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Biomedical subjects

E Eerola

Publications and source records attributed to E Eerola.

At least 19 recordsLinked to original sources
PubMed1999

Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery.

BACKGROUND: Newborn infants in modern maternity hospitals are subject to numerous factors that affect normal intestinal colonization--for example, cesarean delivery and antimicrobial agents. To study the duration of the effect of external factors on intestinal colonization, two groups of infants with different delivery methods were investigated. METHODS: The fecal flora of 64 healthy infants was studied prospectively. Thirty-four infants were delivered vaginally, and 30 by cesarean birth with antibiotic prophylaxis administered to their mothers before the delivery. The fecal flora was cultured on nonselective and selective media in infants 3 to 5, 10, 30, 60, and 180 days of age. Gastrointestinal signs were recorded daily by the mothers for 2 months. RESULTS: The fecal colonization of infants born by cesarean delivery was delayed. Bifidobacterium-like bacteria and Lactobacillus-like bacteria colonization rates reached the rates of vaginally delivered infants at 1 month and 10 days, respectively. Infants born by cesarean delivery were significantly less often colonized with bacteria of the Bacteroides fragilis group than were vaginally delivered infants: At 6 months the rates were 36% and 76%, respectively (p=0.009). The occurrence of gastrointestinal signs did not differ between the study groups. CONCLUSIONS: This study shows for the first time that the primary gut flora in infants born by cesarean delivery may be disturbed for up to 6 months after the birth. The clinical relevance of these changes is unknown, and even longer follow-up is needed to establish how long-lasting these alterations of the primary gut flora can be.

Antibiotic Prophylaxis↗
PubMed1998

Clinical significance and outcome of anaerobic bacteremia.

We retrospectively studied the incidence of anaerobic bacteremia during 6 years (1991-1996) at Turku University Central Hospital (Turku, Finland). The clinical significance of a positive anaerobic blood culture, the effect of a positive culture on the choice of antimicrobial therapy, and the outcome for patients were evaluated. Cultures of blood from 81 patients yielded anaerobic bacteria (4% of all bacteremias). Anaerobic bacteremia was clinically significant in 57 patients (0.18 cases per 1,000 admissions). Only half (28) of these patients received appropriate and effective antimicrobial treatment before the results of blood cultures were reported; for 18 patients (32%), initially ineffective treatment was changed on the basis of the bacteriologic results, and for 11 patients (19%), the treatment was not changed. The mortality in these patient groups was 18%, 17%, and 55%, respectively. Empirical therapy may provide coverage for anaerobes in only half of the patients with anaerobic bacteremia, and failure to pay attention to the results of anaerobic blood cultures may have serious consequences for patients.

Bacteremia↗
PubMed1998

Phylogenetic characterization and proposal of a new pigmented species to the genus Prevotella: Prevotella pallens sp. nov.

Complete 16S rRNA gene sequences of three representative strains of anaerobic, Gram-negative, pigmented, moderately saccharolytic, indole-positive bacteria isolated from the oral cavity of humans were determined. According to comparative analyses of the rRNA sequence data, this organism represents a previously unknown species within the genus Prevotella. In addition, 22 representative strains and 21 reference strains (including 11 Prevotella intermedia and 10 Prevotella nigrescens strains) were subjected to multilocus enzyme electrophoretic analysis. The strains were consistently separated into three clearly distinct groups, corresponding to their previous entities. On the basis of the present phylogenetic results that confirmed our biochemical and genetic data, we propose a new species, Prevotella pallens. The type strain is NCTC 13042 (= AHN 10371).

Acetylglucosaminidase↗
PubMed1998

A Ser315Thr substitution in KatG is predominant in genetically heterogeneous multidrug-resistant Mycobacterium tuberculosis isolates originating from the St. Petersburg area in Russia.

Parts of katG and rpoB from 27 Russian Mycobacterium tuberculosis isolates were sequenced to detect mutations causing resistance to isoniazid (INH) and rifampin (RMP), respectively. All 24 INH-resistant isolates had a mutated katG, and 22 of them (91.7%) carried a mutation coding for a Ser315Thr shift. An rpoB mutation was noted for each of the 21 RMP-resistant isolates, with Ser531Leu being the most prevalent change encoded. Only two isolates had identical IS6110 fingerprints.

Bacterial Proteins↗
PubMed1998

Diagnosis of meningococcal meningitis by broad-range bacterial PCR with cerebrospinal fluid.

