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Biomedical subjects

F Allerberger

Publications and source records attributed to F Allerberger.

At least 37 records · Page 2Linked to original sources
PubMed2002

Occurrence of Salmonella enterica serovar Dublin in Austria.

In Austria, Salmonella enterica subsp. enterica serovar Dublin, a bovine-adapted serovar, rarely causes infections in humans. In 2000, Austria was within the European mean with an incidence of 0.1 per million inhabitants. Our data show that the vast majority of all serovar Dublin infections (human and non-human) can be traced epidemiologically to two districts in the Tyrol. This concentration of cases can be explained by a particularly traditional aspect of cattle farming in this area, the alpine pasture. There is an increased risk of cross infection due to the communal keeping of animals from various farms. Infected cattle are a source of infection for humans, and transmission usually occurs from eating beef and drinking cows milk. Using pulsed field gel electrophoresis and automated ribotyping, three out of five isolates from human infections could be traced to characteristic Tyrolean Dublin clones. Bacteriological screening for faecal carriage before the transfer of cattle from risk-herds to the alpine pastures and before the return from risk-pastures to the farms would be a possible starting point to prevent cross-contamination of large mixed herds and contamination of pasture through latently infected cattle. Appropriate research is necessary.

Animals↗
PubMed2001

Necrotizing fasciitis with Clostridium perfringens after laparoscopic cholecystectomy.

Necrotizing fasciitis is a rapidly progressive infection of the fascia and subcutaneous tissues accompanied by a high mortality rate approaching 80% to 100%. Factors that predispose patients to this life-threatening complication include obesity, malnutrition, malignancy, chronic alcoholism, drug abuse, peripheral vascular disease, diabetes mellitus, and immunosuppressive therapy. The pathomechanisms for the development of this rare disease still remain unclear. We report a case of necrotizing fasciitis with Clostridium perfringens after laparoscopic cholecystectomy. The patient left the hospital 5 months after admission. Early recognition based on clinical signs (pain, asymmetric abdominal thickening, crepitus) and computed tomography scanning (gas dissection along fascial planes), in conjunction with prompt, aggressive surgical therapy and debridement of all devitalized tissue, high-dose antibiotic therapy, and therapy at the intensive care unit, appears to afford patients the best chance of survival.

Cholecystectomy, Laparoscopic↗
PubMed2001

Prevalence and characterization of Listeria monocytogenes in the feces of healthy Austrians.

The aims of the study were to determine the prevalence of Listeria monocytogenes in the feces of healthy Austrians and to characterize the isolates by various typing methods. Stool specimens from 505 healthy volunteers from the Tyrol were tested for the presence of L. monocytogenes using cold enrichment for 6 months and five different detection methods: conventional plating onto Palcam and Rapid'L.MONO agar, immunomagnetic separation (IMS) followed by conventional plating, enzyme-linked fluorescent immunoassay (ELFA), ELISA, and PCR. L. monocytogenes was isolated by conventional plating from one specimen (0.2%), and a further three were positive on immunomagnetic separation (0.8%). Only one specimen tested positive with ELFA and EIA, although it tested negative by conventional culture, IMS, and PCR. Eighteen of 505 samples were positive by PCR (3.6%), and this included three of the four culture-confirmed specimens. Serotyping, phage-typing, arsenic cadmium, antimicrobial-resistance typing and pulsed-field gel electrophoresis showed that multiple L. monocytogenes isolates from three of the four carriers were indistinguishable. Our data indicate that the Austrian fecal carriage rate is at least 0.8%. In view of a listeriosis incidence of 0.16/100,000 per year, the chances of fecal carriage developing into listeriosis appear to be very low.

Adolescent↗
PubMed2001

Characterization of consecutive Streptococcus pyogenes isolates from patients with pharyngitis and bacteriological treatment failure: special reference to prtF1 and sic / drs.

