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J Prag

Publications and source records attributed to J Prag.

At least 19 recordsLinked to original sources
PubMed2003

Diagnosis of Chlamydia trachomatis infections in a sexually transmitted disease clinic: evaluation of a urine sample tested by enzyme immunoassay and polymerase chain reaction in comparison with a cervical and/or a urethral swab tested by culture and polymerase chain reaction.

OBJECTIVE: To evaluate the value of a urine sample for diagnosing Chlamydia trachomatis infection in an STD clinic in a prospective study of samples collected from 410 consecutive STD patients (167 female and 243 male). METHODS: Urine samples were tested by enzyme immunoassay (EIA) and polymerase chain reaction (PCR) in comparison with cervical and/or urethral swabs tested by PCR and cell culture. A questionnaire was completed for a total of 320 patients concerning symptoms, and determining whether they were controls, contacts or were being tested subsequent to legal abortion. RESULTS: The overall prevalence of C. trachomatis infection was 11.5%. At least 40% of patients were asymptomatic. Of the C. trachomatis-positive patients, 85% were diagnosed by testing urine, compared to 91% by testing swabs. For urine tests, the sensitivities of PCR were 66.7% and 71.9% for female and male patients, respectively, and the sensitivities of EIA were 40.0% and 62.5%, or 46.7% and 71.9%, for female and male patients, respectively, by including a 30% gray zone below the cut-off value. For swabs, the sensitivities of PCR were 93.3% and 87.5% for female and male patients, respectively, and equal to the sensitivities of culture. In total, 3.3% of controls and 35% of contacts were found to be C. trachomatis positive. CONCLUSION: The use of urine samples for the diagnosis of C. trachomatis infections was effective, but urine samples should be additional to conventional swab(s) instead of replacing. Partner notification and a confirmation of cure is recommended.

Adolescent↗
PubMed2003

A five-year survey of pneumococcal peritonitis in two Danish counties--incidence, diagnosis and clinical entities.

Eighteen patients with pneumococcal peritonitis were hospitalized in a five-year survey period from a Danish catchment population of 730 000 (0.5/100 000/year). They were naturally divided into three groups: (1) six children with appendicitis; (2) eight women of childbearing age with pelvic inflammatory disease (PID); and (3) four elderly patients with ulcerating gastric diseases. Complications were observed in six patients. All infections were community-acquired, but the pneumococcal etiology was not suspected before the organism was isolated in the laboratory. A classification of peritonitis caused by Streptococcus pneumoniae is discussed.

Adult↗
PubMed2001

A 7-month outbreak of relapsing postpartum group A streptococcal infections linked to a nurse with atopic dermatitis.

A 7-month outbreak of 15 cases of postpartum sepsis with group A haemolytic Streptococci (GAS) was stopped when a carrier was identified. Comparing delivery dates with duty rotas revealed that the carrier had been present during delivery in 13 of the 15 cases. The epidemic GAS type, T3-13-B3264, was found in a carbuncle in her groin and in atopic dermatitis lesions behind her ears and on her eyelids. Thus, it was not the microbiological screening of staff that helped detect the carrier. The outbreak went unnoticed for 6 months, as no 2 cases were diagnosed by the same physician and 5 cases were diagnosed by different general practitioners. The main risk factors for infection were presence of the carrier relative risk (relative risk RR 47.8, 95% confidence interval (CI) 10.9-209.5) and suturing of episiotomy (RR 11.0; 95% CI 2.6-47.9). We recommend that a thorough epidemiological investigation should be carried out in every single case of GAS postpartum infection. Despite initial intravenous treatment with penicillin, 8 patients experienced > 15 recurring postpartum GAS infections, such as endometritis, wound infection, tonsillitis, erysipelas and Brodie's abscess. Eradication of GAS should be confirmed after completion of treatment.

Adult↗
PubMed2000

Human necrobacillosis, with emphasis on Lemierre's syndrome.

Lemierre's syndrome is the classical presentation of human necrobacillosis. It is characterized by a primary infection in the head in a young, previously healthy person who subsequently develops persistent high fever and disseminated metastatic abscesses, frequently including a septic thrombophlebitis of the internal jugular vein. The main pathogen is Fusobacterium necrophorum, an obligate anaerobic, pleomorphic, gram-negative rod. Clinical microbiologists have a key role in alerting clinicians and advising proper antibiotic treatment when the characteristic microscopic morphology of the pleomorphic F. necrophorum is seen in Gram stains from positive anaerobic cultures of blood and pus. Early diagnosis and prolonged appropriate antibiotic treatment with good anaerobic coverage are crucial to reduce morbidity and mortality. F. necrophorum also causes human necrobacillosis with foci caudal to the head, mainly in elderly patients with high mortality related to age and predisposing diseases, such as cancers of the primary focus.

