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J Bille

Publications and source records attributed to J Bille.

At least 145 records · Page 8Linked to original sources
PubMed1988

Simple method for rapid diagnosis of catheter-associated infection by direct acridine orange staining of catheter tips.

Direct acridine orange (AO) staining was used to detect bacteria adherent to intravascular catheters (IVC). Samples from 710 IVC tips were first cultured on blood agar plates by a semiquantitative technique and then independently colored with AO and screened dry at a magnification of x100 for 3 min. In the absence of fluorescence, they were considered negative. When fluorescence was present, they were further examined for the presence of microorganisms at x1,000 with immersion oil. Of 710 IVC tips, 37 (5.2%) were positive upon culture (greater than or equal to 15 colonies) and 673 were negative (640 were sterile and 33 [4.6%] had 1 to 14 colonies). The AO sensitivity was 84%, and the AO specificity was 99%. When restricted to the 212 long IVC, AO sensitivity rose to 94%. AO staining was positive in all cases of catheter-associated bacteremia. The negative predictive value of the preliminary screening at x100 was 99.5%. The direct examination of IVC tips stained by AO appears to be a simple and rapid method for diagnosing IVC-associated infections. In addition, AO staining is easier to perform than Gram staining.

Acridine Orange↗
PubMed1988

Antibiotic prophylaxis of experimental endocarditis after dental extractions.

In rats with catheter-induced sterile aortic valve vegetations we studied the efficacy of single-dose amoxicillin and single-dose erythromycin prophylaxis for the prevention of bacterial endocarditis after extractions of periodontally diseased teeth. Endocarditis after extractions occurred in 89% of control animals and was due to group G streptococci, to Staphylococcus aureus, or to both organisms. A single-dose of amoxicillin or erythromycin successfully prevented endocarditis due to these bacterial species. The analysis of the bacteremia (by culturing blood drawn 1 min after extraction on penicillinase-containing blood agar plates) indicated that amoxicillin did not influence the incidence or the magnitude of circulating group G streptococci and S. aureus, while erythromycin apparently suppressed them. However, when care was taken to eliminate blood erythromycin by a lysis-centrifugation process, the incidence and magnitude of bacteremia after erythromycin prophylaxis was similar to that in control rats. We conclude that single doses of amoxicillin and erythromycin successfully prevent experimental endocarditis after dental extractions. Since this prophylaxis was operative by mechanisms other than the prevention of the circulation of bacteria before seeding the valvular vegetations, it suggests that recommendations for prevention of bacterial endocarditis should not be aimed only at providing adequate antibiotic blood levels to suppress the bacteremia produced by the invasive procedure.

Amoxicillin↗
PubMed1988

[Listeriosis].

Explore the source record for details and available documents.

Female↗
PubMed1987

[Disseminated histoplasmosis due to Histoplasma capsulatum in a patient with acquired immunodeficiency syndrome (AIDS)].

Very commonly encountered in the United States, histoplasmosis is rare in Europe, where only 27 patients have so far been infected by this mycosis. In Africa, two varieties of histoplasmosis have been observed: those due to H. capsulatum and H. duboisii. Histoplasmosis due to H. capsulatum is one of the twelve secondary infectious diseases listed in the surveillance definitions of AIDS. This complication has been described only in approximately 20 patients with AIDS; all patients had stayed on the American Continents. We report the case of a 30-year-old African male who lived in Switzerland and in Zaïre. With AIDS and multiple Kaposi's sarcoma, the patient died from disseminated histoplasmosis due to H. capsulatum; a peripheral blood smear obtained a few hours before death revealed numerous typical yeast forms of H. capsulatum inside polymorphonuclear leukocytes. Post-mortem examination and cultures confirmed the diagnosis of disseminated histoplasmosis. Histoplasmosis should be suspected in AIDS patients even in Europe, especially where they have stayed in endemic areas. Examination of blood smears and bonemarrow aspirate may allow early recognition of the disease and permit appropriate treatment with amphotericin B and ketoconazole.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Comparative study of the treatment of simple urinary infection with a single dose of norfloxacin versus cotrimoxazole].

