Search PubMed⌕ Search

Biomedical subjects

J Prag

Publications and source records attributed to J Prag.

At least 19 recordsLinked to original sources
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↗
PubMed1997

Subcutaneous lesions and bacteraemia due to Stenotrophomonas maltophilia in three leukaemic patients with neutropenia.

Subcutaneous lesions were seen in three of 13 neutropenia patients who had Stenotrophomonas (Xanthomonas) maltophilia bacteraemia. The characteristic clinical presentation resembled leukaemic infiltrates, and were different from deep ulcers or subcutaneous nodules caused by Pseudomonas aeruginosa. The three patients had acute leukaemia and were treated with intensive combination chemotherapy. All had previously been treated with broad-spectrum antibiotics, and each patient recovered after proper combination antibiotic treatment given according to sensitivity testing.

Adult↗
PubMed1997

Mycoplasma in urine and blood following catheterisation of patients undergoing vascular surgery.

OBJECTIVES: The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment. DESIGN: Prospective study. MATERIALS AND METHODS: A total of 100 patients (63 men and 37 women) undergoing elective vascular surgery had urine and blood cultures performed for mycoplasmas. Blood cultures were taken preoperatively after urinary tract catheterisation and the urine was collected during catheterisation. The median age of the patients was 67 years (range 42-87). RESULTS: A total of 12 (12%), 5 men and 7 women, had a positive urine culture for mycoplasmas (One patient had Mycoplasma hominis and 11 had Ureaplasma urealyticum isolated). Their median age was 60 years (range 42-76). No blood cultures were positive for Mycoplasma. CONCLUSIONS: Mycoplasmas do not enter the blood-stream after catheterization in sufficient amounts and sufficiently often to be detected by blood-cultures in this small patient sample. The number of vascular patients harbouring mycoplasmas in the urine was low and we found no indication for changes in the prophylactic antibiotic treatment based on these findings.

Adult↗
PubMed1996

[Vibrio vulnificus infections in Denmark during the summer of 1994].

The clinical manifestations and epidemiological data of 11 patients infected with Vibrio vulnificus found in Denmark during the unusually warm summer of 1994 are reported. All patients had been exposed to seawater prior to illness, but none had consumed seafood. Nine patients, including four with bacteraemia, developed skin manifestations of various degrees of severity. One patient died of septic shock despite surgery and treatment with relevant antibiotics. Four patients contracted the disease while fishing. High seawater temperature increases the risk of V. vulnificus infections even in temperate climates such as the Danish. Exposure to seawater, including handling of fresh seafood, during warm periods carries a risk of infection with V. vulnificus.

Adolescent↗
PubMed1996

High rate of nasopharyngeal carriage of potential pathogens among children in Greenland: results of a clinical survey of middle-ear disease.

Nasopharyngeal and middle-ear colonization with bacteria and viruses, including Mycoplasma pneumoniae and chlamydiae, was investigated in a survey of 54 children with acute otitis media (AOM) and 201 control children without AOM in Greenland. In total, 98% with AOM and 91% without AOM carried potentially pathogenic bacteria in the nasopharynx. Two or more potentially pathogenic species were carried by 78% with AOM and 57% without AOM. Haemophilus influenzae was found in 92% and 77%, respectively, but only Streptococcus pneumoniae was found significantly more often in the nasopharynx of children with AOM than in age-matched controls (P < .03). The two species were found in 22 of 24 ear-discharge specimens. Nine children (three with AOM) had chlamydiae in the nasopharynx, and seven of them reported rhinitis. Enteroviruses or rhinoviruses were detected in 23 nasopharyngeal specimens from 39 children with AOM, in 13 such specimens from 39 children without AOM (P = .040), and in 4 of 14 ear-discharge specimens. The potentially pathogenic load in the nasopharynx was massive, suggesting an association with the high prevalence of otitis media among children in Greenland.

Bacterial Infections↗
PubMed1995

Evaluation of staphylococci isolated from a blood culture system (Colorbact).

