutrophilic influx in order to help prevent or cure pneumonia.

  8. Nasopharyngeal carriage of Streptococcus pneumonia in pneumonia-prone age groups in Semarang, Java Island, Indonesia.

    Directory of Open Access Journals (Sweden)

    Helmia Farida

    Full Text Available INTRODUCTION: Streptococcus pneumoniae is a worldwide occurring pathogen Nasopharyngeal carriage of Streptococcus pneumoniae precedes pneumonia and other pneumococcal diseases in the community. Little is known about S. pneumoniae carriage in Indonesia, complicating strategies to control pneumococcal diseases. We investigated nasopharyngeal carriage of S. pneumoniae in Semarang, Indonesia. METHODS: A population-based survey was performed in Semarang, Indonesia. Nasopharyngeal swabs and questionnaires were taken from 496 healthy young (6-60 month-old children and 45-70 year-old adults. RESULTS: Forty-three percent of children aged 6-60 months and 11% of adults aged 45-75 years carried S. pneumoniae. Determinants of carriage were being a child (OR 7.7; 95% CI = 4.5-13.0, passive smoking (OR 2.1; 95% CI = 1.3-3.4, and contact with toddler(s at home (OR 3.0; 95% CI = 1.9-4.7. The most frequent serotypes found were 6A/B and 15B/C. The current commercially available vaccines cover <50% serotypes found in children. Twenty-four percent of S. pneumoniae strains were penicillin non-susceptible, and 45% were resistant to cotrimoxazol. CONCLUSIONS: The limited coverage of commercially available vaccines against the serotypes found in this population, and the high proportion of non-susceptibility to penicillin and cotrimoxazol suggest the need for region-specific information and strategies to control S. pneumoniae.


    Akiyama, Norimichi; Yokomura, Koshi; Nozue, Tsuyoshi; Abe, Takefumi; Matsui, Takashi; Suda, Takafumi


    We report three cases of drug-induced pneumonia caused by mesalazine. They were all diagnosed as ulcerative colitis and treated with mesalazine orally. Our three cases and literature review revealed that mesalazine-induced pneumonia resemble like eosinophilic pneumonia or organizing pneumonia and that have good prognosis with drug cessation or administration of corticosteroid. The patient of ulcerative colitis is increasing every year and it is anticipated that the patient with mesalazine-induced pneumonia may also increase. In the treatment of ulcerative colitis with mesalazine, we should pay attention with patient's cough or fever for early detection of drug-induced pneumonia.

  10. Microbial fuel cell based on Klebsiella pneumoniae biofilm

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Lixia [School of Chemistry and Environment, South China Normal University, Guangzhou 510006 (China); Guangdong Institute of Eco-Environmental and Soil Sciences, Guangzhou 510650 (China); Zhou, Shungui; Zhuang, Li; Zhang, Jintao; Lu, Na; Deng, Lifang [Guangdong Institute of Eco-Environmental and Soil Sciences, Guangzhou 510650 (China); Li, Weishan [School of Chemistry and Environment, South China Normal University, Guangzhou 510006 (China); Key Laboratory of Electrochemical Technology on Energy Storage and Power Generation in Guangdong Universities, Guangzhou 510006 (China)


    In this paper we reported a novel microbial fuel cell (MFC) based on Klebsiella pneumoniae (K. pneumoniae) strain L17 biofilm, which can utilize directly starch and glucose to generate electricity. The electrochemical activity of K. pneumoniae and the performance of the MFC were evaluated by cyclic voltammetry, scanning electron microscope (SEM) and polarization curve measurement. The results indicated that an established K. pneumoniae biofilm cells were responsible for the direct electron transfer from fuels to electrode during electricity production. The SEM observation proved the ability of K. pneumoniae to colonize on the electrode surface. This MFC generated power from the direct electrocatalysis by the K. pneumoniae strain L17 biofilm. (author)

  11. Novel structurally designed vaccine for S. aureus α-hemolysin: protection against bacteremia and pneumonia.

    Directory of Open Access Journals (Sweden)

    Rajan P Adhikari

    Full Text Available Staphylococcus aureus (S. aureus is a human pathogen associated with skin and soft tissue infections (SSTI and life threatening sepsis and pneumonia. Efforts to develop effective vaccines against S. aureus have been largely unsuccessful, in part due to the variety of virulence factors produced by this organism. S. aureus alpha-hemolysin (Hla is a pore-forming toxin expressed by most S. aureus strains and reported to play a key role in the pathogenesis of SSTI and pneumonia. Here we report a novel recombinant subunit vaccine candidate for Hla, rationally designed based on the heptameric crystal structure. This vaccine candidate, denoted AT-62aa, was tested in pneumonia and bacteremia infection models using S. aureus strain Newman and the pandemic strain USA300 (LAC. Significant protection from lethal bacteremia/sepsis and pneumonia was observed upon vaccination with AT-62aa along with a Glucopyranosyl Lipid Adjuvant-Stable Emulsion (GLA-SE that is currently in clinical trials. Passive transfer of rabbit immunoglobulin against AT-62aa (AT62-IgG protected mice against intraperitoneal and intranasal challenge with USA300 and produced significant reduction in bacterial burden in blood, spleen, kidney, and lungs. Our Hla-based vaccine is the first to be reported to reduce bacterial dissemination and to provide protection in a sepsis model of S. aureus infection. AT62-IgG and sera from vaccinated mice effectively neutralized the toxin in vitro and AT62-IgG inhibited the formation of Hla heptamers, suggesting antibody-mediated neutralization as the primary mechanism of action. This remarkable efficacy makes this Hla-based vaccine a prime candidate for inclusion in future multivalent S. aureus vaccine. Furthermore, identification of protective epitopes within AT-62aa could lead to novel immunotherapy for S. aureus infection.