Fusobacterium Infections↗
PubMed2000

[Venous leg ulcers].

Explore the source record for details and available documents.

Anti-Bacterial Agents↗
PubMed2000

Isolation of Kingella kingae from synovial fluids using four commercial blood culture bottles.

According to the literature, Kingella kingae may be an underdiagnosed cause of joint and bone infections in children. The use of the Bactec blood culture system for culture of joint fluids has dramatically improved the isolation of this fastidious bacterium. The aim of this study was to test the recovery rate and detection time of four commercial blood culture systems: three different BacT/Alert (Organon Teknika, USA) bottles and one Bactec (Becton Dickinson Microbiology Systems, USA) bottle, all inoculated with Kingella kingae strains mixed with pooled synovial fluids. For each strain the same inoculum and volume of synovial fluid was distributed into each of the four bottles. All 24 strains tested grew in the BacT/Alert Aerobic (100%) and the BacT/Alert Pedi-BacT (100%) bottles. Twenty-one strains grew in the BacT/Alert FAN aerobic (88%) bottle, and 15 strains grew in the Bactec Plus Aerobic F (63%) bottle, in both systems within 12 days (P<0.01). The Kingella kingae strains were first detected in the BacT/Alert Pedi-BacT bottles (P<0.001). The results were reproducible. The BacT/Alert blood culture bottles were superior to previously described blood culture systems in isolating Kingella kingae from synovial fluid, even with small inoculums and small volumes of synovial fluid.

Blood↗
PubMed1999

Survival and function of phagocytes in blood culture media.

The survival and function of human phagocytes in sterile aerobic and anaerobic blood culture media were investigated using neutrophil morphology, white blood cell count in a haemoanalyser, flow cytometry, oxidative burst response, and bactericidal effect in Colorbact and Septi-Chek blood culture media and Bact/Alert. When comparing agitation to stationary incubation no difference in phagocytic activity was found. The methods showed the same trends demonstrating that the phagocytes' viability and activity were prolonged by oxygen and shortened by anaerobic conditions and sodium polyethanol sulfonate (SPS). Best preserved activity and viability were found in the aerobic media containing less than 0.5 g/l SPS, in which significant phagocyte oxidative burst and bactericidal activity were found up to 4 days after inoculation. Considering that the majority of bacteremias are due to aerobic or facultatively anaerobic bacteria, the present data suggest that most bacteria may be recovered by the use of one aerobic bottle with SPS concentration below 0.5 g/l to protect meningococci and other SPS-sensitive bacteria and one above 0.5 g/l to stop phagocytic activity, plus one anaerobic bottle with SPS below 0.5 g/l.

Cell Count↗
PubMed1998

[Did pneumococcal endocarditis come back?].

Endocarditis caused by pneumococci represents 1-5% of all cases of endocarditis according to publications from different western countries. Necropsy studies show frequencies of up to 14% of all cases of endocarditis. It usually occurs as a complication to a pneumococcal pneumonia but other foci might be seen. Concomitant meningitis is seen in 20-85% of patients suffering from pneumococcal endocarditis. By knowing this disease entity there is a good possibility for treatment with antibiotics and valve replacement, but if overlooked the mortality is high. The frequency of pneumococcal endocarditis might be underestimated. Careful stethoscopic examination for heart murmurs should be a part of the clinical examination in case of invasive pneumococcal disease, especially with concomitant meningitis. Since bacteriaemia due to pneumococci is diagnosed with increasing frequency in many Northern European countries, special attention should be paid to pneumococcal endocarditis. The literature is reviewed with reference to pathology, pathogenesis, frequency, clinical presentation, diagnosis, treatment and prognosis.

Endocarditis, Bacterial↗
PubMed1998

[Pneumococcal endocarditis].

With the increasing frequency of pneumococcal bacteriaemia in Denmark during the last ten years, it is important to be aware of pneumococcal endocarditis. Two cases of pneumococcal endocarditis are described and an estimate is made of the incidence. The first case had endocarditis of the aortic valve with concomitant meningitis. Acute valve replacement was necessary and recovery was complete. The second case, which started with an embolic episode, also had endocarditis of the aortic valve. This patient recovered after treatment with antibiotics.

Adult↗
PubMed1998

Incidence and clinical epidemiology of necrobacillosis, including Lemierre's syndrome, in Denmark 1990-1995.

