Search PubMed⌕ Search

Biomedical subjects

M F Peeters

Publications and source records attributed to M F Peeters.

At least 55 records · Page 3Linked to original sources

[Is Chlamydia TWAR of significance in The Netherlands?].

Chlamydia TWAR is as a newly recognised organism that causes respiratory tract infection with human-to-human transmission. Our sero-epidemiological study showed that in The Netherlands prevalence of TWAR antibodies is very low in children under the age of five years, increases after beginning of school age until adolescence, and remains high (80%) during adulthood. It is known that Chlamydia TWAR can cause acute lower respiratory tract infection. However, the exact clinical spectrum within the various groups of patients still needs to be defined.

Adolescent↗

[Aeromonas species as cause of diarrhea and infections outside the gastrointestinal tract in The Netherlands].

In a national survey in the period May 1986-December 1987, Aeromonas was isolated from 277 out of 16,857 (1.6%) samples of watery, bloody or mucous stool, from patients with diarrhoea. There was a clear seasonal pattern (less than 1% in winter, up to 3% in summer). A. caviae was isolated most frequently (49%), followed by A. sobria (35%) and A. hydrophila (15%). Some non-identifiable strains were isolated as well. Aeromonas were isolated in particular from faeces of patients aged over 70 years (predominantly A. sobria) or under 5 years (predominantly A. caviae). In 67% Aeromonas was isolated as the only possible bacterial cause of diarrhoea, but in 33% other enteropathogenic bacteria were found as well (17% Campylobacter, 14% Salmonella, 2% Shigella). In addition, all Aeromonas isolates were collected which were obtained in normal diagnostic activities in the participating laboratories, among others from blood, from pus or wound fluid, from faecal samples which did not meet the above mentioned criteria. A. caviae was the dominant species in 'other' faeces and 'various' body sites but was not isolated from blood. The results of this study do not indicate that routine examinations for Aeromonas in faeces of patients with diarrhoea are necessary.

Adolescent↗

[Maxillary sinusitis in children].

In children with nasal discharge the distinction between the group with a diagnosis of rhinitis and the group with a diagnosis of sinusitis was vague. Anamnestic data and findings at physical examination were not significantly different. There was hardly any relation between radiographic and echographic findings, the nature of the irrigation fluid, and isolation of pathogenic or non-pathogenic bacteria from cultures of nasal or sinus secretions. In our opinion there is no clearcut difference between rhinitis and simple sinusitis (i.e. mucositis of the maxillary sinus without empyema). Nor is this therapeutically relevant because both conditions are mostly features of a respiratory tract infection. It is therapeutically important, however, to differentiate between sinusitis without and sinusitis with empyema. The latter requires special treatment. None of the patients studied had a sinusitis with empyema. When a child has running nose there is no reason to look for a sinusitis when there are no clinical symptoms of empyema.

Child↗

Human serum antibody response to the presence of Aeromonas spp. in the intestinal tract.

A bacterial agglutination assay, a toxin-neutralizing assay, and an enzyme-linked immunosorbent assay (ELISA) were used to compare antibodies against intestinal Aeromonas strains in serum samples from healthy carriers (n = 6), from patients with acute (n = 15) or chronic (n = 8) gastroenteritis, from patients with gastroenteritis caused by other enteropathogenic bacteria (n = 3), and from healthy blood donors (n = 50). Evaluation of the bacterial agglutination assay showed that it was not very useful. The sensitivity of the ELISA in patients with acute or chronic aeromonas-associated diarrhea was 30% (7 of 23 patients were positive), whereas the specificity was 74% (13 of 50 healthy donors were positive). Positive results in the ELISA correlated with immunoglobulin M and immunoglobulin G responses to lipopolysaccharides of homologous Aeromonas strains, as determined by gel immunoradioassay and Western immunoblot analysis. The sera showed cross-reactions with heterologous Aeromonas strains and with Escherichia coli strains. The toxin-neutralizing assay was positive in 5 of 11 patients who had developed acute severe diarrhea associated with cytotoxin-producing Aeromonas strains (46% sensitivity), whereas only 3 of 50 healthy donors had low serum titers of cytotoxin-neutralizing antibodies (94% specificity). All five patients were over 60 years of age. Cytotoxin-neutralizing activity was not observed in the sera of other groups of patients with aeromonads in their feces. We concluded that the three different serologic assays were not consonant with one another and that only the toxin-neutralizing assay distinguished patients with acute diarrhea from other groups of patients.