  12. Functionally cloned pdrM from Streptococcus pneumoniae encodes a Na(+ coupled multidrug efflux pump.

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    Kohei Hashimoto

    Full Text Available Multidrug efflux pumps play an important role as a self-defense system in bacteria. Bacterial multidrug efflux pumps are classified into five families based on structure and coupling energy: resistance-nodulation-cell division (RND, small multidrug resistance (SMR, major facilitator (MF, ATP binding cassette (ABC, and multidrug and toxic compounds extrusion (MATE. We cloned a gene encoding a MATE-type multidrug efflux pump from Streptococcus pneumoniae R6, and designated it pdrM. PdrM showed sequence similarity with NorM from Vibrio parahaemolyticus, YdhE from Escherichia coli, and other bacterial MATE-type multidrug efflux pumps. Heterologous expression of PdrM let to elevated resistance to several antibacterial agents, norfloxacin, acriflavine, and 4',6-diamidino-2-phenylindole (DAPI in E. coli KAM32 cells. PdrM effluxes acriflavine and DAPI in a Na(+- or Li(+-dependent manner. Moreover, Na(+ efflux via PdrM was observed when acriflavine was added to Na(+-loaded cells expressing pdrM. Therefore, we conclude that PdrM is a Na(+/drug antiporter in S. pneumoniae. In addition to pdrM, we found another two genes, spr1756 and spr1877,that met the criteria of MATE-type by searching the S. pneumoniae genome database. However, cloned spr1756 and spr1877 did not elevate the MIC of any of the investigated drugs. mRNA expression of spr1756, spr1877, and pdrM was detected in S. pneumoniae R6 under laboratory growth conditions. Therefore, spr1756 and spr1877 are supposed to play physiological roles in this growth condition, but they may be unrelated to drug resistance.

  13. Gatifloxacin used for therapy of outpatient community-acquired pneumonia caused by Streptococcus pneumoniae. (United States)

    Jones, Ronald N; Andes, David R; Mandell, Lionel A; Gothelf, Samantha; Ehrhardt, Anton F; Nicholson, Susan C


    Gatifloxacin is an advanced-generation fluoroquinolone with demonstrated efficacy and safety as therapy for community-acquired pneumonia (CAP). As part of a phase IV postmarketing surveillance program (TeqCES), 136 outpatients with CAP whose sputum was culture-positive for Streptococcus pneumoniae were enrolled in an open-label trial of oral gatifloxacin 400 mg daily for 7 to 14 days. An antibiogram of isolates showed 100% susceptibility to gatifloxacin (MIC(90) 0.5 micro g/mL) and respective susceptibilities of 67%, 70%, and 80% to penicillin, erythromycin, and tetracycline. Clinical cure was achieved in 95.3% of evaluable patients, including seven patients infected with penicillin-resistant S. pneumoniae (MIC > or =2 micro g/mL). The bacteriologic eradication rate for S. pneumoniae was 94.5%. Diarrhea, nausea, and dizziness, the most common adverse events in CAP patients (pneumoniae including multidrug-resistant strains, with the newer 8-methoxy-fluoroquinolone, gatifloxacin.

  14. Epidemiology and antibiotic resistance of bacterial meningitis in Dapaong, northern Togo

    Institute of Scientific and Technical Information of China (English)

    Simplice D Karou; Abago Balaka; Mitiname Bamok; Damhan Tchelougou; Malki Assih; Kokou Anani; Kodjo Agbonoko; Jacques Simpore; Comlan de Souza


