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Biomedical subjects

E Semenitz

Publications and source records attributed to E Semenitz.

At least 19 recordsLinked to original sources
PubMed1991

[Percutaneous drainage of complicated infections of the upper urinary tract].

Acute pyelonephritis associated with obstruction may result in urosepsis and septic shock. Besides the administration of antimicrobial agents, quick removal of the obstruction is the essential part of the therapeutic regimen. In 43 patients with urosepsis the obstruction which was mainly due to urinary calculi was removed by percutaneous nephrostomy. Nephrostomy drainage was the only therapeutic measure required in all but 3 patients in whom nephrectomy had to be performed. 1 patient died after nephrectomy; no death occurred after percutaneous nephrostomy. Once diuresis has started after drainage, the patient will improve. If the kidney does not produce urine immediately after drainage the decision has to be made as soon as possible whether nephrectomy has to be performed for survival or whether it is justified to wait. Perfusion studies with radioisotopes have proven to be very helpful in such decisions. If there is no perfusion, immediate nephrectomy is mandatory; however, if perfusion can be demonstrated, recovery of the kidney can be expected. 21 patients with pyonephrosis were drained percutaneously. In 2 patients the infection could be controlled by nephrectomy only. The rate of secondary nephrectomy because of a non-functioning kidney was 50%. Percutaneous drainage has proven to be very effective in 6 patients with infected renal cysts, 7 patients with intrarenal abscesses and 4 patients with perinephric abscesses. There was only 1 patient presenting with intrarenal abscess in whom percutaneous drainage was insufficient and surgical intervention became necessary.

Abscess↗
PubMed1991

[The treatment of septicemia in childhood using time-spaced administration of antibiotic combinations].

Theoretical consideration, empirical findings since 1972 and in vitro results had suggested that a combination of antibiotics for treatment of sepsis is more effective if the 2 or 3 antibiotics are not applied simultaneously but individually and sequentially at short intervals of 4 hours. Between January 1986 and March 1990 100 children were treated with spaced administration of antibiotic combinations at the University Hospital Innsbruck (Department of Paediatric). Causative agents isolated compared well to data published for other institutions; staphylococci were the dominating species. Anaerobic bacteria and fungi accounted for only 1% each, 60% of the cases were nosocomial infections. Overall, the fatality was 4%, a result significantly below the values reported in the literature for conventional therapeutic regimens.

Anti-Bacterial Agents↗
PubMed1989

[Principles of the Innsbruck chemotherapy schedule in bacterial infections].

Presented here are the ideas and the experimental results which led us to this scheme for the chemotherapy of severe bacterial infections. The approach is twofold, administering mainly two chemotherapeutics not concomitantly but alternating every four hours by means of a short-time i.v. infusion. Furthermore, immediately after admittance and even before the outbreak of an infection the patients' bacterial spectrum of wounds, the pharynx or the urine is monitored by carrying out bacteriological tests. These prophylactic diagnostics allow the identification of a dangerous proliferation of germs even before the outbreak of a florid infection. Therefore, an early chemotherapy can be put into practice considering the available evaluations of resistance studies.

Anti-Bacterial Agents↗
PubMed1989

[The kinetics of bacterial killing by fluctuating concentrations of antibiotics].

Differences in kill kinetics and the regrowth pattern of bacteria under the influence of various antibiotics are frequently not represented by their MIC values. The area under the concentration curve represents antimicrobial activity more accurately than the peak concentration. Readministration of antibiotics should occur prior to bacterial regrowth for optimal efficacy. When administering combinations of antibiotics non-simultaneous dosing is superior to simultaneous administration.

Ampicillin↗
PubMed1989

[Infectious complications in the early phase following kidney transplantation].

A retrospective analysis of 533 patients receiving kidney transplantation was performed to study the incidence of infection in the early postoperative period. Mostly localized in the lungs and renal system, bacterial complications arose in 133 patients. As compared with the unproblematic management of the urinary tract infections, 45 pulmonary infections were characterized by difficulties in diagnosis and treatment. Poor graft function was closely related to pulmonary infections: mean creatinine was 2.4 mg% (in patients without pneumonia - 1.5 mg%). Out of 45 patients with pneumonia, the graft failed in 16 patients. 6 patients died as a result of pneumonia. Rapid detection of the pathogenic organism is required, if necessary by invasive diagnosis. The administration of erythromycin before identification of the responsible pathogen may be indicated, in view of the fatal outcome in several patients subsequently diagnosed as having Legionella infection.

