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Biomedical subjects

O V Renkonen

Publications and source records attributed to O V Renkonen.

At least 37 records · Page 2Linked to original sources
PubMed1992

Bacterial vaginosis in early pregnancy and pregnancy outcome.

OBJECTIVE: We assessed the association between bacterial vaginosis in early pregnancy and adverse pregnancy outcome. METHODS: Vaginal swabs for bacterial culture, Gram stain, and Papanicolaou stain were taken at the first prenatal visit between 8-17 weeks' gestation in 790 healthy nulliparous women. RESULTS: Culture-proven bacterial vaginosis was detected in 169 of 790 women (21.4%), 167 (98.8%) of whom could also be identified by Gram stain. Papanicolaou smears were available from 299 women, among whom 101 had bacterial vaginosis on culture; of these 101, 78 (77.2%) could be detected by Papanicolaou stain. Of the 751 women whose clinical follow-up was completed, 42 had been treated for preterm uterine contractions (preterm labor), but only 17 delivered between 20-36 weeks' gestation (preterm birth). Premature rupture of membranes (PROM) occurred more than 6 hours before delivery in 80 cases (nine preterm and 71 term). Bacterial vaginosis in early pregnancy predicted preterm labor, preterm birth, or preterm PROM with a sensitivity of 41-67%, specificity of 79%, and negative predictive value of 96-99%, but the positive predictive value was low at 4-11%. However, bacterial vaginosis was associated with a 2.6-fold risk (95% confidence interval [CI] 1.3-4.9) for preterm labor, a 6.9-fold risk (95% CI 2.5-18.8) for preterm birth, and a 7.3-fold risk (95% CI 1.8-29.4) for preterm PROM. CONCLUSIONS: Bacterial vaginosis in early pregnancy can be detected reliably by Gram stain and, in most cases, by Papanicolaou smear. Although bacterial vaginosis is associated with preterm labor, preterm birth, and preterm PROM, the clinical usefulness of its assessment is limited because of the high rate of false-positive findings.

Adult↗
PubMed1991

Emergence of fluoroquinolone resistance in Campylobacter jejuni and Campylobacter coli in subjects from Finland.

The in vitro susceptibilities of 102 human campylobacter strains isolated between 1978 and 1980 and 100 strains isolated in 1990 to ciprofloxacin, norfloxacin, erythromycin, gentamicin, and doxycycline were examined. The biotypes and heat-stable serotypes of the strains as well as antimicrobial treatments and travel history of the campylobacter-positive patients were also studied. The results indicated that susceptibility to erythromycin, gentamicin, and doxycycline has remained the same during the past 10 years. No gentamicin-resistant strains were found. Resistance to erythromycin was 3% in both groups of strains. However, the number of norfloxacin-resistant strains increased from 4 to 11% in the follow-up period, and ciprofloxacin-resistant strains, which had not occurred 10 years ago, composed 9% of the strains isolated in 1990. Thus, the increase of fluoroquinolone resistance in Campylobacter jejuni and Campylobacter coli has been significant in Finland in the past 10 years.

4-Quinolones↗
PubMed1991

Antibiotic concentrations in liquor compared to the minimal inhibitory concentrations of isolates in paediatric bacterial meningitis. The Finnish Study Group.

The susceptibilities of 171 bacteria which caused meningitis in 200 children were tested for their susceptibility as minimal inhibitory concentrations (MICs) for the antibiotics used in therapy. These antibiotics were chloramphenicol, ampicillin, cefotaxime and ceftriaxone. The MICs were compared to the minimal concentrations of the drugs seen in the cerebrospinal fluid (CSF) samples. The minimal bacteriostatic capacity (lowest concentration in CSF/MIC) of both cephalosporins was superior to that of chloramphenicol and ampicillin. The correlation of the finding with the speed of liquor sterilization in the treatment groups is discussed.

Adolescent↗
PubMed1990

The emergence and mechanisms of trimethoprim resistance in Escherichia coli isolated from outpatients in Finland.