    Objective:To assess the seasonality of the bacterial meningitis and the antibiotic resistance of incriminated bacteria over the last three years in the northern Togo. Methods: From January 2007 to January 2010, 533 cerebrospinal fluids (CSF) samples were collected from patients suspected of meningitis in the Regional Hospital of Dapaong (northern Togo). After microscopic examination, samples were cultured for bacterial identification and antibiotic susceptibility. Results:The study included 533 patients (306 male and 227 female) aged from 1 day to 55 years [average age (13.00±2.07) years]. Bacterial isolation and identification were attempted for 254/533 (47.65%) samples. The bacterial species identified were:Neisseria meningitidis A (N. meningitidis A) (58.27%), Neisseria meningitidis W135 (N. meningitidis W135) (7.09%), Streptococcus pneumoniae (S. pneumoniae) (26.77%), Haemophilus influenza B (H. influenza B) (6.30%) and Enterobacteriaceae (1.57%). The results indicated that bacterial meningitis occur from November to May with a peak in February for H. influenzae and S. pneumoniae and March for Neisseriaceae. The distribution of positive CSF with regards to the age showed that subjects between 6 and 12 years followed by subjects of 0 to 5 years were most affected with respective frequencies of 67.82% and 56.52% (P20%for both bacterial strains), macrolides (resistance rate> 30%for H. influenzae) quinolones (resistance rate>15%for H. influenzae and N. meningitidis W135). Over three years, the prevalence of S. pneumoniae significantly increased from 8.48%to 73.33%(P<0.001), while the changes in the prevalence of H. influenzae B were not statistically significant: 4.24%, vs. 8.89%, (P= 0.233). Conclusions:Our results indicate that data in African countries differ depending on geographical location in relation to the African meningitis belt. This underlines the importance of epidemiological surveillance of bacterial meningitis.

  15. Elucidation of the RamA regulon in Klebsiella pneumoniae reveals a role in LPS regulation.

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    Shyamasree De Majumdar


    Full Text Available Klebsiella pneumoniae is a significant human pathogen, in part due to high rates of multidrug resistance. RamA is an intrinsic regulator in K. pneumoniae established to be important for the bacterial response to antimicrobial challenge; however, little is known about its possible wider regulatory role in this organism during infection. In this work, we demonstrate that RamA is a global transcriptional regulator that significantly perturbs the transcriptional landscape of K. pneumoniae, resulting in altered microbe-drug or microbe-host response. This is largely due to the direct regulation of 68 genes associated with a myriad of cellular functions. Importantly, RamA directly binds and activates the lpxC, lpxL-2 and lpxO genes associated with lipid A biosynthesis, thus resulting in modifications within the lipid A moiety of the lipopolysaccharide. RamA-mediated alterations decrease susceptibility to colistin E, polymyxin B and human cationic antimicrobial peptide LL-37. Increased RamA levels reduce K. pneumoniae adhesion and uptake into macrophages, which is supported by in vivo infection studies, that demonstrate increased systemic dissemination of ramA overexpressing K. pneumoniae. These data establish that RamA-mediated regulation directly perturbs microbial surface properties, including lipid A biosynthesis, which facilitate evasion from the innate host response. This highlights RamA as a global regulator that confers pathoadaptive phenotypes with implications for our understanding of the pathogenesis of Enterobacter, Salmonella and Citrobacter spp. that express orthologous RamA proteins.

  16. Effects of new penicillin susceptibility breakpoints for Streptococcus pneumoniae--United States, 2006-2007. (United States)


    Streptococcus pneumoniae (pneumococcus) is a common cause of pneumonia and meningitis in the United States. Antimicrobial resistance, which can result in pneumococcal infection treatment failure, is identified by measuring the minimum inhibitory concentration (MIC) of an antimicrobial that will inhibit pneumococcal growth. Breakpoints are MICs that define infections as susceptible (treatable), intermediate (possibly treatable with higher doses), and resistant (not treatable) to certain antimicrobials. In January 2008, after a reevaluation that included more recent clinical studies, the Clinical and Laboratory Standards Institute (CLSI) published new S. pneumoniae breakpoints for penicillin (the preferred antimicrobial for susceptible S. pneumoniae infections). To assess the potential effects of the new breakpoints on susceptibility categorization, CDC applied them to MICs of invasive pneumococcal disease (IPD) isolates collected by the Active Bacterial Core surveillance (ABCs) system at sites in 10 states during 2006-2007. This report summarizes the results of that analysis, which found that the percentage of IPD nonmeningitis S. pneumoniae isolates categorized as susceptible, intermediate, and resistant to penicillin changed from 74.7%, 15.0%, and 10.3% under the former breakpoints to 93.2%, 5.6%, and 1.2%, respectively, under the new breakpoints. Microbiology laboratories should be aware of the new breakpoints to interpret pneumococcal susceptibility accurately, and clinicians should be aware of the breakpoints to prescribe antimicrobials appropriately for pneumococcal infections. State and local health departments also should be aware of the new breakpoints because they might result in a decrease in the number of reported cases of penicillin-resistant pneumococcus.

