Biomedical subjects
Publications and source records attributed to F Daschner.
The costs of catheters in a university radiology department are listed and the reasons for re-sterilization of catheters discussed. Questionnaires have been sent to 17 German university radiology departments. Thirteen of them routinely re-sterilize catheter material. The advantages and complications of catheter re-use are discussed.
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The in vitro efficacy of temocillin in combination with ticarcillin and with gentamicin, tobramycin, amikacin and netilmicin against 80 Gram-negative and 20 Gram-positive bacterial strains was compared by use of the checkerboard agar dilution technique. No synergistic or additive effect was seen on the Gram-positive strains. Great variations occurred between the different bacterial species, and the temocillin-ticarcillin combination had only little effect against the Pseudomonas strains tested. On average, only 12% of all strains tested were inhibited synergistically by temocillin-gentamicin combinations, and only 7 to 10% by combinations of temocillin with the other aminoglycosides. However, 25% of Gram-negative strains were inhibited synergistically and 40% of Gram-negative strains were inhibited additively by the combination of temocillin-gentamicin.
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Twenty-nine adult patients undergoing open-heart surgery were given 2 g cefotaxime as 5 min intravenous bolus injection preoperatively. Within 6 h cefotaxime serum concentrations declined from 81.0 to 6.3 mg/l. Subcutaneous tissue and muscle concentrations varied between 0.3 and 8.7 micrograms/g, heart valve concentrations varied between 2.2 and 13.0 micrograms/g. Cefotaxime concentrations in heart valves are high enough to inhibit most Gram-negative organisms causing postoperative wound infections and endocarditis.
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During the last decades the spectrum of microorganisms causing nosocomial infections has changed. The frequency of Streptococci group A decreased and bacteria formerly considered as apathogen now cause serious infections. More and more "new" organisms are responsible for nosocomial infections. Especially in immunocompromised patients Legionella pneumophila causes infections with often severe and fatal course. Clostridium difficile can be isolated in 6% to 48% in the stool of patients with antibacterial treatment. Up to 36% of all hospitalized patients excrete Clostridium difficile asymptomatically. Acinetobacter species are responsible for 1% to 3% of all nosocomial infections. These changes are probably due to selection by antibiotics and an increase of invasive medical procedures even in immunocompromised patients.
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During the last decades the spectrum of microorganisms causing nosocomial infections has changed. The frequency of Streptococci group A decreased and bacteria formerly considered as apathogen now cause serious infections. More and more "new" organisms are responsible for nosocomial infections. Especially in immunocompromised patients Legionella pneumophila causes infections with often severe and fatal course. Clostridium difficile can be isolated in 6% to 48% in the stool of patients with antibacterial treatment. Up to 36% of all hospitalized patients excrete Clostridium difficile asymptomatically. Acinetobacter species are responsible for 1% to 3% of all nosocomial infections. These changes are probably due to selection by antibiotics and an increase of invasive medical procedures even in immunocompromised patients.
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