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Biomedical subjects

A Brauner

Publications and source records attributed to A Brauner.

At least 91 records · Page 5Linked to original sources
PubMed1987

The use of biochemical markers, serotype and fimbriation in the detection of Escherichia coli clones.

Biochemical reactions, O and K serotypes and presence of P-fimbriae were analysed in 116 Escherichia coli strains isolated in blood cultures from patients with bacteraemia and in 99 faecal strains isolated from healthy individuals. By using biochemical typing, the strains could be grouped into six main clusters with similarity index less than 0.8 (Gower, 1971) and altogether 16 subclusters with similarity index 0.82-0.89. The most discriminating tests between the clusters were fermentation of D-tagatose, saccharose, salicin and sorbose. No single biochemical property could differentiate bacteraemic isolates from faecal strains, although strains isolated from blood were significantly more often found in certain subclusters, whereas other subclusters contained mainly control strains. Bacteraemic strains possessed P-fimbriae more often, especially strains isolated from patients with E. coli in the urine concomitantly with bacteraemia. Equally, no single reaction could separate P-fimbriated from non-P-fimbriated strains. D-Tagatose was fermented more often by the P-fimbriated strains; on the other hand, melibiose and lactose fermentation tests were less often positive. Certain O serotypes (O1, O4, O6, O7, O18 and O25) were more common among bacteraemic isolates than controls. K serotypes such as K1, K5 and K52 were also more frequent among blood isolates. We conclude that a combination of biochemical tests, fimbriation and serotyping might be used to identify potentially pathogenic clusters of E. coli.

Adolescent↗
PubMed1987

Bacteremia with P-fimbriated Escherichia coli in diabetic patients: correlation between proteinuria and non-P-fimbriated strains.

In a consecutive material of 652 E. coli bacteremia 70 episodes (11%) were found in 64 patients with diabetes mellitus. 10 patients had insulin-dependent and 54 had non-insulin-dependent diabetes. The E. coli strains were tested for adhesive properties as mediated by P-fimbriae, a virulence factor in human urinary tract infections. Half of the strains were P-fimbriated with a higher occurrence in women (26/42, 62%) than in men (9/27, 33%). Diabetic patients with a positive urine culture had a higher incidence of P-fimbriated E. coli strains (27/37, 73%) in blood culture than patients with negative or no urine culture taken (8/32, 25%). Furthermore, patients without compromising factors, regardless of their diabetes mellitus, had a higher incidence of P-fimbriated E. coli strains (19/29, 66%) than those with malignancies and other debilitating diseases (6/22, 27%). The high incidence of P-fimbriated E. coli strains in the non-compromised patients may depend on the ability of such bacteria to invade the urinary tract and cause acute pyelonephritis, which often precedes E. coli bacteremia. A lower incidence of P-fimbriated E. coli strains was found in patients with proteinuria prior to the bacteremic episode (10/31, 32%), compared to those without proteinuria (25/35, 71%). No correlation was noted between P-fimbriation and duration of diabetes or serum creatinine. The low incidence of P-fimbriated E. coli strains in patients with proteinuria indicates that nephropathy, or some concurrent complication, predisposes the diabetic patient to bacteremia with low virulent, non-P-fimbriated E. coli.

Adult↗
PubMed1986

Antibody responses to Escherichia coli J5 lipopolysaccharide and to Salmonella porin in patients with bacteremia.

This study was undertaken in order to evaluate whether patients with bacteremia respond with antibodies directed towards two outer membrane components of Gram-negative bacteria. The antibody responses to the core of the lipopolysaccharide molecule (LPS) of the rough E. coli J5 mutant and to a purified outer membrane protein (porin) from Salmonella were studied in bacteremic patients. Two or three serum samples were consecutively collected from 77 patients having 82 episodes of bacteremia altogether, of these 50 were caused by bacteria of the genus Enterobacteriaceae. As controls, sera from 82 age and sex matched patients and 100 healthy blood donors were analysed. The antibody titers were assessed by enzyme-linked immunosorbent assays (ELISA). None of the patients with bacteremia responded with an increase in antibody level to the E. coli J5 rough LPS. This finding indicates that the core portion of the E. coli J5 LPS contains no antigenic epitopes immunologically cross-reactive with Gram-negative bacteria causing bacteremia. By contrast, 13 patients showed significant titer increases to the porin preparation derived from Salmonella. Twelve of these patients had bacteremia caused by Gram-negative organisms belonging to Enterobacteriaceae. One patient had bacteremia with Bacteroides fragilis but also suffered from a severe peritonitis with growth of both E. coli and Klebsiella. It is suggested that the measurement of antibody response to porin may be of value for differential serological diagnosis in patients with bacteremia, to distinguish between Enterobacteriaceae and other organisms.