Trimethoprim (TMP), either alone or in combination with sulphonamides, is commonly used for treating urinary tract infections. In Finland, TMP alone has been in clinical use since 1973. TMP resistance in the major outpatient urinary tract pathogen, Escherichia coli, increased during 1978-1988 from 5% to 16% in the Turku area, during 1980-1988 from 3% to 19% in the Helsinki area and also during 1980-1988 from 3% to 14% in the Rovaniemi area. The majority (91%) of TMP-resistant strains were highly-resistant to TMP (MIC greater than or equal to 1024 mg/l). The most common (57%) TMP resistance gene, detected by DNA hybridization, was the type I dihydrofolate (DHFR) gene. The type II DHFR genes were found in less than 3% of the strains studied. No positive hybridizations were detected with the type III DHFR probe, and only a few positive hybridizations were found with the type V DHFR probe. Forty percent of the isolates did not hybridize with any of the DHFR probes used, suggesting additional unknown resistance mechanisms responsible for the high-level TMP resistance. These unknown TMP resistance mechanisms, together with the type I DHFR-mediated resistance, were responsible for the increase of TMP resistance among the E. coli strains studied.

Escherichia coli↗
PubMed1990

On the proteolytic activity of contact lenses and bacteria.

Contact lens wear (CLW) has been shown to cause an elevation in tear fluid (TF) plasmin levels. This study investigated whether the proteolytic activity assayed by a caseinolytic technique was also bound by CLs and whether certain bacterial species contribute to the production of plasmin. CLs worn by patients with corneal disease showed proteolytic activity in five out of nine cases when examined on casein agar. Histological and electron microscopic examination of the lenses revealed bacterial adherence and growth on both surfaces of the CLs. Strains of Staph. epidermidis, Staph. aureus, Pseudomonas aeruginosa and Branhamella catarrhalis, isolated from eyes with external infections, were cultured on a modified milk casein agar and examined for their proteolytic activity. Neither cultures of Branhamella catarrhalis nor Staph. aureus showed proteolytic activity when examined by direct caseinolytic assay. The proteolytic activity shown by Staph. epidermidis or Pseudomonas aeruginosa was not affected by a proteinase inhibitor aprotinin. However, when exogenous plasminogen was added into the casein agar, Staph. aureus was shown to produce caseinolytic activity. This activity was interpreted to be due to plasminogen activator (PA) activity. It was inhibited by aprotinin. Examination of culture fluids of the bacterial species mentioned above did not show caseinolytic activity. Culture fluid of Staph. aureus contained PA activity. The present study confirms the ability of certain bacterial species to adhere to CLs. Moreover, proteases such as plasmin and bacterial enzymes are present in TF during CL wear and may even adhere to the surface of CLs. Hence, bacterial growth probably contributes to the production of proteases on the ocular surface during CL wear.

Adolescent↗
PubMed1990

A randomised comparison of ceftazidime and piperacillin, both in combination with flucloxacillin for treatment of febrile episodes in neutropenic children. Finnish Three-Centre Study.

111 febrile episodes in 98 neutropenic children were randomly treated with either ceftazidime (CAZ) 150 mg/kg/day or with piperacillin (PIP) 200 mg/kg/day, both combined with flucloxacillin (FLUC) 50 mg/kg/day. A total of 37/47 (79%) eligible episodes in the CAZ group and 41/53 (77%) in the PIP group were cured without needing to stop the initial therapy. The success without modification of the treatment in the verified septicaemias in the CAZ group was 8/18 (44%) and in the PIP group 5/18 (28%). Of the bacteriologically documented infections, 13/24 (54%) in the CAZ group and 11/24 (46%) in the PIP group were cured without modification of the therapy. Similarly, 17/31 (55%) of all the isolated bacteria in the CAZ group and 14/33 (42%) in the PIP group were eradicated with the initial therapy. Overall there were 13 deaths of which 4 in the CAZ group and 5 in the PIP group occurred during the infection. An increasing granulocyte count exceeding 0.25 x 10(9)/l at the end of the therapy was a good prognostic sign for the outcome of the infection. This study indicates that CAZ is as effective as PIP in the treatment of infections in neutropenic children.

Adolescent↗
PubMed1989

Randomised comparison of chloramphenicol, ampicillin, cefotaxime, and ceftriaxone for childhood bacterial meningitis. Finnish Study Group.

