Combined plasmapheresis and hemodialysis treatment for severe hemolytic-uremic syndrome following Campylobacter colitis.
Explore the source record for details and available documents.
Campylobacter Infections↗
Biomedical subjects
M Walder
Publications and source records attributed to M Walder.
Diarrhoea in Swedish infants. Aetiology and clinical appearance.
Ninety-five children with gastroenteritis admitted at the Department of Paediatrics, Malmö General Hospital, Malmö, Sweden, starting November 1978 through October 1979 were studied. Patients were examined clinically and the course of their disease was followed. Stool specimens from all patients were analysed by routine bacteriology and rotavirus identification was done by immune-electroos-mophoresis. Fifty-eight per cent of patients had rotavirus. Campylobacter was found in 6%, enteropathogenic E. coli in 2%, Yersinia enterocolitica in 2% and Salmonella in 1% of patients. Stool specimens from 53 healthy children matched for sex and age served as controls for bacterial pathogens. All were negative. Forty per cent of patients presented with a clinical dehydration, but only 11%-half of them with bacterial enteropathogens-needed i.v. therapy and 4% required antibiotic treatment. Median time for hospitalization was three days. Vomiting, fever, watery diarrhoea and initial clinical dehydration were more commonly associated with rota virus infection. Macroscopic blood in stools was restricted to patients with bacterial aetiology.
Adolescent↗
Enzyme-linked immunosorbent assay (ELISA) for antibodies against Campylobacter jejuni, and its clinical application.
Antibody response to Campylobacter jejuni/coli (CJC) was investigated, using an enzyme-linked immunosorbent assay, ELISA. With a mixture of lipopolysaccharide from two CJC strains as antigen in ELISA, all 24 tested rabbit anti-CJC sera showed high antibody levels. However, only 70% of sera from patients with Campylobacter enteritis demonstrated an antibody response against the combined LPS antigen, using paired sera. In addition, the results obtained suggested non-specific binding of human immunoglobulin. When 24 formalinized whole CJC bacteria were used as antigen in ELISA, all corresponding rabbit antisera reacted with one strain (M 14). Essentially no unspecific binding of human immunoglobulin was obtained. Antibodies were detected in sera from healthy blood donors and at a lower level in sera from children, suggesting early immunization. In 67 enteritis patients with positive stool cultures for CJC, a significantly increased level of IgG antibodies could be detected in single or paired serum samples from 82% of the patients. An IgG titre increase occurred early in the course of infection, suggesting a boosting of an earlier immunization. IgM antibodies could be detected in the same sera in 77% of the patients. Considering both IgG and IgM analyses of the enteritis sera, 94% of the patients were positive in Campylobacter ELISA serology compared with only 5% of healthy controls.
Adult↗
Epidemiology of campylobacter enteritis.
Campylobacter jejuni/coli (CJC) was isolated from 386 patients (6.9%) of 5571 with a history of acute diarrhoea between December 1977 and June 1980. In the same study population Salmonella was found in 4.1%, Shigella in 1.7% and Yersinia enterocolitica in 2.1%. Only 5 (0.25%) of 2000 health controls had CJC in their stools. 53% of the patients had acquired their infection in Sweden. The peak incidence for CJC was from July to September. More than 50% of the patients were between 16-35 years. Within 1 month of the acute enteritis 80% had negative stool cultures for CJC. In general, campylobacter enteritis is not a severe disease and only 11% were admitted to hospital. The most common signs were high fever in 35%, frequent watery diarrhoea in 37%, colics or abdominal pains in 84%, and fresh blood in stools in 12%. Antibiotic treatment was given in 13% and was erythromycin in 56% and doxycycline in 26% of these patients. If chemotherapy was given and the strain was sensitive, no relapse occurred within 2 weeks of the treatment. The antibiograms for 435 strains showed that the aminoglycosides, erythromycin, doxycycline, chloramphenicol and nalidixic acid were the most effective drugs. This study implies that CJC is a common cause of bacterial diarrhoea also in patients with domestic enteritis.
