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Biomedical subjects

B Gahrn-Hansen

Publications and source records attributed to B Gahrn-Hansen.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Infections in connection with epidural catheterization].

Seventy-eight patients with culture-positive epidural catheters were studied. Fifty-nine had symptoms of exit site infection and 11 patients had clinical meningitis, two of whom also had en epidural abscess. This corresponds to a local infection incidence of at least 4.3% and an incidence of central nervous system infection of at least 0.7% at Odense University Hospital. The patients with generalized symptoms of infection had been catheterized for a longer time, and were older than patients with only local symptoms of infection. The microorganisms isolated from the epidural catheters were coagulase- negative staphylococci (41%), Staphylococcus aureus (35%), Gram-negative bacilli (14%) and other bacteria (10%). The Gram-negative bacilli and S. aureus caused serious infections more frequently than the others. We discuss the symptoms and diagnosis of spinal epidural abscess and propose prophylactic and diagnostic guidelines for epidural catheter-related infections.

Adult↗
PubMed1996

Capnocytophaga canimorsus septicemia in Denmark, 1982-1995: review of 39 cases.

Thirty-nine Danish cases of Capnocytophaga canimorsus septicemia were reviewed to determine the clinical course of this infection. The cases of septicemia were related to recent dog bites or other close contact with dogs. The period from the bite to the onset of symptoms ranged from 1 to 8 days. The mean age of the patients was 59.1 years (range, 28-83 years). Underlying conditions included previous splenectomy and alcoholism. Thirteen patients had previously been in good health. Common initial symptoms were fever, malaise, myalgia, vomiting, diarrhea, abdominal pain, dyspnea, confusion, headache and skin manifestations. Disseminated intravascular coagulation developed in 14 patients, meningitis in 5, and endocarditis in 1. Twelve of the patients died. All patients except two were treated with penicillin or ampicillin. Five patients had received antibiotics prior to admission. Attention should be drawn to C. canimorsus septicemia in cases of febrile illness following dog bites or contact with dogs, as well as those involving previously healthy persons. The incidence of this condition in Denmark is estimated to be 0.5 case per 1 million people per year.

Adult↗
PubMed1996

Pasteurella aerogenes isolated from ulcers or wounds in humans with occupational exposure to pigs: a report of 7 Danish cases.

Pasteurella aerogenes is rarely isolated from human specimens. The species is found in the digestive tract of pigs. From 1976 to 1994 7 strains were cultured in Denmark from wounds or ulcers. Five patients were bitten by pigs and 2 patients with ulcers were employed in pig farming. A mixture of bacterial species was often found. All 7 strains of P. aerogenes were susceptible to ampicillin, cephalosporins and ciprofloxacin. Ability to hydrolyse urea, to produce oxidase and catalase, to decarboxylate ornithine and to produce gas from glucose and inability to produce indole was characteristic for P. aerogenes. Most bite wounds were located on the lower lateral part of the thigh. Foul smelling pus and abscess formation was the rule. Incision, drainage and antibiotic treatment were usually necessary.

Adult↗
PubMed1995

[Respiratory tract infections in general practice--the effect of a medical audit project].

A medical audit of the management of respiratory tract infections was performed among 31 general practitioners in Funen county. The first registration of prescriptions in 1992 showed that broadspectrum antibiotics were used to a higher extent than seemed necessary. An intervention with courses, visits to the department of clinical microbiology and distribution of recommendations concerning diagnosis and treatment was performed. The intention was to give the necessary and only the necessary amount of antibiotics and when an antibiotic was indicated to use penicillin as often as possible. A new registration was made one year after the first one. The proportion of antibiotic prescriptions was reduced from 0.49 to 0.38 and the proportion of prescriptions of broadspectrum antibiotics was reduced from 0.21 to 0.12. Detection of group A streptococci in tonsillitis was used more frequently in 1993 than in 1992. Medical audit performed after this model seems a good instrument for changing prescription habits. Medical audit thus seems to be a useful tool in quality improvement in general practice.

Anti-Bacterial Agents↗
PubMed1995

[Nosocomial Legionella pneumophila infection in a nephrology department].