During a one-year period, all blood cultures positive for staphylococci from two of the smaller Danish counties with non-university hospitals only were evaluated. The isolates were speciated and coagulase-negative staphylococci (CoNS) were biotyped. Furthermore, antibiogram, phage typing and lectin typing were performed for all isolates. Clinical information was obtained by telephone, and before any bacteriological identification was performed, a preliminary judgment was made as to whether the positive blood culture was of clinical significance. A total of 3,500 blood cultures were evaluated and 426 (12.2%) were positive. One hundred and sixty blood cultures from 137 patients contained staphylococci; 36 of these patients had a pure culture of Staphylococcus aureus. One hundred and twenty-four CoNS were found and identified as S. epidermidis (81), S. hominis (19), S. haemolyticus (8), S. simulans (1), and Micrococcus species (3), and another 12 staphylococcal isolates which could not be identified to species level. A total of 35 patients had mixed cultures, including 6 with S. aureus as one of the isolates and 15 with mixed CoNS. Clinical relevance was estimated in 90% of cases where the later bacterial identification showed S. aureus, whereas clinical relevance was absent in the majority of cases including CoNS. Methicillin and gentamicin resistance was absent among S. aureus, but frequent among CoNS, especially S. epidermidis, where 40% were resistant to methicillin and 30% to gentamicin.

Bacteremia↗
PubMed1994

Bacteremia in HIV-positive and AIDS patients: incidence, species distribution, risk-factors, outcome, and influence of long-term prophylactic antibiotic treatment.

From a cohort of 837 adult, mainly homosexual HIV-infected patients, 76 bacteremic/fungemic episodes were identified in 63 patients over a 5-year period. Compared with an age-matched reference population with an incidence of 10.3 bacteremias/10,000 person-years, the incidence was 170 among pre-AIDS (p < 0.001) and 3,200 among AIDS patients (p < 0.001). Staphylococcal infections comprised 35% of all episodes, while the HIV-related pathogens Streptococcus pneumoniae, Salmonella spp. and C. neoformans together accounted for 34%. The overall mortality associated with clinical bacteremia was 12%, but nil for Salmonella spp. and S. pneumoniae. Predisposing factors for the infection were: low CD4 count (< 100 x 10(6)/l) in 71%, permanent intravenous line, 44%; neutropenia, 11% and active intravenous drug abuse, 7%. Hence, in this population, intensified hygienic precautions for intravenous lines should be the primary target for intervention. Long-term cotrimoxazole prophylaxis may prevent bacteremia with S. pneumoniae and Salmonella spp.

AIDS-Related Opportunistic Infections↗
PubMed1991

Should aerobic blood cultures be shaken intermittently or continuously?

Stationary incubation of aerobic blood cultures was compared with intermittent shaking in aerobic Vacutainer 2630 bottles with agar slants during the first 24 h, and was simultaneously compared with the continuously shaken aerobic Bactec 6A bottles as a reference system. Intermittent shaking did not significantly increase or decrease the seven days yield of the Vacutainer bottles as compared with the continuously agitated Bactec 6A bottles. When one of 604 paired Vacutainer bottles was agitated for eight h and the other incubated stationary, the speed of growth detection was significantly greater in the agitated bottle (p less than 0.001), but significantly less than with continuously agitated Bactec 6A bottles (p less than 0.001). Agitation for 14 h showed the same pattern of detection speed. These results suggest that it is desirable initially to agitate aerobic blood cultures either intermittently or continuously.

Aerobiosis↗
PubMed1991

Darkening of haemoglobin in simulated, continuously agitated aerobic blood cultures: an early indicator of bacterial growth.

The change of purple oxyhaemoglobin to the darker reduced haemoglobin and methaemoglobin was used as an initial visual growth indicator in continuously agitated, aerobic Colorbact bottles after inoculation with a broad assortment of aerobic and facultatively anaerobic bacteria previously isolated from blood cultures. Growth of all the faster growing strains could be detected by darkening of the blood cultures within a 24 h period of agitation, after they had stood unshaken for eight h. The darkening was accompanied by consumption of O2 and acidification of the fluid media. The slower growing bacteria were detected by turbidity. This growth detection method is easy, quick, inexpensive and reliable, and is especially promising for application in clinical microbiological departments which daily receive blood cultures from peripheral hospitals.

Aerobiosis↗