Search PubMed⌕ Search

Biomedical subjects

G Wewalka

Publications and source records attributed to G Wewalka.

At least 37 records · Page 2Linked to original sources
PubMed1985

Isolation of spirochetes from the skin of patients with erythema chronicum migrans in Austria.

Spirochetal organisms were isolated from biopsies (skin punches) of the erythematous anular skin lesion of three patients with erythema chronicum migrans. The organisms were cultivated in modified Kelly's medium and - after an incubation period of 2 weeks - discovered by dark field microscopy (X 200). Compared with the Lyme disease agent Borrelia burgdorferi the organisms did not differ in shape, motility and reaction with polyclonal antiserum. Differences to B. burgdorferi were found in (i) very slow growth of the isolated organisms in modified Kelly's medium and in (ii) non reactivity with monoclonal antibodies against the outer membrane protein of B. burgdorferi. It is concluded that the Austrian isolates are closely related to but not identical with the Lyme disease agent.

Adult↗
PubMed1984

Postoperative infections in colonic surgery after enteral bacitracin-neomycin-clindamycin or parenteral mezlocillin-oxacillin prophylaxis.

In a prospective randomized, blind trial, three groups of patients undergoing elective colonic surgery were compared for frequency of surgical wound infection, intra-operative wound contamination and other postoperative infections. All patients allotted to the three groups received whole gut irrigation (101 balanced salt solution) by gastric tube on the evening before surgery and were treated as follows. Group A: no antibiotics; Group B: neomycin (1 g/l) + bacitracin (50,000 IU/l) + clindamycin (900 mg/l), contained in the last 31 of irrigation fluid; Group C: mezlocillin (4 g) + oxacillin (2 g) intravenously (iv) at induction of anaesthesia, followed by two identical doses at 8 and 16 h. The rate of postoperative wound infection was highest in A (38 per cent) and much lower in B (3.3 per cent, P less than 0.002) and C (6.9 per cent, P less than 0.004). The difference between B and C was statistically not significant. In A a correlation was established between the degree of wound contamination and the occurrence of wound infection. Intra-operative wound contamination was lowest in B (30 per cent), equal in A (58.1 per cent) and B (55.2 per cent). Other infections were least frequent in group C (four of 29 patients), but were not significantly different to groups B (six of 30) and A (nine of 31). It is concluded that antibiotics together with an effective mechanical preparation considerably reduce the rate of wound infection in colonic surgery.

Adult↗
PubMed1984

[Control of infection in a primarily surgical intensive care unit].

All of one year's 251 patients of a predominantly surgical intensive care unit (i.c.u.) were continuously followed up for infections according to a standard protocol. These protocols were evaluated for 174 patients who stayed at least 48 h at the unit. More than one third (36.7%) were already infected on admission (external origin), 35% contracted infections at the unit, primarily or additionally (internal origin) and 40% remained without an infection. Fifty eight percent of patients already infected on admission were surgical and required intensive care for complications. Among the patients who contracted their infection solely at the unit 61.5% suffered from trauma. Patients having contracted their infections at the i.c.u. stayed significantly longer than those without (additional) infections (13 and 6 days respectively). Mortality was highest (45%) in patients who were already infected on admission and who acquired additional infections during their stay at the i.c.u. Of patients with infections of exclusively external or internal origin 23.5 and 17.9% respectively died whereas among those who remained uninfected this proportion was only 7%. The 75 infections acquired before admission to the i.c.u. included infections of the respiratory tract in 14.4% of all patients, peritonitis with 10.3%, urinary tract in 8.0% and septicemia in 5.2%. Artificial ventilation was employed more often in infected patients (73.8-100%) than in non-infected ones (56.3%). They also carried more intravasal catheters (2.76-3.05 per patient) than the latter group (1.79). Of the 82 infections acquired in the i.c.u. the respiratory tract was affected in 19.5% of all patients and the urinary tract in 13.8%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Evaluation of procedures for vaginal disinfection].