Adult↗
PubMed1985

Occurrence of P-fimbriated Escherichia coli in patients with bacteremia.

The case history of 88 patients with blood cultures positive for Escherichia coli and evidence of systemic disease was reviewed, and the Escherichia coli blood isolates tested for P-fimbriation. Fifty-five strains (63%) were P-fimbriated. Patients with a positive urine culture had a higher incidence of P-fimbriated Escherichia coli strains (53/75, 71%) than patients with a negative urine culture (2/13, 15%). Patients with no predisposing factors, such as instrumentation of the urinary tract or a chronic disease, had a significantly higher frequency of P-fimbriated strains (31/36, 86%) compared to patients without such underlying factors (p less than 0.01). There was no significant difference in clinical parameters or in frequency of P-fimbriated strains between patients with one positive blood culture and those with two or more positive cultures. The high incidence of P-fimbriated Escherichia coli strains in these patients is thought to depend on the ability of such bacteria to cause acute pyelonephritis, which in many cases precedes Escherichia coli bacteremia.

Adhesiveness↗
PubMed1985

Pseudomonas cepacia septicemia in patients with burns: report of two cases.

Pseudomonas cepacia has been ascribed to low pathogenicity in man. Within a 10-day period this organism caused 2 cases of septicemia in the Karolinska Hospital burn unit, one with fatal outcome. Both cases were severely burned patients. A serological response to Ps. cepacia was observed in the surviving patient. The blood isolates from the patients showed a very high degree of similarity in biochemical tests, indicating a common origin although the source was not found. The characteristic antibiogram with resistance to aminoglycosides as well as ampicillin and most cephalosporins causes therapeutic problems, since many septicemias of unknown origin are treated with a combination of ampicillin and an aminoglycoside.

Adult↗
PubMed1981

Use of labetalol in hypertensive patients during discontinuation of clonidine therapy.

Eleven hypertensive patients in whom clonidine therapy had to be discontinued, were treated prophylactically with labetalol, in order to avoid a possible hypertensive crisis. Most of the known side effects, which are consistent with the withdrawal phenomenon were observed, e.g. tremor, insomnia and apprehension, but headaches and flushing did not occur. Blood pressure levels remained unchanged, despite up to a 20-fold increase in plasma catecholamines. The lack of change in serial measurements of plasma cyclic AMP level appears to indicate that adequate adrenergic blockade was induced by labetalol. Since labetalol is a potent anti-hypertensive drug, and is also effective in avoiding a possible hypertensive crisis due to withdrawal of clonidine, we propose to use it as the drug of choice whenever discontinuation of clonidine therapy is indicated.

Adult↗
PubMed1978

beta-lactamase production by strains of Escherichia coli of intermediate susceptibility to beta-lactam antibiotics. A study of their clinical significance in urinary tract infection.

In a prospective study of patients treated with cephalexin or co-trimoxazole, almost all isolated E. coli strains of intermediate susceptibility to ampicillin or cephalosporin (MIC 2-16 microgram/ml) were shown to produce beta-lactamase detectable with a chromogenic cephalosporin substrate, or by the clover-leaf test or the acidimetric method. When assayed in preparations of sonicated bacteria, the enzyme had a cephalosporinase-substrate profile in a large majority of cases. In order to evaluate the clinical significance of this beta-lactamase production, 48 patients with urinary tract infection (UTI) were treated with cephalexin, an antibiotic hydrolysed by the enzyme. Forty-three additional patients were treated with co-trimoxazole for comparison. A statistically significant difference in cure rate (p less than 0.05) was found after 2 weeks. Six recurrences occurred in the cephalexin group and none in the co-trimoxazole group. However, after six weeks there were 8 and 5 recurrences, respectively (p less than 0.05). There were no differences in beta-lactamase activity or MIC/MBC between initial strains and isolates from recurrent UTI. Thus, the recurrent infections were not due to emergence of resistance.

Adolescent↗
PubMed1975

[Roads in the phantasms of psychotic children].

The authors have previously analyzed themes such as 'the rails', 'the sun', 'the house' in the drawings and modellings of very regressed, psychotic children. Here we have 'the roads', another anxiogenous subject. The mental condition of the young patients expresses itself clearly in the way the theme is treated in plastic works, and even in the stage play. The colours used, the entanglement, the importance of cross-roads, and the delirious comments are studied. The image of the roads is changing with progressing success of treatment.

