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Biomedical subjects

E Stobberingh

Publications and source records attributed to E Stobberingh.

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

Influence of oropharyngeal flora and specimen pretreatment on the recovery of Helicobacter pylori.

The recovery of Helicobacter pylori was studied in vitro in the presence of different concentrations of oropharyngeal flora. The effect on the bacterial yield of Helicobacter pylori and oropharyngeal flora of washing biopsies once, twice or thrice before culture was then studied in biopsies taken from 35 patients. A low rate of recovery of low Helicobacter pylori concentrations (< or = 10(3) cfu/ml) was related to the presence of relatively high oropharyngeal flora concentrations (> or = 10(4) cfu/ml). After three washings a decrease in oropharyngeal flora between 10-fold and 100-fold cfu/biopsy was observed in seven patient samples. In another three specimens a more than 100-fold reduction in cfu/biopsy was observed. In the case of Helicobacter pylori, a 60-fold decrease in log cfu/biopsy was observed in only one patient. Pretreatment of the specimens by washing of the biopsies improved the recovery of small amounts of Helicobacter pylori in 10 of 28 patients. For optimal detection of Helicobacter pylori in gastric mucosal biopsies, washing of the specimens in addition to the use of selective media is recommended.

Biopsy↗
PubMed1996

Clinical spectrum of ventilator-associated pneumonia caused by methicillin-sensitive Staphylococcus aureus.

The incidence of tracheal colonization and its association with ventilator-associated pneumonia caused by methicillin-sensitive Staphylococcus aureus (MSSA) was studied prospectively in 530 consecutively admitted mechanically ventilated patients in a general intensive care unit. Furthermore, the clinical spectrum, outcome, and microbiological results of 27 cases of staphylococcal ventilator-associated pneumonia (SVAP) were examined. Ventilator-associated pneumonia was diagnosed by protected specimen brush and/or bronchoalveolar lavage. On admission, 7% of the patients were colonized with MSSA in the trachea. Acquired tracheal colonization was demonstrated in 10% of the patients and occurred less frequently in patients with a hospital stay of > 48 h before ICU admission compared to patients admitted directly to the ICU (6% vs. 15%, p < 0.001). Moreover, colonization was acquired more frequently among trauma and neurological/neurosurgical patients (22%) as compared to surgical and medical patients (7%) (p < 0.0001). Twenty-one patients (4%) developed SVAP, the incident being higher in patients colonized in the trachea with MSSA than in those not colonized (21% vs. 1%), p < 0.00001). Staphylococcal ventilator-associated pneumonia developed more often in trauma and neurological/neurosurgical patients as compared to surgical and medical patients (8% vs. 3%, p < 0.05). Moreover, patients with a hospital stay of < 48 h before admission to the ICU had a higher incidence of SVAP as compared to those with a longer hospital stay before ICU admission (7% vs. 2%, p < 0.01). Crude infection-related mortality was 26%. Preceding colonization with MSSA in the trachea appears to be an important risk factor for the development of SVAP, and patients with a short duration of hospitalization before intensive care unit admission have the highest incidence of ventilator-associated pneumonia caused by MSSA.

Adolescent↗
PubMed1996

Omeprazole inhibits growth of gram-positive and gram-negative bacteria including Helicobacter pylori in vitro.

The antibacterial effects of omeprazole (100, 200 and 300 mg/L) were assessed using bacterial growth curves. A dose-related permanent inhibition was seen with actively growing Gram-positive cocci. A reduced and only temporary effect was observed with Gram-negative bacilli. After 1 day the bacterial count of Helicobacter pylori in the presence of omeprazole 200 mg/L was reduced from 10(4) cfu/mL for the control to zero. No synergic or antagonistic interaction of omeprazole with amoxycillin or doxycycline was observed for Escherichia coli and Enterococcus faecalis.

Anti-Ulcer Agents↗
PubMed1996

Antibiotic resistance among Escherichia coli isolated from faecal samples of pig farmers and pigs.

The prevalence and degree of antibiotic resistance of Escherichia coli found in 266 faecal samples of pig farmers was significantly lower than that observed in 285 samples obtained from their pigs. Moreover, porcine E. coli were significantly more resistant to chloramphenicol, nitrofurantoin, oxytetracycline, streptomycin and sulphamethoxazole than were farmer isolates. Resistant pig isolates showed resistance patterns mainly to oxytetracycline and streptomycin and oxytetracycline and streptomycin and sulphamethoxazole whereas the corresponding farmer isolates were mainly resistant to a single agent such as amoxycillin or sulphamethoxazole although 41 were resistant to both streptomycin and sulphamethoxazole. The resistance patterns of only 4% of farmer E. coli and those of pigs from the same farm (n = 259) showed resistance to the same antibiotics. These results suggest that the resistance of the faecal E. coli of farmers and their pigs is distinctly different.

