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Biomedical subjects

L Verbist

Publications and source records attributed to L Verbist.

At least 73 records · Page 4Linked to original sources
PubMed1990

Capsular types and antibiotic sensitivity of pneumococci isolated from patients with serious infections in Belgium 1980 to 1988.

A total of 2,765 strains of Streptococcus pneumoniae isolated in more than 60 Belgian laboratories from blood or normally sterile body fluids between 1 November 1980 and 31 December 1988 were serotyped. From January 1983 onwards susceptibility of the strains to antimicrobial agents was also tested. The 2,765 isolates belonged to 57 of the 84 currently identified serotypes. Overall, 94% of the strains were represented in the current 23-valent vaccine. The remaining 6% of strains were distributed among 18 serotypes. More than 84% of the middle ear fluid isolates came from children under ten years. Meningitis was commonest in children under five years and in adults over sixty years. Two-thirds of pneumococcal bacteremia isolates came from patients over 50 years. Of 1,933 isolates tested for susceptibility to antibiotics, 335 (17%) were resistant to one or more of the agents tested (tetracycline, erythromycin, chloramphenicol, penicillin). Only 19 strains were relatively resistant to penicillin, while six were fully resistant. Resistance to erythromycin increased significantly from 5.2% in 1986 to 11.5% in 1988. The resistance of Streptococcus pneumoniae to other antimicrobial agents did not change significantly during the study period. There was no relationship between age group and resistance to any of the agents tested.

Adolescent↗
PubMed1990

In vitro activity of cefonicid compared to other antibiotics against clinical bacterial isolates.

The in vitro activity of cefonicid compared to that of other antibiotics has been evaluated against 401 Enterobacteriaceae, 20 H. influenzae, 17 Branhamella catarrhalis and 71 staphylococci. Cefonicid was always more active than cefazolin, and usually more active than cefamandole and cefuroxime against susceptible gram-negative organisms (E. coli, P. mirabilis, Klebsiella, Shigella, Salmonella, H. influenzae). Cefonicid was ineffective against most strains of Enterobacter, Citrobacter, S. marcescens and M. morganii. Staphylococci were 6 to 8 times less susceptible to cefonicid than to the other cephalosporins.

Cefonicid↗
PubMed1990

[Coagulation disorders caused by cephalosporins containing methylthiotetrazole side chains].

Treatment with MTT side chain containing cephalosporins can result in a clinically relevant coagulopathy due to a deficiency in active vitamin K dependent clotting factors. This complication is not caused by a decreased production of vitamin K by the intestinal flora, but by an interference with hepatic enzymes which synthetize active clotting factors. The gamma-carboxylation of glutamic acid components of inactive precursor peptides of vitamin K dependent clotting factors is inhibited as well as the reduction of vitamin K2,3 epoxide to active vitamin K. Predisposing factors for the coagulopathy caused by certain MTT side chain containing cephalosporins are a limited supply of vitamin K, impaired liver and renal function and a prolonged treatment.

Blood Coagulation Factors↗
PubMed1990

The antimicrobial activity of fusidic acid.

Fusidic acid, a fusidane that interferes with protein synthesis via the translocase enzyme, is mainly notable for its activity against staphylococci, coagulase-positive and negative, whether or not they are resistant to methicillin and related penicillins. It is also active against corynebacteria and against many genera of strict anaerobes and microaerophiles. Mutants showing resistance, by more than one mechanism, may readily be selected in vitro. Combination of fusidic acid with other antibiotics generally gives addition or indifference, but also delays emergence of resistant mutants.

Bacteria↗
PubMed1990

Characterization, in vitro susceptibility, and clinical significance of CDC group HB-5 from Rwanda.

From June 1984 until July 1988, CDC group HB-5 isolates were recovered from the exudates of genital ulcers in 25 of 675 (3.6%) patients (204 women, 471 men) in Kigali, Rwanda. Among a group of 145 men presenting with urethritis but without genital ulcers, a positive culture for HB-5 of a specimen from the coronal groove of the penis of only 1 man (0.7%) was found. During the same period, the organism was not obtained in cultures of vaginal specimens from 838 women without genital ulcer disease. The main biochemical characteristics of the isolated microorganisms included weak oxidase positivity, catalase negativity, indole positivity, reduction of nitrate to nitrite, acid production from D-glucose and fructose, and H2S production. A total of 75% of the organisms were susceptible to penicillin G. beta-Lactamase production was detected by the chromogenic cephalosporin test in a quarter of the strains. This study confirms that HB-5 can be found in the genital tract. HB-5 was associated with genital ulcer disease in Rwanda. However, its etiologic role in patients with this condition remains unclear.

Drug Resistance, Microbial↗
PubMed1990

Hypoglycemia owing to inappropriate glucagon secretion treated with a continuous subcutaneous glucagon infusion system.

