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PubMed2006

Characterization of erythromycin resistance of Streptococcus pyogenes isolated from pharyngitis patients in Korea.

Six hundred fifteen isolates of Streptococcus pyogenes were collected over a 6-year period from patients with pharyngitis in Korea. All isolates were characterized in terms of their antibiotic resistance, the phenotypes of erythromycin resistance, the frequencies of erm(B), erm(A), and mef(A) genes, and the emm genotype. The prevalent emm genotypes were emm12 and emm4. Moreover, the emm12 genotype was found to be the most resistant strain to erythromycin. Among the 126 strains demonstrating resistance to erythromycin, those with erm(B) were the most prevalent, accounting for 64.3% of the total. In summary, it is suggested that the S. pyogenes pathogen isolated from pharyngitis patients in Korea developed resistant gene acquisition, as well as a resistant phenotype, according to the annual prevailing emm type. It is also suggested that the emm genotype distribution of erythromycin-resistant strains is correlated to the acquisition of resistant genes.

Anti-Bacterial Agents↗
PubMed2005

Standardized incidence rates of surgical site infection: a multicenter study in Thailand.

BACKGROUND: No previous multicenter data regarding the incidence of surgical site infection (SSI) are available in Thailand. The magnitude of the problem resulting from SSI at the national level could not be assessed. The purpose of this study was to estimate the incidence of SSI in 9 hospitals, together with patterns of surgical antibiotic prophylaxis, risk factors for SSI, and common causative pathogens. METHODS: A prospective data collection among patients undergoing surgery in 9 hospitals in Thailand was conducted. The National Nosocomial Infection Surveillance (NNIS) system criteria and method were used for identifying and diagnosing SSI. The SSI rates were benchmarked with the NNIS report by means of indirect standardization and reported in terms of standardized infection ratio (SIR). Antibiotic prophylaxis was categorized into preoperative, intraoperative, and postoperative. Risk factors for SSI were evaluated using multiple logistic regression models. RESULTS: From July 1, 2003, to February 29, 2004, the study included 8764 patients with 8854 major operations and identified 127 SSIs, yielding an SSI rate of 1.4 infections/100 operations and a corresponding SIR of 0.6 (95% CI: 0.5-0.8). Of these, 35 SSIs (27.6%) were detected postdischarge. The 3 most common operative procedures were cesarean section, appendectomy, and hysterectomy. The 3 most common pathogens isolated were Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, which accounted for 15.3%, 8.5%, and 6.8% of infections, respectively. The 3 most common antibiotics used for prophylaxis were ampicillin/amoxicillin, cefazolin, and gentamicin. The proportion of types of antibiotic prophylaxis administered were 51.6% preoperative, 24.3% intraoperative, and 24.1% postoperative. Factors significantly associated with SSI were high degree of wound contamination, prolonged preoperative hospital stay, emergency operation, and prolonged duration of operation. CONCLUSION: Overall SSI rates were less than the average NNIS rates. The causative pathogens of SSI were different from those of other reports. There was a crucial proportion of operations that did not comply with the antibiotic guidelines. The risk factors for SSI identified in this study were consistent with most other reports.

Adult↗
PubMed2003

Prevalence of pathogens in cystic fibrosis patients in Bahia, Brazil.

INTRODUCTION: Recurrent respiratory infections account for most of the morbidity and mortality of cystic fibrosis patients. MATERIALS AND METHODS: The objective was to determine the prevalence of pathogens isolated from lower respiratory tract secretions in cystic fibrosis patients. In this descriptive observational study, data from 69 patients was collected from medical records. RESULTS: The microorganisms that were identified included 36.2 P. aeruginosa, 28.9% S. Aureus, 4.3% K. pneumoniae, 1.5% H. influenzae, 1.5% E. coli, 1.5% S. maltoophilia, and in 27.5% the flora was normal. The prevalence of P. aeruginosa was 83% in patients under two years of age, demonstrating early colonization. CONCLUSION: P. aeruginosa and S. aureus were the most prevalent pathogens; there was also early infection/colonization by P. aeruginosa. This information will contribute to improved therapeutic measures for patients of the Bahia Cystic Fibrosis Reference Center.