To analyze bacteriological treatment failure in streptococcal pharyngitis, 40 consecutive Streptococcus pyogenes isolates from 18 patients were characterized. For 17 patients, isolates were indistinguishable with respect to emm type, random amplified polymorphic DNA pattern, and presence of prtF1 encoding the fibronectin-binding protein F1. prtF1 was detected only in the 11 isolates (4 patients) with emm12 and in the single isolate with emm6. Further analysis by vir(mga) regulon typing, sequencing of sic encoding the streptococcal inhibitor of complement from 19 isolates with emm1 (9 patients), and sequencing of drs (distantly related sic) from 11 isolates with emm12 revealed distinct sic alleles with insertions and/or deletions in sic that corresponded to differences in restriction patterns of the vir(mga) regulon only for paired isolates of 2 patients. Among isolates with emm12, 2 novel drs alleles were found. Analysis of these data suggests that neither the presence of prtF1 nor the diversification of sic / drs is required for the persistence of S. pyogenes in pharyngitis.

Adhesins, Bacterial↗
PubMed2001

Effects of daily oral administration of rifaximin and neomycin on faecal aerobic flora in rats.

The aim of this study was to compare the influence of rifaximin and neomycin on faecal flora in rats. The study was performed on 18 Wistar rats (three groups of six male animals). Group 1 received rifaximin (50 mg kg(-1)/day), group 2, neomycin (50 mg kg(-1)/day) and group 3 was used as control. Drugs were administered orally, once daily for 3 days. Faecal specimens, collected from each rat on day 3, were cultured for the quantitative and qualitative determination of aerobic microorganisms. Rifaximin treatment produced a marked reduction in the number of total aerobic bacteria and Salmonellae; neomycin caused reduction in Salmonellae, but did not cause statistically significant changes in total aerobic bacterial count. The binding of neomycin with faeces could explain this limited activity, which does not correlate with the in vitro susceptibility of the organism affected. These results confirm that rifaximin is suitable for topical treatment to reduce selected bacterial load in the gut intestines.

Administration, Oral↗
PubMed2001

Helminthic infestations in the Tyrol, Austria.

At the federal public health laboratory, Innsbruck, 142 426 samples were examined for intestinal helminthosis from 1990 until 2000. Enterobius vermicularis accounted for half (49.7%) of the cases diagnosed, followed by Taenia saginata (28.3%), Ascaris lumbricoides (12.8%), and Trichuris trichiura (3.9%). Of all specimens tested for helminths, 26% had been positive in 1945, and 0.98% in 1985. The proportion of positive findings with respect to the total number of specimens tested was 0.24% in the time span 1990-2000. It appears to us that these numbers fairly reflect the real prevalence of helminthosis in Austria.

Animals↗
PubMed2001

In vitro activity of fosfomycin in combination with various antistaphylococcal substances.

Using the chequerboard technique we studied the in vitro activity of the broad spectrum antibiotic fosfomycin in combination with vancomycin, rifampicin, linezolid, quinupristin/ dalfopristin, cefazolin, meropenem and moxifloxacin against two Staphylococcus epidermidis strains (ATCC 12228, DSM 3269) and five Staphylococcus aureus isolates (ATCC 29213, DSM 683, DSM 46320, GISA 323/93, MRSA 3558/00). The phenomena of 'trailing' and 'skipped wells' did not present a problem. Synergy was the most common effect of all drugs tested in combination with fosfomycin; only combination with vancomycin showed antagonism for two of seven isolates. Using a killing-curve technique fosfomycin showed cidal activity, where increasing the drug concentration above the MIC did not enhance killing velocity. Inhibitory concentrations of vancomycin plus fosfomycin against DSM 46320 caused effects identical to those observed with vancomycin alone. The combination of fosfomycin plus linezolid exerted the bacteriostatic effect found with linezolid alone. Fosfomycin plus quinupristin/dalfopristin exhibited the bactericidal effect found with fosfomycin alone (in contrast to the rapidly bactericidal effect of quinupristin/dalfopristin). Electron microscopy showed that fosfomycin given in combination with linezolid, quinupristin/dalfopristin or moxifloxacin (substances that do not cause morphological alterations when given alone) resulted in 'cauliflower-shaped' distortion as caused by fosfomycin alone. Our in vitro data indicate considerable potential for fosfomycin used in combination with other antistaphylococcal antimicrobials, especially linezolid or quinupristin/dalfopristin.