  17. In vitro pharmacodynamics of various antibiotics in combination against extensively drug-resistant Klebsiella pneumoniae. (United States)

    Lim, Tze-Peng; Cai, Yiying; Hong, Yanjun; Chan, Eric Chun Yong; Suranthran, Sasikala; Teo, Jocelyn Qi-Min; Lee, Winnie Huiling; Tan, Thean-Yen; Hsu, Li-Yang; Koh, Tse-Hsien; Tan, Thuan-Tong; Kwa, Andrea Lay-Hoon


    Extensively drug-resistant (XDR) Klebsiella pneumoniae is an emerging pathogen in Singapore. With limited therapeutic options available, combination antibiotics may be the only viable option. In this study, we aimed to elucidate effective antibiotic combinations against XDR K. pneumoniae isolates. Six NDM-1-producing and two OXA-181-producing K. pneumoniae strains were exposed to 12 antibiotics alone and in combination via time-kill studies. A hollow-fiber infection model (HFIM) with pharmacokinetic validation was used to simulate clinically relevant tigecycline-plus-meropenem dosing regimens against 2 XDR K. pneumoniae isolates over 240 h. The emergence of resistance against tigecycline was quantified using drug-free and selective (tigecycline at 3× the MIC) media. The in vitro growth rates were determined and serial passages on drug-free and selective media were carried out on resistant isolates obtained at 240 h. Both the polymyxin B and tigecycline MICs ranged from 1 to 4 mg/liter. In single time-kill studies, all antibiotics alone demonstrated regrowth at 24 h, except for polymyxin B against 2 isolates. Tigecycline plus meropenem was found to be bactericidal in 50% of the isolates. For the isolates that produced OXA-181-like carbapenemases, none of the 55 tested antibiotic combinations was bactericidal. Against 2 isolates in the HFIM, tigecycline plus meropenem achieved a >90% reduction in bacterial burden for 96 h before regrowth was observed until 10(9) CFU/ml at 240 h. Phenotypically stable and resistant isolates, which were recovered from tigecycline-supplemented plates post-HFIM studies, had lower growth rates than those of their respective parent isolates, possibly implying a substantial biofitness deficit in this population. We found that tigecycline plus meropenem may be a potential antibiotic combination for XDR K. pneumoniae infections, but its efficacy was strain specific.

  18. Induction of prophages by fluoroquinolones in streptococcus pneumoniae: implications for emergence of resistance in genetically-related clones


    Elena López; Arnau Domenech; María-José Ferrándiz; Maria João Frias; Carmen Ardanuy; Mario Ramirez; Ernesto García; Josefina Liñares; de la Campa, Adela G.


    Antibiotic resistance in Streptococcus pneumoniae has increased worldwide by the spread of a few clones. Fluoroquinolone resistance occurs mainly by alteration of their intracellular targets, the type II DNA topoisomerases, which is acquired either by point mutation or by recombination. Increase in fluoroquinolone-resistance may depend on the balance between antibiotic consumption and the cost that resistance imposes to bacterial fitness. In addition, pneumococcal prophages could play an impo...

  19. Clinical characteristics of pulmonary embolism with concomitant pneumonia. (United States)

    Cha, Seung-Ick; Choi, Keum-Ju; Shin, Kyung-Min; Lim, Jae-Kwang; Yoo, Seung-Soo; Lee, Jaehee; Lee, Shin-Yup; Kim, Chang-Ho; Park, Jae-Yong


    Although pneumonia is associated with an increased risk of venous thromboembolism, patients with pulmonary embolism and concomitant pneumonia are uncommon. The aim of the present study was to investigate the clinical features of pulmonary embolism with coexisting pneumonia. We retrospectively compared clinical, radiologic and laboratory parameters between patients with pulmonary embolism and concomitant pneumonia (pneumonia group) and those with unprovoked pulmonary embolism (unprovoked group), and then between the pneumonia group and those with pulmonary infarction (infarction group). Of 794 patients with pulmonary embolism, 36 (5%) had coexisting pneumonia and six (1%) had no provoking factor other than pneumonia. Stroke was significantly more common in the pneumonia group, than either the unprovoked group or the infarction group. In the pneumonia group, fever was significantly more common and serum C-reactive protein levels were significantly higher. By contrast, central pulmonary embolism and right ventricular dilation on computed tomography were significantly less frequent in the pneumonia group. In addition, an adverse outcome due to pulmonary embolism was less common in the pneumonia group than in either of the other two groups. The coexistence of pulmonary embolism and pneumonia is rarely encountered in clinical practice, especially without the presence of other factors that could provoke venous thromboembolism and is commonly associated with stroke. It is characterized by lower incidences of central pulmonary embolism and right ventricular dilation and by a lower rate of adverse outcomes due to pulmonary embolism itself.

