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Biomedical subjects

A Digranes

Publications and source records attributed to A Digranes.

At least 37 records · Page 2Linked to original sources
PubMed1997

Antibiotic susceptibility of blood culture isolates of Enterobacteriaceae from six Norwegian hospitals 1991-1992.

From August 1991 to February 1992, each of the six largest hospitals throughout Norway collected 84 to 107 consecutive blood culture isolates of Enterobacteriaceae, altogether 571 isolates. The distribution of various species and genera at the different hospitals was uniform; Escherichia coli being most prevalent (57-67%), followed by Klebsiella spp. (12-18%) and Proteus mirabilis (7-11%). Twenty-one and 4% of E. coli isolates were resistant to ampicillin and cefuroxime, respectively, and 11% of Klebsiella isolates were cefuroxime resistant. Five Enterobacter isolates and one Citrobacter isolate were resistant to ceftazidime, and one Salmonella isolate was resistant to imipenem. All isolates were susceptible to ciprofloxacin and tobramycin. These results were compared with the antibiotic consumption in each hospital region. Although hospitals in the regions with the highest consumption of ampicillin tended to have a higher percentage of isolates resistant to this agent, no significant differences were found. There was no significant difference between hospitals regarding prevalence of cefuroxime-resistant isolates.

Anti-Bacterial Agents↗
PubMed1997

Candida norvegensis: a fluconazole-resistant species.

Candida norvegensis has been an unusual cause of infections in humans. In Norway this species was isolated from eight patients from 1990 to 1996 and was of probable pathogenic significance in four of them. All isolates were resistant to fluconazole. The same was true for two C. norvegensis isolates from before 1940, and it is therefore assumed that the fluconazole resistance is inherent.

Adult↗
PubMed1996

[Pyuria, bacteriuria and urinary tract infections in hospitalized patients with spinal cord injuries].

Urine specimens from 15 patients with paresis of the urinary bladder following injury of the spinal cord were examined weekly for a total number of 352 weeks. Pyuria was found in 103 specimens. In more than 95% there was concordance between microscopic and chemical evaluation. Bacteriuria was found in 144 specimens, among which pyuria was found in 76. In 77 cases there was indication for antibacterial treatment, based on bacteriological and clinical parameters. The most frequent bacterium isolated was Escherichia coli. Pyuria was present in more than three of four cases that were identified as urinary tract infections. However, almost one of every two cases with bacteriuria showed no pyuria. It is concluded that clinical symptoms of urinary tract infection together with identification of pyuria call for antibacterial treatment. Bacterial examination, should always be undertaken given symptoms of infection with no presence of pyuria.

Adult↗
PubMed1995

Systemic and mucosal antibody responses to group B streptococci following immunization of the colonic-rectal mucosa.

The cervico-vaginal mucosa is poorly designed for inducing a mucosal immune response, but it can effect such a response evoked at other mucosal sites. This study was undertaken to determine whether colonic-rectal immunization with group B streptococci (GBS) might induce a local cervico-vaginal immune response. Mice were immunized with either fragmented GBS rectally, whole GBS rectally, or whole GBS subcutaneously. Cholera toxin (CT) was used as an adjuvant for the rectal immunizations. Following colonic-rectal immunization with whole GBS, the mean anti-GBS IgA antibody level in vaginal secretions was 735 kU/ml, with individual values reaching 3480 kU/ml. Corresponding levels of IgA antibodies never exceeded 10 kU/ml in serum and intestinal secretions, or 90 kU/g in feces. In vaginal secretions IgA antibodies to GBS also constituted a much larger fraction of total IgA than in serum, intestinal secretions and feces. Immunizations with fragmented GBS produced much lower IgA responses. Anti-GBS IgA response at the inductive site in the colon-rectum was not significant, as opposed to a strong anti-CT IgA response. Except in serum, the anti-GBS IgG responses to colonic-rectal immunizations were generally low, or absent. The results may provide a basis for the development of mucosal vaccines against GBS-infection.

Administration, Rectal↗
PubMed1995

Evaluation of a rapid enzyme immunoassay for detection of genital colonization of group B streptococci in pregnant women: own experience and review.

We have compared an enzyme immunoassay (ICON Step B, Hybritech) with cultures for demonstration of genital carriage of group B streptococci (GBS) in pregnant women, and studied the relationship between vaginal and rectal carriage of this organism. Pertinent literature has also been reviewed. Two hundred pregnant women at gestational week 17 were included. Swabs from the uterine cervix were tested for GBS by ICON Strep B immunoassay and ordinary cultures on blood agar. Additional swabs from the rectum were tested by cultures. The percentage of women with GBS in cervical secretions was 13.5% (27/200) by cultures and 4% (8/200) by the ICON Strep B immunoassay. The overall sensitivity of the immunoassay was 7.4%, and the specificity 96.5%. In conclusion, the sensitivity of rapid enzyme immunoassays is too low for accurate screening of GBS in the genital tract of pregnant women.