We used broad-range bacterial PCR combined with DNA sequencing to examine prospectively cerebrospinal fluid (CSF) samples from patients with suspected meningitis. Fifty-six CSF samples from 46 patients were studied during the year 1995. Genes coding for bacterial 16S and/or 23S rRNA genes could be amplified from the CSF samples from five patients with a clinical picture consistent with acute bacterial meningitis. For these patients, the sequenced PCR product shared 98.3 to 100% homology with the Neisseria meningitidis sequence. For one patient, the diagnosis was initially made by PCR alone. Of the remaining 51 CSF samples, for 50 (98.0%) samples the negative PCR findings were in accordance with the negative findings by bacterial culture and Gram staining, as well as with the eventual clinical diagnosis for the patient. However, the PCR test failed to detect the bacterial rRNA gene in one CSF sample, the culture of which yielded Listeria monocytogenes. These results invite new research efforts to be focused on the application of PCR with broad-range bacterial primers to improve the etiologic diagnosis of bacterial meningitis. In a clinical setting, Gram staining and bacterial culture still remain the cornerstones of diagnosis.

Cerebrospinal Fluid↗
PubMed1997

Muramic acid in human peripheral blood leucocytes in different age groups.

Presence of muramic acid (as a marker for bacterial cell wall peptidoglycan) was analysed by gas chromatography and mass spectrometry in the peripheral blood leucocytes of subjects from a range of ages (9-80 years) and groups (healthy individuals, patients with rheumatoid arthritis, osteoarthrosis, essential hypertension or multiple sclerosis). Sixty per cent of the sample from the youngest subjects contained detectable muramic acid. The percentage of people with circulating leucocytes containing muramic acid decreased gradually with age, being less than 5% in all groups over 40 years. No clear correlation between the presence of muramic acid and the disease was observed.

Adolescent↗
PubMed1997

Faecal fatty acids and gastrointestinal upset in newborn infants.

Patterns of long-chain faecal fatty acids were studied by gas-liquid chromatography in 55 newborn infants in a neonatal intensive care unit. Decreased fractions of fatty acid C16:1 and increased fractions of C16:0 and C17:0 were associated with the occurrence of abdominal distension. Decreased fractions of C16:1 and C18:2 were associated with diarrhoea. Flatulence was found in infants who had relatively smaller amounts of fatty acids C17:0D and C15:0 in their faecal samples. The differences in the patterns of faecal fatty acids are due to differences in bacterial flora. The results support the hypothesis that the initial intestinal colonization plays a role in the later gastrointestinal signs of newborn infants.

Diarrhea↗
PubMed1997

Faecal microbial flora and disease activity in rheumatoid arthritis during a vegan diet.

To clarify the role of the faecal flora in the diet-induced decrease of rheumatoid arthritis (RA) activity, 43 RA patients were randomized into two groups: the test group to receive living food, a form of uncooked vegan diet rich in lactobacilli, and the control group to continue their ordinary omnivorous diets. Based on clinical assessments before, during and after the intervention period, a disease improvement index was constructed for each patient. According to the index, patients were assigned either to a group with a high improvement index (HI) or to a group with a low improvement index (LO). Stool samples collected from each patient before the intervention and at 1 month were analysed by direct stool sample gas-liquid chromatography of bacterial cellular fatty acids. This method has proved to be a simple and sensitive way to detect changes and differences in the faecal microbial flora between individual stool samples or groups of them. A significant, diet-induced change in the faecal flora (P = 0.001) was observed in the test group, but not in the control group. Further, in the test group, a significant (P = 0.001) difference was detected between the HI and LO categories at 1 month, but not in the pre-test samples. We conclude that a vegan diet changes the faecal microbial flora in RA patients, and changes in the faecal flora are associated with improvement in RA activity.

Arthritis, Rheumatoid↗
PubMed1996

Eradication of the long-term carriage of methicillin-resistant Staphylococcus aureus in patients wearing dentures: a follow-up of 10 patients.

To cure the long-term carriage of methicillin-resistant Staphylococcus aureus (MRSA), eradication treatment was given to 10 patients wearing complete dentures. In addition to multiple body sites, MRSA was cultured from the dentures of six patients. The contaminated dentures were rebased and sterilized with heat in order to prevent recolonization. The patients did not use their dentures during the decolonization therapy. Subsequently, MRSA was eradicated from three of these patients but three others remained MRSA-positive despite at least two courses of combined systemic and topical eradication treatment. These particular patients had persistent stomatitis and their dentures were a poor fit, in poor condition and repeatedly grew MRSA. Eradication treatment was successful in the remaining four patients whose dentures were MRSA-negative. These results confirm that dentures may function as foreign bodies and sustain persistent nasopharyngeal. MRSA colonization. Therefore, we suggest that whenever eradication of MRSA is deemed necessary in cases of nasal, oral or pharyngeal carriage, heat treatment of the dentures should be included. Further comparative studies with larger patient populations are needed to evaluate the contribution of dentures to the long-term carriage of MRSA, as well as to assess the value of denture sterilization during the eradication course.