Anti-Bacterial Agents↗
PubMed2001

Hemolytic-uremic syndrome surveillance to monitor trends in infection with Escherichia coli O157 and non-O157 enterohemorrhagic E. coli in Austria.

Austrian data underline that relying on the number of enterohemorrhagic Escherichia coli (EHEC) O157 strains isolated from clinical specimens does not allow assessment of the actual incidence of EHEC infections. A hospital-based system for identification of hemolytic-uremic syndrome cases based on voluntary cooperation was established in 1995 and provides information needed to monitor trends in the incidence of O157 and non-O157 EHEC infections.

Adolescent↗
PubMed2001

Fleroxacin uptake in ischaemic limb tissue.

Antibiotic application to patients with ischaemia of lower limbs may be indicated to avoid or treat infection of soft tissues. Fleroxacin, a fluoroquinolone, active against various Gram-negative and Gram-positive organisms may be used for this purpose. We evaluated the diffusion of fleroxacin into bone, subcutaneous fat, muscle and tendon tissues of lower limb tissue after a 400 mg i.v. dose. Concentrations in ischaemic tissues were similar to those found in non-ischaemic sites. Since the maximum antibiotic levels found were lower than the MICs of various pathogens relevant for infection, we suggest to increase the dose used for this peri-operative prophylaxis to 800 mg.

Adipose Tissue↗
PubMed2001

Escherichia coli O157 infections and unpasteurised milk.

We report on two children with Escherichia coli O157 infection, one of whom developed haemolytic uraemic syndrome (HUS). Both had drunk raw cows or goats milk in the week before their illness. Molecular subtyping identified a sorbitol fermenting Escherichia coli O157:H isolate from a dairy cow. This isolate differed from Shiga toxin producing O157:H strains isolated from the 6 year old boy with HUS. This result underlines the need to search for other causes of infection, despite documented consumption of unpasteurised milk. In the second patient, human sorbitol non-fermenting O157:H isolates and animal isolates from goats were indistinguishable. The isolation of indistinguishable sorbitol non-fermenting Escherichia coli O157:H from contact animals supports the association between HUS and consumption of raw goats milk, and re-emphasises the importance of pasteurising milk.

Animals↗
PubMed2000

Nontoxigenic sorbitol-fermenting Escherichia coli O157:H- associated with a family outbreak of diarrhoea.

A recent study from Germany reported the isolation of E. coli O157:H7/H- from patients with non-bloody diarrhoea and hemolytic uremic syndrome, questioning the role of Shiga toxin as the main trait of virulence for human disease. We isolated 6 sorbitol-fermenting E. coli O157:H- strains that do not contain Shiga toxin genes. The isolates originated from an outbreak (3 patients, 3 asymptomatic contacts) of non-bloody diarrhoea affecting two families sharing one household. Two children (age 10 months and 2 years) suffered severe diarrhoea over 30 and 10 days, respectively. Their uncle had moderate diarrhoea for 2 weeks. In contrast to the other isolates, the uncle's strain (EH109) did not harbour a chromosomal eae gene encoding gamma-intimin nor the plasmid gene E-hly; it also showed a PFGE pattern that was different from the unique pattern of the other isolates. Employing PFGE, phage typing, and P-gene typing, five of the six stx negative isolates were indistinguishable from the stx 2 positive "Bavarian outbreak strain". The only human serum tested, obtained from one asymptomatic contact, contained antibodies to the O157 lipopolysaccharide antigen. Our finding of five stx negative sorbitol-fermenting E. coli O157:H- isolates (harbouring eae and E-hly) associated with an outbreak of non-bloody diarrhoea supports the hypothesis that Stx production is not obligatory for the pathogenicity of E. coli O157 for humans.