Adolescent↗
PubMed2005

Telithromycin new product overview.

Community-acquired respiratory tract infections (CARTIs), including community-acquired pneumonia, acute exacerbations of chronic bronchitis, and acute bacterial sinusitis, contribute substantially to health care costs in the United States. Although many prescriptions for antibiotics are written each year for the treatment of CARTIs, most are prescribed on an empiric basis. Concerns about the increasing prevalence of antimicrobial resistance and the changing pattern of pathogens isolated from subjects with CARTIs have raised questions about the empiric treatment paradigm. When choosing appropriate antimicrobial therapy for CARTIs, physicians must consider not only the spectrum of activity of antibiotics but also the potential risk of resistance. Telithromycin is the first member of the ketolide class, a new family of antimicrobials structurally related to the macrolides, to be approved by the US Food and Drug Administration for the treatment of CARTIs. The spectrum of activity of telithromycin includes common typical and atypical causative pathogens associated with community-acquired respiratory tract infections, including antibiotic-resistant strains of Streptococcus pneumoniae. Clinical trials have shown that telithromycin is as effective as traditionally used antimicrobial agents in the treatment of mild-to-moderate community-acquired pneumonia, acute exacerbations of chronic bronchitis, and acute bacterial sinusitis.

Anti-Bacterial Agents↗
PubMed1992

Isolation rates and pathogenicity of enterococci in obstetric and gynecological operations.

Isolation of enterococci in patients undergoing obstetric and gynecological operations was studied as well as reviewing the postoperative infection due to this organism during the period from 1985 to 1990. 1) In 126 cases undergoing abdominal total hysterectomy, vaginal specimens were obtained before and after (3rd day) the operation. The isolation rates increased after the operation (before 16.7%, after 35.7%). They increased not only in the group using PIPC, CEZ, CEPR, CMZ, and LMOX by drip infusion but also in the group without prophylactic use of antibiotics. On the other hand in the group using CP vaginal suppositories, the isolation rate decreased. However no statistical proof was obtained as to antibiotics especially in regard to cephem drugs as the reason for the increase. 2) Enterococci were isolated from the surgical field during abdominal total hysterectomy in only 2.0% (n = 88). 3) Isolation rates of enterococci inside the transvaginal drain following radical hysterectomy (n = 30) reached 86.7%. 4) E. faecalis was isolated in 20.0% of the cases with wound infection (n = 25). However isolated Enterococcus strains were not regarded to be the causative organism. 5) There was one case of postoperative enterococcal septicemia in treating stage Ib adenocarcinoma of the uterine cervix.

Anti-Bacterial Agents↗
PubMed1981

Urethritis in women attending an STD clinic.

Of an unselected group of 159 women attending a sexually transmitted diseases (STD) clinic 20% (32) had symptoms of urethritis. A positive correlation existed between the finding of more than 10 polymorphonuclear leucocytes (PMNL) per high-power field in the Gram-stained urethral smear and the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis. Conversely, these organisms were rarely isolated if no PMNL were present. Fewer cultures gave positive results for these organisms if micturition had occurred less than four hours before examination. C trachomatis was recovered from the urethra or endocervix in 29/150 (19 . 3%) and from the urethra alone in six women. In contrast, N gonorrhoea was never recovered from the urethra in the absence of endocervical infection. Of the 159 women 10% had bacteriuria due to non-sexually transmissible agents; 50% had asymptomatic bacteriuria. All, however, had other urethral pathogens isolated as well. Thus, sexually transmitted disease agents are highly prevalent in women attending an STD clinic who have signs and symptoms of urethritis. As in non-gonococcal urethritis in men, C trachomatis may be an important cause of urethritis in women.