To establish the incidence and describe the clinical epidemiology of necrobacillosis and Lemierre's syndrome in Denmark, the clinical records of all laboratory-recorded cases of septicaemia due to Fusobacterium necrophorum biovar A, B, and C were reviewed retrospectively during a 6-year period. The incidence of necrobacillosis and Lemierre's syndrome was 1.5 and 0.8 per million persons per year, respectively, showing a tendency to increase during the period. Fusobacterium necrophorum was grown after three days' incubation, but the characteristic pleomorphic fusiform morphology was often disregarded as an important help in diagnosing necrobacillosis. The 24 patients with Lemierre's syndrome were all young and previously healthy, and none died, but pre-hospital delay was associated with a significantly higher morbidity and risk of metastatic infections. The remaining 25 patients with necrobacillosis had a high mortality, 24%, which was correlated with age and predisposing diseases, especially cancers. These findings stress the importance of a quicker clinical and microbiological diagnosis in cases of Lemierre's syndrome, and of screening for cancer in the remaining cases of necrobacillosis.

Adolescent↗
PubMed1998

Pneumococcal endocarditis is not just a disease of the past: an analysis of 16 cases diagnosed in Denmark 1986-1997.

To remind clinicians and clinical microbiologists of the clinical features and therapeutic aspects of pneumococcal endocarditis, patients with pneumococcal endocarditis from 1986 to 1997 were identified via an enquiry to clinical microbiologists across Denmark. For all patients records were reviewed to confirm the diagnosis of pneumococcal endocarditis, and the clinical course, therapy and outcome were analysed. 16 patients with definitive pneumococcal endocarditis were found. All pneumococcal isolates were sensitive to penicillin. 15 patients had no previously known cardiac valvular disease, 10 patients had X-ray-proven pneumonia and 5 had meningitis. The aortic valve was affected in 13 patients, of whom 12 developed aortic insufficiency and 11 cardiac failure. Of 7 patients who underwent surgery, 6 needed immediate cardiac valve replacement. The 30-day case fatality rate was 19% (95% confidence limits 4-46%). Pneumococcal endocarditis must be considered when treating patients with pneumococcaemia. The most important clue to the diagnosis is a significant murmur and development of heart failure. Evaluation by transoesophageal echocardiography is helpful in determining the diagnosis and assessing the need for surgical intervention. With appropriate antibiotic therapy, close observation and cardiac valve replacement if necessary, the prognosis is better than recorded in earlier studies.

Adult↗
PubMed1998

Nasopharyngeal bacteria found on blood agar plates from healthy children in Greenland.

We have systematically studied the aerobic nasopharyngeal bacteria isolated from swabs by unselective subculturing on 5% horse blood agar and chocolate agar in 70 healthy children aged 0-1, 3-5 and 8 years in Nuuk and Sisimiut, Greenland. The purpose was to provide a basis for a better understanding of the infectious pathology and blind antibiotic treatment against potential pathogens thereby improving standard antimicrobial treatment of upper respiratory tract infections (URTI) and otitis media (OM) among children in Greenland. The study serves also as a baseline for future microbiological and immunological research projects. The children were clinically examined for any infectious diseases and a medical history was obtained which allowed for selection of children without a history of severe clinical infection. Nasopharyngeal swabs obtained via the oral route were instantly spread on 5% blood agar and chocolate agar culture plates and incubated aerobically. Subsequently, potentially pathogenic as well as non-pathogenic bacteria were identified by conventional methods. Healthy children in Greenland carry grossly the same aerobic bacterial flora as children in other parts of the world but potentially pathogenic bacteria were found in very high frequency (94%). Staphylococcus aureus, Streptococcus pneumoniae and Moraxella catarrhalis were found in higher frequencies in the youngest children. Haemophilus influenzae non-b was found in high frequencies in all age groups (67-76%). H. influenzae type b was carried by 11.4%. Group A streptococci were found more frequently in older children and in children from Sisimiut. Of M. catarrhalis strains 88% produced beta-lactamase. Neisseria meningitidis, Mycoplasma pneumoniae and chlamydiae were not detected at all. The high carrier frequency of potentially pathogenic bacteria in healthy children in Greenland may be related to the high frequency of URTI's and episodes of OM among children in Greenland.

Bacteria, Aerobic↗
PubMed1997

Escherichia vulneris in a Danish soccer wound.

Escherichia vulneris was isolated from an infected soccer wound, a finding which has not apparently been described in Europe before, but by questioning Danish clinical microbiological laboratories a further 12 cases were discovered. Treatment with simple debridement and cefuroxime quickly eradicated the bacteria in our case.

Adolescent↗
PubMed1997

Surgical infections with Mycoplasma: a brief review.

Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma.

Cross-Sectional Studies↗