53 women with acute, uncomplicated urinary tract infection proven clinically and bacteriologically were treated, after double-blind randomisation, with a single dose of norfloxacin (1200 mg) or a single dose of cotrimoxazole (480/2400 mg). Follow-up one week after treatment showed a comparable success rate (85%) for both antibiotics. Only few minor side effects were recorded in both patient groups. Most failures were due to gram positive bacteria (coagulase-negative staphylococci). These results suggest that single dose therapy for urinary tract infections due to gram positive germs should be reconsidered.

Adolescent↗
PubMed1987

The inflammatory response and tissue damage. The example of renal scars following acute renal infection.

Most clinical and experimental evidence suggests that renal scarring occurs following urinary tract infections in those patients with an abnormality of the urinary tract or kidney function. Experimentally, bacterial multiplication within the kidney occurs only in the presence of obstruction, leading rapidly to acute exudative pyelonephritis and invariably to kidney scars within weeks. Various manipulations of the bacterial load and/or of the inflammatory response during acute pyelonephritis have demonstrated that the inflammatory processes, not the bacterial component of pyelonephritis, are responsible for permanent renal tissue damage. Polymorphonuclear leucocytes (PMNLs) infiltrating the kidney tissue during acute pyelonephritis appear to release metabolites that are toxic to the parenchyma. Indeed, both the prevention of PMNL influx into renal tissue, by means of colchicine or cyclophosphamide, and the inactivation of some of their toxic metabolites, by means of dapsone, have led to the prevention of tissue damage and kidney scars. However, the most potent protective activity was observed with early antibiotic treatment, which stopped bacterial multiplication and prevented the early influx of PMNLs, thus preventing tissue damage and scar formation. Similar observations have been made in children with acute pyelonephritic episodes, in whom early and aggressive antibiotic treatment prevented subsequent kidney scars, while delayed treatment did not.

Cicatrix↗
PubMed1987

Single-dose rifampin prophylaxis for experimental endocarditis induced by high bacterial inocula of viridans streptococci.

In rats challenged with viridans streptococci poorly susceptible to antibiotic killing, single doses of antibiotics only prevent endocarditis induced by bacterial inoculum sizes that produce disease in 90% of control animals (ID90): additional doses are required to protect against inocula exceeding the ID90. We investigated whether single-dose rifampin would extend the efficacy of single-dose prophylaxis to inocula exceeding the ID90. We used two strains of viridans streptococci highly susceptible to killing by rifampin and two resistant strains. All rats were injected with 10-1,000 times the ID90 of the four strains. Single-dose rifampin successfully prevented endocarditis due to all four strains. A few prophylaxis failures were observed after challenge with the two poorly susceptible strains, but in vivo emergence of resistant variants did not account for these failures. Thus, rifampin was the first antibiotic given as a single dose that successfully prevented experimental streptococcus endocarditis after challenge with high bacterial inocula.

Adhesiveness↗
PubMed1987

Cobas-Bact system for identification of members of the family Enterobacteriaceae in 4 h 20 min.

The Cobas-Bact (Roche Diagnostics, Basel, Switzerland) new rotor for the identification (ID) in 4 h 20 min of 33 members of the family Enterobacteriaceae to genus and species level was evaluated by testing 444 strains of which 398 belonged to common species and 46 belonged to rare species of Enterobacteriaceae. Each strain was identified by the API 20E system (Analytab Products, Plainview, N.Y.), and additional discriminating tests were set up if necessary. Only first-choice ID were considered in this study and were classified either as high-confidence ID (normalized likelihood, greater than or equal to 80%) or as low-confidence ID (normalized likelihood, less than 80%) requiring additional tests for confirmation. The data were analyzed by two versions of Cobas-Bact software. With the first version of the software (SW8446), the overall accuracy of Cobas-Bact was 95.5% (424 correct ID of 444). When restricted to high-confidence ID it rose to 99.4% (350 of 352) for the common species and 96.9% (31 of 32) for the rare species. Only three strains of the high-confidence group were misidentified. Sixty ID were considered unacceptable because of their low confidence. Using the first software version (SW8446) they represented 12% (46 of 398) of the common species (17 typical strains, 10 Shigella species, 10 inactive Escherichia coli strains, and 9 rare biotypes) and 30% (14 of 46) of the rare species. The same data analyzed by the new version (SW8524) of the Cobas-Bact software resulted in an overall accuracy of 93.9% (417 correct ID). The number of high-confidence ID rose to 401, of which 392 (97.7%) were accurate. The decrease in low-confidence ID (43 versus 60) was mainly due to the Shigella species. In conclusion the accuracy of Cobas-Bact identification system was very good when restricted to high-confidence ID. The Cobas-Bact performance for rare species ID was poorer, but the small number of strains tested does not allow definitive conclusions.

