Search PubMed⌕ Search

Biomedical subjects

B Svenungsson

Publications and source records attributed to B Svenungsson.

At least 19 recordsLinked to original sources
PubMed2001

Clostridium difficile cytotoxin B in adults with diarrhea: a comparison of patients treated or not treated with antibiotics prior to infection.

OBJECTIVE: To study the detection rate of Clostridium difficile cytotoxin B in stool specimens from adults with diarrhea as related to previous antimicrobial treatment. METHODS: Stool specimens from 802 adult patients with diarrhea and 203 healthy controls were tested for C. difficile cytotoxin B using a cell cytotoxicity assay. Antibiotic susceptibility testing of C. difficile was performed with the E test. RESULTS: Of 173 patients treated with antimicrobial medication within 5 weeks of onset of diarrhea, 60 (35%) were positive for C. difficile cytotoxin B (group A) compared to only 41 (7%) of 629 untreated patients (group B) and two of the 203 (1%) healthy controls. Compared to patients in group A, patients in group B possessed characteristics not usually connected with C. difficile disease. They were generally younger (median age 40 years vs. 73 years), had been hospitalized less frequently (10% vs. 67%), had more often travelled abroad within the previous 2 weeks (46% vs. 1%), and more often had multiple enteropathogens (41% vs. 3%). Minimal inhibitory concentrations for vancomycin, metronidazole and fucidic acid to C. difficile isolates ranged from 0.5 to 4 mg/L, from 0.125 to 256 mg/L and 0.25 to 4 mg/L, respectively. CONCLUSIONS: The detection rate of C. difficile cytotoxin B in patients with diarrhea, not associated with antibiotic treatment, is comparable to that in healthy control subjects. It probably merely reflects a carrier state without clinical significance.

Adult↗
PubMed2001

Fecal carriage of vancomycin- and ampicillin-resistant Enterococci observed in Swedish adult patients with diarrhea but not among healthy subjects.

During a 1-y prospective study between 1 October 1996 and 30 September 1997, fecal samples from 786 adult patients with diarrhea and 203 healthy control subjects were screened for vancomycin-resistant Enterococci (VRE) and ampicillin-resistant Enterococci (ARE). The carriage rates of VRE and ARE were 0.4% and 6%, respectively among patients and 0% among controls. The 3 VRE isolates were all VanA and were obtained from patients who had been abroad (Thailand, Spain, France) within the previous 3 months. Thirteen of the 45 patients with ARE (29%) had been abroad within 2 weeks of the onset of diarrhea. These findings suggest a potential risk of introduction of antibiotic-resistant Enterococci in Swedish hospitals by patients receiving treatment for diarrhea after traveling abroad.

Adolescent↗
PubMed2001

Frequency of antibiotic-associated diarrhoea in 2462 antibiotic-treated hospitalized patients: a prospective study.

The frequency of antibiotic-associated diarrhoea (AAD) and Clostridium difficile-associated diarrhoea (CdAD) was prospectively determined in a population of 2462 patients recruited from five Swedish hospitals, including divisions for infectious diseases, orthopaedics, surgery, geriatrics, nephrology and internal medicine. AAD developed in 4.9% of the treated patients. Faecal samples were obtained from 69% of patients with AAD and 55.4% were positive for C. difficile cytotoxin B. The frequency of AAD varied from 1.8 to 6.9% at the participating centres (P < 0.001). The frequency of AAD also varied considerably between medical disciplines and wards within different hospitals and was highest in the nephrology and geriatric units (6.7 and 7.1%, respectively). There was no difference in frequency of AAD when analysed with respect to gender or age. Medical interventions (laxative treatment, endoscopy and abdominal surgery) or presence of one concomitant disease (diabetes, malignancy, chronic renal disease and inflammatory bowel disease) did not significantly affect the frequency of AAD, whereas patients suffering from two or more of these illnesses had significantly (P = 0.001) higher frequencies of AAD. Patients treated with antibiotics for 3 days had a significantly (P = 0.009) lower frequency of AAD than those treated for longer periods. Treatment with cephalosporins, clindamycin or broad-spectrum penicillins was associated with an increased risk of AAD. With specimens from one centre, 62.5% of tested patients with AAD and 33.8% of asymptomatic patients were positive for cytotoxin B. Although C. difficile cytotoxin B in stool samples was significantly associated with AAD (P = 0.003), the causal relationship with diarrhoea is not always evident.