  20. Effects of the hindlimb-unloading model of spaceflight conditions on resistance of mice to infection with Klebsiella pneumoniae (United States)

    Belay, Tesfaye; Aviles, Hernan; Vance, Monique; Fountain, Kimberly; Sonnenfeld, Gerald


    BACKGROUND: It has been well documented in several studies that many immunologic parameters are altered in experimental animals and human subjects who have flown in space. However, it is not fully known whether these immunologic changes could result in increased susceptibility to infection. Hindlimb (antiorthostatic) unloading of rodents has been used successfully to simulate some of the effects of spaceflight on physiologic systems. OBJECTIVE: The objective of this study was to determine the effect of hindlimb unloading on the outcome of Klebsiella pneumoniae infection in mice. METHODS: Hindlimb-unloaded, hindlimb-restrained, and control mice were intraperitoneally infected with one 50% lethal dose of K pneumoniae 2 days after suspension. Mortality and bacterial load in several organs were compared among the groups. RESULTS: Unloaded mice showed significantly increased mortality and reduced mean time to death compared with that seen in the control groups. Kinetics of bacterial growth with smaller infective doses revealed that control mice were able to clear bacteria from the organs after 30 hours. In contrast, unloaded mice had continued bacterial growth at the same time point. CONCLUSION: The results of this study suggest that hindlimb unloading might enhance the dissemination of K pneumoniae, leading to increased mortality. The complex physiologic changes observed during hindlimb unloading, including stress, have a key role in the pathophysiology of this infection.


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    Full Text Available BACKGROUND Pneumonia is defined as the inflammation and consolidation of the lung tissue due to an infectious agent. In as many as half of cases, the pathogen remains unidentified which greatly hampers the evaluation of slowly resolving or non-resolving pneumonia. OBJECTIVE The main objective is to evaluate the aetiology and clinical profile of non-resolving pneumonia in a tertiary care center and to study the outcome of treatment of non-resolving pneumonia. DESIGN AND SETTING A prospective, observational study was carried out in the department of pulmonary medicine of a 700 bedded tertiary care teaching hospital, Kerala. MATERIALS AND METHODS The patients who were diagnosed as non-resolving pneumonia were included in the study. Various investigations were done on patients to identify the aetiology and clinical profile of their pneumonia which includes sputum gram stain, culture and sensitivity for bacterial infections, AFB culture, fungal culture, chest X-ray, CT thorax, fibrotic bronchoscopy (For selected patients only and sputum cytology for malignant cells. STATISTICAL METHODS USED Descriptive statistical analysis was done with help of ‘Graph pad prism’. RESULTS With good clinical interpretations and appropriate treatment, about 31.8% of patients had good clinical improvement and complete chest X-ray clearance after 2 months of follow up where as 36.2% of study subjects had good clinical improvement with incomplete chest X-ray clearance. Majority of this group includes patients who were put on anti-tubercular treatment based on careful interpretation of chest X-ray findings of tuberculosis, Mantoux test and sputum AFB culture results. This implies the importance of early diagnosis of treatable diseases like tuberculosis in our population. Out of the total cases 21.2% of patients had poor clinical outcome whereas 4.4% patients were grabbed by death. CONCLUSION Tuberculosis was the commonest cause of non-resolving pneumonia followed by

  2. 降钙素原在儿童感染性肺炎早期诊断中的应用%Application of Procalcition in Early Clinical Diagnosis of Children Infectious Pneumonia

    Institute of Scientific and Technical Information of China (English)



    Objective:To investigate the clinical significance of serum procalcition( PCT) in the children patients with infectious pneu-monia.Methods:107 children patients were divided into local bacterial pneumonia patients (32 eases)、mycoplasmal pneumonia patients (40 eases) and viral pneumonia patients(35 eases).40 healthy children were controls .Serum PCT and C-reactive protein (CRP) were measured by the methods of immunity chromatography assay .Results:the Serum PCT level in local bacterial pneumonia patients was sig-nificantly higher than that in mycoplasmal pneumonia patients and viral pneumonia patients.The positive rate of PCT in local bacterial pneumonia patients was 75%which was significant higher than that in mycoplasmal pneumonia patients(15%) and viral pneumonia pa-tients (8.57%).there was no statistical difference of PCT level between mycoplasmal pneumonia patients and viral pneumonia patients, but the positive rate of PCT level in mycoplasmal pneumonia patients was significantly higher than that in viral pneumonia patients.There was no statistical difference of the positive rate of CRP in local bacterial pneumonia patients (78.15%) mycoplasmal pneumonia patients (80%) and viral pneumonia patients(82.86%) .Conclusion:Serum PCT was an important clinical marker in clinical diagnosis of local bacterial pneumonia .%目的:探讨血清PCT检测在儿童感染性肺炎早期诊断中的应用价值。方法:107例住院肺炎儿童分为局部细菌性肺炎组(32例)、肺炎支原体性肺炎组(40例)和病毒性肺炎(35例),另有40例正常儿童作为对照组。采用免疫荧光层析法测定血清CRP、PCT浓度。结果:107例患儿中,局部细菌性肺炎组血清PCT浓度明显高于肺炎支原体性肺炎组和病毒性肺炎组( P<0.05),肺炎支原体性肺炎组和病毒性肺炎组PCT浓度未见显著差异(P=0.723)。局部细菌性肺炎组PCT阳性率(75%)亦明显高于