Aged↗
PubMed1996

Genetic diversity among Mycobacterium avium complex AccuProbe-positive isolates.

The partial 32-kDa-protein gene sequences of 22 Mycobacterium avium complex (MAC) clinical isolates that were positive by the AccuProbe MAC probe only (not by the M. avium or M. intracellulare probe) were determined. The obtained nucleotide sequences were compared with the published sequences for M. tuberculosis, M. avium, and M. intracellulare by a sequence analysis program. There was a wide range of genetic diversity among the strains studied. Most of them (16 of 22) had sequences similar but not identical to those of M. avium and M. intracellulare. These strains were considered to be true MAC strains. Five strains had sequences in the category of the novel MAIX sequence, which was very different from the sequences of other mycobacteria analyzed thus far. In addition to these strains, one isolate had a sequence that differed greatly from the reference sequences. These results support previous findings showing that the MAC probably contains several additional species. Our results also suggest that the MAC AccuProbe may react with strains that do not belong to the MAC.

Bacterial Proteins↗
PubMed1996

Diagnosis of disseminated candidiasis by measurement of urine D-arabinitol/L-arabinitol ratio.

Relative amounts of D-arabinitol (fungal origin) and L-arabinitol (part of normal human metabolism) in urine were determined by gas chromatography and mass spectrometry from 61 hospitalized patients with hematological malignancies. Seventeen neutropenic patients with acute leukemia (with 53 samples) had disseminated yeast infections and received empiric antifungal therapy before confirmation of the diagnosis. Control groups consisted of 22 hematologic patients (76 samples) with either mucosal (n = 10) or urinary (n = 12) Candida colonization and 22 neutropenic patients (34 samples) with no clinical or laboratory signs of invasive yeast infection. Reference values were also obtained from 50 healthy adults (50 samples). The mean urine D-arabinitol/L-arabinitol ratio +/- standard deviation (range) was 16.91 +/- 41.79 (1.41 to 254.75) in patients with disseminated infection, 2.73 +/- 2.48 (1.11 to 19.00) in colonized hematologic patients, 2.12 +/- 0.84 (1.16 to 5.84) in neutropenic controls, and 1.95 +/- 0.34 (0.97 to 3.44) in healthy adults (P < 0.001 between patients with disseminated infection and all control groups). The sensitivity and specificity of the assay for detecting disseminated yeast infection were, respectively, 88 and 91% per patient (upper limit of normal, 4.00). Seventy-one percent of patients already expressed elevated values at the onset of empiric antifungal therapy. The diagnosis of disseminated infection was confirmed on average 21.7 days after the first elevation of the D-arabinitol/L-arabinitol ratio. The method contributes to diagnosis of disseminated yeast infection and helps in monitoring patients at risk, to support the initiation of antifungal therapy at an early stage of the disease.

Adolescent↗
PubMed1996

Bacteraemic pneumococcal disease in a teaching hospital in Finland.

A total of 94 adult patients with bacteraemic pneumococcal disease were retrospectively analyzed for the factors associated with a fatal outcome. Included there were 61 males and 33 females with a mean age of 54.1 =/- 17.7 years. Of all patients, 28 (29.8%) were previously healthy, 66 (70.2%) had at least one chronic underlying disease and 29 (30.9%) were classified as alcohol abusers. The total case-fatality rate was 34%, which is higher than in the other recent Scandinavian studies. The disease was fulminant in 13 patients who died within 24 hours of admission. The mortality was significantly higher among those patients who had underlying diseases than among those who were previously healthy (p = 0.03). In addition, unfavourable prognosis was associated with septic shock on arrival (p = 0.03) respiratory insufficiency requiring mechanical ventilation (p < 0.05) and nosocomial infection (p = 0.03). The patients who succumbed were significantly older that those who survived (p < 0.01). Moreover, the absence of leucocytosis, thrombocytopenia and elevated serum creatinine levels predicted an unfavourable outcome. Contradictory to some previous reports, increased mortality was associated neither with the male sex, alcohol abuse nor the focus of infection. The continuously high mortality and rapid lethality of bacteraemic pneumococcal disease underscore the importance of following the present recommendations on the use of pneumococcal vaccine in high-risk patients.