Agricultural Workers' Diseases↗
PubMed1996

In-vitro transfer of antibiotic resistance between faecal Escherichia coli strains isolated from pig farmers and pigs.

Faecal Escherichia coli isolated from farmers and their pigs were analyzed for biotypes, plasmid patterns and transferability of antibiotic resistance. Pairs of isolates from the farmer and pigs from the same farm with the same resistance patterns formed group A and were compared with pig and farmer isolates showing different patterns (group B). Only one pair of isolates in group A and one in group B had the same biotype. Whole plasmid patterns and plasmid profiles after restriction analysis of the paired isolates of group A showed only minimal similarities. Whereas 10/11 pig isolates in group B transferred resistance, 50% in group A did so. Transfer experiments showed similar frequencies of transfer for farmer and pig isolates in both groups. The present study does not provide conclusive evidence that there is a common pool of resistance plasmids among farmers and their pigs.

Animal Husbandry↗
PubMed1995

In-vivo transfer of resistance plasmids in rat, human or pig-derived intestinal flora using a rat model.

Germ-free rats associated with either rat- (RIF), human- (HIF) or pig-(PIF) derived Enterobacteriaceae-free intestinal flora were used for in vivo experiments to detect transfer of antibiotic resistance. Transfer of resistance was observed most frequently from the porcine donor strain to acceptor strain Escherichia coli K12, showing the highest number of transconjugants in the faeces of HIF-rats. The rats associated with the human donor strain and E. coli K12 as acceptor showed transconjugants less frequently. Only the HIF-rats yielded transconjugants on each sampling day and none at all could be isolated from the PIF-rats. Almost no transconjugants were found in the faeces of rats associated with the pig donor strain and a wild human E. coli strain as acceptor. Factors such as the nature of the donor and recipient strains as well as the origin of the intestinal flora seemed to have an influence on plasmid transfer. Transferability was highest in the HIF-rats and could be increased by administration of lincomycin. This study showed that in vivo transfer of resistance plasmids is possible in rats associated with intestinal floras of different origins. The human intestinal flora seemed to permit better transfer of resistance than that derived from the pig or the rat.

Animals↗
PubMed1995

A piperacillin-tazobactam resistant Escherichia coli strain isolated from a faecal sample of a healthy volunteer.

As part of a surveillance programme of the prevalence of antibiotic resistance, the faecal bacteria of healthy people (n = 1348) were examined, and the antibiotic resistance of the Escherichia coli strains determined. One strain out of 142 amoxycillin-resistant isolates, E. coli strain 1662, was also resistant to piperacillin-tazobactam but susceptible to amoxycillin-clavulanic acid. The piperacillin-tazobactam resistance determinant was transferable to standard E. coli strains by conjugation. However, the strain produced a beta-lactamase with several characteristics very similar to those of the TEM-1 beta-lactamase, i.e. pI of 5.4, an M(r) value of 22,000 and a comparable substrate profile. The enzyme was as efficiently inhibited by clavulanic acid and tazobactam as the TEM-1 and TEM-2 beta-lactamases but more than the amoxycillin-clavulanic acid-resistant TRC-1 enzyme. The transferable resistance to piperacillin-tazobactam appears to be mediated by a novel resistance mechanism that has previously not been described.

Anti-Bacterial Agents↗
PubMed1994

Antimicrobial prophylaxis in bowel surgery in The Netherlands.

The guidelines for antimicrobial prophylaxis in various types of bowel surgery (colorectal, biliary and gastroduodenal) in 33 antibiotic formularies used by 89 Dutch hospitals were studied. The majority of the formularies recommended drugs with adequate efficacy against bacteria most frequently associated with surgical wound infection. Amoxicillin/clavulanic acid and first- or second-generation cephalosporins, with or without metronidazole, were recommended most frequently. Recommendations for third-generation cephalosporins and broad-spectrum penicillins were limited. A relatively high proportion (between 52 and 66%) of the formularies recommended multiple-dose regimens.

Anti-Bacterial Agents↗
PubMed1994

In vitro antibacterial activity of sucralfate.

