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PubMedDate not supplied

Are ABH antigenic determinants on human outer ear canal epithelium responsible for Pseudomonas aeruginosa infections?

The outer ear canal expression of ABH human blood group antigens has been analyzed with a standardized routine histological procedure by monoclonal antibodies in the case of blood groups A and B, and a corresponding lectin in the case of blood group 0, respectively. In all 20 cases the blood groups were histochemically confirmed. Furthermore, Pseudomonas aeruginosa-specific inhibition experiments were performed with different sugar solutions as well as A-like substance incubating outer ear canal tissue sections with P. aeruginosa strain (No. 60) presenting lectin specificity for N-acetyl-galactosamine (GalNAc). P. aeruginosa lectins with GalNAc specificity apparently adhere to GalNAc as terminal blood group A determinant and indicate that patients presenting with blood group A may have a genetic predisposition to this form of otitis externa.

ABO Blood-Group System↗
PubMed1987

Ceftazidime monotherapy vs. combined therapy in Pseudomonas pulmonary infections in cystic fibrosis.

To evaluate whether the addition of an aminoglycoside might enhance the clinical efficacy of ceftazidime in cystic fibrosis patients with acute exacerbations of chronic Pseudomonas lung infections we carried out a prospective, comparative, randomized blind study with three schedules: ceftazidime vs. ceftazidime plus sisomicin (C/S) vs. piperacillin plus sisomicin, for a total of 60 courses of 14 days of treatment. Each treatment led to clinical and radiologic improvement with marked reduction of signs of acute infection. Statistically there was no significant difference in clinical responses among the schedules. No side effect appeared during treatments with ceftazidime or C/S. Hyperpyrexia was seen in 35% of patients receiving piperacillin. Decrease in Pseudomonas aeruginosa count to less than 10(5) colony-forming units/ml of sputum was achieved in 60% of patients treated with C/S and in 30% of patients who received ceftazidime or piperacillin plus sisomicin (statistically not significant). A transient increase in mean geometric minimal inhibitory concentrations for ceftazidime and piperacillin was observed at the end of the combined therapies. A larger percentage of persistent resistant strains of P. aeruginosa was seen after the combined therapies. We conclude that ceftazidime as monotherapy may be an effective alternative in Pseudomonas lung infections in cystic fibrosis patients. Its clinical efficacy seems not to be enhanced by the addition of an aminoglycoside, although reduction of Pseudomonas in the sputum was better achieved by the combination of C/S.

Adolescent↗
PubMed1994

Investigation of a pseudo-outbreak of orthopedic infections caused by Pseudomonas aeruginosa.

OBJECTIVE: To report a pseudoepidemic of Pseudomonas aeruginosa infections discovered during an investigation of postoperative joint infections. DESIGN: A retrospective review of case patients' hospital charts, operative reports, and laboratory data, as well as environmental culturing, polymerase chain reaction (PCR) ribotyping of outbreak isolates, and in vitro analysis of P aeruginosa growth characteristics. SETTING: A 510-bed, university-affiliated adult tertiary care hospital. RESULTS: Between October 1 and December 1, 1992, seven postsurgical joint infections were diagnosed, including four caused by P aeruginosa. A bottle of "sterile" saline used to process tissue specimens was found to be contaminated with P aeruginosa. Further investigation revealed that P aeruginosa had grown from seven additional tissue cultures, all of which had been processed with the contaminated saline. PCR ribotypes of the contaminant matched those of the clinical isolates. In vitro, P aeruginosa strains were viable in commercial nonbacteriostatic saline, but never caused visible turbidity. Six patients received antibiotics for their presumed infections; four patients had peripherally inserted central catheters placed, and one experienced severe anaphylactic reactions to several antibiotics. CONCLUSIONS: Pseudoepidemics due to common organisms are often difficult to detect, and delayed recognition can result in substantial morbidity. This outbreak investigation illustrates the potential for contamination of diluents in the microbiology laboratory and emphasizes the need for meticulous quality control.

Adolescent↗
PubMed1985

Anti-LPS antibody response in Pseudomonas aeruginosa infections. I. Kinetics of the serological response.

A continuous survey of the serological response in 59 Pseudomonas aeruginosa infections of 30 patients treated in a respiratory intensive care unit revealed that anti-LPS antibody production paralleled the intensity of the infection from the early onset. In lethal cases the immunological response was depressed from the start of the P. aeruginosa complications, probably as a consequence of a too intensive antigenic stimulus exerted by a massive infection. Septic shock was always accompanied by a marked fall in antibody titres. The loss was more expressed in the most effective IgG class antibodies.

Antibody Formation↗
PubMed1987

Protection against Pseudomonas aeruginosa infection by passive transfer of anti-flagellar serum.

The specificity of adsorbed flagellar antisera for H-antigen was demonstrated in vitro by cross-agglutination assays, motility inhibition, and an ELISA. The specific flagellar antibody was determined to be an IgG. Complete protection against burn wound sepsis was achieved with flagellar antisera. Cross-protection experiments revealed that protection was not only H-antigen dependent, but specific for the flagella antigen type. Antiserum raised against b-type flagella would only protect against homologous bacterial challenge and not against a-type flagellated strains. Results using a-type antisera were consistent, giving protection only against the homologous strain. In contrast, protective capacity was selectively removed from antisera by adsorbing with Fla+ cells. Bacteria colonized the burn wounds of passively protected mice to similar levels as seen in nonprotected animals, but the colonization remained localized and did not result in systemic infection, a pattern similar to infections with motility mutants observed in other studies. Animals rendered neutropenic prior to burning were not protected with flagellar antisera. These data suggested a role for phagocytic cells in protection. Immobilization by flagellar antiserum was observed both by microscopic studies and by inhibition of colony spreading. Antiflagellar antibody is hypothesized as exerting its protective capacity possibly in two ways; first by inhibiting the motility of invading bacteria by binding to the flagellum and immobilizing the bacteria, and secondly by acting as an opsonin, targeting either immobilized or mobile cells for phagocytosis.