Adolescent↗
PubMedDate not supplied

False-positive treponemal serology in patients with diabetes mellitus.

In sera from 476 diabetic outpatients, positive reaction in the Fluorescent Treponemal Antibody-Absorption (FTA-Abs) test, a commonly used serological test for syphilis, was found in 36 of the patients. None of 100 healthy control subjects were positive in the FTA-Abs test. Additional treponemal and nontreponemal tests confirmed the diagnosis of syphilis in only three of the diabetic patients. In 10 of the 36 patients, the positive FTA-Abs reactivity appeared to be due to cross-reactivity between the treponemal antigen and Borrelia burgdorferi, which causes Lyme borreliosis. In the remaining 23 patients (5%), no other explanation for a false-positive FTA-Abs reactivity was found besides diabetes. Diabetic patients with false-positive FTA-Abs reactivity had similar degree of long-term metabolic control and prevalence of islet cell antibodies (ICA) as well as late diabetic complications as FTA-Abs negative diabetic patients, matched regarding to sex, age, type, and duration of diabetes. In conclusion, false-positive FTA-Abs reactivity is not rare in diabetic patients. The reason for this phenomenon is unknown, but could be a sign of autoimmunity of its own. Hence, in diabetic patients with FTA-Abs test indicating syphilis, the diagnosis must be verified with a combination of other tests.

Adolescent↗
PubMedDate not supplied

Haemophilus influenzae and Streptococcus pyogenes group A challenge induce a Th1 type of cytokine response in cells obtained from tonsillar hypertrophy and recurrent tonsillitis.

We have previously shown that tonsil tissue both from children with tonsillar hypertrophy and recurrent tonsillitis is colonized and invaded by Haemophilus influenzae and Streptococcus pyogenes group A. In order to evaluate if these bacteria are involved in the immunopathogenesis of these two conditions, tonsillar cells from both groups were stimulated in vitro with intact, heat-inactivated H. influenzae or S. pyogenes A. The immunoreactivity was evaluated by assessing the induction of cytokine production (IL-1 alpha, IL-1 beta, TNF-alpha, IL-6, IL-8, IL-2, IFN-gamma, IL-4, TNF-beta and IL-10), which was detected at the single-cell level. All cytokines studied except IL-4 were induced in both groups after stimulation with H. influenzae or S. pyogenes A. The dominating cytokines were IL-1 beta, IFN-gamma and TNF-beta. No major differences in the cytokine pattern or number of cytokine-producing cells were noticed between the two patient cohorts after H. influenzae stimulation. Activation by S. pyogenes A bacteria gave rise to higher frequencies of IFN-gamma- and TNF-beta-synthesizing cells in the recurrent tonsillitis group. The incidence of CD4-, CD8-positive T cells and CD40-positive B cells was comparable between the two groups while the MAC-387-positive macrophages were significantly higher in the recurrent tonsillitis groups. In conclusion, a Th1 type of cytokine response was found in both groups following stimulation with H. influenzae or S. pyogenes A.

Antigens, Bacterial↗
PubMedDate not supplied

Bacteraemia with Escherichia coli in diabetic patients. Studies on bacterial virulence and host factors.

A total of 70 episodes of E. coli bacteraemia occurred in 10 patients with insulin-dependent, and 54 patients with non-insulin-dependent diabetes mellitus. The bacteraemic strains were tested for aerobactin mediated iron uptake, a property that is regarded as a virulence factor of E. coli. Aerobactin mediated iron uptake was present in 60% of the isolated strains from the diabetic patients. A similar prevalence, 54%, was noted in E. coli from a control group of non-diabetic patients with bacteraemia. The prevalence of aerobactin positive strains, isolated from both diabetic and non-diabetic patients, was significantly higher than in faecal E. coli strains (39%) obtained from healthy subjects. In E. coli from diabetic patients, another bacterial virulence factor, P-fimbriae, was present on 62% of the aerobactin positive strains but only on 33% of strains lacking aerobactin mediated iron uptake. No examined host factors in the diabetic patients, such as age, sex, duration of diabetes, serum creatinine and presence of proteinuria, influenced the prevalence of aerobactin mediated iron uptake. In conclusion, bacterial virulence mediated by the aerobactin system occurs as frequently in diabetic as in non-diabetic patients with E. coli bacteraemia, and furthermore seems to co-exist with P-fimbriation.

Diabetes Mellitus, Type 1↗