A selective glucagon deficiency was documented in a 36-year-old female patient suffering from severe hypoglycemic attacks. The extremely low fasting plasma glucagon levels could not be stimulated by hypoglycemia. The increase in plasma glucagon during stimulation with arginine did not prevent hypoglycemia provoked by the simultaneous insulin secretion. Treatment consisting of a continuous sc glucagon infusion system resulted in correction of both postabsorptive and postprandial hypoglycemia. Further lowering of the glucose level during an arginine test could be the hallmark of this hypoglycemic syndrome characterized by an inappropriate glucagon secretion. This case report would indicate that epinephrine cannot prevent hypoglycemia when glucagon release is completely deficient.

Adult↗
PubMed1989

Listeria monocytogenes meningitis.

The history and findings of all patients with Listeria meningitis admitted to the University Hospital of Leuven from 1967 to 1987 were reviewed. Listeriosis during pregnancy or the perinatal natal period was not considered. Predisposing conditions in these 23 patients included renal transplants (9), immunosuppressive therapy (2), diseases of the lympthoreticular system (3) and chronic alcoholism (1). One man had an inversed T4/T8 ratio. In 7 patients no underlying disorder was detected. Disease onset may be acute or subacute. There are no clinical features distinguishing Listeria meningitis from other acute bacterial meningitides. The number of leukocytes in the CSF varied from 3 to 3700, most often with a predominance of mononuclear cells. A decrease of the glucose level in the CSF was not always present. The initial gram stain was often unrevealing and it took up to 4 days for CSF cultures to become positive. Blood cultures were often important for the identification of the organism.

Adolescent↗
PubMed1989

National study on the utilization of prophylactic antibiotics in surgery, Belgium, 1986.

During the last week of May 1986, a 1-week prospective study on antibiotic utilization in surgical patients was held in 104 (42%) of the 247 Belgian acute care hospitals. All surgical patients with a post-operative stay of at least 3 days were studied, involving 3112 patients. Each patient was observed for 7 days, starting from the day before surgery. Antibiotics were administered to 71.9% of all patients; 21.9% received therapeutic antibiotics and 52.9% prophylactic antibiotics; 2.9% received both. Of the 1285 patients undergoing a surgical procedure with no indication for antimicrobial prophylaxis, 50.7% nevertheless received prophylaxis; 92.8% of patients with a generally recognized indication for prophylaxis received antibiotic prophylaxis. Less than one fifth (17.1%) of all prophylactic courses were stopped on the day of the intervention whilst 26.3% were continued up to the fifth post-operative day or beyond. The most frequently prescribed drugs for this indication included first and second generation cephalosporins and nitroimidazoles. The number of different generic drugs utilized per hospital ranged from 1 to 18 (mean: 7.7).

Aged↗
PubMed1989

Once-daily dosing decreases renal accumulation of gentamicin and netilmicin.

The pathogenesis of aminoglycoside nephrotoxicity is intimately related to the extent of drug accumulated in the renal cortex. In the framework of searching for preventive measures of aminoglycoside-induced nephrotoxicity, we investigated the influence of dosage regimen on the renal cortical accumulation of gentamicin and netilmicin in humans. Patients with a tumor partly involving one kidney, with normal renal function, and scheduled for nephrectomy received one dose of either gentamicin (4.5 mg/kg) or netilmicin (5 mg/kg) as a single short-term infusion or as 24-hour continuous infusion. Treatment started 24 hours before surgery. Serum aminoglycoside pharmacokinetics were examined during treatment and renal cortical tissue was sampled at the moment of operation for drug determination. The short-term infusion schedule yielded cortical concentrations of 103.2 +/- 36.3 and 137.4 +/- 34.6 micrograms/gm for gentamicin and netilmicin, respectively. Tissue levels after continuous infusion were 158.1 +/- 52.9 and 178.5 +/- 21.8 micrograms/gm for gentamicin and netilmicin, respectively. For each aminoglycoside, a single short-term infusion resulted in significantly lower renal drug levels than did a continuous infusion of the same dose. From the nephrotoxicity point of view, these data support the administration of gentamicin and netilmicin as once-daily injections. This also supports the appropriateness of further studies to determine clinical efficacy of once-a-day dosing for aminoglycosides.

Drug Administration Schedule↗
PubMed1989

The role of radiology in Campylobacter enterocolitis.

A series of 18 patients with diarrhoea and positive stool cultures for Campylobacter jejuni is presented. The most important radiological features were thickening of ileal mucosal folds, of interhaustral indentations and of the ileocaecal valve, lymphoid hyperplasia and microulcerations. Radiology, as well as endoscopy, are both nonspecific in Campylobacter jejuni enterocolitis. The importance of radiology is to exclude more typical features of other causes of inflammatory bowel diseases. Moreover, before the result of the stool culture is available, the radiological features should suggest the suspicion of an acute infectious enterocolitis by Campylobacter jejuni as possible diagnosis.