Adolescent↗
PubMedDate not supplied

Construction and evaluation of a delta cya delta crp Salmonella typhimurium strain expressing avian pathogenic Escherichia coli O78 LPS as a vaccine to prevent airsacculitis in chickens.

Avian pathogenic strains of Escherichia coli cause a number of extraintestinal diseases in poultry, including airsacculitis and colisepticemia. Expression of O78 lipopolysaccharide (LPS) is frequently associated with pathogenic isolates. Salmonella, a common poultry contaminant, is a major public health concern. The purpose of this work was to develop an E. coli vaccine for poultry with the use of an attenuated Salmonella typhimurium carrier that would benefit both the bird and the consumer. Orally administered attenuated S. typhimurium delta cya delta crp strains have been shown to provide excellent protection against wild-type Salmonella challenge in chickens. This work describes the construction of a delta cya delta crp derivative of an avian pathogenic S. typhimurium that expresses both the homologous group B determinants (O1,4,5,12) and the heterologous E. coli O78 LPS O antigens. This was accomplished by inserting the E. coli rfb region, which encodes the genes required for O78 expression, into the chromosomal cya gene of S. typhimurium, creating a defined deletion/insertion mutation. A delta crp mutation was introduced in a subsequent step. Expression of both O antigens was stable in vitro and in vivo. Vaccination of white leghorn chicks at day of hatch and 14 days with the recombinant vaccine strain induced serum immune responses against both S. typhimurium and E. coli LPS and protected the birds against subsequent challenge with an avian pathogenic E. coli O78 strain. Introduction of a mutation in rfc, which encodes the O antigen polymerase, reduced the chain length of the S. typhimurium LPS without affecting the expression of O78. The rfc mutation further enhanced the ability of the vaccine strain to protect chickens against E. coli challenge.

Air Sacs↗
PubMed2004

Increase in methicillin-resistant Staphylococcus aureus acquisition rate and change in pathogen pattern associated with an outbreak of severe acute respiratory syndrome.

BACKGROUND: An outbreak of severe acute respiratory syndrome (SARS) occurred in our 22-bed intensive care unit (ICU; Prince of Wales Hospital, Hong Kong, HKSAR, China) from 12 March to 31 May 2003, when only patients with SARS were admitted. This period was characterized by the upgrading of infection control precautions, which included the wearing of gloves and gowns all the time, an extensive use of steroids, and a change in antibiotic prescribing practices. The pattern of endemic pathogenic organisms, the rates of acquisition of methicillin-resistant Staphylococcus aureus (MRSA), and the rates of ventilator-associated pneumonia (VAP) were compared with those of the pre-SARS and post-SARS periods. METHODS: Data on pathogenic isolates were obtained from the microbiology department (Prince of Wales Hospital). Data on MRSA acquisition and VAP rates were collected prospectively. MRSA screening was performed for all ICU patients. A case of MRSA carriage was defined as an instance in which MRSA was recovered from any site in a patient, and cases were classified as imported or ICU-acquired if the first MRSA isolate was recovered within 72 h of ICU admission or after 72 h in the ICU, respectively. RESULTS: During the SARS period in the ICU, there was an increase in the rate of isolation of MRSA and Stenotrophomonas and Candida species but a disappearance of Pseudomonas and Klebsiella species. The MRSA acquisition rate was also increased: it was 3.53% (3.53 cases per 100 admissions) during the pre-SARS period, 25.30% during the SARS period, and 2.21% during the post-SARS period (P<.001). The VAP rate was high, at 36.5 episodes per 1000 ventilator-days, and 47% of episodes were caused by MRSA. CONCLUSIONS: A SARS outbreak in the ICU led to changes in the pathogen pattern and the MRSA acquisition rate. The data suggest that MRSA cross-transmission may be increased if gloves and gowns are worn all the time.