During the autumn and winter of 1993-94 four cases of legionellosis were diagnosed in a Department of Nephrology. Three of the patients were kidney transplanted patients. Two of the patients died. The diagnosis was based on positive culture in two patients and by positive urinary antigen test in the other two patients. Serology was negative for all four patients. Legionella pneumophila was initially found in the cold and hot shower water, in ice-water from the ice machine, from the hot water tank and in the cold water inlet to the building. The isolate from patient no. one and isolates of serogroup 5 from the ice machine and the shower water had identical REA profiles, different from the profiles of the isolate from patient no. four. We concluded that at least one of the four patients was likely to have been infected from the water in the department, either by inhalation of contaminated aerosols from the shower or by aspiration of contaminated ice-water. Precautions were taken to reduce the number of Legionella in the shower- and ice-water. In addition, restrictions in the use of showers and ice-water from the ice machine were introduced.

Aged↗
PubMed1995

Prevalence and antibiotic sensitivity of Danish versus other European bacterial isolates from intensive care and hematology/oncology units.

The prevalence and antibiotic sensitivity patterns of bacteria collected consecutively from medical and surgical intensive care units (ICUs) and from hematology/oncology units in nine hospitals in Denmark were determined and compared to data collected simultaneously in 12 other European countries. Bacterial isolates from 794 Danish patients were tested and compared to 8,625 isolates from European patients. The minimal inhibitory concentrations of eight different antibiotics were determined using a microdilution plate. Similar to findings in European countries, the most common source of bacterial isolates in Danish units was the respiratory tract (49%), followed by blood (18%), urinary tract (14%) and surgical wounds (10%). Staphylococcus aureus was the most prevalent respiratory organism in Danish units, whereas Enterobacteriaceae and Pseudomonas aeruginosa dominated in other countries. In blood, Escherichia coli was most prevalent in Denmark while coagulase-negative staphylococci were predominant in other countries. Urinary tract isolates were dominated by Escherichia coli in both Denmark and the other countries, but Enterococcus faecalis and Pseudomonas aeruginosa were more frequently isolated in the other countries. Staphylococcus aureus was the most frequent wound isolate in Denmark, while Enterobacteriaceae other than Escherichia coli dominated in other European countries. Thus, in Denmark Escherichia coli and Staphylococcus aureus, followed by Pseudomonas aeruginosa and Klebsiella spp. (from ICUs) or Enterococcus spp. and Klebsiella spp. (from hematology/oncology units), are the most prominent pathogens in these units today. Indicator organisms of antibiotic consumption (Pseudomonas aeruginosa and methicillin-resistant coagulase-negative staphylococci and Staphylococcus aureus) were more frequent in other European countries than Denmark. In general the Danish isolates were more sensitive to antibiotics than the European isolates.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1995

Infections following epidural catheterization.

Seventy-eight patients with culture-positive epidural catheters, were studied. Fifty-nine had symptoms of exit site infection and 11 patients had clinical meningitis, two of whom also had an epidural abscess. This corresponds to a local infection incidence of at least 4.3% and an incidence of central nervous system infection of at least 0.7% at Odense University Hospital. This degree of infection is of the same magnitude as that reported for intravascular devices. We found that the patients with generalized symptoms of infection had been catheterized for a longer time, and were older than patients with only local symptoms of infection. The microorganisms isolated from the tips of the epidural catheters were coagulase-negative staphylococci (41%), Staphylococcus aureus (35%), Gram-negative bacilli (14%) and others (10%). The Gram-negative bacilli and S. aureus caused serious infections more frequently than the others. We discuss the symptoms and diagnosis of spinal epidural abscess and suggest a proposal for prophylactic and diagnostic guidelines for epidural catheter-related infections.

Adolescent↗
PubMed1994

[Extraintestinal infections caused by Vibrio parahaemolyticus and Vibrio alginolyticus at the county of Funen 1987-1992].

Over a six-year period we detected 30 clinical infections caused by halophilic vibrios in a restricted geographical area. Vibrio parahaemolyticus infections were found in 13 patients (three with wound infections, ten with ear infections), and Vibrio alginolyticus infections in 17 patients, all of whom had ear infections. From 1987 to 1990, infections caused by marine vibrios were found in at most four cases annually, in 1992 in six instances, whereas over a five-month period in 1991 we experienced 15 cases of extraintestinal infections. Fifteen of the infections found in 1991 and 1992 were ear infections, ten of which occurred shortly after exposure to Danish coastal seawater. The disease was mild in most of the patients and all recovered. Most of the patients showed predisposing conditions such as chronic otitis media, perforation of the tympanic membrane or ulcus cruris. The organisms were isolated in minor numbers from coastal water samples from five of 12 bathing areas around Funen at the end of July, but not at the end of November. This study indicates that halophilic marine vibrios may be pathogenic in Denmark in persons exposed to seawater.