In a multicentre study, 220 consecutive cases of bacterial meningitis in children older than 3 months were randomised to treatment with chloramphenicol, ampicillin (initially with chloramphenicol), cefotaxime, or ceftriaxone. The drugs were given in four equal daily doses for 7 days, except ceftriaxone which was given only once daily. 200 cases could be assessed; the causative organisms were Haemophilus influenzae type b (Hib) in 146; meningococci (Mnc) in 32; pneumococci (Pnc) in 13; and other or unknown in 9. In patients with Hib meningitis, sterilisation of the cerebrospinal fluid occurred most rapidly with ceftriaxone. Otherwise, in terms of overall clinical recovery, normalisation of laboratory indices, clinically significant adverse reactions, toxic effects, sequelae, and mortality rate, the treatment groups were very similar. However, there were 4 bacteriological failures, all in the chloramphenicol group. Also, the treatment was extended or changed in more cases in the chloramphenicol group than in the other groups. Chloramphenicol was thus inferior to the other three antimicrobials. Ampicillin is a good and cheap alternative, but there are difficulties with resistance. Easy administration tempts the use of ceftriaxone rather than cefotaxime but it causes diarrhoea. A 7-day course of ampicillin, cefotaxime, or ceftriaxone is sufficient in Hib, Mnc, or Pnc meningitis.

Adolescent↗
PubMed1989

Prospective study of the etiology of diarrhea in adult outpatients and inpatients.

A prospective study of the etiology of diarrhea in 253 adult outpatients and inpatients was conducted in Helsinki in 1985-86. The outpatients constituted 84.6% of all patients studied. A broad panel of diagnostic techniques was applied, including detection of bacteria and parasites in the feces and determination of the serologic responses to campylobacter, salmonella, Yersinia enterocolitica, and several viruses. Pathogens were identified for 28.5% of the patients. The commonest findings were Campylobacter jejuni/coli in 13.0% and Salmonella species in 7.1% of the patients. Mixed infections of several pathogens were found in 16 patients.

Adult↗
PubMed1989

Effect of erythromycin acistrate and erythromycin stearate on human colonic microflora.

The effects of erythromycin acistrate (2'-acetyl erythromycin stearate), a new erythromycin derivative, and erythromycin stearate on the faecal microflora were compared in a randomized cross-over study. 12 healthy volunteers were given either drug 500 mg t.i.d. for 1 week. Their faeces were studied before, immediately after, and 1 week after the drug administration period. After a wash-out period of 4 weeks, the drugs were interchanged. Both erythromycin acistrate and erythromycin stearate induced changes in the normal colonic microflora to about the same extent. The most marked effect was the suppression of gram-negative anaerobic and aerobic rods. Clostridium difficile appeared in 1 subject on both drugs. Also the counts of aerobic gram-positive cocci were altered; enterococci increased in number. An increased resistance to erythromycin was noted among staphylococci and enterococci after both drugs.

Adolescent↗
PubMed1988

Cefamandole and isoxazolyl penicillins in antibiotic prophylaxis of patients undergoing total hip or knee-joint arthroplasty.

In a prospective comparative clinical efficacy and safety study, 58 patients undergoing total hip or knee arthroplasty were randomly allocated to two groups; one received 29 cefamandole intravenously before operation and then 1 g every 6 h parenterally for 3 days and the other received 29 cloxacillin i.v. every 8 h for 1 day and 29 dicloxacillin perorally every 8 h for 2 days. Concentrations of cefamandole and cloxacillin were measured in the serum of all patients and in the synovial fluid of 28 patients. The serum C-reactive protein (CRP) level was measured in 16 randomly allocated patients preoperatively and daily for 8 days. In serum the concentrations of cefamandole and cloxacillin were high. The great variation in cloxacillin concentration can be due in part to its strong affinity for blood proteins. Cefamandole entered the synovial fluid of the knee joint at high concentrations in 5-15 min; similar concentrations of cloxacillin were measured after 16-30 min. Thus, cefamandole seems to be more recommendable as antibiotic prophylaxis in total hip and knee replacements. The CRP level decreased to below 60 mg/l in all 16 patients on the 6th postoperative day.

Aged↗
PubMed1988

Fleroxacin versus standard therapy in gonococcal urethritis.

