Concentration of metronidazole in serum during peritoneal dialysis.
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Biomedical subjects
Publications and source records attributed to E Holten.
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During the first 6 months of 1978, 114 strains of Neisseria meningitidis isolated from patients in Norway were serotyped. Among 27 group C strains, type 2 was most common, whereas 82% of the 82 group B isolates did not react with antisera to the standard serotypes 1 to 12. These strains were shown to belong to a new serotype, type 15. Also some group A and C strains had the type 15 antigen. Investigations on a possible immunoprophylaxis against group B meningococcal disease in Norway should accordingly proceed with type 15 rather than with type 2 meningococci.
Using standardized laparoscopy technique, fluid was aspirated from the pouch of Douglas, from the Fallopian tubes and from ovarian cysts in 85 cases with clinical diagnosis of pelvic inflammatory disease (PID). The concentration of doxycycline in the aspirates was measured after oral ingestion of 200 mg of doxycycline (Vibramycin). A therapeutic level was achieved in the tubes and in ovarian cysts within a few hours, and on continuation of the treatment these values followed the plasma concentration closely, still being within the therapeutic range 24 hours after the final dose. The clinical effect was excellent, 94% (60/64) of the cases with verified PID being cured by doxycycline.
The carriage of Neisseria meningitidis was examined in the Norwegian population of Svalbard (1150 persons) after a fatal case of meningococcal septicaemia. The overall carrier rate was 39.0%. The rate was highest among males (47.8%), with a maximum of 63.4% in the age group 15-24 years. The carrier rate was low among children aged 3 to 15 years (6.5%). Children below 3 years were frequent meningococcal carriers, however (37.5%). Sulphonamide-resistant strains were often found, 22.6% of the total material being resistant. Group B was the most frequent serogroup, and accounted for 44.5% of the isolated strains. Non-groupable strains were second in frequency (23.8%), followed by group Y (15.8%). Only a few strains belonged to the serogroups A, C, X and Z. N. lactamica was isolated from 26.9% of children below 15 years, but seldom in older age groups.
A severe epidemic of disease due to Neisseria meningitidis has been occurring in northern Norway since 1974. Based on bacteriological and clinical examination of cases during the 18 months between January 1, 1974 and June 30, 1975, an overall attack rate of 26.3 cases per 100,000 population per year has been calculated. The attack rates were highest in 1975 (total, 37.4 cases per 100,000 population; Troms County, 54.5) and in children younger than four years (total, 173.6; Troms County, 328.9). The epidemic shows a total case-fatality ratio of 14.1%. The highest case fatality ratio was recorded for patients older than 20 years (25.0%). Among the youngest children, cases were distinctly more frequent in males than females; in older children and adults, male patients had a clearly higher case-fatility ratio than female patients. Of the three serogroups of N. meningitidis, group B caused more cases of infection that groups A and C together. In addition, the causative meningococcal strains were almost uniformly resistant to high concentrations of sulfonamide. Both of these traits appear to have developed in northern Norway at or shortly before the time when the epidemic began.
Neisseria elongata subsp. glycolytica strain 6171/75 is closely similar to the type strain of N. elongata, M2, as regards DNA base composition, fatty acid content and electrophoretic mobility of two glutamate dehydrogenases, one of which showed a reaction of identity with the corresponding enzyme from M2 in double immunodiffusion in agar. The strain showed genetic homologies with strain M2 in genetic transformation at a level suggesting species identity, and with N. meningitidis at a lower level. No affinity to Moraxella species or "false neisseriae" was demonstrated, with the exception of a production of a few transformants in the 6171/75 recipient by DNA from Kingella kingae. The strain showed the same pattern of associated variation of colony type, fimbriation and competence in transformation as that found in other Neisseria and Moraxella species. After continuous subcultivation for some time some clones of the strain appeared to have lost the ability to produce acid from glucose.
Activities corresponding to the enzymes glucokinase, glucose 6-phosphate dehydrogenase, 6-phosphogluconate dehydrogenase, malate dehydrogenase, pyridine nucleotide independent malate dehydrogenase, and glutamate dehydrogenase were found in cell free extracts from Neisseria elongata subsp. gkcolytica. Activities corresponding to 6-phosphogluconate dehydrase and 2-keto-3-deoxy-6-phosphogluconate aldolase were not found. Glucose was catabolized only vira the pentose phosphate pathway. The radiorespirometric findings suggest an extensive recycling of the triose and fructose phosphates. There was no evidence for formation of pyruvate from glucose. Glutamate was oxidized via the tricarboxylic acid cycle. Pyruvate and acetate were obviously catabolized by the glyoxylic and tricarboxylic acid cycles, as in N. elongata.
The inhibitory effect of sodium polyanethol sulfonate (0.05%) upon growth of Neisseria meningitidis was found to be neutralized by adding gelatin (l.1%) to the growth medium. The neutralizing effect was demonstrated in solid medium, as well as in nutrient broth for blood cultures. The findings parallel those of Wilkins and West (6) regarding gelatin neutralization of the inhibitory effect of sodium polyanethol sulfonate on Peptostreptococcus anaerobius.
In cell free extract from Neisseria meningitidis an enzyme has been found which catalyses the oxidation of L-malate to oxaloacetate in the absence of pyridine nucleotides, using ferricyanide as electron acceptor. The enzyme was found to be particle-bound, as determined by sucrose gradient centrifugation. Activity corresponding to this enzyme was demonstrated in extracts from all strains tested of selected Neisseria species. In contrast to the large differences in NAD-linked malate dehydrogenase activity among the species, the interspecies variation of the pyridine nucleotide independent oxidation of malate was not sufficiently distinct to be useful for classification purposes.
The catabolism of glutamate and fumarate was studied by radiorespirometry in selected Neisseria species. The tricarboxylic acid cycle is functioning in all species tested, in spite of the known absence of in vitro malate dehydrogenase activity in N. meningitidis, N. gonorrhoeae and N. cinerea. The results imply a pyridine nucleotide independent oxidation of malate. The oxidation of glutamate is less complete in the presence of phosphate. In N. meningitidis, N. perflava, N. flava, N. subflava and N. lactamica the catabolism of fumarate was slow and incomplete in the absence of glutamate.
The catabolism of pyruvate and acetate is selected Neisseria species was studied by radiorespirometry. Both substrates were oxidized via the tricarboxylic acid cycle. N. elongata and the "false neisserias" (N. catarrhalis, N. ovis and N. caviae) did oxidize acetate in the absence of other substrates. This can be explained if it is assumed that these species have glyoxylic acid cycle activity. In the "true neisserias" other than N. elongata, acetate was oxidized only in the presence of glutamate, indicating that these species do not possess a glyoxylic acid cycle.
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The catabolism of glucose in selected Neisseria species was studied by radiorespirometry. The Entner-Doudoroff and pentose phosphate pathways were operating in all species, the greater part of the substrate being routed through the former, somewhat dependent on the medium used. Acetate was oxidized via the tricarboxylic acid cycle. In all species, a fraction of the triose was recycled through fructose phosphates to glucose 6-phosphate. Phosphate inhibited the oxidation of acetate. In media devoid of phosphate and sodium (N. meningitidis and N. gonorrhoeae) or of phosphate and potassium (other saccharolytic Neisseria), the conversion of triose to pyruvate was inhibited. In these media the catabolism of glucose proceeded slowly, and no substrate was used for biosynthetic purposes. The results point to a difference in the regulation of glucose metabolism in pathogenic and non-pathogenic Neisseria.
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