  3. Treatment of community-acquired pneumonia. (United States)

    Lee, Young R; Houngue, Coovi; Hall, Ronald G


    Community-acquired pneumonia is the sixth leading cause of death in the USA. Adherence to the 2007 Infectious Diseases Society of America/American Thoracic Society community-acquired pneumonia guidelines has been associated with improved clinical outcomes. However, choice between guideline-recommended treatments is at the discretion of the prescribing clinician. This review is intended to discuss the characteristics of these treatment options including dosing frequency, dose adjustment for renal/hepatic dysfunction, serious/common adverse events, drug interactions, lung penetration, pharmacokinetic-pharmacodynamic target and effect of obesity to help guide antimicrobial selection. An increasing portion of patients are receiving expanded empiric coverage for methicillin-resistant Staphylococcus aureus as recommended by the American Thoracic Society and Infectious Diseases Society of America for healthcare-associated pneumonia. However, this expanded coverage may not be achieving the desired improvements in clinical outcomes. We expect this increasingly diverse spectrum of patients with pneumonia to eventually result in the merger of these two guidelines to include all patients with pneumonia.

  4. Perianal Abscess and Proctitis by Klebsiella pneumoniae. (United States)

    Jeong, Woo Shin; Choi, Sung Youn; Jeong, Eun Haeng; Bang, Ki Bae; Park, Seung Sik; Lee, Dae Sung; Park, Dong Il; Jung, Yoon Suk


    Klebsiella pneumoniae (K. pneumoniae) can at times cause invasive infections, especially in patients with diabetes mellitus and a history of alcohol abuse. A 61-year-old man with diabetes mellitus and a history of alcohol abuse presented with abdominal and anal pain for two weeks. After admission, he underwent sigmoidoscopy, which revealed multiple ulcerations with yellowish exudate in the rectum and sigmoid colon. The patient was treated with ciprofloxacin and metronidazole. After one week, follow up sigmoidoscopy was performed owing to sustained fever and diarrhea. The lesions were aggravated and seemed webbed in appearance because of damage to the rectal mucosa. Abdominal computed tomography and rectal magnetic resonance imaging were performed, and showed a perianal and perirectal abscess. The patient underwent laparoscopic sigmoid colostomy and perirectal abscess incision and drainage. Extended-spectrum beta-lactamase-producing K. pneumoniae was identified in pus culture. The antibiotics were switched to ertapenem. He improved after surgery and was discharged. K. pneumoniae can cause rapid invasive infection in patients with diabetes and a history of alcohol abuse. We report the first rare case of proctitis and perianal abscess caused by invasive K. pneumoniae infection.

  5. Ventilator associated pneumonia in major paediatric burns. (United States)

    Rogers, Alan David; Deal, Cailin; Argent, Andrew Charles; Hudson, Donald Anthony; Rode, Heinz


    More than three-quarters of deaths related to major burns are a consequence of infection, which is frequently ventilator associated pneumonia (VAP). A retrospective study was performed, over a five-year period, of ventilated children with major burns. 92 patients were included in the study; their mean age was 3.5 years and their mean total body surface area burn was 30%. 62% of the patients sustained flame burns, and 31% scalds. The mean ICU stay was 10.6 days (range 2-61 days) and the mean ventilation time was 8.4 days (range 2-45 days). There were 59 documented episodes of pneumonia in 52 patients with a rate of 30 infections per 1000 ventilator days. Length of ventilation and the presence of inhalational injury correlate with the incidence of VAP. 17.4% of the patients died (n=16); half of these deaths may be attributed directly to pneumonia. Streptococcus pneumonia, Pseudomonas aeruginosa, Acinetobacter baumanii and Staphylococcus aureus were the most prominent aetiological organisms. Broncho-alveolar lavage was found to be more specific and sensitive at identifying the organism than other methods. This study highlights the importance of implementing strictly enforced strategies for the prevention, detection and management of pneumonia in the presence of major burns.

  6. Reflections on pneumonia in the tropics

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    Michael P Alpers


    Full Text Available This review of pneumonia in the tropics is based on experience with respiratory infections in Papua New Guinea since the 1970s. It discusses ideas, principles, historical aspects of pneumonia research and the need to work with people in the community. In order to understand pneumonia in a tropical setting and evaluate new interventions it is essential to study the ecosystem of the causative infections, within the host and the community and between interacting microorganisms. Vaccines are much-needed preventive tools, and for pneumonia in a highly endemic setting the prevention of severe and fatal disease takes priority over the prevention of infection. In this setting mild infection plays an important role in preventing severe disease. For achieving long-term sustainable outcomes, sometimes ‘less is more’. A multipronged approach is required to control and prevent pneumonia, and in devising new ways of doing so. This includes appropriate and accessible clinical care, a clean, smoke-free environment, good nutrition and a range of vaccines. Also required are persistent advocacy from the global scientific community and strong engagement with and by the communities that bear the burden of disease. Better health care must be pursued in conjunction with raising literacy rates and reducing poverty