Adult↗
PubMed2000

Epstein-Barr virus-associated Hodgkin's lymphoma and legionella pneumophila infection complicating treatment of juvenile rheumatoid arthritis with methotrexate and cyclosporine A.

We describe the case of a 53-month-old girl with juvenile rheumatoid arthritis (JRA), complicated by the occurrence of Hodgkin's lymphoma and Legionella pneumophila infection during immunosuppressive treatment with methotrexate (MTX) and cyclosporine A (CSA). The girl had received variable anti-inflammatory combination therapy, including MTX for 28 months and CSA for 3 months. Thirty-six months after the onset of arthritis, the girl presented with an enlargement of the lymph nodes of the mediastinum, the hilum of the lungs, and the abdomen. Concomitantly, a diagnosis of Legionella pneumonia was rendered. Autopsy showed Epstein-Barr virus (EBV)-associated nodular sclerosing Hodgkin's lymphoma. The neoplastic cells were positive for CD15, CD 30, and latent membrane protein 1 (LMP 1). The present case is the second reported to occur in a child, and it lends support to the hypothesis that immunosuppressive treatment may contribute to an increased risk of the development of EBV-associated lymphoproliferative disorders (LPD) in pediatric patients suffering from JRA.

Arthritis, Rheumatoid↗
PubMed2000

Spectrum and transferability of beta-lactam resistance in hospital strains of Enterobacter isolated in Bratislava and Innsbruck.

The transferability and expression of beta-lactam resistance were compared in multiresistant clinical isolates of Enterobacter spp. collected from different hospitals in Bratislava, Slovakia (n = 15) and Innsbruck, Austria (n = 19) during 1996-1997. The strains from Bratislava were resistant to ampicillin, cefoxitin, cefotaxime, ceftazidime and ceftriaxone. All strains from Innsbruck were resistant to ampicillin and cefoxitin; 17 were also resistant to ceftazidime and aztreonam but the majority remained susceptible to cefotaxime and ceftriaxone. All strains were susceptible to cefepime and imipenem. The majority of the tested strains transferred resistance determinants to E. coli recipient by conjugation. Production of beta-lactamase including ESBL was the major mechanism of beta-lactam resistance. Large plasmids of 77-88 and 91 kb were confirmed in clinical isolates from Bratislava and Innsbruck.

Anti-Bacterial Agents↗
PubMed2000

Nosocomial cross transmission as a primary cause of vancomycin-resistant enterococci in Austria.

Stool specimens from 226 patients from intensive care units (N=69), general wards (N=112), and outpatient-clinics (N=45) at the Innsbruck University Hospital and from 433 healthy volunteers were inoculated on to Enterococcosel Agar supplemented with 5 microg/mL vancomycin and 4 microg/mL cefodizime. Faecal specimens from 105 dairy cows, 171 pigs and 47 egg-laying hens were processed the same way. Thirteen of 226 patients (5.8%) harboured 14 vancomycin-resistant enterococci (VRE) of the vanA genotype; 12 E. faecium (from 11 patients) and two E. faecalis (ICU patients: 5.8%, general ward patients: 5.4%, outpatients: 6.7%). None of the faecal specimens from healthy volunteers or animals yielded VRE. Nine of the 13 patients harbouring VRE had received antibiotic therapy during the previous four weeks (broad-spectrum cephalosporins: six patients; i.v. vancomycin: five patients). Of the 14 VRE (vanA type) isolates six strains were indistinguishable by PFGE using Sma I as restriction endonuclease, six strains formed three pairs, and only two single isolates showed unique patterns. The results of our study supports the view that nosocomial cross transmission is currently the main cause of colonization and infection with VRE in Austria.

Animals↗