At the occasion of the usual preparations preceding gynecological operations the average vaginal bacterial release of 42 patients, already anaesthesized, was assessed by a rinsing technique to be 5,04 +/- 0,98 log10 c.f.u. per ml sampling fluid after aerobic and anaerobic culture. The reduction of this bacterial release caused by the measurement itself is relatively small, therefore the technique was found to be suitable for evaluation of the efficacy of germreducing measures like irrigation or disinfection. An irrigation with isotonic saline during 30 s was measured to reduce the vaginal bacterial release by 0,4 +/- 0,5 log-steps. A solution containing 0,08% chlorhexidine gluconate + 0,1% benzalkon gluconate applicated during 5 min caused a reduction of 1,04 +/- 0,76 and a watery solution of povidone-iodine one of 2,29 +/- 1,00 log-units when used for 3 min. When after disinfection the sustained antimicrobial action of the chlorhexidin-containing preparation was not neutralized already during the sampling process by Tween 80 + lecithine + histidine being contained in the sampling fluid, an erroneously optimistic log reduction of 2,35 +/- 0,48 was measured. From the results it was calculated that 17-23 volunteers are necessary in order to detect with sufficient statistical safety an observed mean log reduction to be 0,5 log-units smaller than a hypothetical minimal reduction of 2,00 log-steps as required provisionally on an arbitrary basis.

Aerobiosis↗
PubMed1983

Indirect immunofluorescence assay (IFA), microagglutination test (MA) and enzyme-linked-immunosorbent assay (ELISA) in diagnosis of legionellosis.

Lipopolysaccharide was extracted with cold phenol water from Legionella pneumophila and used as antigen for ELISA. IgG and IgM antibodies were measured with the ELISA and the immunofluorescence assay (IFA). Agglutinating antibodies were measured by the microagglutination (MA) test. In tests on sera from 27 patients with confirmed Legionella infections predominantly due to L. pneumophila serogroup 1 the results with the ELISA, the IFA and the MA were compared to each other. Antibody titers obtained by the ELISA were in general much higher than those obtained by both other tests. The ELISA proved to be the most sensitive method (IgG: 91.3%, IgM: 52.2%) whereas the sensitivities of IFA and MA were IgG: 69.6%, IgM: 30.4% and 60.9%, respectively. There was low correlation of the IgG antibody titers but good correlation of the IgM titers. Further 49 sera from patients without Legionella infection were screened to calculate the specificities of the three tests which were equally good with all methods (98%).

Agglutination Tests↗
PubMed1983

Sero-epidemiology of legionellosis in Austria.

Out of 1961 patients with the clinical diagnosis of atypical pneumonia 11 cases (0.65%) of recent Legionella infections were diagnosed by indirect immunofluorescence test (IFA). A higher incidence (1.37%) has been found in 364 patients in whom clinicians suspected a Legionella infection and therefore asked for serological testing. Prevalence of antibodies (greater than or equal to 1:32) reacting with antigens of L. pneumophila serogroup 1 to 6 was highest to serogroup 6 (37%), and lowest to serogroup 1 (4.3%). Specificity of IFA for reciprocal titer of 128 to L. pneumophila serogroup 1 was calculated with 99.5%, for serogroup 6 with only 87.7%. Morbidity of severe Legionella pneumonias in Austria can be estimated at about 1.5 cases per 100 000 inhabitants.

Antibodies, Bacterial↗
PubMed1982

[Antibiotic concentrations in wound secretions and bone during the simultaneous administration of mezlocillin and oxacillin].