Adolescent↗
PubMed1995

Use of gas-liquid chromatography for subgrouping coagulase-negative staphylococci during a nosocomial sepsis outbreak.

Gas-liquid chromatographic (GLC) fatty acid profile correlation analysis was applied for the subgrouping of 169 coagulase-negative staphylococci collected during an outbreak of nosocomial sepsis in a hematologic unit. The fatty acid profile similarity index between six ciprofloxacin-resistant Staphylococcus epidermidis septicemia strains was as high as 98.39 +/- 0.68, indicating a high degree of resemblance. This finding corroborated the finding by conventional typing methods that the isolates shared the same strain characteristics and, therefore, could be derived from the same epidemiological origin. Further, the GLC fatty acid profiles were analyzed for coagulase-negative staphylococcal cutaneous isolates recovered from colonization cultures of the patients and personnel in that same unit. The similarity index between 88 ciprofloxacin-resistant Staphylococcus epidermidis skin isolates with similar plasmid profiles was as high as 95.47 +/- 3.78, whereas the correlation coefficient between 45 ciprofloxacin-susceptible Staphylococcus epidermidis skin isolates with different plasmid profiles was only 85.23 +/- 10.82. Cluster analysis grouped the ciprofloxacin-resistant Staphylococcus epidermidis isolates into one distinct cluster, while most of the ciprofloxacin-susceptible Staphylococcus epidermidis isolates were grouped into two separate clusters. When compared with the plasmid profiling, the GLC method congruously grouped 127 (87%) of the 146 Staphylococcus epidermidis isolates, thereby suggesting its potential value in subgrouping coagulase-negative staphylococci during nosocomial outbreaks.

Anti-Infective Agents↗
PubMed1995

Additional tests to differentiate Arcanobacterium haemolyticum and Actinomyces pyogenes.

A commercially available biochemical test panel, commercially available diagnostic tablets and gas-liquid chromatography (GLC) of cellular fatty acids were used to find out whether Arcanobacterium haemolyticum and Actinomyces pyogenes could be further differentiated from each other. Xylitol and alpha-methyl-D-glucoside fermentation, Voges-Proskauer reaction and tributyrate hydrolysis were found to be useful additional tests which differentiated Arc. haemolyticum and A. pyogenes. GLC analysis revealed major differences in the cellular 16:0, 18:2(9,12) and 18:1(9) fatty acid composition of the two species. Especially the Voges-Proskauer test available as diagnostic tablets can be easily performed in clinical microbiology laboratories, in addition to the tests now used to differentiate Arc. haemolyticum from A. pyogenes.

Acetoin↗
PubMed1995

Use of the polymerase chain reaction and DNA sequencing for detection of Bartonella quintana in the aortic valve of a patient with culture-negative infective endocarditis.

We used the polymerase chain reaction (PCR) and broad-range bacterial primers, combined with DNA sequencing, to identify Bartonella quintana as the etiologic agent in a case of culture-negative infective endocarditis; all blood cultures, as well as the bacterial cultures of the resected aortic valve and vegetations, remained negative. PCR was used to amplify bacterial 16S rDNA from a template prepared from the aortic valve vegetation. The amplified 16S rDNA produced a nucleotide sequence that was 99.79% identical to the B. quintana rDNA sequence. The patient had a highly elevated level of serum antibodies to Bartonella antigen (1:8,192).

Antibodies, Bacterial↗
PubMed1995

Muramic acid in peripheral blood leukocytes of healthy human subjects.

Peptidoglycan, a specific marker for all bacterial cell walls, was studied in peripheral blood of healthy human subjects by mass spectrometric analysis of muramic acid. Peripheral blood mononuclear and polymorphonuclear cells from 98 healthy adults were hydrolyzed and analyzed by gas chromatography-mass spectrometry as alditol acetate derivatives using selective ion monitoring. Muramic acid was observed in cell samples from 21 of 98 subjects. Blood cultures were done simultaneously and remained negative. As a control, mononuclear and polymorphonuclear cells separated from umbilical vein blood of 41 healthy newborns were studied; all were muramic acid-negative. Since newborns lack gut flora, intestinal absorption of bacteria or of their degradation products appears to be the most likely explanation for the finding.

Adult↗