Adolescent↗

Antimicrobial susceptibility of sixty human fecal isolates of Aeromonas species.

The MICs of 21 antimicrobial agents were determined for 60 strains of Aeromonas spp. isolated from human feces. All isolates tested were susceptible to aztreonam, tetracycline, imipenem, moxalactam, pipemidic acid, gentamicin, trimethoprim-sulfamethoxazole, pefloxacin and ciprofloxacin. Resistance to erythromycin and streptomycin was observed in all 60 strains. Aeromonas caviae was less susceptible to cefamandole, cefotaxime, norfloxacin, chloramphenicol, tetracycline, sulfamethoxazole and trimethoprim than was either Aeromonas hydrophila or Aeromonas sobria. It was concluded that cotrimoxazole or one of the newer quinolones can be considered for treatment of aeromonas-associated diarrhea.

Adult↗

Phenotypic characterization and DNA relatedness in human fecal isolates of Aeromonas spp.

Phenotypic characteristics were used to identify 189 Aeromonas strains isolated from human feces. One hundred forty-two of these strains were placed in 11 DNA hybridization groups, and the genetic and phenotypic data were compared. According to the criteria of Popoff, 66% of the strains were identified as Aeromonas caviae, 18% were identified as A. sobria, and 16% were identified as A. hydrophila. Some biochemical characteristics differed from the criteria of Popoff; 19 of 40 (48%) of tested strains were encapsulated, 42 of 124 (34%) of A. caviae strains were nonmotile, and all A. sobria strains were resistant to KCN. Gas production from D-glucose was temperature dependent; 11 of 64 (17%) A. hydrophila and A. sobria strains produced gas only at 22 degrees C. Of 142 Aeromonas strains, 57% belonged to hybridization group 4, 25% belonged to group 8, 11% belonged to group 1, 4% belonged to group 5A, 2% belonged to group 3, and 1% belonged to group 2. Of 26 strains phenotypically identified as A. hydrophila, 8 (31%) were in hybridization group 8, which contains strains of the new species A. veronii. It therefore appears that our ability to identify Aeromonas strains phenotypically is not sufficiently specific. Either additional definitive biochemical markers must be found or phenotypic identification, at least for some Aeromonas groups, must be regarded as only presumptive.

Aeromonas↗

Clinical and epidemiologic aspects of members of Aeromonas DNA hybridization groups isolated from human feces.

Between June 1982 and May 1987 Aeromonas species were isolated from 208 of 34,311 (0.61%) fecal samples submitted to a Regional Public Health Laboratory in The Netherlands. Aeromonas isolates were found most frequently in summer and rarely in winter. Of 169 Aermonas isolates that were available for further study, 19% were isolated from patients with a mixed infection, 5% from patients with underlying diseases, and 15% from patients who used medication that could predispose the intestinal tract to colonization with Aeromonas species. Aeromonas species that produced cytotoxins to Vero cells (cytotoxigenic) were found in hybridization groups 1 (11% of all isolates), 2 (1%), 3 (2%), and 8 (25%) and were identified phenotypically as A. hydrophila or A. sobria. Aeromonas species that did not produce cytotoxins to Vero cells (noncytotoxigenic) were found in hybridization groups 4 (57%) and 5A (4%) and were identified phenotypically as A. caviae. Distribution of Aeromonas species by age showed a predominance of noncytotoxigenic strains in children under the age of 5 years (46% of all noncytotoxigenic strains), while cytotoxigenic strains were mainly cultured from patients aged 50 years or older (54% of all cytotoxigenic strains). Significant correlations were found between cytotoxigenic strains and hospitalization, foreign travel, and contact with surface water. Cytotoxigenic strains were isolated significantly more often than noncytotoxigenic strains from patients with diarrhea, but in a multivariate analysis including age, previous medication, underlying disease, and foreign travel, this association was not significant.

