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F Fleisch

Publications and source records attributed to F Fleisch.

At least 19 recordsLinked to original sources
PubMed2005

Transregional spread of a single clone of methicillin-resistant Staphylococcus aureus between groups of drug users in Switzerland.

BACKGROUND: An epidemic spread of methicillin-resistant Staphylococcus aureus (MRSA) among intravenous drug users (IDUs) has been observed in Zurich. In the present study we investigated the situation in the Grisons, Switzerland. PATIENTS AND METHODS: We screened IDUs and their caregivers in medical and socio-therapeutical institutions in the Grisons for MRSA. Nose swabs were used for bacterial culture and pulsed-field gel electrophoresis for MRSA genotyping. RESULTS: A total of 191 nose swabs from 111 IDUs and 80 caregivers was analyzed. None of the caregivers was MRSA positive. Six IDUs were asymptomatic MRSA carriers (5.4%). They participated in the official heroin program (MRSA prevalence in this group 16%). The MRSA genotype was identical with the single clone found in IDUs in Zurich, strongly suggesting an epidemic spread. Decolonization was successful in two persons only. Persistence of MRSA in IDUs must therefore be assumed. CONCLUSION: We conclude that a single clone of MRSA, found in IDUs in Zurich, has spread to a distant region of Switzerland. A rigorous infection control program in all institutions with IDUs is necessary to prevent a further spread of MRSA.

Adult↗
PubMed2004

[The importance of a careful examination of all persons in close contact with newly diagnosed infectious tuberculosis].

The diagnosis of infectious pulmonary tuberculosis was made in a 53-year-old Macedonian man. A careful examination of all persons in close contact with him according to the guidelines of the Swiss respiratory society was performed. Pulmonary tuberculosis was diagnosed in his 22-year-old son, in his 20-year-old daughter and in his 3-year-old granddaughter. Seven persons had isoniazid preventive treatment for latent tuberculosis. These data shows very clearly that a careful examination of all persons in close contact with contagious tuberculosis is very important.

Adult↗
PubMed2002

[Legionellosis, a tourist problem?].

Legionellosis is a relatively rare disease characterized by an often prolonged and complicated course even in immunocompetent patients. Its diagnosis is mandatory for therapeutic and epidemiologic reasons. At the Kantonsspital Chur between 1998 and 2001, 6 cases of legionellosis have been observed: four of them were travel-associated and one concerned a local hotel employee. Due to the increasing international mobility epidemiologic investigations for the localization and elimination of the sources of infection are very difficult. A european task force, the European Working Group for Legionella Infections (EWGLI/www.ewgli.org) is addressing this problem. It is a matter of debate to what extent the public should be informed about sources of legionellosis (so called legionella hotels).

Adult↗
PubMed2002

[Suspected neurological side-effects of tick-borne meningoencephalitis vaccination: experiences of the Swiss Adverse Drug Reaction Reporting Center].

The number of patients affected by tick-born encephalitis (TBE) in Switzerland has increased in the last years and an extension of the endemic foci of TBE has been observed. Therefore, active immunization by TBE vaccination has become more important. The possible adverse vaccine reactions have to be known as exactly as possible. The Swiss Drug Monitoring Center SANZ received from 1987 until June 2000 33 spontaneous cases reporting on 39 neurological adverse reactions in a close temporal relationship with a TBE vaccination and a suspected causal relationship. The following adverse reactions were reported most frequently: headache in 36%, neuropathy in 18% and meningeal irritation in 13%. Twelve out of 33 patients were hospitalized due to the adverse reaction. All neurological reactions were reversible. The spontaneous reporting scheme of the SANZ does not allow to calculate the incidence of neurological reactions after TBE vaccination. In general, adverse neurological reactions after TBE vaccination seem to be rare. According to the experiences of SANZ all reported neurological reactions were reversible.

Adolescent↗
PubMed2001

[Fatigue].

Fatigue is one of the most frequent symptoms in medicine. A detailed history must include sleeping habits, other diseases, drugs, and concomitant symptoms. A physical examination is necessary, followed by laboratory tests and imaging techniques, which must be used in a cost-effective manner. When underlying diseases are excluded, a chronic fatigue syndrome may be present. Its pathogenesis is largely unknown. Established treatment options in chronic fatigue syndrome are graded exercise, antidepressants in case of depression and anxiety, and cognitive behaviour treatment. The large number of other treatments including diets have no proven value. Fatigue remains a diagnostic and therapeutic challenge to the physician.