Anti-Bacterial Agents↗
PubMed2002

[Nosocomial bacteremias in pediatrics].

OBJECTIVES: To identify pathogenic microorganisms responsible for hospital-acquired bloodstream infections and to evaluate the associated risk factors in pediatric units, in a case-control study over 30 months from January 1st 1997 to June 30th 1999. RESULTS: Forty-six of 855 (5.4%) positive blood cultures were attributed to nosocomial infections. They were related to 32 infectious episodes in 28 patients hospitalized for more than 48 hours. The incidence rate was 0.11 per 100 admissions. Gram-positive cocci (n = 14; 38.8%) were the most frequently isolated pathogens (7 cases of Staphylococcus aureus, 5 of coagulase-negative staphylococci), followed by enterobacteria (n = 9; 25%), Pseudomonas aeruginosa (n = 5; 13.8%) and yeasts (n = 5; 13.8%). The major risk factors for hospital-acquired bloodstream infections were: length of stay before positive blood culture (32 +/- 51 days in cases vs 15 +/- 43 days in controls, p < 0.01), presence of central venous catheter [odds ratio (OR): 6.05, 95% confidence interval (CI): 1.87-20.42], number of days with central venous catheter (p < 0.001) and parenteral nutrition (OR: 9.44, 95% CI: 2.03-50.05). CONCLUSION: Central venous catheter use, length of stay, parenteral nutrition and particularly intravenous lipids are major risk factors for the acquisition of bloodstream infection in hospitalized children.

Age Factors↗
PubMed1998

Resistance pattern of middle ear fluid isolates in acute otitis media recently treated with antibiotics.

BACKGROUND: Little information is available about the effect of antibiotic treatment on the prevalence and MIC of the subsequently isolated pathogens in cases of acute otitis media (AOM) failing a course of antibiotic therapy. This information is important, particularly regarding the effectiveness of the oral antibiotics used in children failing initial therapy. PATIENTS AND METHODS: One hundred eighty-one children with culture-positive AOM were prospectively studied between October, 1995, and July, 1996. Sixty-three (35%) patients received various antibiotics for variable periods during the 14 days preceding enrollment. RESULTS: A total of 94 Streptococcus pneumoniae (Pnc) and 113 Haemophilus influenzae (Hi) were isolated. Thirty-eight Pnc and 35 Hi were isolated in the 63 patients with recently treated AOM. Pnc as a single isolate was more prevalent in patients recently treated with antibiotics (27 of 63, 43%) than among those not recently treated (32 of 118, 27%, P = 0.047). The MIC50 values of penicillin, cefaclor and cefuroxime axetil for Pnc were significantly higher in the pneumococci isolated from patients recently treated than among those isolated from patients not recently treated with antibiotics (0.38, 3 and 0.75 microg/ml vs. 0.094, 0.38 and 0.12 microg/ml, respectively). Seventy-nine percent of Pnc isolates in the recently treated group had MIC for penicillin of >0.1 microg/ml vs. only 47% in those not recently treated (P < 0.05). The respective figures for MIC >0.5 microg/ml of cefaclor were 79% vs. 41% for the recently treated and not recently treated groups (P < 0.001); cefuroxime MIC >0.5 microg/ml was found in 61 and 25%, respectively (P = 0.001). CONCLUSIONS: Pneumococcus is more prevalent in AOM after a recent antibiotic treatment, and the MIC of the commonly used beta-lactam drugs for Pnc is considerably higher in this setting. In view of our data, the use of oral cephalosporins like cefaclor or cefuroxime as second line drugs in the treatment of unresponsive AOM, particularly in regions where resistant PNC is prevalent, should be reconsidered.

Acute Disease↗
PubMed2003

Systemic signaling in tomato plants for defense against herbivores. Isolation and characterization of three novel defense-signaling glycopeptide hormones coded in a single precursor gene.