Denmark↗
PubMed1993

[Peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. Evaluation of cephalothin/cephalexin monotherapy as initial treatment].

To evaluate the initial antibiotic regime of cephalothin monotherapy in the treatment of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD), the frequency of peritonitis was registered retrospectively together with the frequency of recurrent episodes and change of antibiotic. A median frequency of 0.96 episodes per year of dialysis was found. In 24% of the episodes no microorganism was cultured. 82% of the microorganisms were gram-positive cocci, 17% gram-negative rods. The frequency of recurrent episodes was 7%. The initial antibiotic treatment with cephalothin had to be changed in 33% of the cases due to microbial resistance. In another 33% the antibiotic treatment was changed to something with a narrower spectrum. More than one third of the resistant microorganisms were methicillin-resistant coagulase-negative staphylococci. With quick and reliable microbiological diagnostic technique that makes it possible to change the antibiotic treatment early, we find cephalothin to be a suitable initial monotherapy.

Adolescent↗
PubMed1993

Phenotypical characters and ribotyping of Pasteurella aerogenes from different sources.

On the occasion of five Danish human Pasteurella aerogenes from pig bite lesions, a comparison was made between 6 isolates from man and 15 animal isolates, mainly from pigs. The strains originated from 6 different countries (USA, Canada, Czechoslovakia, France, Belgium and Denmark). The 21 isolates were characterized by conventional biochemical tests, antibiogram and the API 20 NE kit; finally ribotyping was carried out by hybridizing EcoRI-digested chromosomal DNA with a probe derived from E. coli ribosomal RNA. By ribotyping, 19 of the 21 strains clustered at a similarity level of 81% or more; both phenotypical tests and ribotyping indicated that the remaining two strains did not belong to the species P. aerogenes. In conclusion, despite minor differences our P. aerogenes isolates constituted a well-defined group and they could not be subdivided on basis of animal or geographical origin.

Animals↗
PubMed1993

Extraintestinal infections caused by Vibrio parahaemolyticus and Vibrio alginolyticus in a Danish county, 1987-1992.

Over a 6-year period we detected 30 clinical infections caused by halophilic vibrios in a restricted geographical area. Vibrio parahaemolyticus infections were found in 13 patients (3 with wound infections, 10 with ear infections), and Vibrio alginolyticus infections in 17 patients, all of whom had ear infections. From 1987 to 1990, infections caused by marine vibrios were found in at most 4 cases annually, in 1992 in 6 instances, whereas in a 5-month period in 1991 we experienced 15 cases of extra-intestinal infections. 15 of the infections found in 1991 and 1992 were ear infections, 10 of which occurred shortly after exposure to Danish coastal seawater. The disease was mild in most of the patients and all recovered. Most of the patients showed predisposing conditions such as chronic otitis media, perforation of the tympanic membrane or ulcus cruris. The organisms were isolated in minor numbers from coastal water samples from 5 of 12 bathing areas around Funen at the end of July, but not at the end of November. This study indicates that the halophilic marine vibrios may be pathogenic in Scandinavian areas in persons exposed to seawater.

Adolescent↗
PubMed1991

Conglutinin exhibits a complement-dependent enhancement of the respiratory burst of phagocytes stimulated by E. coli.

Conglutinin is a mammalian C-type lectin which shows anti-bacterial activity when tested in vivo and in vitro. This study concerns the effect of conglutinin on the respiratory burst of murine spleen cells, using a chemiluminescence assay for measurement of generated reactive oxygen metabolites. Conglutinin enhances, in a dose-dependent manner, the respiratory burst of spleen cells stimulated with serum-opsonized Escherichia coli. The enhancement was only demonstrable in the presence of a functional complement system. The conglutinin-mediated enhancement of the respiratory burst was inhibited in the presence of a N-acetyl-D-glucosamine, D-mannose and N-acetyl-D-mannosamine, monosaccharides reported to inhibit conglutinin-binding to zymosan and the complement factor iC3b. On the other hand, N-acetyl-D-galactosamine was non-inhibitory.

Animals↗