Adolescent↗
Haemophilus influenzae, Pneumococci, group A streptococci and Staphylococcus aureus: sensitivity of outpatient strains to commonly prescribed antibiotics.
The degree of resistance of Haemophilus influenzae, pneumococci, group A streptococci and Staphylococcus aureus to phenoxymethylpenicillin, ampicillin, doxycycline, erythromycin and chloramphenicol was investigated with the MIC-method (plate-dilution technique). Each bacterial group consisted of 100 outpatient strains. Seven strains of H. influenzae were beta-lactamase-producing. Of the 100 haemophilus strains, 58% were sensitive and the rest intermediate sensitive to erythromycin. 99% were sensitive to doxycycline and all strains were sensitive to chloramphenicol. Essentially all pneumococcal strains were sensitive to the antibiotics tested. However, a few strains demonstrated diminished sensitivity to penicillins. All group A streptococci were sensitive to ampicillin, penicillin and chloramphenicol, and 98% were sensitive to erythromycin. Approximately 1 strain out of 5 was resistant to doxycycline. 75% of S. aureus were beta-lactamase producers. Four of the S., aureus strains were resistant to erythromycin and 8 to doxycycline. The results presented indicate a better antibiotic situation than in some other countries, but suggest the need for a more extensive antibiotic sensitivity examination of isolated bacteria.
Anti-Bacterial Agents↗
Five cases of Campylobacter jejuni/coli bacteremia.
During a 3-year period (1977-1979) 5 cases of Campylobacter jejuni/coli (CJC) bacteremia were observed in the south of Sweden. Four of the 5 patients had diarrhoea and 3 of 4 patients tested showed a serological response to a homologous strain. This accumulation of bacteremia cases may be explained from the short duration between the onset of high fever (less than 38.5 degrees C) and obtaining blood cultures, and the use of blind subcultures in the laboratory procedures.
Aged↗
Susceptibility of shigellae to mecillinam, nalidixic acid, trimethoprim, and five other antimicrobial agents.
A total of 199 strains of shigella (1 Shigella dysenteriae, 15 S. boydii, 47 S. flexneri, and 136 S. sonnei) isolated in Malmö, Sweden, within a 3-year period (1977 through January 1980) were tested with the agar plate dilution method for susceptibility to commonly used and newer antimicrobial agents. Mecillinam, nalidixic acid, and trimethoprim had the best in vitro activity. S. flexneri dominated among strains resistant to three or more antimicrobial agents and were less susceptible to ampicillin, chloramphenicol, and doxycycline than other types studied. Sixty-four percent of the strains were resistant to sulfamethoxazole. In vitro, a synergistic effect with trimethoprim was shown only in strains susceptible to sulfamethoxazole. The amidinopenicillin mecillinam was highly active against shigellae. When resistance occurred, it was linked to ampicillin in 17 of 18 strains. The quinolines, here represented by nalidixic acid, might be the drugs of choice.
Amdinocillin↗
Influence of serum protein binding and mode of administration on penetration of five cephalosporins into subcutaneous tissue fluid in humans.
The penetration of five cephalosporins into interstitial fluid was investigated by a new method employing cotton threads implanted subcutaneously. Penetration after short bolus injections, calculated as area under interstitial fluid level curve divided by area under serum level curve x 100, was 47.0% for cephradine, 30.6% for cefuroxime, 26.7% for cefotaxime, 24.6% for cefoxitin, and 9.6% for cefoperazone. There was an inverse correlation between the degree of penetration and serum protein binding with r = -0.97. The area under interstitial fluid level curves was the same whether the drugs were administered as short bolus injections or short time infusions.
Adult↗
Incidence of Legionella pneumophila in acute lower respiratory tract infections.