An 18-amino acid peptide in tomato leaves called systemin is a primary signal released at wound sites in response to herbivory that systemically signals the activation of defense genes throughout the plants. We report here the isolation of three hydroxyproline-rich glycopeptides from tomato leaves, of 20, 18, and 15 amino acids in length, that signal the activation of defense genes, similar to the activity of the systemin peptide. The three new peptides cause an alkalinization of suspension-cultured cells and induce the synthesis of defensive proteinase inhibitor proteins when supplied at fmol levels to young tomato plants through their cut stems. This suggests that they are part of the wound signaling of tomato plants that activates defense against herbivores and pathogens. Isolation of cDNAs coding for the tomato peptides revealed that they are all derived from the same pre-proprotein precursor that is systemically wound-inducible. The peptides are considered members of the functionally characterized systemin family of defense signals from plants that are synthesized both in wounded leaves and in distal, unwounded leaves in response to herbivory or other mechanical wounding. The precursor deduced from the cDNA exhibits a leader sequence, indicating that it is synthesized through the secretory pathway, where it is hydroxylated and glycosylated. The amino acid sequence of the precursor exhibited weak identity to the precursor of two hydroxyproline-rich defense signals recently found in tobacco, suggesting that the two pre-protein precursors have evolved from a common ancestral protein. The identification of hydroxyproline-rich glycoprotein systemins in tomato indicates that the initiation of wound signaling is more complex than previously thought and appears to involve multiple peptide signals.

Amino Acid Sequence↗
PubMed2003

Ventilator-associated pneumonia: Incidence, risk factors, outcome, and microbiology.

OBJECTIVE: To determine the incidence, risk factors, outcome, and pathogens of ventilator-associated pneumonia (VAP) in a cardiac surgical intensive care unit (ICU). DESIGN: Prospective study. SETTING: Escorts Heart Institute and Research Centre, New Delhi, India. PARTICIPANTS: Nine hundred fifty-two consecutive patients undergoing cardiac operations who received intermittent positive-pressure ventilation (IPPV). INTERVENTIONS: All patients were assigned into VAP (n = 25) and non-VAP (n = 927) groups. MEASUREMENTS AND MAIN RESULTS: Risk factors and other variables were analyzed with univariate and multivariate analysis. Of the 952 patients studied, 25 (2.6%) had VAP. On univariate analysis, significant risk factors were emergency surgery, chronic obstructive pulmonary disease (COPD), reintubation, coma, steroid treatment, intra-aortic balloon counterpulsation (IABC), enteral feedings, tracheostomy, acute physiology, age, and chronic health evaluation (APACHE II) score, prior antibiotics, and IPPV hours. On multivariate analysis, IPPV hours (153.75 +/- 114.44 v 19.65 +/- 7.99; p < 0.001) and steroids (20% v 0%; p < 0.001) were independent predictors of VAP. The most common pathogens isolated were Pseudomonas aeruginosa (22), Escherichia coli (10), Klebsiella pneumoniae (4), Staphylococcus species (4), and Acinetobacter species (2). The mortality rate in VAP was 16% as compared with 0.2% in non-VAP cases (p < 0.001). CONCLUSION: These data suggest that by univariate analysis the risk factors for VAP were emergency surgery, COPD, reintubation, coma, steroid treatment, IABC, enteral feedings, tracheostomy, APACHE II score, prior antibiotics, and IPPV hours. On multivariate analysis, only IPPV hours and steroids were independent predictors of VAP. Pseudomonas aeruginosa is the most common pathogen associated with VAP, and the mortality is increased with VAP.

Cardiac Surgical Procedures↗
PubMed1992

Comparative clinical and microbiological study of amoxycillin-clavulanic acid and ciprofloxacin in acute purulent exacerbations of chronic bronchitis.