Eighty male patients with gonococcal urethritis were randomly allocated to receive, in an open study, either a single oral 400 mg dose of fleroxacin, or, as standard therapy, a single intramuscular dose of 2.4 million units of penicillin G plus 1.0 g of probenecid orally. Microbiological analysis of the urethral smear and complete physical examination with blood and midstream urine samples was carried out before and after therapy (day 7 or 8). Urethral Neisseria gonorrhoeae was the only pathogen in 50 patients while 29 presented with mixed infections of both N. gonorrhoeae and Chlamydia trachomatis. In one case, the culture was not positive for either of the pathogens. N. gonorrhoeae was eradicated by both regimens in all 78 evaluable patients. However, the 29 patients with mixed infections remained clinically symptomatic and still showed C. trachomatis irrespective of the treatment regimen. Two patients failed to return for follow-up. No adverse reactions were reported.

Adult↗
PubMed1988

Beta-haemolytic group A, B, C and G streptococcal septicaemia: a clinical study.

87 beta-haemolytic streptococcal septicaemias in adult patients during 1979-86 in a university hospital were reviewed. 25% were caused by group A streptococcus, 17% by group B, 14% by group C and 44% by group G streptococcus. 67% of the septicaemias due to group B streptococcus were nosocomial, whereas the group A, C or G septicaemias were in most cases community-acquired. Alcoholism was the most common underlying disease in group A (32%) and malignancy in group G streptococcal septicaemias (45%). The most common origin and focus of infection in group A, C and G streptococcal septicaemias was the skin. The total mortality in beta-haemolytic streptococcal septicaemias was 20%, higher in septicaemias caused by group A (32%) and group B (33%) than by group C (17%) and group G (8%) streptococci. Nevertheless, there were more patients in group G streptococcal septicaemias with severe underlying diseases than in other groups of beta-haemolytic streptococci. The present data seem to indicate that a septicaemia due to group G is a more benign disease than a septicaemia due to group A streptococcus.

Adult↗
PubMed1987

In vitro activity of RO 15-8074 and RO 19-5247.

The in vitro activity of RO 15-8074 (cefetamet) and RO 19-5247, new oral cephalosporins, was compared with that of amoxicillin, cephalexin, cefaclor, cefuroxime and erythromycin against 292 clinical isolates using the agar dilution method. Both RO 15-8074 and RO 19-5247 were very active against Proteus mirabilis, Neisseria gonorrhoeae, Haemophilus influenzae and Streptococcus pyogenes, but less active against Staphylococcus saprophyticus and Enterobacter cloacae. RO 19-5247 was more active than RO 15-8074 against Haemophilus influenzae and Streptococcus viridans.

Amoxicillin↗
PubMed1987

Septicemia in a university pediatric hospital: a five-year analysis of the bacterial and fungal isolates and outcome of the infections.

A 5-year analysis comprising all positive blood culture isolates from a 222-bed university pediatric hospital in Helsinki revealed 369 bacteremic but only 8 fungemic cases. Haemophilus influenzae and Staphylococcus aureus, 19% of the total material each, were the most common pathogens isolated, followed by S. epidermidis (11%), Escherichia coli (8%), pneumococci (8%), and group B beta-hemolytic streptococci (6%). Remarkable differences in distribution of the pathogens were observed in different hospital units. However, 5 most common microorganisms covered 62-86% of the spectrum in each unit. Two bacteria, H. influenzae in the unit for infectious diseases and S. aureus in the hematology-oncology unit were significantly (p less than 0.001 or less than 0.01, respectively) more common than any other organism in those units. The average case fatality rate was 14% with a range from 1.5% to 40%, depending upon the causative agent isolated. Also, the mortality was much higher in neonates than in other age groups. We conclude that by monitoring the blood isolates separately in each unit one can find remarkable differences in the same hospital. On the other hand, characteristics of an individual hospital may vary significantly from those described in textbooks. These characteristics should be recognized and taken into account in the antimicrobial policy.

Bacteria↗
PubMed1986

Reliability of a disk diffusion method using semiconfluent growth in the determination of aminoglycoside resistance.

Susceptibility of 553 blood culture isolates to gentamicin, tobramycin, amikacin, and netilmicin was determined by a routine disk diffusion method with semiconfluent growth (AB Biodisk, Solna, Sweden) and a microtiter-method (Sensititre). The disk diffusion test gave false sensitive results in 9.4-71% of the 9-39 aminoglycoside resistant strains studied. False resistant results occurred in 1.0-7.6% of measurements among the over 500 aminoglycoside sensitive strains. Because of the frequent error rate, the disk method with semiconfluent growth should be replaced with other methods in the determination of aminoglycoside resistance in bacteriological laboratories.

Amikacin↗