Animals↗
PubMed1980

Antibody response in patients with Pseudomonas aeruginosa infection to a 'common antigen' from P. aeruginosa analysed by means of quantitative immunoelectrophoretic methods.

381 sera from 101 patients suffering from Pseudomonas aeruginosa infection have been investigated for antibodies against a 'common antigen' (CA) and other antigens from P. aeruginosa by means of crossed immunoelectrophoresis with intermediate gel, using a polyspecific P. aeruginosa antigen/antibody reference system. The earliest antibody response during the P. aeruginosa infections included increased CA antibodies in only 38% of the patients examined. The peak level of the antibody response included increased CA antibodies in 71% of the patients. By means of 'absorption of antibodies in situ', it was found that the antibody response to CA was directed against both the common cross-reactive part of the CA molecule and the Pseudomonas-specific part, with individual variations. During infections caused by other bacteria containing CA, one-third of the patients developed antibodies against CA. The diagnostic implications of the results are discussed.

Antibodies, Bacterial↗
PubMed1987

Murine cytomegalovirus-Pseudomonas synergistic infections: comparison of virulent and attenuated virus.

The synergistic interactions between Pseudomonas aeruginosa and virulent or attenuated murine cytomegalovirus (MCMV) were compared in vivo. Virulent MCMV challenge at a dose of 5 X 10(5) pfu/mouse intraperitoneally, followed by intranasal superinfection with 5 X 10(6) cfu/mouse of Pseudomonas aeruginosa after 48 h resulted in greater than 80% mortality, apparently owing to a failure of pulmonary clearance mechanisms. Single infections, or the use of attenuated MCMV in synergistic infections, did not result in significant morbidity or mortality. Infection with virulent MCMV in vivo resulted in the rapid spread of virus to the lung, liver, and spleen, followed later by spread to the salivary glands. Attenuated virus was detected in salivary glands only. Virulent MCMV was more effective in adsorbing to, or infecting, spleen cells in vitro than attenuated virus. Viral neutralization experiments using anti-viral serum, rabbit complement, and anti-mouse IgG confirmed the presence of a nonneutralizing antibody on the surface of the virulent virus. Our results suggest that the presence of the nonneutralizing antibody on virulent MCMV allows the virus to preferentially infect, or adsorb to, Fc+ cells in the peritoneum. These cells may then carry the virus, via the lymphatic circulation, to other areas of the body, resulting in the replication of virus in multiple organs. Virus replication in the lung may, in part, be the cause of the observed suppression of pulmonary clearance.

Animals↗
PubMed1999

Inhaled antibiotic therapy in non-cystic fibrosis patients with bronchiectasis and chronic bronchial infection by Pseudomonas aeruginosa.

The aim of this study was to investigate the long-term effectiveness and safety of inhaled antibiotic treatment in non-cystic fibrosis patients with bronchiectasis and chronic infection by Pseudomonas aeruginosa, after standard endovenous and oral therapy for long-term control of the infection had failed. After completing a 2-week endovenous antibiotic treatment to stabilize respiratory status, 17 patients were randomly allocated to a 12-month treatment either with inhaled ceftazidime and tobramycin (group A) or a symptomatic treatment (group B). One patient from group A abandoned inhaled treatment because of bronchospasm and another from group B died before the end of the study. The remaining 15 patients, seven from group A and eight from group B, completed the study. Both groups had similar previous characteristics. The number of admissions and days of admission (mean +/- SEM) of group A [0.6 (1.5) and 13.1 (34.8)] were lower than those of group B [2.5 (2.1) and 57.9 (41.8)] (P < 0.05). Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), PAO2 and PACO2 were similar in the two groups at the end of follow-up, showing a comparable decline in these parameters. There were no significant differences either in the use of oral antibiotics or in the frequency of emergence of antibiotic-resistant bacteria between groups. Microbiological studies suggested that several patients had different Pseudomonas aeruginosa strains. None of the patients presented impaired renal or auditory function at the end of the study. This study suggests that long-term inhaled antibiotic therapy may be safe and lessen disease severity in non-cystic fibrosis patients with bronchiectasis and chronic bronchial infection by Pseudomonas aeruginosa which do not respond satisfactorily to antibiotics administered via other routes.

Administration, Inhalation↗
PubMed2006

Pseudomonas aeruginosa infection: an uncommon cause of post-renal obstruction following induction therapy for acute lymphoblastic leukemia.

A 14-month-old infant presented with gastroenteritis with febrile pancytopenia and was diagnosed with acute lymphocytic leukemia (ALL). Ten days post induction therapy, the patient developed hypertension that was ascribed to steroid therapy and treated with metoprolol and amlodipine. As leukocyte numbers began to recover the asymptomatic patient became anuric. Ultrasound showed echoic floating structures in the bladder. Following cystoscopy and retrograde pyelography examination, purulent debris was irrigated from the bladder and grew Pseudomonas aeruginosa. Ciprofloxacin therapy was initiated and renal function was restored within 2 days. The case highlights the potential for renal obstruction after neutropenia recovery in children undergoing induction therapy for ALL.

Antineoplastic Combined Chemotherapy Protocols↗