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F Daschner

Publications and source records attributed to F Daschner.

297 records · Page 17Linked to original sources
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[Antibacterial activity of clindamycin and lincomycin in broth, serum, and in combination with polymorphonuclear leukocytes against Staphylococcus aureus and Staphylococcus epidermidis].

We investigated the antibacterial activity of clindamycin and lincomycin at 1/4 X minimum inhibitory concentration (MIC), 1 X MIC and 4 X MIC against a serum-resistant Staphylococcus aureus and a serum-resistant Staphylococcus epidermidis strain in broth, in serum with and without the presence of leukocytes and in Hank's medium in combination with leukocytes alone. Against both test strains, lincomycin in broth and serum was similarly effective, whereas against S. aureus clindamycin in broth was somewhat more active. In the combined test mixture of serum with leukocytes, even a 1/4 X MIC of clindamycin or lincomycin markedly improved leukocyte killing of S. aureus, whereas both compounds could not further enhance the marked leukocyte killing of S. epidermidis, even at inhibitory concentrations. In Hank's medium with leukocytes alone, clindamycin and lincomycin had at the most only a bacteriostatic effect against both test strains.

Blood↗
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Concentrations of sulbactam/ampicillin in serum and lung tissue.

The penetration of sulbactam plus ampicillin into lung tissue was studied in 15 patients undergoing thoracic surgery for pneumonectomy after the administration of 1 g of sulbactam plus 2 g of ampicillin as a 15 min intravenous short infusion. Ampicillin serum concentrations declined from 40.8 mg/l at 1 h to 18.8 mg/l 2-4 h after administration. Concomitant serum concentrations of sulbactam were 25.5 mg/l and 11.8 mg/l, respectively. In lung tissue, peak ampicillin concentrations of 35.6 mg/kg were reached 1.5 h after administration declining slowly to 26.8 mg/kg after 2-4 h. The respective sulbactam concentrations were 8.6 and 5.5 mg/kg. In our study sufficient sulbactam and ampicillin levels active against important pathogenic organisms causing community- and hospital-acquired respiratory tract infections have been achieved in lung tissue, suggesting that the combination sulbactam/ampicillin is suited for the treatment of most community- and hospital-acquired respiratory tract infections as well as for chemoprophylaxis and treatment of postoperative lung infections after thoracic surgery.

Adult↗
PubMedDate not supplied

Are nosocomial infection rates in intensive care units useful benchmark parameters?

BACKGROUND: The objectives of this study were to determine to what extent the German national nosocomial infection surveillance system (Krankenhaus Infektions Surveillance System, KISS) can take into account the circumstances prevailing in various intensive care units (ICUs) and to establish whether KISS-ICU infection rates can serve as useful benchmark parameters. METHODS: The investigation focused on three major factors: microbiological monitoring, severity of illness and the duration of surveillance. For each of these factors separate infection rates were calculated for various ICU groups and the differences compared. RESULTS: Significant differences were found for catheter-associated urinary tract infections (CAUTI) with routine monitoring, but not for ventilator-associated pneumonia (VAP). Significant differences were assessed for central venous catheter-associated bloodstream infections (CVC-BSI), considering the average ventilator utilization rate in the ICU as a surrogate parameter for the average severity of illness in its patient group. Surveillance periods of about 1 year were necessary to confirm definite outlier and nonoutlier positions for the majority of the ICUs. CONCLUSION: Using KISS data for internal orientation, it is possible to note important differences between ICUs when interpreting infection rates; some initial examples of successful use of surveillance data for the reduction of infection rates are already available. However, the use of such data for external assessment is not possible, because external observers are often unable to fully consider important factors in the interpretation of infection rates.

Benchmarking↗
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Antibiotic resistance in intensive care unit areas.

The incidence of nosocomial infections and antimicrobial resistance rates of nosocomial pathogens vary considerably among countries and even among intensive care units (ICUs) within one hospital. Such differences might be partly due to the selection pressure exerted by certain antibiotics, since intensive care patients are given more antimicrobials than any other group of patients. We therefore compared resistance rates of four important nosocomial pathogens (Staphylococcus aureus, E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) isolated from patients in general wards and ICUs. There were few trends toward higher resistance of ICU isolates, and most differences were found with Klebsiella pneumoniae. We also tried to relate antibiotic use in ICUs and frequency of antibiotic resistance of five selected nosocomial pathogens. The ampicillin and cephalosporin resistance of E. coli and Klebsiella pneumoniae arose along with an increase in usage of both drugs. Decreasing prescription of cotrimoxazole was not reflected by decrease in resistance of Staphylococcus aureus and Staphylococcus epidermidis. Increasing prescriptions of tetracyclines were followed by an increasing resistance of E. coli, but not of Staphylococci. The oxacillin resistance of Staphylococcus epidermidis almost paralleled the consumption, the opposite was true for Staphylococcus aureus. There seemed to be a rather close relationship between the incidence of resistant Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa strains and the quantities of gentamicin, tobramycin and azlocillin prescribed. The increase or decrease of prescriptions of certain antimicrobials increased or decreased their resistance rate to the respective drugs of only certain bacterial strains in one ICU, but not in the other. The findings in our hospital cannot necessarily be applied to other hospitals.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMedDate not supplied

[Prevention of infection: facts and myths].

Postoperative wound infection in orthopaedic surgery following implantation of foreign bodies is a possibly disastrous event since this complication can result in serious consequences for the affected patient. To recommend effective hygienic measures for the prevention of postoperative infectious complications the available literature was examined for scientific evidence.

Bone Diseases↗
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[Chorioamniotic infections following diagnostic amniocentesis in the 2d trimester].

Between 1978 and 1984 we performed 3 122 amniocentesis for prenatal diagnosis in second trimester. Based on a four week follow-up in more than 96% of all amniocentesis the percentage of fetal loss was 0.74% (n = 23). In 13 cases abortion was accompanied by chorioamnionitis. These cases were examined for various technical details and it could be concluded, that the incidence of febrile abortion is related to the early gestational age for amniocentesis. On the other hand, multiple insertions or the localisation of placenta both show no relation to the short-time febrile complications. To investigate the maternal-fetal transfer of mezlocillin, a single dose of 5 g mezlocillin was administered intravenously in 25 patients. In amniotic fluid mezlocillin levels exceeded 2 micrograms/ml nearly 120 minutes after administration. These pharmacokinetic data suggest, that a prophylactic regimen with antibiotics in the course of amniocentesis seems not to be beneficial for the prevention of chorio-amniotic infections.

Abortion, Septic↗
PubMedDate not supplied

Nosocomial wound infections: a prevalence study and analysis of risk factors.

This first German prevalence study surveilling nosocomial wound infections (NWI) was carried out in 72 representatively selected hospitals. NWI were recorded by 4 validated investigators. Seventy-nine NWI were recorded among 4983 operated patients (prevalence rate: 1.61%), most of them after amputation of limbs (6.1%) and operations on the colon or rectum (3.1%). The 3 risk factors from the NNIS (National Nosocomial Infection Surveillance) index for postoperative wound infections were for the first time applied in this prevalence study. Patients with contaminated wounds had significantly more wound infections (P=0.01, likelihood ratio test) whereas, in contrast to the NNIS index, patients with ASA score >3 (P= 0.07) or long lasting operations (>75th percentile) did not (P=0.1). Therefore, for the stratification of NWI rates wound contamination is the single most important factor.

Cross Infection↗