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Neonatal Proteus meningoencephalitis. Case report.

Proteus is an uncommon pathogen in neonatal meningitis and has, to our knowledge, not previously been described from Scandinavia. Our case illustrates the typical course of the disease when onset is within the first two weeks of life. The typical patient is a previously healthy, sometimes slightly preterm infant, who develops multiple brain abscesses and has a very poor prognosis. In cases with a later onset, factors predisposing for infection are common and the outcome is less severe. Our patient was a girl born at a gestational age of 36 full weeks, who was a little less alert than normal during the first three days and then became dramatically sick with convulsions and apnoeas. She died at the age of six days with severe brain damage.

Brain↗

[Antibodies to Yersinia enterocolitica and Proteus mirabilis in blood sera of rheumatoid arthritis patients].

Data on specific antibodies to the bacterial antigens of Yersinia enterocolitica (serovars 03, 09) and Proteus mirabilis in rheumatoid arthritis (RA) patients are presented. According to the data of some researchers, these organisms play some role in the pathogenesis of RA. The highest level of IgG antibodies to Y. enterocolitica antigens of both serovars was noted. The activity of specific IgG antibodies to serovar 03 was higher than that to serovar 09. In the sera of RA patients with P. mirabilis antgens the activity of IgM antibodies was higher.

Antibodies, Bacterial↗

Selective IgA immune unresponsiveness to Proteus mirabilis fumarate reductase A-chain in rheumatoid arthritis.

OBJECTIVE: To determine if selective immune unresponsiveness to microbial antigens is associated with predisposition to rheumatoid arthritis (RA). METHODS: Proteins from Proteus mirabilis lysate were isolated by SDS-PAGE and examined by Western blotting for antibody responses in sera from patients with RA compared to healthy subjects and patients with psoriatic arthritis (PsA). RESULTS: Although RA patients had marked IgA immune responses to many P. mirabilis proteins compared to healthy subjects, selective unresponsiveness was found in RA to a 66 kDa protein identified as fumarate reductase A-chain (FRD-A) by mass spectroscopy. This was confirmed in Western blots with recombinant FRD-A from P. mirabilis. IgA unresponsiveness to FRD-A was found in 21/59 (35.6%) RA patients compared to 7/63 (11.1%) healthy individuals (p < 0.01) and 6/52 (11.5%) patients with PsA (p < 0.01). IgA unresponsiveness to FRD-A was present in 20/46 (43.5%) RA patients with IgA rheumatoid factors (RF) compared to 1/13 (7.7%) without RF (p < 0.025). CONCLUSION: Our results identify a selective hole in the IgA immune repertoire for P. mirabilis FRD-A in a subset of IgA RF-positive patients with RA.

Adult↗

[Neonatal Proteus mirabilis septicemia and cerebral abscess. Value of the assay of antibiotics in the puncture fluid].

The authors describe a case of neonatal Proteus mirabilis septicemia accompanied by cerebral abscess formation despite the presence of therapeutically effective antibiotic levels utilised to treat the disorder. The occurrence of such brain abscesses during the course of effective antibiotic therapy raises the question of the mechanism behind their formation. Cerebritis may occur very early in the clinical course of the infection without being due to failure of antimicrobial therapy.

Anti-Bacterial Agents↗

[Escherichia coli, coliform bacteria, Pseudomonas aeruginosa, Proteus and Staphylococcus aureus carriers among children 5-15 years old].

The throat swap cultures of 250 children between 5-15 years ages examined for the microorganisms, E. coli, Coliform, Protus, Ps. aeruginosa and S. aureus. 66 (26.4%) E. coli, 64 (25.6%) S. aureus, 9 (3.6%) Coliform, 3 (1.2%) Ps. aeruginosa, 2 (0.2%) Proteus organisms were isolated from throat swaps cultures of 144 (57.6%) children. 106 (42.4%) children had contained normal oral flora. S. aureus and E. coli strains were tested using disk method for the sensitivity of some antibiotics. S. aureus strains were resistant 12.5% to gentamycin, 9.4% to cefoperazone and (1% to cefazolin, 48.4% to lincomycin and 87.5% to ampicillin. E. coli strains were resistant 42% to gentamycin, 37% to cefoperazone and 74% to cefazolin.

Adolescent↗

Nonsurgical management of neonatal multiple brain abscesses due to Proteus mirabilis.

A newborn infant with Proteus mirabilis meningitis developed multiple brain abscesses with diameters ranging from 2 to 4 cm. Intravenous antibiotic therapy alone without surgical intervention led to the complete resolution of this complication. The case supports that this may be an acceptable treatment of multiple brain abscesses in neonates. However, the clinical outcome was relatively poor, since a porencephalic cyst, hypodense areas in CT scan, and psychomotor retardation were found at one year of age.