Adolescent↗
PubMed1989

[High-dose short-term antibiotic therapy in bacteremia and infection in severely burned patients].

60 to 70% of all late deaths in patients with severe burns are due to sepsis. Thus, treatment with antibiotics is essential in the overall management of such patients, which in our hospital is carried out according to the following principles: 1. No prophylactic antibiotic treatment. 2. Careful evaluation of the bacterial spectrum of the burns, nasopharyngeal area, anal region, sputum and blood cultures. 3. In case of bacteriaemia we start high-dose combination therapy with two different, specific chemotherapeutic agents, given alternately every 4 to 6 hours. 4. In concordance with the clinical picture antibiotic therapy is discontinued as soon as three subsequent blood cultures remain sterile. Since 1980, 58 patients with severe burns (extent: 20 to 90% of body surface) have been treated according to these principles. Mortality due to sepsis was low, namely 9.5% (2 out of 21 patients presenting with bacteriaemia), so that our method of treatment has proven to be effective.

Anti-Bacterial Agents↗
PubMed1986

Kill kinetics of bacteria under fluctuating concentrations of various antibiotics. I. Description of the model.

Traditional antimicrobial susceptibility testing uses fixed concentrations of an antibiotic over 24 hours. In order to imitate conditions closer to the actual in vivo situation we developed a model which allows us to simulate serum and tissue concentrations observed under clinical conditions in vitro. Kill kinetics and regrowth pattern of various bacteria have been investigated under the influence of different antibiotics in this kinetic model.

Anti-Bacterial Agents↗
PubMed1986

Kill kinetics of bacteria under fluctuating concentrations of various antibiotics. II. Description of experiments.

Differences in kill kinetics and regrowth patterns of bacteria under the influence of various antibiotics are frequently not represented by their MIC values. The area under the concentration curve represents antimicrobial activity more accurately than the peak concentration. Readministration of antibiotics should occur prior to bacterial regrowth for optimal efficacy. When administering antibiotics in combinations nonsimultaneous dosing is superior to simultaneous administration.

Anti-Bacterial Agents↗
PubMed1986

[Septic disease pictures in Salmonella infections].

3715 strains of salmonella have been isolated from various sources from 1976 to 1985. 26 of these isolates have been S. typhi and paratyphi B, 3689 isolates were nontyphoid strains. 7 isolates of S. typhi and S. paratyphi have been isolated from blood cultures. All persons infected with these strains have acquired these organisms in tropical and subtropical areas. In contrast, salmonella gastroenteritis is mainly confined to the intestinal tract. 21 isolates of nontyphoid salmonellae, however, have been isolated from blood cultures. The vast majority of these patients showed compromised host defense mechanisms. Newborn infants up to 3 months are considered particularly vulnerable for bloodstream invasion with nontyphoid salmonellae. Patients with chronic consuming disorders, solid tumors and haematologic malignancies, and the treatment of these ailments with immunosuppressive drugs and corticosteroids predisposes patients for extraintestinal spread of an enteric salmonella infection. Corticosteroid therapy seems to be particularly responsible for a fulminant course of the disease and poor outcome of the infection.

Adolescent↗
PubMed1985

Kill kinetics and regrowth pattern of bacteria exposed to antibiotic concentrations simulating those observed in vivo.

Antibiotic concentrations observed in vivo were simulated in an in vitro two compartment model with a dialyser interconnection. Kill kinetics and regrowth pattern of bacteria were investigated under these fluctuating antibiotic concentrations. There were large differences in the rate of reduction of viable organisms by various antibiotics not reflected in small differences in initial MIC values. Data suggested that the area under the concentration curve might be of importance in determining the antimicrobial activity of substances rather than the initial concentration. The inclusion of pharmacokinetic parameters in antimicrobial susceptibility testing might add a new dimension to the appreciation of the activity of antimicrobial substances.

Anti-Bacterial Agents↗
PubMed1983

[Mechanism of action of beta-lactam antibiotics and problems concerning the development of resistance in antibacterial chemotherapy].