Adolescent↗
PubMed2001

Effect of perorally administered pivmecillinam on the normal oropharyngeal, intestinal and skin microflora.

To study the ecological effects of pivmecillinam on the human oropharyngeal, intestinal and skin microflora, 15 healthy volunteers were given pivmecillinam tablets 400 mg twice daily for 7 days. Saliva, stool and skin specimens were taken before (days -3 and 0) and on the 2nd, 4th and 7th days during the administration period and 14 and 21 days after the start of administration. Mecillinam caused no major changes in the aerobic or anaerobic oropharyngeal microflora. In the aerobic intestinal microflora there was a decrease in the numbers of Escherichia coli while no changes occurred in the anaerobic microflora. In the skin microflora there was a transient decrease in the numbers of Propionibacterium spp. underneath the wing of the nose. The major effect of pivmecillinam was seen on E. coli and to some extent on Propionibacterium spp. No further ecological disturbances were noticed in the oropharyngeal, intestinal or skin microflora.

Administration, Oral↗
PubMed2000

Incidence and genetic diversity of group C rotavirus among adults.

Fecal samples from a 1-year prospective study were investigated to establish the role of group C rotavirus infections in acute diarrhea in Swedish adults (>15 years old). Rotaviruses were found in samples from 3% of the patients, and, in 35% of these, group C rotavirus was detected. Clinical symptoms of group C rotavirus infection were generally milder than those of group A rotavirus infection. Gene 8 (vp7) from 12 group C isolates, including strains from the prospective study, a military outbreak, and a sporadic case, was sequenced. The gene was found to be extremely conserved, with identities of 99.1%-100% at the amino acid level. This study has systematically investigated the prevalence and genetic diversity of group C rotavirus in adults. The data confirm the extreme sequence conservation within human group C rotavirus strains and suggest that symptomatic group C rotavirus infections occur more frequently in adults than has been previously recognized.

Adult↗
PubMed2000

Enteropathogens in adult patients with diarrhea and healthy control subjects: a 1-year prospective study in a Swedish clinic for infectious diseases.

A 1-year prospective study was conducted to identify enteropathogens in adults with diarrhea (n=851) and in healthy control subjects (n=203) by use of conventional laboratory methods. Virulence factor genes for diarrheagenic Escherichia coli were detected by polymerase chain reaction. Enteropathogens were identified in 56% of patients and 16% of control subjects. The isolation rate was 65% for patients with symptoms for <1 week and for travelers; >1 pathogen was found in 11% of patients. The most frequent enteropathogens were Campylobacter (13% of patients), Clostridium difficile (13%), enterotoxigenic Escherichia coli (8%), Salmonella (7%), Shigella (4%), Blastocystis hominis (4%), calicivirus (3%), rotavirus (3%), enteroaggregative E. coli (2%), Aeromonas (2%), Giardia intestinalis (2%), Cryptosporidium (2%), and astrovirus (2%). Less frequently isolated (< or =1% of patients) were verotoxigenic E. coli, enteropathogenic E. coli, enteroinvasive E. coli, Entamoeba histolytica/Entamoeba dispar, microsporidia, and adenovirus. Fifty percent of the patients were hospitalized, and 43% needed intravenous fluids. The median duration of diarrhea was 14 days. Clinical features were not helpful for predicting the etiology of diarrhea.

Adolescent↗
PubMed1999

Increased nitric oxide in infective gastroenteritis.