Anti-Bacterial Agents↗

[Neonatal meningitis caused by Proteus mirabilis with cerebral abscess].

A case neonatal meningitis by proteus mirabilis is presented. Echographic and CT scan studies were performed during clinical evolution, showing generalized brain abscesses appearances that needed surgical treatment. A ventriculo-peritoneal shunt was later practiced to correct hydrocephaly.

Brain Abscess↗

Lens implant cyto-pathology in postoperative Proteus panophthalmitis.

The reactive membrane on a posterior chamber lens implant removed from an eye with postoperative proteus mirabilis panophthalmitis was found to be based on a continuous proteinaceous capsule exhibiting only very few fibroblast-like cells. Diffusely arranged neutrophils exhibiting evidence of phagocytosis were attached to a delicate fiber network continuous with the processes of fibroblast-like cells. There was also pus and acellular debris loosely covering the outer surface of this capsule.

Aged↗

Ammonia encephalopathy secondary to urinary tract infection with Proteus mirabilis.

Hyperammonemia with coma, tachypnea, and respiratory alkalosis developed in a 3-year-old boy with prune"-belly syndrome during a urinary tract infection with Proteus mirabilis. Hyperammonemia is thought to have resulted from the production within the massively dilated urinary tract of excessive amounts of ammonia due to bacterial urease, and its subsequent reabsorption into the systemic circulation. The patient rapidly improved following parenteral antibiotic therapy and continuous catheter drainage of the urinary tract.

Abdominal Muscles↗

Experimental induction of Proteus mirabilis cystitis in the pony and evaluation of therapy with trimethoprim-sulfadiazine.

Proteus mirabilis cystitis was induced in 9 ponies by chemically eroding the bladder mucosa before the organism was inoculated. Comparisons were made in the treatment of P mirabilis cystitis between ponies treated daily for 13 days with a trimethoprim-sulfadiazine (TMP-SDZ) paste and both positive and negative controls. Urine cultures from ponies treated with TMP-SDZ became negative for P mirabilis between days 3 and 9 after the start of the treatment, whereas positive controls remained infected until day 13. Urine cultures from all ponies were negative for P mirabilis on day 28. Urine concentrations of TMP and SDZ were relatively high after day 1 of therapy.

Administration, Oral↗

Comparison of epidemiological methods for differentiation of Proteus mirabilis.

During the study of suspected cross-infection within a hospital, epidemiological typing techniques are often employed to aid in the identification of transmission patterns of nosocomially-acquired bacteria. In this study, five bacteriological typing methods were assessed for their ability to type and differentiate 100 clinical isolates of Proteus mirabilis. The methods evaluated include biotyping, bacteriophage typing with the method of Hickman and Farmer and the scheme of Schmidt and Jeffries, and typing by both bacteriocin production and bacteriocin sensitivity. Each of the phage and bacteriocin methods were further evaluated by typing 14 isolates of P mirabilis derived from an outbreak of infection on a surgical intensive care unit. All 100 isolates were typed by biochemical characteristics and were divided into seven distinct biotypes. Ninety-five percent of these strains were separated into 61 lysis patterns with the phage set of Hickman and Farmer whereas the Schmidt and Jeffries phage scheme was able to type 67% of the cultures into nine unique lysis patterns. Bacteriocin sensitivity typing resulted in 41 distinct patterns with 71% of the strains typable and typing by bacteriocin production yielded 29 distinct bacteriocin types among the 80% typable strains. Typing by bacteriocin production demonstrated that 13 of the 14 epidemic isolates were the same strain. All epidemic-related cultures were untypable with the Hickman and Farmer phage set, whereas typing by bacteriocin sensitivity and the phage set of Schmidt and Jeffries resulted in two and four isolates typable, respectively. Based on the results of typing random and epidemic isolates of P mirabilis, bacteriocin production typing is recommended as a sensitive and specific typing method for future epidemiological surveys.

Bacteriological Techniques↗

[Epidemiological studies of increasing appearances of Proteus inconstans (Providencia stuartii) infections (author's transl)].

Since proteus inconstans turns out to be the causative agent of an increasing amount of hospital infections, studies on this species are necessary. By means of bacteriocines, biochemical reactions and antibiograms 53 strains were subclassified. 47 strains displayed same biochemical properties, 44 strains showed the same antibiogram. By the method on the basis of bacteriocine typing 15 groups were established. The strains with the same biochemical properties and the same antibiograms could be further subclassified. The distribution of the different bacteriocine groups showed that the infections were not due to a single strain. In contrast there were some indices for cross-infections on some stations.

Anti-Bacterial Agents↗

[Impairments of lipid metabolism in liver, kidney and heart tissues of mice infected with Proteus vulgaris].