Mezlocillin and oxacillin have been used in combination for short-term antibiotic prophylaxis in orthopedic surgery. Antibiotic concentrations were measured in serum, wound secretions from subcutaneous tubings and bone. Half an hour after the i. v. application of 4 g mezlocillin + 2 g oxacillin, the concentrations in wound secretions were 20% of the serum levels. After four hours the levels of both antibiotics in wound secretions increased to 2.66 times the serum levels of mezlocillin, and 5.37 times those of oxacillin. After eight hours the concentrations in wound secretions dropped to about one half, but remained well within therapeutic levels. The parallel course of the concentrations of both antibiotics in wound secretions indicates that mezlocillin and oxacillin have very similar half-lives in wound secretions, although the serum half-lives (t 50% beta) of the two antibiotics are different. The concentrations obtained from cancellous bone were approximately. 10% of the serum levels one to two hours after the antibiotic infusion.

Aged↗
PubMed1982

[A new method for the microbiological evaluation of disinfecting laundering procedures for textiles].

A new method is described to evaluate the efficacy of disinfecting laundering processes. Testpieces (contaminated cotton fabric patches) are enclosed between a pair of membrane-filter discs. Being immersed in the wash liquor this test system acts as a perfusion chamber permeable for detergent and disinfectant solution but retaining the testbacteria to the testpieces. Tests performed in a shaking water bath as well as practical laundering processes with detergents showed the following: from contaminated test pieces wrapped in cotton fabric - as commonly used in such experiments - test bacteria can hardly be recovered even after a non-bactericidal washing process. This is a result of mechanical wash-off. In contrary, with the new method reductions of viable counts are mainly due to bactericidal effects as physical removal of testbacteria is prevented by the filter membranes. Thus, disinfecting laundering procedures are readily distinguishable from merely cleaning ones. As additional advantage the filter-method prevents test pieces from being contaminated by other bacteria carried by the wash liquor.

Disinfection↗
PubMed1981

[Epidemiology and diagnosis of Legionella infections in Austria (author's transl)].

Out of 2,105 patients with atypical pneumonia and febrile infections 15 cases of legionellosis were diagnosed by the indirect immunofluorescent antibody test (IFA) in Austria from the middle of 1977 to the end of 1979. Among the patients with the diagnosis of atypical pneumonia Legionnaires' disease was found in 0.65%. Among those patients whose sera were examined because of suspected legionella infection the frequency was 1.96% (p less than 0.1). Therefore it may assumed that some symptoms of legionella infections may lead to the clinical diagnosis of the disease. Neither the geographical distribution of the cases nor environmental examinations nor the prevalence of antibodies gave any indication of an epidemic or hyperendemic occurrence of Legionnaires' disease in Austria. Low antibody titres to serogroup 1 of Legionella pneumophila (1:32-1:64) were found in 6.4%, higher titres (greater than or equal to 1:128) in 1.2% of all patients examined. Crossreactions of sera mainly occurred between antigens of serogroup 1 and serogroup 2. Antibodies to serogroups 3 and 4 were found seldom. According to our results crossreactivity between L. pneumophila on the one side and Mycoplasma pneumoniae or Chlamydia psittaci on the other side is of no importance and does not interfere with serological diagnosis. In serological routine examinations frequency of recent infections with L. pneumophila in patients with pneumonia was about as high as with Chlamydia psittaci or Picornavirus. To our opinion the expenditure for serological diagnosis is justified in all patients with severe pneumonia of unclear etiology as there exists the possibility of a purposive chemotherapy in legionellosis as it does in mycoplasma pneumonia or ornithosis. Moreover for quick diagnosis it should always be attempted to demonstrate the causative agent by direct immunofluorescence or by isolation.

Adolescent↗
PubMed1980

[Orthograde intestinal irrigation as a preoperative intestinal preparation. Reduction of the intestinal flora using antibiotics].

Whole gut irrigation is a now a well-established method of preoperative bowel preparation. Additional reduction of bacterial content is desirable. The influence of neomycin/bacitracin and clindamycin as well as the combination, as admixture to the whole gut irrigation, on the flora of the large intestine, was therefore investigated in a prospective controlled study. While neomycin/bacitracin caused only a reduction of aerobic, and clindamycin of the anaerobic bacteriae, the combination resulted in a nearly total eradication of detectable bacterial content at the time of operation.