Adolescent↗
PubMed1995

Strain differentiation of Neisseria meningitidis by small-fragment restriction endonuclease analysis (SF-REA).

Following an outbreak involving 3 cases of serogroup B meningococcal disease in a rural part of Western Norway, 2 clinical and 99 carrier isolates of Neisseria meningitidis were examined by small-fragment restriction endonuclease analysis (SF-REA) using EcoRI, to determine its potential for strain differentiation. SF-REA characterized all isolates and provided reproducible results with acceptable inter-clonal differentiation. The results of SF-REA correlated well with those of serological typing and were used to determine clonal diversity and prevalence of invasive strains among the carrier isolates. SF-REA was also useful in demonstrating acquisition of a new carrier strain after eradication of the initial strain by ofloxacin. Thirty-one different restriction patterns/pattern complexes were recognized among the 101 isolates. The two clinical isolates had identical restriction patterns and showed > or = 90% similarity to those of six carrier isolates. In three out of six apparent treatment failures, successful eradication of the original strain by ofloxacin was demonstrated by SF-REA. SF-REA proved valuable in strain differentiation of Neisseria meningitidis, complemented serology, and characterized all isolates which could not be typified by serology.

Carrier State↗
PubMed1994

Bloodstream infections at a Norwegian university hospital, 1974-1979 and 1988-1989: changing etiology, clinical features, and outcome.

All episodes of bloodstream infection in patients admitted to a Norwegian university hospital in 1974-1979 and in 1988-1989 were analyzed; altogether, there were 1,447 episodes involving 1,286 patients, and 54.3% of all episodes were hospital-acquired. The incidence of bloodstream infection increased between the two periods studied from 4.26/1,000 admissions to 8.71/1,000. Crude mortality rates were 27.6% and 18.8% and attributable mortality rates were 12.3% and 6.9% in the first and second periods, respectively. Patients > 60 years of age accounted for more than half of the bloodstream infections; mortality in this group was significantly higher than that among younger patients (31.4% vs. 13.9%). The frequency of isolation of Enterobacteriaceae decreased from 48% in the first period to 34% in the second, while the rate of isolation of coagulase-negative staphylococci increased from 6.5% to 16.9%. The shift in etiology may be explained in part by the occurrence of significantly more bloodstream infections related to intravascular devices, endocarditis, and skin and wound infections and of significantly fewer episodes related to abdominal or genitourinary disease in the second than in the first period. Almost all isolates of Enterobacteriaceae were susceptible to newer cephalosporins and aminoglycosides. In 1974-1979, 96 (69.1%) of 139 patients with septic shock died; in 1988-1989, the figure was 35 (52.2%) of 67 patients (P = .019). Clinical factors predictive of an adverse outcome were septic shock (odds ratio for first/second period, 12.7/4.6), intensive care treatment (not significant/10.6), malignant disease (4.6/2.6), any underlying disease (4.2/not significant), diabetes mellitus (3.6/not significant), age of > 60 years (not significant/3.0), and pulmonary source of infection (not significant/2.8).

Adolescent↗
PubMed1994

Mixed bacteremia with Vibrio metschnikovii in an 83-year-old female patient.

An 83-year-old woman suddenly fell ill and was admitted to the hospital on suspicion of a heart attack. After admission she developed high fever, chills and malaise. Vibrio metshnikovii and Staphylococcus hominis were isolated from 2 separately obtained blood cultures. One of the cultures also yielded Escherichia coli. The patient's condition improved rapidly after treatment with ampicillin intravenously. To our knowledge, this is the fourth reported case of V. metschnikovii bacteremia in humans.

Aged↗
PubMed1994

Vaginal application of lactobacilli in the prophylaxis of recurrent lower urinary tract infection in women.

OBJECTIVE: To examine whether vaginal application of Lactobacillus casei v. rhamnosus reduces the reinfection rate in cystitis-prone women. DESIGN: A controlled, randomized, double-blind clinical trial. SETTING: Division for General Practice, University of Bergen, Norway. INTERVENTION: Vaginal application of lactobacilli twice weekly. SUBJECTS: 47 women, aged 18-50 years, reporting three or more episodes of distal urinary symptoms during the previous 12 months, of which at least one episode had been medically verified as a lower UTI. MAIN OUTCOME MEASURE: The incidence rate of lower UTI during 6 months' follow-up. RESULTS: No difference in infection rate between the two groups; the incidence rate ratio between the treatment group and the placebo group was 1.41 (95% confidence interval 0.88-1.98). Lactobacilli were not found more frequently periurethrally in the treatment group than in the control group. CONCLUSION: It is still uncertain whether vaginal application of lactobacilli reduces the infection rate in cystitis-prone women.

Adolescent↗
PubMed1993

Use of single-dose ofloxacin to eradicate tonsillopharyngeal carriage of Neisseria meningitidis.