The effect of sucralfate (12.5 mg/ml) on the growth of Escherichia coli (ATCC 25922), Enterococcus faecalis (ATCC 29212) and two isolates of Pseudomonas aeruginosa (ATCC 27853 and a multi-resistant clinical isolate) was studied in vitro at pH values of 3.0, 4.5, 6.0 and 7.4. A bacteriostatic effect of sucralfate was demonstrated for Pseudomonas aeruginosa at a pH of 6.0 and 7.4 and for Escherichia coli and Enterococcus faecalis at a pH of 6.0. The bacteriostatic effect was most pronounced at high pH values. Sucralfate had no bactericidal effect on the bacteria tested at the concentration used.

Bacteria↗
PubMed1994

Resistance in faecal Escherichia coli isolated from pigfarmers and abattoir workers.

Faecal samples collected from three populations of healthy adult volunteers (290 pigfarmers, 316 abattoir workers, 160 (sub)urban residents) living in the south of The Netherlands were analysed for the prevalence and degree of antibiotic resistance of Escherichia coli. Significant differences in prevalence of resistance to amoxicillin, neomycin, oxytetracycline, sulfamethoxazole and trimethoprim were observed. The pigfarmers showed the highest percentages of resistance and the (sub)urban residents the lowest. In contrast no significant differences in high degrees of resistance were observed, except for neomycin. Although both pigfarmers and abattoir workers have regular contact with pigs differences in prevalences of resistance were observed. However, because abattoir workers with intensive and less intensive pig(carcass) contact did not show significant differences, this is probably not the only important source of resistant E. coli in pigfarmers. The high antibiotic use by pigfarmers (5%) and abattoir workers (8%) than by (sub)urban residents (0%) did not result in significantly different resistance percentages.

Abattoirs↗
PubMed1994

Effect of antibiotic therapy on the antibiotic resistance of faecal Escherichia coli in patients attending general practitioners.

To analyse the influence of antibiotic therapy on the faecal flora of patients from general practice with complaints of a respiratory tract infection (RTI), 189 paired faecal specimens were collected, before and after completing antibiotic treatment (n = 129) and symptomatic treatment (n = 60). Faecal specimens were examined for the prevalence and degree of resistance to amoxycillin, apramycin, ciprofloxacin, nalidixic acid, neomycin, nitrofurantoin, oxytetracycline, sulphamethoxazole and trimethoprim. In the antibiotic-treated group a significant increase in the prevalence of resistance to amoxycillin post-treatment from 50% to 64% (P < 0.05, Wilcoxon) was observed. In the symptomatic treated group no significant differences in the prevalence of resistance were found. Using discriminant analysis, amoxycillin and doxycycline therapy contributed to an increased prevalence of resistance to amoxycillin and oxytetracycline, respectively. In the antibiotic-treated group Escherichia coli isolates post-treatment had a significantly increased resistance rate to amoxycillin (15%-23%) and to neomycin (2%-6%) (P < 0.05, Wilcoxon). Logistic regression analysis showed a cross resistance to neomycin and kanamycin, and for kanamycin cross-resistance to apramycin, neomycin and streptomycin occurred.

Adolescent↗
PubMed1994

Antibiotic policies in Dutch hospitals for the treatment of patients with serious infection.

In order to assess the guidelines available in Dutch hospitals for the treatment of patients with serious infection of unknown aetiology, 39 antibiotic formularies used in 88 hospitals were analyzed. The recommendations considered were those for the treatment of sepsis for which the source was not apparent or which originated in the urinary tract, respiratory tract or abdomen. beta-Lactam antibiotics (most commonly amoxycillin and cefuroxime) were the preferred agents for empirical therapy of infections of all types; an aminoglycoside was also included in the majority of regimens, irrespective of the clinical presentation. However, there were wide variations in the choice and dosages of the drugs administered. Because of the absence of local data for the susceptibilities of blood culture isolates, the appropriateness of the recommendations could not be properly evaluated.

Anti-Bacterial Agents↗
PubMed1993

Antimicrobial drug use in hospitals in The Netherlands, Germany and Belgium.

Data on the use of antimicrobial drugs was collected by means of an inquiry to 30 hospitals in Belgium (15 in Dutch sectors and 15 in the French sectors), 21 hospitals in Germany and 20 hospitals in the Netherlands. The use of these drugs was expressed as the number of defined daily doses (DDD) per 100 bed days by the anatomical therapeutical chemical classification system. The total use of antimicrobial agents was significantly (p < 0.001) higher in both parts of Belgium (55.6 and 52.0 DDD per 100 bed days) than in Germany (37.9 DDD) or the Netherlands (34.1 DDD). In particular, amoxicillin-clavulanic acid, the first- and second-generation cephalosporins, aminoglycosides and fluoroquinolones were used more in Belgium than in either of the other countries. At least part of the differences observed in antimicrobial drug use could be explained by differences in written antibiotic policy.