  7. The management of pneumonia in internal medicine. (United States)

    Bouza, E; Giannella, M; Pinilla, B; Pujol, R; Capdevila, J A; Muñoz, P


    Pneumonia generates a high workload for internal medicine departments. Management of this disease is challenging, because patients are usually elderly and have multiple comorbid conditions. Furthermore, the interpretation and adherence to guidelines are far from clear in this setting. We report the opinion of 43 internists especially interested in infectious diseases that were questioned at the 2011 XXXII National Conference of Spanish Society of Internal Medicine about the main issues involved in the management of pneumonia in the internal medicine departments, namely, classification, admission criteria, microbiological workup, therapeutic management, discharge policy, and prevention of future episodes. Participants were asked to choose between 2 options for each statement by 4 investigators. Consensus could not be reached in many cases. The most controversial issues concerned recognition and management of healthcare-associated pneumonia (HCAP). Most participants were aware of the differences in terms of underlying diseases, etiological distribution, and outcome of HCAP compared with community-acquired pneumonia, but only a minority agreed to manage HCAP as hospital-acquired pneumonia, as suggested by some guidelines. A clinical patient-to-patient approach proved to be the option preferred by internists in the management of HCAP.

  8. The importance of bacterial and viral infections associated with adult asthma exacerbations in clinical practice.

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    Motoyasu Iikura

    Full Text Available Viral infection is one of the risk factors for asthma exacerbation. However, which pathogens are related to asthma exacerbation in adults remains unclear.The relation between various infections and adult asthma exacerbations was investigated in clinical practice.The study subjects included 50 adult inpatients due to asthma exacerbations and 20 stable outpatients for comparison. The pathogens from a nasopharyngeal swab were measured by multiplex PCR analysis.Asthma exacerbations occurred after a common cold in 48 inpatients. The numbers of patients with viral, bacterial, or both infections were 16, 9, and 9, respectively. The dominant viruses were rhinoviruses, respiratory syncytial virus, influenza virus, and metapneumovirus. The major bacteria were S. pneumoniae and H. influenzae. Compared to pathogen-free patients, the patients with pathogens were older and non-atopic and had later onset of disease, lower FeNO levels, lower IgE titers, and a higher incidence of comorbid sinusitis, COPD, or pneumonia. Compared to stable outpatients, asthma exacerbation inpatients had a higher incidence of smoking and comorbid sinusitis, COPD, or pneumonia. Viruses were detected in 50% of stable outpatients, but a higher incidence of rhinovirus, respiratory syncytial virus, and metapneumovirus infections was observed in asthma exacerbation inpatients. H. influenzae was observed in stable asthmatic patients. Other bacteria, especially S. pneumoniae, were important in asthma exacerbation inpatients.Viral or bacterial infections were observed in 70% of inpatients with an asthma exacerbation in clinical practice. Infection with S. pneumoniae was related to adult asthma exacerbation.

  9. Mechanical Ventilation Alters the Development of Staphylococcus aureus Pneumonia in Rabbit.

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    Saber-Davide Barbar

    Full Text Available Ventilator-associated pneumonia (VAP is common during mechanical ventilation (MV. Beside obvious deleterious effects on muco-ciliary clearance, MV could adversely shift the host immune response towards a pro-inflammatory pattern through toll-like receptor (TLRs up-regulation. We tested this hypothesis in a rabbit model of Staphylococcus aureus VAP. Pneumonia was caused by airway challenge with S. aureus, in either spontaneously breathing (SB or MV rabbits (n = 13 and 17, respectively. Pneumonia assessment regarding pulmonary and systemic bacterial burden, as well as inflammatory response was done 8 and 24 hours after S. aureus challenge. In addition, ex vivo stimulations of whole blood taken from SB or MV rabbits (n = 7 and 5, respectively with TLR2 agonist or heat-killed S. aureus were performed. Data were expressed as mean±standard deviation. After 8 hours of infection, lung injury was more severe in MV animals (1.40±0.33 versus [vs] 2.40±0.55, p = 0.007, along with greater bacterial concentrations (6.13±0.63 vs. 4.96±1.31 colony forming units/gram, p = 0.002. Interleukin (IL-8 and tumor necrosis factor (TNF-αserum concentrations reached higher levels in MV animals (p = 0.010. Whole blood obtained from MV animals released larger amounts of cytokines if stimulated with TLR2 agonist or heat-killed S. aureus (e.g., TNF-α: 1656±166 vs. 1005±89; p = 0.014. Moreover, MV induced TLR2 overexpression in both lung and spleen tissue. MV hastened tissue injury, impaired lung bacterial clearance, and promoted a systemic inflammatory response, maybe through TLR2 overexpression.