Beta-lactam antibiotics influence the metabolism of bacteria in very low concentrations by blocking the activity of penicillin binding proteins of gram-negative rods. Dependent on the type of binding protein affected bacteria form filaments or sphaeroblasts. The most important resistance mechanism is the formation of beta lactamases, which cleave the beta-lactam ring and inactivate the antimicrobially active molecule. Gram-positive bacteria like Staphylococci excrete the enzymes into the environment; as long as the antibiotic is not destroyed by the enzyme, activity antimicrobial effectiveness is present and prevents bacterial proliferation. In gram-negative bacteria the beta lactamases are formed in the periplasmic space and inactivate the antibiotic after penetration into the bacterial organism. This type of beta-lactamase formation is transferred to the organism by transduction, transformation or conjugation. Bacterial resistance against beta-lactam antibiotics need not only be due to inactivation of the antimicrobial substance by beta lactamases, but can also be due to mechanisms independent of enzyme activity. We call this intrinsic resistance. Prior to clinical application of beta-lactam antibiotics the susceptibility of the organism should be determined by an antibiogram.

Anti-Bacterial Agents↗
PubMed1982

[Comparative analysis of tetracycline, doxycycline and minocycline on chromosomal and plasmid tetracycline-resistant and -sensitive strains of Staphylococcus aureus using MIC, microcalorimetric effect and ultrastructural alterations].

A staphylococcus aureus strain of a patient with plasmidical tetracyclinresistance has first been cured from the plasmid and after that selected in nutritive broth by increasing the concentrations of tetracyclin. By this way we found three variants of the same strain: a tetracyclin-sensitive and two tetracyclin-resistant: an R-plasmid-mediated and the other as a result of mutation. These three variants have been tested against tetracyclin, minocyclin and doxycyclin on an agarmedium. Under influence of these three substances a microcalorimetrical investigation of the strains has taken place. We then tested the strains with the electronic microscope for alterations in the ultra-structure by the three substances. Following results have been obtained: 1. The sensitive strains were inhibited in the same extent by all of the three substances. Plasmidical resistant strains were only resistant against tetracyclin but not against minocyclin and even less against doxycyclin. 2. The microcalorimetrical tests confirmed the conclusions from the cultural test. 3. Alterations in ultra-structure were only found under tetracyclin-influence by strains in division. Comparing the three tetracyclines we did not find any significant difference in quality. 4. With all of the three investigation-methods we proved that R-plasmid-mediated tetracyclin-resistance of staphylococci is not effective for minocyclin and even less for doxycyclin.

Calorimetry↗
PubMed1979

[Microcalorimetric testing of the antibacterial activity of doxycycline, gentamicin and their combination (author's transl)].

The antibacterial activity of doxycycline and gentamicin was tested by microcalorimetric methods and by finding out the MIC of these substances, the test organisms being Staph. aur. haem. (13.665) and E. coli (3.579). The investigations were carried out with the above mentioned substances both alone and in combination. A synergistic effect was found with both methods applied, but microcalorimetry showed that the combination influences the cell metabolism in another way than the individual substances. Another remarkable finding is that doxycycline inhibits the microcalorimetric activity of our bacterial strains in doses 10 to 100 times lower than found with the standard MIC finding methods.

Calorimetry↗
PubMed1978

[The antibacterial activity of diphenhydramine (author's transl)].

Diphenhydramine (N,N-dimethyl-2-diphenyl-methoxy-ethylamine) [N,N-dimethyl-2-(diphenylmethoxy)-ethylamin] (DPH) is a well-known local anaesthetic and an antagonist of both acetylcholine and histamine. We tested its antibacterial efficacy by means of three different investigation methods, i.e. microcalorimetry, continuous density measurement and the microdilution test to find out the MIC of this compound against various bacteria. DPH inhibits the growth of E. coli and Klebsiella strains at a concentration of 0.18% of Staphylococcus aureus haemolyticus at 0.37%, of Pseudomonas aeruginosa at 0.75% and Streptococcus faecalis strains at 1.5%. The results of microcalorimetry and continous density measurements showed that the addition of 0.2% DPH to a broth with growing bacteria interferes very quickly with cell metabolism and stops further reproduction. The microcalorimetric findings were carried out with Staphylococcus aureus haemolyticus strain No. 13,665 an- the E. coli strain No. 3579.

Anti-Bacterial Agents↗