In a retrospective study, the clinical and microbiological efficacy of amoxycillin-clavulanic acid and ciprofloxacin were evaluated in outpatients observed within the previous year who were affected by acute purulent exacerbations of chronic bronchitis. Of the 95 patients included in the trial, 50 received amoxycillin 875 mg-clavulanic acid 125 mg 8-hourly for 10 days and 45 received ciprofloxacin 500 mg 12-hourly before meals for 10 days. Of the amoxycillin-clavulanic acid-treated patients, 90% showed clear clinical improvement and in 10% treatment failed. In the ciprofloxacin group, 75.5% of patients showed improvement and in 24.5% treatment failed. All pathogens isolated prior to therapy were susceptible to the antibiotic used for therapy. At the end of treatment, in the amoxycillin-clavulanic acid-treated group, 84% of strains were eradicated and 8% persisted; others were superinfections. In the ciprofloxacin group, 57.7% of strains were eradicated, 26.6% persisted and 15.5% were superinfections. No clinically significant side effects were observed in either group. Overall, amoxycillin-clavulanic acid demonstrated superior clinical and microbiological efficacy to ciprofloxacin, although this might be attributable to the higher proportion of aerobic Gram-negative pathogens in the ciprofloxacin group.

Adult↗
PubMed2003

Antagonistic activity of Aeromonas media strain A199 against Saprolegnia sp., an opportunistic pathogen of the eel, Anguilla australis Richardson.

A bacteriocin-like inhibitory substance (BLIS) produced by Aeromonas media strain A199 inhibited the growth of Saprolegnia sp. in vitro, an opportunistic pathogen isolated from affected eels, Anguilla australis (Richardson). The presence of BLIS in solid media inhibited the growth of the vegetative state of the aquatic mould as well as the germination of cysts. Uninhibited growth was, however, observed in the presence of inactive BLIS, suggesting that the in vitro antagonism derived from the BLIS of A199. In four independent in vivo tank observations of fish affected with saprolegniosis, the daily addition of A199 to tank water contributed to the subsequent swift recovery of affected hosts from invasion by this opportunistic pathogen.

Aeromonas↗
PubMed1994

Use of ampicillin/sulbactam versus imipenem/cilastatin in the treatment of limb-threatening foot infections in diabetic patients.

In a double-blind randomized trial, imipenem/cilastatin (I/C; 500 mg every 6 hours) and ampicillin/sulbactam (A/S; 3 g every 6 hours) were compared in regard to their efficacy for initial empirical and definitive parenteral treatment of limb-threatening pedal infection in diabetic patients. The major endpoints of treatment were cure (resolution of soft-tissue infection), failure (inadequate improvement, necessitating a change in antibiotic therapy), and eradication (clearance of all pathogens from the wound and any bone cultures). Patients in the two treatment groups were similar in regard to the severity of diabetes; presence of neuropathy and peripheral vascular disease; site and severity of infection; pathogen isolated; and frequency of osteomyelitis (associated with 68% of the 48 A/S-treated infections and 56% of the 48 I/C-treated infections). After 5 days of empirical treatment, improvement was noted in 94% of the A/S and 98% of the I/C recipients. At the end of definitive treatment (days' duration [mean +/- SD]: 13 +/- 6.5 [A/S], 14.8 +/- 8.6 [I/C]), outcomes were similar: cure, 81% (A/S) vs. 85% (I/C); failure, 17% (A/S) vs. 13% (I/C); and eradication, 67% (A/S) vs. 75% (I/C). Treatment failures were associated with the presence of antibiotic-resistant pathogens and possible nosocomial acquisition of infections. The number of adverse events among patients in the two treatment groups was similar: 7 in the A/S group (4 had diarrhea and 3 had rash) and 9 in the I/C group (5 had diarrhea, 2 had severe nausea, 1 had rash, and 1 had seizure). Efficacy of A/S and I/C is similar for initial empirical and definitive treatment of limb-threatening pedal infection in patients with diabetes.