Aeromonas↗

Diagnosis of herpes simplex virus encephalitis by detection of virus-specific immunoglobulins A and G in serum and cerebrospinal fluid by using an antibody-capture enzyme-linked immunosorbent assay.

An enzyme-linked immunosorbent assay was evaluated for detection of intrathecal synthesis of immunoglobulin G (IgG) and IgA antibodies to herpes simplex virus (HSV) in patients with HSV encephalitis (HSVE). Since the antibody-capture principle was used and the assay was carried out at the saturation level of the anti-IgG- or anti-IgA-coated solid phase, correction for blood-brain barrier leakage was not needed. A total of 34 pairs of serum and cerebrospinal fluid specimens obtained from 20 patients with HSVE were examined. Intrathecal synthesis of HSV IgG and IgA was detected from day 7 after the onset of illness in patients with HSVE. Specimens from all 19 patients from whom paired serum and cerebrospinal fluid specimens were obtained at more than 10 days after the onset of illness were positive. Intrathecal synthesis of HSV IgG and IgA was not detected in patients with HSVE before day 7 of illness or in any of the 16 control patients with other causes of (meningo)encephalitis. Use of the antibody-capture enzyme-linked immunosorbent assay for HSV IgG and IgA allows the rapid diagnosis of HSVE during the second week of illness.

Antibodies, Viral↗

Rapid diagnosis of herpes encephalitis by enzyme immuno-assay.

Five cases of encephalitis caused by herpes simplex virus (HSV) are described. HSV-specific IgM and IgM antibodies were detected in cerebrospinal fluid and serum by use of antibody-capture noncompetitive enzyme-linked immunosorbent assay. The tests seem suitable for rapid diagnosis in the second week after onset of neurological symptoms. The clinical importance of early diagnosis and therapy in patients of HSV encephalitis has been discussed.

Adolescent↗

Acute otitis media: a new treatment strategy.

The incidence of acute otitis media and its response to treatment only with nose drops and analgesics (but without antibiotics or myringotomy) were assessed over three months by 45 doctors in and around Tilburg. In addition, over 17 months 60 general practitioners assessed the effects of this limited treatment in children aged 2 to 12 years and referred all those in whom the condition took an unsatisfactory course (either a severe course--illness continuing beyond three to four days with high temperature or pain, or both--or persistent discharge after 14 days) to an ear, nose, and throat specialist. Those referred because of appreciable illness continuing beyond three or four days were entered into a further study, comparing the effects of myringotomy alone, antibiotics alone, and myringotomy and antibiotics combined. Bacteriology was assessed in all children in whom the course of the condition was unsatisfactory. More than 90% of an estimated 4860 children seen over 17 months (estimation based on incidence of severe course in the three month study) recovered within a few days. The course of the condition was severe in only 126 (2.7%) patients; haemolytic streptococci group A were identified in 30 of these 126 patients but Haemophilus influenzae in only one. One hundred of these patients with a severe course entered the trial of treatment, which showed antimicrobial treatment either alone or in combination to be more effective than myringotomy alone. Whether combined treatment was more effective than antibiotics alone remained unconfirmed. Acute otitis media in children can be treated with nose drops and analgesics alone for the first three to four days. Patients in whom this regimen is not accompanied by satisfactory recovery can be recognised within a short time and treated by the general practitioner.

Acute Disease↗