Anti-Infective Agents↗
PubMed1993

Antibiotic resistance of Enterobacteriaceae isolated from the faecal flora of fattening pigs.

From June 1991 to April 1992 407 faecal samples were collected from three groups of pigs (I n = 248, II n = 87, III n = 72) at a pig fattening farm to determine the prevalence and the degree of antibiotic resistance of Enterobacteriaceae as well as the antibiotic susceptibility of the strains isolated. Despite the absence of mass medication during the observation period, the prevalence of resistance to the most commonly used antimicrobial agents in veterinary medicine was high (range amoxicillin 70%-97%, oxytetracycline 89%-100%, sulfamethoxazole 88%-100%, trimethoprim 78%-100%). The high degree of resistance to oxytetracycline and sulfamethoxazole ranged from 8%-67% and 4%-46%, respectively. The percentage of the isolated Escherichia coli strains resistant to oxytetracycline, streptomycin and sulfamethoxazole ranged from 49% to 68%; the other agents tested showed lower percentages (0-13%). Resistance to three or more antibiotics was observed in 43% of the isolates. Of the 52 resistance patterns that could be distinguished, 51% was accounted by only four patterns: oxytetracycline+streptomycin+sulfamethoxazole 20%, sulfamethoxazole 12%, streptomycin+sulfamethoxazole 11% and streptomycin+oxytetracycline 8%.

Animal Husbandry↗
PubMed1993

Antibiotic guidelines and antibiotic utilization in Dutch hospitals.

In April-May 1991 the availability of antibiotic formularies in Dutch hospitals was analysed as well as data available on antibiotic susceptibility patterns. In addition data on the use of different groups of antimicrobial agents (aminoglycosides, beta-lactam compounds including aztreonam and imipenem, co-trimoxazole, vancomycin and fluoroquinolones) were collected by a questionnaire. Thirty-eight formularies were received which were used in 78 hospitals. No formulary was available from 31 hospitals: 15 hospitals did not intend to set up antibiotic guidelines, nine hospitals were using their first formulary and seven used a revised version of the existing one. Fifteen formularies dated from 1987 or earlier. The availability of antibiotic susceptibility patterns ranged from no data at all (n = 14) to extensive data per species, per agent and per ward (n = 5). From 20 hospitals data on antibiotic usage as well as on antibiotic guidelines were obtained. Because several hospitals used the same formulary, 15 different formularies were analysed from 20 hospitals. Fluoroquinolones were used in all hospitals, but were only mentioned in the formularies of six hospitals. The data in the present study underscore the need for a collaborative approach of medical staff, hospital pharmacy and microbiologist in order to maintain a relatively low level of antibiotic resistance in Dutch hospitals.

Anti-Bacterial Agents↗
PubMed1993

Antibiotic resistance of faecal Enterobacteriaceae isolated from healthy volunteers, a 15-week follow-up study.

From 25 March to 1 July 1991 faecal samples from healthy volunteers of two cities and their rural surroundings, Weert (n = 91) and Roermond (n = 96) were collected weekly and analysed for the presence of Enterobacteriaceae, resistant to ampicillin, ciprofloxacin, nalidixic acid, neomycin, nitrofurantoin, oxytetracycline, sulphamethoxazole or trimethoprim. In total, 682 and 690 samples from Weert and Roermond, respectively, were analysed for the prevalence and the degree of resistance to each antimicrobial agent. The mean prevalence of resistance of the samples from Weert varied from 28% +/- 12 (mean +/- S.D.) for ampicillin to 0.1% +/- 1 (range 0-2%) for ciprofloxacin. For Roermond the prevalence of resistance varied from 41% +/- 7% for sulphamethoxazole to 0% for ciprofloxacin. The high degree of resistance (i.e. > 50% of the faecal flora of one particular individual) varied from 8% +/- 4 for sulphamethoxazole to 2% +/- 2 for trimethoprim for Weert. For Roermond the figures varied from 14% +/- 4 for sulphamethoxazole to 0.3% +/- 1 (range 0-2%) for nalidixic acid. High degrees of resistance were not found for ciprofloxacin and nitrofurantoin in either city. In Weert ampicillin-resistant Enterobacteriaceae were isolated from 69/91 individuals.

Adult↗