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B Gahrn-Hansen

Publications and source records attributed to B Gahrn-Hansen.

At least 19 recordsLinked to original sources
PubMed2005

Shewanella algae and Shewanella putrefaciens: clinical and microbiological characteristics.

The occurrence of the two Shewanella species found in clinical specimens, Shewanella algae and Shewanella putrefaciens, correlates with the temperature and salinity of seawater. This means that Shewanella infections occur in warm climates or during especially warm summers in temperate climates. The infections described most commonly involve ears, skin and soft tissue, with or without bacteraemia. Primary bacteraemia with a fulminant course is also seen in immunocompromised patients. Important differential characteristics between the two species include the ability of S. algae to produce mucoid colonies with beta-haemolysis on sheep blood agar, to grow at 42 degrees C and in NaCl 6% w/v, and to reduce nitrite, and an inability to produce acid from maltose, all of which are in contrast to the characteristics of S. putrefaciens. Automated identification systems fail to differentiate between S. algae and S. putrefaciens, as S. algae is not included in the databases of these systems. Presumably for this reason, most Shewanella infections reported during recent years have been attributed to S. putrefaciens. However, when extensive phenotypic characterisation is performed, most human infections are seen to be caused by S. algae. As the two species seem to have different pathogenic potential for humans, correct identification is important, and this is possible in routine clinical microbiology laboratories.

Animals↗
PubMed2004

Fusarium fungaemia in immunocompromised patients.

Fusarium spp. cause infections only rarely in immunologically competent hosts, but disseminated infection may occur in severely immunocompromised patients. Symptoms of disseminated infection are persistent fever, despite broad-spectrum antibacterial and antifungal treatment, associated with skin lesions, most commonly on the extremities, in 60-80% of patients. A mortality rate of 50-75% has been reported for patients with disseminated fusariosis. Despite treatment failures, amphotericin B remains the preferred drug, in part because of lack of alternatives. Voriconazole is a promising new agent, but more clinical experience is required.

Aged↗
PubMed2003

Respiratory syncytial virus infection--risk factors for hospital admission: a case-control study.

UNLABELLED: Most infants are infected with respiratory syncytial virus (RSV) during the first 2 y of life. The majority have only a mild upper respiratory tract infection, but 1-2% develop a more severe illness and are admitted to hospital. AIM: To carry out a study of risk factors for hospital admission because of RSV infection in Denmark in children aged less than 2 y of age. METHODS: The study population included all 1252 children admitted to hospital with verified RSV infection in two Danish counties during the 5-y period 1990-1994. The investigation comprised a retrospective case-control study with five matched controls per case. In a multivariate analysis the risk factors included medical and demographic variables, and in infants <3 mo of age at hospitalization, two aspects of innate immunity: mannose-binding lectin (MBL) concentration and maternal RSV serum antibody titre, measured on eluates from stored dried blood from the infants' 4th day of life. The effect of each risk factor is expressed as an odds ratio, corresponding to the relative risk of being a case rather than a control if the risk factor is present. RESULTS: The following independent risk factors were identified: age, sex, month of birth, gestational age, birthweight, presence of a sibling, up to 5 y older than the case, and maternal smoking during pregnancy. There was a marginal effect of maternal RSV antibody levels, but no effect of neonatal serum MBL concentration or of crowding in the household. CONCLUSIONS: Ninety percent of cases and 80% of controls had one or more risk factors. Even though several factors were found to increase the risk for hospitalization for RSV disease, all the effects were small and no single specific factor could be identified to explain the hospitalization of the minority of children with RSV infection.

Age Factors↗
PubMed2002

Mecillinam susceptibility as an indicator of beta-lactamase production in Staphylococcus aureus.

The use of direct susceptibility testing from specimens has led to the fortuitous observation that penicillin-susceptible strains have larger inhibition zones for mecillinam than do beta-lactamase producers. The current study was, therefore, undertaken to test 179 Staphylococcus aureus isolates for mecillinam susceptibility by Rosco Neo-Sensitabs and to compare the results with commonly used tests for beta-lactamase production, i.e. size and character of penicillin inhibition zones, chromogenic cephalosporin (nitrocefin) tests and clover leaf assays. Agreement between methods was reached for 175 of 179 strains when disregarding the results of the nitrocefin tests, 88 isolates being found susceptible and 87 being found to be beta-lactamase producers. All 88 susceptible isolates had mecillinam zones of >22 mm, with the great majority being >25 mm; double zones did, however, occur. The 87 beta-lactamase producers had zones <14 mm or no zones. Four isolates presenting problems in had mecillinam zones of <or=20 mm and were without tapering growth at the penicillin inhibition zone edge. In conclusion, the size of the mecillinam inhibition zone is found to be a useful supplementary test in the clinically important distinction between beta-lactamase-producing and non-producing isolates of S. aureus.

Amdinocillin↗
PubMed2000

[Treatment of upper respiratory tract infections].