Combined Modality Therapy↗
PubMed2001

Epidemic spread of a single clone of methicillin-resistant Staphylococcus aureus among injection drug users in Zurich, Switzerland.

We describe an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) among injection drug users (IDUs). From August 1994 through December 1999, we registered 31 IDUs with MRSA infections (12 with soft-tissue infection, 7 with pneumonia [fatal in 1], 7 with endocarditis [fatal in 1], 2 with osteomyelitis, 2 with septic arthritis, and 1 with ulcerative tonsillitis), with a marked increase in the number of IDUs registered during 1998 and 1999. Of 31 patients, 15 (48%) were infected with human immunodeficiency virus. A point-prevalence study among IDUs who frequented outpatient facilities in Zurich revealed an MRSA carriage rate of 10.3% (range, 0%-28.6%) in various facilities. In all but 1 case, pulsed-field gel electrophoresis banding patterns of isolates obtained from these patients were indistinguishable from isolates of the initial 31 IDUs registered. Risk factors for MRSA carriage were disability and prior hospitalization in a hospice. In summary, MRSA became endemic in IDUs in Zurich as a result of the spread of a single clone. This clone caused major morbidity and was responsible for a lethal outcome in 2 cases.

Adult↗
PubMed2000

Intestinal infection due to enteroaggregative Escherichia coli among human immunodeficiency virus-infected persons.

To investigate the pathogenic role of enteroaggregative Escherichia coli (EAggEC) among human immunodeficiency virus-infected persons, 111 outpatients with and 68 without diarrhea were evaluated. Examination of stool samples included the HeLa cell adherence assay and an EAggEC polymerase chain reaction (PCR) assay using primers complementary for the plasmid locus CVD432. The pCVD432 genotype, adherence phenotype, and patient characteristics were correlated with occurrence of diarrhea by multivariate analyses. EAggEC PCR and adherence assays were positive in 7 (6%) and 24 (22%) patients with diarrhea and in 1 (1%) and 21 (31%) asymptomatic control patients, respectively. Clinical manifestations associated with EAggEC PCR-positive isolates were nonspecific; EAggEC infections were independent of CD4 lymphocyte counts. Of the pCVD432 genotype, 5 (71%) of 7 were resistant to cotrimoxazole and ampicillin, and 1 strain was resistant to ciprofloxacin. Overall, pCVD432 PCR-positive E. coli was the most prevalent intestinal organism associated with diarrhea. The adherence assay results did not correlate with diarrhea.

Adult↗
PubMed2000

Automated ribotyping and pulsed-field gel electrophoresis reveal a cluster of group A streptococci in intravenous drug abusers.

BACKGROUND: In 1998, an unexpected increase of group A streptococci (GAS) in blood cultures was observed at our institution. MATERIALS AND METHODS: To determine whether they were from unrelated sporadic cases or attributable to a common source, all isolates were analyzed by pulsed-field gel electrophoresis (PFGE) and by automated ribotyping. RESULTS: Two clusters were found. All isolates, except one, of cluster 2 had been isolated from intravenous drug abusers. CONCLUSION: All patients were hospitalized either in different hospitals or at different times in the same hospitals indicating that the putative common source is to be found in the drug community rather than in a particular hospital.

Adult↗
PubMed1997

[Cervical lymphadenitis in an immunocompetent patient: Mycobacterium gordonae as the cause?].

HISTORY AND FINDINGS: A 76-year-old man went to an ENT outpatient clinic because of stabbing pain in the left throat and difficult swallowing. He was found to have tonsillitis on the left and cervical lymphadenitis. The symptoms regressed on treatment with amoxycillin and clavulanic acid, but the cervical lymphadenitis persisted. Fine-needle biopsy of the cervical swelling was not diagnostic. Computed tomography of the neck showed an encapsulated liquid space-occupying lesion with infiltration of surrounding soft tissues. TREATMENT AND COURSE: The cervical lymph-node mass was excised and histologically found to contain epithelioid granulomas with a few giant cells and scattered centrally caseous necroses. Tuberculostatic treatment was started; drainage fluid from the wound grew acid-fast bacilli, identified by gene probe as Mycobacterium gordonae. CONCLUSIONS: Mycobacterium gordonae is ubiquitous in the environment and is being identified ever more frequently in microbiological laboratories, usually as contaminant. It rarely causes infections of soft tissues and the lungs or systemically.

Aged↗