Adult↗
PubMed1989

Campylobacter fetus subspecies fetus infection of an abdominal aneurysm.

We report a case of aneurysm of the abdominal aorta with spontaneous rupture in a 64-year-old man with emphysema and chronic alcoholism. Campylobacter fetus subspecies fetus was repeatedly recovered from the blood and from specimens of the excised aneurysm. The patient died in spite of early diagnosis, intravenous erythromycin and surgical intervention. The bacteriology and epidemiology of campylobacteriosis in man is briefly discussed and eight other published cases of aneurysm, infected with the same organism, are tabulated. C. fetus ssp. fetus should be added to the list of bacteria having a tropism for vascular endothelium.

Aorta, Abdominal↗
PubMed1989

Antifungal prophylaxis with itraconazole in prolonged neutropenia: correlation with plasma levels.

Seventy-two patients with haematological malignancies were treated prophylactically with itraconazole during remission induction therapy. The incidence of proven fungal infections was 18%, of which 12.5% were fatal. Aspergillus, Torulopsis and Candida proved to be major invasive pathogens. Plasma levels of itraconazole were monitored for all patients. The occurrence of fungal infection is significantly greater in the group where no therapeutic plasma levels were obtained during at least two weeks. There is a clear need to obtain quick information on itraconazole plasma levels in order to adapt dosage during prophylactic treatment in immunocompromised patients. The influence of itraconazole on liver function tests could not be separated from concomitant cytostatic or antibiotic treatment. No jaundice directly related to itraconazole could be found. During itraconazole prophylaxis a shift from classic pathogens such as Aspergillus and Candida, to Fusarium, Torulopsis and Mucor, may be seen.

Adult↗
PubMed1988

A Belgian multicentre in-vitro study of ofloxacin.

In a large multicentre study, the susceptibility of 2171 bacterial isolates to ofloxacin and other antibiotics has been examined by the Kirby-Bauer method. Susceptibility to ofloxacin (breakpoint less than or equal to 2 mg/l) was observed in 99.2% of 1104 strains Enterobacteriaceae, 88.9% of 217 Pseudomonas aeruginosa, 93.6% of 31 other Pseudomonas spp., 96.3% of 27 Acinetobacter calcoaceticus, 99.2% of 118 Haemophilus influenzae, 97.4% of 423 staphylococci, 79.4% of 107 Streptococcus faecalis and 98.7% of 142 other streptococci. There was no relationship between resistance to ofloxacin and resistance to beta-lactam antibiotics, aminoglycosides or other antibiotics tested within the same bacterial species.

Belgium↗
PubMed1987

In vitro activity and mode of action of fluoroquinolones.

The in vitro activity of nine fluoroquinolones has been determined by agar dilution method against 1100 clinical isolates of different microorganisms: 412 Enterobacteriaceae, 93 non-fermenters, 398 enteropathogens, 140 Gram-positive cocci, 31 Haemophilus and 26 gonococci. The bactericidal activity tested in broth against different representative isolates was generally similar to the inhibitory concentration. Killing kinetics studied in different isolates of Enterobacteriaceae, in Pseudomonas aeruginosa, Vibrio cholerae, Staphylococcus aureus and Streptococcus faecalis showed a very rapid bactericidal effect, after 2 to 8 h of contact, in all species except in Streptococcus faecalis.

Anti-Bacterial Agents↗
PubMed1987

Treatment of chronic osteomyelitis with ciprofloxacin.

The results of the treatment of twenty-one patients (age 22-66 years) with chronic bone or joint infections with ciprofloxacin were evaluated. The osteomyelitis was secondary to trauma in 12 patients, joint replacement in six, previous acute hematogenous infection in two and osteotomy in one. Stafylococcus aureus (11 times) and Pseudomonas aeruginosa (9 times) were most frequently cultured. The duration of ciprofloxacin therapy averaged 76 days. Concomitant antimicrobial drugs were used in one patient only. Fifteen patients were operated during treatment; in most cases the surgical procedure consisted of a thorough debridement. Nineteen patients could be evaluated. The bacteriological results were as follows: eradication 27; marked reduction 1; eradication with recurrence 1. Contamination occurred in five patients and superinfection in two, without much influence on the final outcome. The investigator's assessment at the end of the therapy was as follows: complete success in 14 patients and partial success in seven. During the follow-up (3-13 months) the therapy was judged completely successful in 16, partially successful in four and unsuccessful in one. Two patients had minor gastric complaints during therapy and one showed a temporary slight increase in the liver transaminases.

Adult↗