Today most upper respiratory tract infections are mild and of short duration with minor risk of complications. Hence, the effects of antibiotic treatment are marginal. The only and most important reason for treatment is to stop dissemination. Penicillin V should be the first drug of choice. A review of the literature about antibiotic treatment of upper respiratory tract infections shows that most published studies exclude two categories of patients: children below the age of 6 months and patients who are severely ill. Therefore, there is an additional need for further studies focused on select groups of patients to investigate the benefit, if any, of antibiotic treatment as well as to study the effect of introducing near-patient-tests and the use of extended microbiological service in daily clinical practice.

Anti-Bacterial Agents↗
PubMed1999

Long-lasting improvement in general practitioners' prescribing of antibiotics by means of medical audit.

OBJECTIVE: To evaluate the usefulness of medical audit of GPs' antibiotic prescription habits. DESIGN: Medical audit according to the APO method. Registration of antibiotic prescriptions for respiratory tract infections during a 3 year period. Intervention with courses, visits to the laboratory, and distribution of recommendations concerning diagnosis and treatment of respiratory infections. SETTING: 24 Danish GPs in cooperation with Audit Project Odense (APO) and Department of Clinical Microbiology, Odense University Hospital. 207 GPs acted as controls. MAIN OUTCOME MEASURES: Changes in the number of antibiotic prescriptions and in the penicillin/broad-spectrum antibiotic ratio. RESULTS: The proportion of antibiotic prescriptions was reduced during the investigation period, but a similar reduction was found in the control groups. Only for acute sinusitis was a lasting decrease not found in the control groups recorded. The penicillin/broad-spectrum antibiotic ratio increased in the intervention group (1.33 in 1992, 1.94 in 1993 and 2.70 in 1995). This increase was significantly higher than in the control groups. The change was seen for acute sinusitis, bronchitis, and pneumonia, but not for acute otitis media or acute tonsillitis. The changes induced from 1992 to 1993 were maintained or increased from 1993 to 1995 although the educational measures had stopped. CONCLUSION: Medical audit according to the APO method is a useful tool for inducing and maintaining desirable changes in GPs' prescription habits.

Anti-Bacterial Agents↗
PubMed1998

Problems of identification in clinical microbiology exemplified by pig bite wound infections.

Our experience from attempts to identify bacteria isolated from boar bite/gore wounds is the background for a discussion of identification problems. Some organisms, although not very common or well-known, can be identified when using commercial kits or conventional methods, provided they are sufficiently characterized, as exemplified by Pasteurella aerogenes isolated from cases 1 and 2. Some organisms may be wrongly identified, or not identified, by both commercial kits and conventional methods, unless seen by experienced microbiologists with knowledge of the original literature. This is exemplified by case 3, in which the final identification result was Bisgaard's taxon 15. Sometimes isolates cannot be identified even in reference laboratories and by using available identification tables and databases. In such cases, the organism involved may turn out to belong to a previously undescribed taxon. This is illustrated by the strains isolated from cases 4 and 5.

Adolescent↗
PubMed1998

Prophylaxis against herpes infections in kidney transplant patients with special emphasis on CMV.

METHOD: Since 1990, we have treated all kidney transplanted patients with cyclosporin (CsA)+ an initial 10 d antilymphocyte globulin (ALG) course, from September 1995 supplemented with mycophenolate mofetil (MMF). In 170 consecutive transplantations from June 1992 to the end of 1996, aciclovir 3200 mg/d (adjusted for kidney function and in children to age) was given prophylactically for 3 months post-transplantation (Tx), monitored with systematic and frequent tests for HSV and CMV. In case of CMV infection, we gave ganciclovir intravenously (oral ganciclovir from 1996) in doses according to kidney function for 3 months, followed by a further 3 months observation and monitoring period. In case of acute cellular rejection, ganciclovir was given during the 10-d OKT3 course and 1 week further. In case of delayed graft function combined with aciclovir side effects, ganciclovir was given until aciclovir could be reintroduced. RESULTS: 39% were HSV seronegative at Tx. There were no seroconversions or reactivations within the observation period. No mucocutaneous HSV infections was observed. No resistant strains developed. 26% were both HSV and CMV negative at Tx. 52% were CMV negative at Tx. 30% experienced a CMV infection post-transplant. The patients were grouped according to CMV status in the donor (D) and recipient (R) before Tx. We found approximately the same number of patients in the 4 CMV groups D-/R-, D+/R-, D-/R+ and D+/R+. Most infections occurred in the D+/R- group compared to D-/R- (p = 0.009). A significant increase in the number of CMV infections occurred in this subgroup when we gave reduced doses in case of delayed graft function (p = 0.015), from 1994. We observed only 1 CMV disease (in 1992). Serological EBV testing were performed concomitantly. No correlation was seen between CMV and EBV infections. From September 1995 we have treated all transplanted patients (n = 40) with CsA/ALG/MMF. We found no significant increase in CMV infections in this group. CONCLUSIONS: Prophylaxis with aciclovir (combined with ganciclovir during acute rejections and in case of delayed graft function with aciclovir side effects) gives a good protection against HSV and CMV infections and prevents CMV disease effectively. High-dose aciclovir post-transplantation (or shift to ganciclovir) seems to be important to obtain effective prophylaxis. Better immunosuppression with MMF does not result in more CMV infections.

Acyclovir↗