Nitric oxide (NO) production is increased in several inflammatory disorders, although the role of this gas is not clear. The purpose of this study was to determine whether luminal NO in the intestine is increased in infective gastroenteritis. Rectal gas was sampled in 17 patients with gastroenteritis and 10 healthy volunteers, with balloon catheters made of 100% silicone and analyzed for NO by chemiluminescence. Plasma nitrate and nitrite levels were determined by capillary electrophoresis. Rectal NO was (mean+/-SEM) 9441+/-3126 parts per billion (ppb) in the patients and 74+/-13 ppb in controls (P<.0001). There was no individual overlap. Plasma nitrite but not nitrate was significantly increased in patients compared with controls. These data indicate that luminal NO is greatly increased in gastroenteritis. The high levels of NO are easily measurable by rectal sampling, and measurement of luminal NO seems to be useful for evaluating local NO production in the gut in health and disease.

Adult↗
PubMed1999

Prevalence of enterotoxigenic Bacteroides fragilis in adult patients with diarrhea and healthy controls.

Enterotoxigenic strains of Bacteroides fragilis (ETBF) have been associated with diarrheal diseases in animals and humans. The enterotoxin of ETBF induces fluid changes in ligated intestinal segments and a cytotoxic response in HT29/C1 cells. An assay based on immunomagnetic-beads separation in combination with PCR was used to detect ETBF in fecal samples from patients with diarrhea and healthy Swedish adults. A total of 922 fecal samples were analyzed in this study, including 728 samples from patients with diarrhea and 194 samples from controls. ETBF was detected in 195 of 728 patients (26.8%) and 24 of 194 healthy controls (12.4%). The difference between the two groups was statistically significant (P<.01). ETBF was the only potential diarrheal agent in 91 (12.5%) of 728 patients. All ETBF-positive samples from patients and controls were also positive in the HT29/C1 assay. The data show high carriage of ETBF in Swedish adults, which might be associated with diarrheal disease.

Adolescent↗
PubMed1998

Intestinal microsporidiosis in a HIV-seronegative patient.

Microsporidial infections have been increasingly reported in immunocompromised patients, particularly those infected with the human immunodeficiency virus (HIV), but only rarely in immunocompetent individuals. We report a case of intestinal microsporidiosis in a HIV-seronegative patient with acute self-limited diarrhoea. Examination of stool specimens revealed plenty of spores that correspond with Enterocytozoon bieneusi in size and shape as well as ultrastructural details.

Adult↗
PubMed1995

Prevalence of Borrelia burgdorferi sensu lato infection in Ixodes ricinus in Sweden.

Between 1988-1991, a total of 3,141 Ixodes ricinus ticks, 2,740 adults and 401 nymphs, was collected from different localities in 23 of the 25 provinces of Sweden. The ticks were identified, dissected and examined for the presence of Borrelia spirochetes. Indirect immunofluorescence was performed, using an antiserum obtained from rabbits, immunized with sonicated, whole Borrelia burgdorferi spirochetes isolated from Swedish Ixodes ricinus ticks. Borrelia-positive I. ricinus were found in all 23 provinces. The prevalence of infection in adults ranged from 3% in Jämtland to 23% in Södermanland. In nymphs, the infection prevalence ranged from 0% in 9 provinces to 15% in Södermanland. A significantly greater proportion of the adult ticks were found to be positive for Borrelia in the southern and central parts of Sweden as compared to the northern part (Norrland). No significant difference in prevalence could be demonstrated between the western and eastern parts of Sweden. On average, 10% of the nymphs and 15% of the adult I. ricinus were positive for Borrelia. Of 41 non-I. ricinus ticks, none was positive for Borrelia. This study shows that Borrelia burgdorferi sensu lato is present throughout the distributional area of I. ricinus in Sweden. This should lead to increased awareness of signs and symptoms compatible with Lyme borreliosis in persons living in or visiting areas where I. ricinus is present.

Animals↗
PubMed1994

Reactive arthritis.

Explore the source record for details and available documents.

Arthritis, Reactive↗
PubMed1994

Serological follow-up after treatment of patients with erythema migrans and neuroborreliosis.