  10. Acute bacterial sinusitis in children. (United States)

    DeMuri, Gregory; Wald, Ellen R


    On the basis of strong research evidence, the pathogenesis of sinusitis involves 3 key factors: sinusostia obstruction, ciliary dysfunction, and thickening of sinus secretions. On the basis of studies of the microbiology of otitis media, H influenzae is playing an increasingly important role in the etiology of sinusitis, exceeding that of S pneumoniae in some areas, and b-lactamase production by H influenzae is increasing in respiratory isolates in the United States. On the basis of some research evidence and consensus,the presentation of acute bacterial sinusitis conforms to 1 of 3 predicable patterns; persistent, severe, and worsening symptoms. On the basis of some research evidence and consensus,the diagnosis of sinusitis should be made by applying strict clinical criteria. This approach will select children with upper respiratory infection symptoms who are most likely to benefit from an antibiotic. On the basis of some research evidence and consensus,imaging is not indicated routinely in the diagnosis of sinusitis. Computed tomography or magnetic resonance imaging provides useful information when complications of sinusitis are suspected. On the basis of some research evidence and consensus,amoxicillin-clavulanate should be considered asa first-line agent for the treatment of sinusitis.

  11. Time and dose-dependent risk of pneumococcal pneumonia following influenza: a model for within-host interaction between influenza and Streptococcus pneumoniae. (United States)

    Shrestha, Sourya; Foxman, Betsy; Dawid, Suzanne; Aiello, Allison E; Davis, Brian M; Berus, Joshua; Rohani, Pejman


    A significant fraction of seasonal and in particular pandemic influenza deaths are attributed to secondary bacterial infections. In animal models, influenza virus predisposes hosts to severe infection with both Streptococcus pneumoniae and Staphylococcus aureus. Despite its importance, the mechanistic nature of the interaction between influenza and pneumococci, its dependence on the timing and sequence of infections as well as the clinical and epidemiological consequences remain unclear. We explore an immune-mediated model of the viral-bacterial interaction that quantifies the timing and the intensity of the interaction. Taking advantage of the wealth of knowledge gained from animal models, and the quantitative understanding of the kinetics of pathogen-specific immunological dynamics, we formulate a mathematical model for immune-mediated interaction between influenza virus and S. pneumoniae in the lungs. We use the model to examine the pathogenic effect of inoculum size and timing of pneumococcal invasion relative to influenza infection, as well as the efficacy of antivirals in preventing severe pneumococcal disease. We find that our model is able to capture the key features of the interaction observed in animal experiments. The model predicts that introduction of pneumococcal bacteria during a 4-6 day window following influenza infection results in invasive pneumonia at significantly lower inoculum size than in hosts not infected with influenza. Furthermore, we find that antiviral treatment administered later than 4 days after influenza infection was not able to prevent invasive pneumococcal disease. This work provides a quantitative framework to study interactions between influenza and pneumococci and has the potential to accurately quantify the interactions. Such quantitative understanding can form a basis for effective clinical care, public health policies and pandemic preparedness.

  12. Mycoplasma pneumoniae and Chlamydia spp. infection in community-acquired pneumonia, Germany, 2011-2012. (United States)

    Dumke, Roger; Schnee, Christiane; Pletz, Mathias W; Rupp, Jan; Jacobs, Enno; Sachse, Konrad; Rohde, Gernot


    Mycoplasma pneumoniae and Chlamydia spp., which are associated with community-acquired pneumonia (CAP), are difficult to propagate, and can cause clinically indistinguishable disease patterns. During 2011-2012, we used molecular methods to test adult patients in Germany with confirmed CAP for infection with these 2 pathogens. Overall, 12.3% (96/783) of samples were positive for M. pneumoniae and 3.9% (31/794) were positive for Chlamydia spp.; C. psittaci (2.1%) was detected more frequently than C. pneumoniae (1.4%). M. pneumoniae P1 type 1 predominated, and levels of macrolide resistance were low (3.1%). Quarterly rates of M. pneumoniae-positive samples ranged from 1.5% to 27.3%, showing a strong epidemic peak for these infections, but of Chlamydia spp. detection was consistent throughout the year. M. pneumoniae-positive patients were younger and more frequently female, had fewer co-occurring conditions, and experienced milder disease than did patients who tested negative. Clinicians should be aware of the epidemiology of these pathogens in CAP.

  13. Serotype distribution in non-bacteremic pneumococcal pneumonia

    DEFF Research Database (Denmark)

    Benfield, Thomas Lars Vibe; Skovgaard, Marlene; Schønheyder, Henrik Carl


    There is limited knowledge of serotypes that cause non-bacteremic pneumococcal pneumonia (NBP). Here we report serotypes, their associated disease potential and coverage of pneumococcal conjugate vaccines (PCV) in adults with NBP and compare these to bacteremic pneumonia (BP).......There is limited knowledge of serotypes that cause non-bacteremic pneumococcal pneumonia (NBP). Here we report serotypes, their associated disease potential and coverage of pneumococcal conjugate vaccines (PCV) in adults with NBP and compare these to bacteremic pneumonia (BP)....

  14. Risk Factors for Aspiration Pneumonia in Olde