Bacteriological Techniques↗
PubMed1986

[Invasive Haemophilus infections in adults].

From 1976 to 1985, 27 adult invasive Haemophilus infections were observed at the University Medical Center in Lausanne. Only 5 cases (19%) were caused by Haemophilus influenzae type b, while 12 cases (44%) were due to Haemophilus species other than H. influenzae. Two out of 24 strains tested were ampicillin-resistant. The infections were meningitis in 8, pneumonia in 7, endocarditis in 5, sepsis of unknown origin in 4, epiglottitis in 2, and one gynecological infection. Except for the latter three patients, each case was associated with one or more underlying conditions. Seven patients died (26%), in three of whom death was directly related to the infectious process. This report and a review of the literature show that adult invasive Haemophilus infections are not uncommon and may be serious. Associated underlying diseases and advanced age are generally present. In contrast to infections occurring in children, invasive Haemophilus infections in adults are not restricted to encapsulated Haemophilus influenzae type b strains.

Adult↗
PubMed1986

[Fulminant gram-negative (CDC-dysgonic-fermenter 2) septicemia in a splenectomized patient].

In a 43-year-old woman admitted because of fever and high cardiac output shock, disseminated intravascular coagulation with purpura was present. The peripheral blood smear revealed the presence of intraleukocytic elongated bacilli, but growth of bacteria (further identified as DF2) in the blood cultures was detected only two weeks after admission. Despite intensive therapy with hemodynamic and respiratory support, associated with broad spectrum antibiotherapy, the patient died on the third day of hospitalisation. The past medical history of the patient revealed splenectomy for Hodgkin's disease 4 years previously, but no recent dog bite.

Adult↗
PubMed1986

[Acute purulent Listeria seelingeri meningitis in an immunocompetent adult].

Within the genus Listeria, the species L. monocytogenes most frequently causes disease in animals and humans. L. Seeligeri, a species recently described, has been considered experimentally nonpathogenic so far. The authors report the first case of human infection in a previously healthy adult presenting with acute purulent meningitis due to L. seeligeri. The patient recovered promptly after a course of ampicillin and gentamicin, but developed severe neurological sequelae (epilepsy, hydrocephalus) one year after the acute episode. The pathogenic properties of this isolate were investigated in two experimental animal models and the results were as follows. The clinical isolate of L. seeligeri was able to colonize the spleens of adult mice without bacterial multiplication, in contrast to the type strain of L. seeligeri (no colonization) and to a L. monocytogenes strain (colonization and multiplication). Previous infection of adult mice with the clinical L. seeligeri isolate protected moderately against spleen colonization and bacterial multiplication after challenge with L. monocytogenes. No lethal effect was observed after inoculation of suckling mice with the clinical L. seeligeri isolate, in contrast to L. monocytogenes strains. Thus, L. seeligeri, previously described as experimentally nonpathogenic for mice, may in fact be a heterogeneous species regarding its pathogenicity, and include strains that may cause life-threatening diseases in humans.

Humans↗
PubMed1986

Rapid coagglutination test for the direct detection of group A streptococci from throat swabs.

A one-minute antigen detection test was compared with a conventional culture method for detecting group A beta-hemolytic streptococci. The test detects coagglutination between protein A and streptococcal antigen extracted directly from throat swabs. Of the 307 specimens tested, 66 (21.5%) were positive for group A streptococci by culture and 16 specimens (5.2%) were positive for other beta-hemolytic streptococci. The direct test agreed with the culture in 274 of 307 specimens (accuracy 89.3%). The sensitivity of the test was 86.4% (57/66), the specificity 90% (217/241), the positive predictive value 70.4% and the negative predictive value 96%. If only throat cultures with more than 100 colonies of group A streptococci per plate were considered, the sensitivity of the direct test rose to 96%. If only a strong agglutination was considered positive, the specificity of the direct test rose to 98%. Further studies are needed to determine whether this test could be used alone or in addition to culture.

Agglutination Tests↗