Adult↗
PubMed1999

An enzyme immunoassay to determine the levels of specific antibodies toward bacterial surface antigens in human immunoglobulin preparations and blood serum.

Human polyvalent intravenous immunoglobulin (IVIG) preparations are used as a complementary aid to the proper antimicrobial treatment of severely septic patients in intensive care units (ICUs) and/or as a prophylactic agent to immunocompromised hosts, particularly prone to bacterial infections. There is skepticism about the usefulness of IVIGs since it is not known whether their administration ensures the enhancement of humoral immune responses by providing a sufficient amount of specific antibodies towards the specified bacterial pathogen to be treated. In this report, a simple and reproducible enzyme-linked immunosorbent assay for determining the content of specific antibodies against bacterial surface antigens in commercially available IVIG preparations is described. The method is also easily applied to determine the amount of bacterial antibodies in blood serum. The levels of specific antibodies toward gram positive and negative pathogenic isolates often encountered in ICUs were estimated in two IVIG (Sandoglobulin and Gamimmune) preparations. Significant differences regarding the content of antibodies to certain clinically bacterial isolates were identified not only between the two IVIG preparations tested, but also among various lots from each IVIG preparation. No significant variation (P < or = 0.001) among the bottles derived from the same lot was determined in both preparations. The variation in the levels of specific antibodies in IVIG preparations may be attributed to differences between the donor pools as well as the manufacturing procedure. Application of the method to patients with primary immune deficiencies showed that infusion of highly reactive IVIG preparations enhanced significantly their humoral response toward various pathogens. The results of this study suggest that the content determination of pathogen-specific antibodies in IVIG preparations before administration may be of great importance for treating bacterial infections.

Antibodies, Bacterial↗
PubMed2000

Mannose-binding lectin binds to a range of clinically relevant microorganisms and promotes complement deposition.

Mannose-binding lectin (MBL) is a collagenous serum lectin believed to be of importance in innate immunity. Genetically determined low levels of the protein are known to predispose to infections. In this study the binding of purified MBL to pathogens isolated from immunocompromised children was investigated by flow cytometry. Diverse Candida species, Aspergillus fumigatus, Staphylococcus aureus, and beta-hemolytic group A streptococci exhibited strong binding of MBL, whereas Escherichia coli, Klebsiella species, and Haemophilus influenzae type b were characterized by heterogeneous binding patterns. In contrast, beta-hemolytic group B streptococci, Streptococcus pneumoniae, and Staphylococcus epidermidis showed low levels of binding. Bound MBL was able to promote C4 deposition in a concentration-dependent manner. We conclude that MBL may be of importance in first-line immune defense against several important pathogens.

Aspergillus fumigatus↗
PubMed1996

Pseudomonas aeruginosa bronchopulmonary infection in patients with advanced human immunodeficiency virus disease.

Pseudomonas aeruginosa is increasingly reported as a respiratory pathogen in patients with advanced human immunodeficiency virus (HIV) disease. We retrospectively reviewed the chest radiographic appearances of 29 HIV-infected adults with bronchopulmonary infection in whom Pseudomonas aeruginosa was the sole respiratory pathogen isolated. The commonest radiographic abnormality was a diffuse reticular (11 patients) or reticulonodular (9 patients) infiltrate in the pulmonary interstitium. Alveolar opacification was seen in seven patients. Cavitation was rare (2 patients), as was ground-glass opacification (2 patients). Five patients had pleural effusions. No patient had mediastinal or hilar lymphadenopathy. Normal chest radiographs were seen in eight patients. Although the radiographic appearances of Pseudomonas bronchopulmonary infection in HIV-infected patients are non-specific, an interstitial infiltrate is a common finding. Pseudomonas aeruginosa should be considered along with the commoner pathogen Pneumocystis carinii in the differential diagnosis of an interstitial infiltrate in this group of patients.

AIDS-Related Opportunistic Infections↗