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Biomedical subjects

H Knothe

Publications and source records attributed to H Knothe.

At least 109 records · Page 6Linked to original sources
PubMed1977

[Prevention using cephalothin in open-heart surgery].

To assay the efficiency of cephalothin prophylaxis in open-heart surgery, bacteriological examination of pressure-measurement units, intravenous catheter tips, and urine were made in 211 consecutive patients as well as blood cultures and sputum in suspected postoperative sepsis. Furthermore, cephalothin concentration in serum and tissue was determined in 12 consecutive adults with intact kidney function. Samples were taken before, during, and after the cardiopulmonary bypass, the tissue from the right atrium only before and after cardiopulmonary bypass. A high serum cephalothin level (80.04 +/- 23.35 microgram/ml) was measured 30 min after administration of 2 g cephalothin given as a 15-min-long i.v. infusion on induction of anesthesia. An antibiotic regimen - 4 X 2 g dose of cephalothin daily (first dose on induction of anesthesia) - provides a serum cephalothin level which is significantly higher than the cephalothin minimum inhibitory concentrations for most gram-positive organisms (0.475 microgram/ml) and so ensures an adequate antibiotic coverage throughout the surgical procedure and during the early postoperative phase of open-heart surgery.

Adult↗
PubMed1976

[Change of bacterial flora during chemotherapy (author's transl)].

Biological side effects, which are particularly characterized by a change of bacterial flora, appear during chemotherapy, and are dependent on the mode of action of the different substances. While shifts in the germ count of skin flora have no great importance, gram-negative bacilli, especially enterobacteriaceae, multiply in the flora of the nose and throat, particularly after administration of beta-lactam antibiotics. These changes usually revert to normal in a short time after the antibiotic has been discontinued. Considerably more important are the changes in the flora of the large intestine, sensitive species being eliminated and resistant strains, usually R factor carriers, become selected. These organisms then play an important part in hospital cross-infection. This state of affairs can only be controlled by specific selection of chemotherapeutic agents and strict observance of all disinfectant measures.

Anti-Bacterial Agents↗
PubMed1976

[Bacteriological studies in outpatients with acute urinary tract infections with particular reference to the resistance spectrum (author's transl)].

Bacteriological investigation of urinary samples from 1,926 non-hospitalised patients with documented or suspected acute urinary tract infection revealed organisms pathogenic for the urinary tract in 56.4% of the patients, who came from various parts of West Germany. Prevalent pathogens were E. coli (69%) and Proteus mirabilis (14%). E. coli and P. mirabilis demonstrated a low rate of resistance against ampicillin, the cephalosporines, gentamicin, tobramycin, and also against nitrofurantoin, nalidixine acid and trimethoprimsulfamethoxazole. The situation was more unfavourable in the case of Klebsiella and indolpositive Proteus species however, there being a noticeably high proportion of strains resistant to gentamicin and tobramycin.

Ampicillin↗
PubMed1976

[The liver concentration of cephradin and cephacetril and their elimination in the bile].

Liver biopsies and serum samples were collected after intravenous application of 2 g cephradin (n = 13) or 2 g cephacetril (n = 11) during surgery. There was no difference in the serum levels of cephradin and cephacetril. 30 min. after i.v. application of cephradin the liver tissue concentration was 72.62 mcg/g. 30 min. after i.v. cephacetril the liver tissue concentration was 5.83 mcg/g. The quotient of liver tissue concentration to serum concentration for cephradin was between 0.36 and 0.83, and for cephacetril between 0.02 and 0.16. The excretion of cephradin and cephacetril in human bile was studied by collecting bile samples from the common bile duct via T-tube drainage (n = 17). Cholecystomized patients were given 2 g of antibiotics intravenously. Serum levels of cephradin were 263 mcg/ml 5 min after application, and 22 mcg/ml after 240 min. Serum levels of cephradin were 263 mcg/ml 5 min after application, and 22 mcg/ml after 240 min. Serum levels of cephacetril were 193 mcg/ml 5 min after application, and 27 mcg/ml after 240 min. The highest levels of cephradin in the bile were found 75 min after injection at a concentration of 86.4 mcg/ml; the highest level for cephacetril was 21.8 mcg/ml at 15 min. In patients with hyperbilirubinaemia cephradin reached a mean maximum concentration of 29.6 mcg/ml in bile samples, in comparison to 117.4 mcg/ml in normal patients, while no difference was seen with cephacetril. After intravenous administration of 2 g cephradin biliary concentration are achieved which may be sufficiently high to be effective not only against the very sensitive gram-positive organisms, but also against most strains of E. coli, Klebsiella and indol-negative Proteus. Cephradin is effective in the treatment of cholangitis and intrahepatic abscesses, as was observed in 18 patients. A free bile-flow is essential.

Bile↗
PubMed1976

In vitro susceptibility of recently isolated gram-negative bacteria to gentamicin, sisomicin, tobramycin, and amikacin.

The emergence of bacteria with R-factor-mediated resistance transferable to many strains of Pseudomononas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, and some Proteus and Providencia species has been reported in hospitals in the Rhine-Main region of Germany. In a comparative study, 1,250 strains belonging to 12 clinically important bacterial species were tested for susceptibility to gentamicin, sisomicin, tobramycin, and amikacin by the tube dilution methods. Gentamicin, sisomicin, and tobramycin can still be employed effectively for the treatment of serious gram-negative infections. However, some findings related to Enterobacteriaceae and P. aeruginosa and demonstration of transfer by R-plasmids among P. aeruginosa, E. coli, K. pneumoniae, Enterobacter, and S. marcescens point to less favorable developments in the future. nearly all bacterial strains tests, including those resistant to other aminoglycosides, were susceptible in vitro to amikacin. This highly valuable antibiotic should be employed only when specifically indicated, since indiscriminate use would favor selective emergence of resistant bacteria in the future.