The etiological role of Legionella pneumophila and other infectious agents in acute lower respiratory tract infections in 112 patients attending an infectious disease clinic was estimated by a serological study of paired sera and bacteriological culture of nasopharynx swabs and culture and immunoelectroosmophoresis of expectorates. Only 2 of the patients had a 4-fold rise in antibody titre to L. pneumophila, suggesting a similar incidence of legionnaires' disease as reported from USA.
Adolescent↗
Penetration of cefuroxime and doxycycline into the pleural fluid.
Explore the source record for details and available documents.
Cefuroxime↗
Failure of excessive doses of ampicillin to prevent bacterial relapse in the treatment of acute pyelonephritis.
In order to evaluate whether very high doses of ampicillin might be more effective than conventional therapy in eradicating bacteria in patients with acute pyelonephritis, 34 affected patients were randomly assigned into two treatment groups. One group was given ampicillin in a daily dose of 30 g for three days and 20 g for four days without further treatment. The other group was given ampicillin in moderate doses for one month. Out of 13 patients treated with excessive doses for one week, only three were completely cured whereas conventional therapy cured 9 out of 21. Thus, excessive doses of ampicillin given for one week were not more effective but more expensive and possibly less beneficial than conventional therapy.
Acute Disease↗
Susceptibility of Campylobacter fetus subsp. jejuni to twenty antimicrobiol agents.
One hundred recent clinical isolates of Campylobacter fetus subsp. jejuni were tested by an agar dilution technique for susceptibility to each of 20 antimicrobial agents. Doxycycline and gentamicin were the most active of the drugs examined, inhibiting all strains at concentrations achievable in serum. Although the median minimal inhibitory concentration of erythromycin was low, 8% of the isolates were highly resistant. All isolates of Campylobacter fetus subsp. jejuni were relatively resistant to the beta-lactam antibiotics. Some strains were highly resistant to metronidazole and tinidazole.
Anti-Bacterial Agents↗
Erythromycin-resistant Campylobacters.
Explore the source record for details and available documents.
Campylobacter↗
Acute otitis media in older children and adults treated with phenoxymethyl penicillin or erythromycin stearate. Bacteriological and immunological aspects.
Seventy-eight patients, all over 10 years of age, with clinical signs of acute otitis media, received either phenoxymethyl penicillin or erythromycin stearate, in a randomized manner, and the clinical, bacteriological and immunological effects were studied. Haemophilus influenzae and Streptococcus pneumoniae were the major pathogens isolated from the nasopharynx in 30 and 28 patients, respectively. Increased levels of C-reactive protein (CRP) were detected in 53 (68%) of the patients. There was no statistical difference in the CRP-levels depending on species of bacteria isolated. The highest incidence was observed in cases with Branhamella catarrhalis and H. influenzae. Persistence of H. influenzae during antibiotic therapy was demonstrated in 70% and after therapy in 63% compared to 4% and 11% persistence of S. pneumoniae. The type of antibiotic treatment did not influence persistence. An immune response to H. influenzae and S. pneumoniae was detected significantly more often in patients treated with erythromycin stearate than with phenoxymethyl penicillin.
Acute Disease↗
Long-term effects on bacterial sensitivity patterns of preoperative antibiotic prophylaxis in colorectal surgery.
Since 1973, when doxycycline was introduced as peroperative prophylaxis in elective colorectal surgery at Malmö General Hospital, Sweden, there has been an unchanged and low rate (8-12%) of septic complications in colonic surgery. For treating postoperative infections ampicillin, cefuroxime and piperacillin have been used since 1973, 1980 and 1982 respectively. The sensitivity pattern of E. coli and Klebsiella against these four antibiotics used for prophylaxis and treatment has been followed for the past five years and only minor changes have occurred through the period. However, a lower frequency of antibiotic resistance was recorded for bacteria isolated peroperatively than postoperatively after colorectal surgery or from infection sites from other patients presumably mostly due to selection caused by antibiotics used within the hospital. Due to the good clinical outcome and seemingly lack of development of antibiotic resistance in peroperative isolates, doxycycline still remains a choice for prophylaxis in bowel surgery.
Adolescent↗