Anti-Bacterial Agents↗
PubMed1980

[Antibiotic concentration in postoperative wound secretions and in serum of patients after implantation of hip endoprostheses having used neomycin-bacitracin loaded bone cement (author's transl)].

Antibiotic concentrations in postoperative wound secretions and in serum give some indication of the local and general effects of an antibiotic additive to bone cement. Ten patients received hip endoprostheses using a prepacked mixture of the bone cement Sulfix 6 with neomycin + bacitracin (Sulfix 6 A). After operation secretions from Redon drains were collected over the next 48 hours as well as venous blood over 14 days in order to measure neomycin and bacitracin levels. Neomycin was found in sera of some patients up to the eighth postoperative day, whereby concentrations did not exceed 0.75 mcg/ml. Bacitracin was not detected in any serum samples. In secretions from Redon drains neomycin as well as bacitracin reached effective levels during the first 48 hours. The results indicate that the addition of neomycin and bacitracin to the bone cement Sulfix 6 for local antibiotic prophylaxis is justified since effective antibiotic concentrations are thereby obtained in the wound without the danger of general toxicity arising when neomycin and bacitracin are administered by the usual method of topical application.

Aged↗
PubMed1979

[Microbiological monitoring of embalmed cadavera during dissection courses (author's transl)].

Microbiological monitoring of normal anatomical specimens was done in order to evaluate results which were obtained in a investigation of decay of embalmed cadavera. The process of decay was characterized by massive colonisation with enterobacteria and aerobic sporeformers. Under normal conditions mainly germs from skin and air are cultivated from surfaces of anatomical specimens, but only in small numbers. The number of germs is increased after periods of intensive preparative work. The results show that the main criterion for the microbiological quality of embalmed cadavera is resistency against external germs during course work. This is to be achieved by consequent preventive measures in the dissection laboratory.

Anatomy↗
PubMed1979

[Comparison of disinfectant activity of 3 different embalming fluids on cadavera for anatomical study (author's transl)].

The antimicrobial effect of 3 different embalming fluids (Phenol/Formaline, JORES 1913 TUTSCH 1975) was evaluated from the beginning of the conservation process through storage in a new system (TUTSCH et al. 1971) and the subsequent dissection course. Endogenous bacteria are significantly reduced 24 hours after injection. Later on during the storage period of at least 6 months no germs are detected in swabs from orifices whereas Staphylococcus epidermidis and aerobic sporeforming bacteria were found on the surfaces of the bodies in some cases. The formula of the disinfectant (Phenol/Formaline or Merfen according to NEUMANN 1974) in the storage system appears to be of no significance. During dissection as a rule Staphylococcus epidermidis and a few aerobic sporeformers were found on the surface of specimens, at one time Pseudomonas aeruginosa was cultivated too. Swabs from the peritoneal cavity and from contents of the intestine were sterile. Investigations by broth dilution method were carried out in order to evaluate the degree of bacteriostatic activity of the various fluids in use. This method is now routinely used for control of the disinfectants in the storage system.

Anatomy↗
PubMed1978

[Antibiotic concentration in postoperative wound fluid during short-term prevention with cephalosporins].

Antibiotic concentrations were measured in wound fluid from Redon-drains and in serum during short-time prophylaxis in orthopaedic surgery. 1. Chephaloridine and cephazolin concentrations in wound fluid rose to therapeutic levels. 3 h after i.v. application of 1 g concentrations in wound fluid and in serum were nearly identical. 6 and 12 h after application the concentrations in wound fluid were significantly higher than those in the serum. 2. At the end of the 12-h interval of administration the mean concentrations of both antibiotics as well in wound fluid as in serum remained at therapeutic levels. 3. For reasons of their good diffusion into the wounds both cephaloridine and cefazolin should be appropriate for short-time prophylaxis in orthopaedic surgery.

Aged↗