Amikacin↗
PubMed1976

[The influence of pivmecillinam on the human gut flora (author's transl)].

The effect of pivaloyloxymethyl ester of 6-beta-[(hexahydro-1H-azepin-1-yl)-methyleneamino]-penicillanic acid (pivmecillinam, FL 1039) on the gut flora of human subjects was investigated at different doses. Following administration of 1.2 g or 2.4 g/die E. coli and other enterobacteriaceae species were markedly reduced. The response of enterococci and bacteroides species showed no uniformity. No overgrowth of the gut flora by Pseudomonas, Staphylococci or Candida was observed. Meanwhile it has been possible to inspect stool specimens of a patient who was suffering from a septicaemic Salmonella infection and was treated with a combination of pivmecillinam-HCl 4 X 800 mg/pivampicillin-HCl 4 X 350 mg/die for one month. After disappearance of Salmonellae during therapy enterobacteriaceae decreased to amounts of 10(2)--10(4), all strains of which were highly susceptible to mecillinam.

Adult↗
PubMed1975

[Long-term follow-up of children with urinary tract infection: bacterial spectrum, E. coli-serotypes 0, relapse, and reinfection (author's transl)].

Within 4 years 1400 children were investigated for urinary-tract infection in a long-term study. Children with manifest infection were treated and followed-up. In 59 children with chronic pyelonephritis 159 recurrences were observed: 146 were reinfections (change of organism) and 13 relapses (organism unchanged). Serotyping of 0-antigens showed differences between children with chronic pyelonephritis and children with a single exacerbation within the observation period. Reinfection with resistant bacteria mainly occurred shortly after cessation of therapy.

Antigens, Bacterial↗
PubMed1975

[Ciclacillin therapy for diseases of the urinary tract].

In our own controlled bacteriological investigations, ciclacillin showed a good effect in urological infections at a daily dosage of 3 g for 10 days. The efficacy is comparable to that of ampicillin and corresponds to that of the double blind trials bescribed in the literature. The specially good tolerance is worthy of note.

Adult↗
PubMed1975

R factor-mediated resistance to aminoglycoside antibiotics in Pseudomonas aeruginosa.

Conjugal transferability of drug resistance was examined, in eleven Pseudomonas aeruginosa strains which were isolated in Frankfurt. Four R factors were demonstrated from three strains using P. aeruginosa as recipients but they were nontransferable to Escherichia coli K12. Two R factors, i.e., Rms146 and Rms147, mediated resistances to tetracycline (TC), streptomycin (SM), sulfanilamide (SA), kanamycin (KM), lividomycin (LV), gentamicin C complex (GM) and 3', 4'-dideoxykanamycin B (DKB). They mediated the formation of aminoglycoside-inactivating enzymes, i.e., SM phosphotransferase, SM adenylyltransferase, KM and LV phosphotransferase l, and GM and DKB 6'-N-acetyltransferase. TC resistance conferred by these R factors was due to impermeability of the drug. P. aeruginosa Ps 142 carried two kinds of R factor in one cell, Rms148 (SM) and Rms149 (SM-SA-GM-CPC) (CPC, carbenicillin). Rms148 (SM) was transferable at a high frequency of 10-1 and mediated the formation of SM phosphotransferase. Rms149 mediated the formation of drug-inactivating enzymes, ie., GM 3-N-acetyltransferase and beta-lactamase, but did not inactivate SM. SM resistance was probably due to impermeability of the drug.

Acetyltransferases↗
PubMed1975

Apparent antagonism by a resident R plasmid for entry of related gentamicin-tobramycin resistance plasmids in Pseudomonas aeruginosa.

From altogether 17 strains of Pseudomonas aeruginosa resistant to gentamicin, isolated in January 1975, 4 have been found to transfer their resistance to gentamicin and tobramycin, along with the resistance to other aminoglycosides, to rifampicin-resistant recipient strains of the same species. In some instances the transfer was strain-specific and therefore it was advisable to use more divergent recipient strains. It was found that a variant of a recipient strain (ML-4258) which already carries an R plasmid (found in the same area in 1972), accepted the Gm-R To-R plasmids with much lower frequencies than the original plasmid-free recipient. From this it may be concluded that R plasmids in P. aeruginosa from the Frankfurt area did not undergo significant genetic alterations within 3 years and thus they might be regarded as phylogenetically related.

Anti-Bacterial Agents↗
PubMed1975

[Aminopenicillins from microbiological viewpoint].

In this report it was tried to emphasize several microbiological aspects of the amino-penicillin. Hereby it turns out that the activity differences of all the substances are very similar on microbiological part. A break of the cross-resistance does not happen with all the amino-penicillins. With regard to the appearance of resistant strains, it can be told that the conditions still are advantageous on non-hospitalized patients in the totality. In the clinic a high part of resistant strains are found on different grounds.

Amines↗
PubMed1975

[The serum and uterine muscle concentrations of Cephradin and Cephalothin].

On the day of operation 2 grams of Cephradin was given intravenously to 33 patient and 2 grams of Cephalothin was given intravenously to 31 patients. At various time intervals, uterine tissue and serum was removed. The mean serum concentrations of Cephradin were 3 times higher and the mean tissue concentrations of Cephradin were 7-8 times higher than the corresponding concentrations of Cephalothin. Because of the difference in protein binding of the examined cephalosporins (Cephradin 6%, Cephalothin 60-65%) the difference for the antimicrobially active portion (Protein free portion) is even more favorable for Cephradin. The significance of these pharmacokinetic differences for the treatment are obvious.

Adult↗