After an outbreak of three cases of serogroup B meningococcal disease at a Norwegian college, 84 of 392 (21%) subjects were tonsillopharyngeal carriers of Neisseria meningitidis. To eradicate meningococcal carriage, 80 volunteers received a single dose of 400 mg of ofloxacin. Three days after treatment, all 75 evaluable volunteers were culture negative for N. meningitidis, and after 7 days none carried the strain that they carried initially, as judged by DNA fingerprinting. A single dose of ofloxacin was found to be 97.2% effective in eradicating carriage of N. meningitidis for a period of 33 days. The carriage acquisition rate among treated students was four times higher than that among nontreated noncarriers (P = 0.02). After ofloxacin treatment, no case of meningococcal disease occurred for 6 months. Ofloxacin may thus prevent the outbreak and spread of meningococcal disease.

Carrier State↗
PubMed1993

Assessment of clinical features predicting streptococcal pharyngitis.

A total of 133 patients who consulted 4 general practitioners in Bergen 1988/89 for sore throat were examined. 8 clinical parameters with expected predictive value for identifying streptococcal tonsillopharyngitis were recorded. Clinical examination was validated against bacteriologic examination at a microbiological laboratory. The prevalence of streptococcal infection (group A, C and G) was 29%. An algorithm was constructed which identifies 3 groups with varying probabilities of streptococcal infection. A positive predictive value of 62% in the group with highest prevalence and a negative predictive value of 90% in the group with lowest prevalence was found. The consequences of performing a confirmative test only on patients in the group with uncertain prediction for streptococcal disease was elaborated. Although slightly reduced accuracy was demonstrated, due to diminished sensitivity, selective testing is recommended. Another algorithm was constructed for use in situations where no confirmative testing is available. The positive predictive value in the group with highest probability of streptococcal infection was 51%, and the negative predictive value in the group with lowest probability was 84%.

Algorithms↗
PubMed1992

Evaluation of urine sampling technique: bacterial contamination of samples from women students.

A urine specimen is traditionally sampled using the clean-catch midstream technique, but this technique is poorly documented. The aim of this study was to evaluate the bacterial content of urine samples taken using individual steps of the clean-catch midstream technique, or combinations of steps. One hundred and ten women students provided a total of 864 early morning urine samples, using a different sampling technique each morning. Holding the labia apart during sampling more than halved the percentage of samples containing 10(5) colony-forming units per ml or more, and increased the percentage of uncontaminated samples, compared with passing urine without employing any of the precautions. Cleaning the perineum or using the midstream technique resulted in percentages no different from urination without employing any precautions. It is therefore recommended that women should be instructed to carry out the simplest effective urine sampling technique: holding the labia apart.

Adult↗
PubMed1991

Temafloxacin: in vitro comparison with five other antibacterial agents.

The in vitro activity of the new fluorinated quinolone temafloxacin was compared with the activities of ciprofloxacin, fleroxacin, ofloxacin, ceftazidime and tobramycin. A total of 662 recent clinical isolates were included in the study, representing a variety of gram-negative and gram-positive bacteria. An agar dilution method was employed for the determination of minimal inhibitory concentrations (MICs). Ciprofloxacin showed the highest potency against the Enterobacteriaceae, 90% of the isolates being inhibited by 0.06 mg/l or less. The other quinolones were also highly active (MIC90 = 0.25-0.5 mg/l). Ciprofloxacin and tobramycin were the most active agents against the Pseudomonas isolates (MIC90 = 0.25 and 0.5 mg/l, respectively), whereas the activities of temafloxacin, fleroxacin and ofloxacin were more variable. All the quinolones had relatively high and similar activity against Staphylococcus aureus and S. epidermidis, but S. saprophyticus was markedly less susceptible to fleroxacin than to the other quinolones. The activity of temafloxacin against Streptococcus pneumoniae was somewhat higher than those of the other quinolones tested. Temafloxacin showed variable activity against Bacteroides fragilis isolates but was generally more potent against these isolates than were the other quinolones. The MICs of temafloxacin were slightly lower at pH 7.3 compared with those obtained at pHs 5.8 or 8.8.

4-Quinolones↗
PubMed1991

Bacteriuria in patients treated with clean intermittent catheterization.

Bacteriuria has been studied in 407 patients treated with clean intermittent catheterization (CIC) during 1 year. Significant bacteriuria was found in 50.6% of 1413 analyzed urine samples. Escherichia coli was the dominating species (54.8%). The relative distribution of species was different in males and females, but there were no differences between the CIC patients and a reference group of outpatients. On the other hand, a higher frequency of resistance among enterobacteria was found in samples from CIC patients compared to the reference group. The majority of CIC patients with bacteriuria had no symptoms, and bacteriuria per se does not seem to be an indication for treatment in most of these patients.

Adolescent↗