To investigate the duration and kinetics of immunoglobulin M (IgM) and IgG antibodies against Borrelia burgdorferi in serum after treatment of Lyme borreliosis, consecutive serum samples from 30 seropositive patients with erythema migrans and 91 seropositive patients with neuroborreliosis were analyzed with a capture IgM enzyme-linked immunosorbent assay (ELISA) and an indirect IgG ELISA, both using B. burgdorferi flagella as the antigen. All the patients improved after treatment: 97 patients had a complete clinical recovery, while 24 patients had sequelae. The results showed that patients with erythema migrans and early neuroborreliosis more often initially had highly elevated IgM optical density (OD) values and low IgG OD values against B. burgdorferi, while the opposite was found in patients with late neuroborreliosis. During follow-up, the majority of patients had developed negative or significantly declining IgM ODs after 1 to 1.5 years but persistently positive IgM ODs were found up to 17 months after treatment of erythema migrans and 3 years after treatment of neuroborreliosis. IgG antibody levels declined more slowly and remained elevated to a larger extent, but more than half of the patients had developed negative IgG ODs within 5 years after therapy. However, positive IgG OD values were found after 9 to 10 years for patients treated for neuroborreliosis as well as erythema migrans. Both IgM and IgG antibodies against B. burgdorferi may persist for months to years after successful treatment of Lyme borreliosis. Consequently, a single serum sample with antibodies against B. burgdorferi must always be carefully evaluated and correlated to clinical symptoms.

Adult↗
PubMed1994

Comparison of intravenous penicillin G and oral doxycycline for treatment of Lyme neuroborreliosis.

To compare the efficacy of oral doxycycline and IV penicillin G for the treatment of neuroborreliosis, we randomized consecutive patients with Lyme neuroborreliosis to receive either IV penicillin G (3 g q 6 h) or oral deoxycycline (200 mg q 24 h) for 14 days. All patients had antibodies against Borrelia burgdorferi in serum, CSF, or both, or had a positive CSF culture. Twenty-three patients randomized to penicillin G and 31 patients to doxycycline were included in the study. All patients improved during treatment, and there were no significant differences between the two treatment groups in patient scoring, CSF analysis, or serologic and clinical follow-up during 1 year. There were no treatment failures, although one patient in each treatment group was re-treated because of residual symptoms. In conclusion, oral doxycycline is an adequate and cost-effective alternative to IV penicillin for the treatment of Lyme neuroborreliosis.

Administration, Oral↗
PubMed1993

Clinical manifestations and antibody prevalence of Lyme borreliosis and tick-borne encephalitis in Sweden: a study in five endemic areas close to Stockholm.

Five populations, including 903 individuals living in 5 different areas close to Stockholm, were studied with regard to clinical manifestations and antibody prevalence of Lyme borreliosis (LB) and tick-borne encephalitis (TBE). The study areas involved 4 groups of islands in the Baltic Sea and 1 island in Lake Mälaren. Serum samples from each individual were tested for antibody activity to Borrelia burgdorferi using a sonicated whole spirochete antigen in an ELISA, and to TBE-virus (TBEV) by ELISA and haemagglutination inhibition. A history of LB was reported by 1-21% and antibodies to Borrelia burgdorferi were found in 7-29% of the participants from the various areas. An increasing seroprevalence with age was seen. In sera from 3 different control groups, including 502 individuals living in non-endemic areas, antibodies to Borrelia burgdorferi were detected in 1-2% and from 1 control group including 150 individuals living in the city of Stockholm, in 9%. A history of TBE was reported by 0-6% of the individuals and in non-immunized individuals seropositivity was seen in 4-22%, depending on the area investigated. No antibody activity to TBEV could be detected in sera from persons in the 3 control groups living in non-endemic areas, whereas 5% of the controls from Stockholm were found to be positive. The prevalence rates of antibodies to TBEV in persons vaccinated against TBE were 40%, 53% and 79% after 1, 2 and 3 injections, respectively.

Adolescent↗