Insensitivity to caffeine of phage-controlled repair-processes.
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Biomedical subjects
Publications and source records attributed to W Witte.
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We report on nosocomial infections caused by Serratia marcescens occurring in a neonatal intensive care unit and a children's ward for cardiac intensive care. According to the plasmid pattern analysis, all isolated epidemic strains belonged to one clone. Multi-drug resistance, even to cephalosporins of the third generation and amikacin, was characteristic for all strains. Certain markers of S. marcescens (haemolysin, proteases, siderophores) which are thought to be related to virulence were studied but will require further investigation.
An outbreak due to a methicillin-resistant S. aureus (MRSA) strain in an orthopaedic septic care unit was observed. 17 patients developed wound infections. Stronger regime of hygiene and chemotherapy and new technics of operations controlled the outbreak within 5 months. Studies of colonisation were performed at the care unit in march, june and august 1992. 618 isolates were investigated from patients, personnel and their environment. The frequencies of detected MRSA diminished from 30% in march only to 22% in august 1992. The long time persistence of endemic MRSA in a care facility was evident from the presence of MRSA even 5 months after the last infection.
Insensitivity of Staphylococcus aureus to glycopeptides became known at the end of the 1990s. To distinguish intermediate (VISA and GISA) and full resistance (vancomycin-resistant Staphylococcus aureus, VRSA) is of both epidemiological and clinical importance. The VISA (GISA) phenotype is obviously selected by glycopeptide usage in individual patients and can be disseminated by clonal spread of particularly affected staphylococcal isolates, preferentially methicillin-resistant S. aureus (MRSA). In the meantime emergence of VISA became known worldwide. VRSA evolve by acquisition of the vanA gene from enterococci, which are of significance as reservoir of resistance genes among gram-positive bacterial pathogens. Until now three independent single cases of emergence of VRSA became known from the USA, in two of them an association with vanA containing Enterococcus spp. at the same site of the affected patients could be established. The frequency of VISA (GISA) among MRSA in Central Europe is still low (<0.1%); no VRSA have been detected until now.
Minimum inhibitory concentrations (MIC) of enoxacin, ciprofloxacin, fleroxacin, lomefloxacin, ofloxacin, pefloxacin and rufloxacin were determined against 400 uropathogens cultured from the urine of patients with complicated and/or hospital-acquired urinary tract infections (UTI) using an agar dilution method. The bacterial spectrum consisted of Entero-bacteriaceae (34.5%), enterococci (31.5%), staphylococci (21.2%) and non-fermenting bacteria (12.8%). Enoxacin inhibited all but one strain (Enterobacter cloacae) of Enterobacteriaceae up to an MIC of 1 mg/l (MIC90 0.25 mg/l). Regarding the total bacterial spectrum, enoxacin inhibited 54.5, 59.5, 76.0 and 83.8% up to an MIC of 1, 2, 4 and 8 mg/l, respectively. If the same breakpoint of resistance for ofloxacin according to DIN 58,940 (NCCLS), i.e. MIC > or = 4 mg/l (> or = 8 mg/l), is also taken for the other fluoroquinolones, and the 126 strains of enterococci are excluded, for which alternative agents, e.g. aminopenicillins, should be considered instead, the following resistance rates were found: ciprofloxacin and enoxacin 15.3% (15.0%), ofloxacin 17.2% (15.3%), pefloxacin 18.2% (15.3%), fleroxacin 19.3% (15.3%), lomefloxacin 19.7% (17.9%) and rufloxacin 31.8% (27.4%). According to their in vitro activity, all fluoroquinolones tested besides rufloxacin show similar rates of resistance against uropathogens and can therefore be considered good alternative agents for the treatment of complicated UTI.