Intraperitoneal administration of Proteus vulgaris living culture of various age (12 hrs and one day) caused impairments in lipid metabolism in mice liver, kidney and heart tissues. The one day-old culture was more toxic. The impairment in lipid metabolism was manifested as distinct increase in cholesterol content in liver tissue and kidney and a decrease in phospholipid content in liver, kidney and heart tissues. These changes were accompanied by an increase in content of sialic acids in liver tissue.

Animals↗

Efficacy of a novel injectable cephalosporin, Cefclidin, on the experimental complicated urinary tract infections with urinary stones caused by Pseudomonas aeruginosa and Proteus mirabilis.

We evaluated the effects of a novel cephalosporin, cefclidin (CFCL) and imipenem (IPM), on the eradication of bacteria from the urine, bladder stones and the kidneys, and also on the prevention of the infection stone formations, in our polymicrobial urinary tract infection model of rats associated with bladder stones using IMP-sensitive or IPM-resistant Pseudomonas aeruginosa and Proteus mirabilis as a causative pathogen. CFCL completely eradicated P. mirabilis from the urine and the stone in the short-term regimen (5 days). CFCL completely eradicated both IPM-sensitive P. aeruginosa and P. mirabilis from the urine, the stones and the kidneys as compared to IPM in the long-term regimen (11 days), reflecting the superior antibacterial activity of CFCL. CFCL also significantly prevented the development of infection stones as compared to IPM in the long-term regimen. There was no significant difference in the blood urea nitrogen (BUN) values between the CFCL or IPM-treated and the non-treated groups. The cumulative recovery rate of unchanged CFCL reached 47.3% of the total dosage (20 mg/kg) within 8 hours.

Animals↗

Comparative activity of tobramycin and gentamicin against Pseudomonas, Proteus and Providencia species.

Tobramycin is a new antibiotic resembling gentamicin. We measured the minimal inhibitory concentrations of these two antibiotics against five bacterial species that cause hospital-acquired infections and are resistant to many presently available antibiotics. The organisms tested were 500 strains of Pseudomones aeruginosa, 100 strains of each of Proteus rettgeri and Pr. morganii, 50 strains of Pr. vulgaris and 250 strains of Providencia stuartii. Tobramycin was 2 to 4 times more active than gentamicin against Ps. aeruginosa; all except 6 of 70 strains resistant to 4 mug/ml of gentamicin were sensitive to 4 mug/ml of tobramycin. The two antibiotics showed a similar degree of activity against the other four species. Tobramycin promises to be of particular value in the treatment of Pseudomonas infections.

Drug Resistance, Microbial↗

Attempted reversal of oxytetracycline resistance of Proteus mirabilis by EDTA-tromethamine lavage in experimentally induced canine and feline cystitis.

An attempt was made to reverse the antibiotic resistance of Proteus mirabilis used to induce experimental cystitis in cats and dogs. Results of in vitro studies on an oxytetracycline-resistant strain of P mirabilis, utilizing standard plate counts, indicated the organism became susceptible to oxytetracycline when it was treated with a solution of EDTA-tromethamine. In vivo experiments were conducted with cats and dogs in which 50% of the experimentally infected animals were treated with bladder lavage twice daily with EDTA-tromethamine solution and 50% with tromethamine buffer alone; all were given standard doses of oxytetracycline. Results of bacteriologic cultural examinations of urinary samples and urinalyses done each day, at the end of the experiments, indicated all animals had cystitis. Thus, although the organism's resistance to oxytetracycline was changed by EDTA-tromethamine in vitro, change in bacterial resistance did not occur in vivo in cats and dogs during clinical treatment.

Animals↗

Prevalence of pathogenic role of Morganella-proteus providencia-group of bacteria in human faeces.

Speculation in literature that organisms of the Morganella-Proteus-Providencia (MPP) group can cause diarrhoea led to the present studies which investigated their occurrence and pathogenic role in human faeces. Faecal specimens were collected from a total of 307 subjects, 80 of which were from diarrhoea cases and 277 from healthy controls. Ninety-two species of the MPP (24/80 diarrhoea and 68/277 control) were isolated from 30% of all subjects. None of the species of the MPP group was significantly associated with diarrhoea as their isolation rate in the controls matched that of the diarrhoea cases (30% of each group). Additional evidence of apparent non-involvement as de facto causative agents of diarrhoea was in their inability to demonstrate the LT or ST enterotoxin production. Tests for invasiveness by Sereny test was also negative. There was a concurrent isolation of other proven diarrhoeal pathogens, such as Salmonella spp and enteropathogenic Escherichia coli (EPEC), with the MPP spp in all the cases in the diarrhoeal group. MPP spp was never isolated as the sole pathogen in any diarrhoeal case. We therefore found no strong evidence from our study to associate the species of the MPP group with diarrhoeal production.

Adolescent↗