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  • 1
    Electronic Resource
    Electronic Resource
    Scoring system for nosocomial pneumonia in ICUs (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1155-1161 
    Details
    ISSN: 1432-1238
    Keywords: Nosocomial pneumonia ; scoring system ; Risk factors ; Intensive care units
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To develop a scoring system for stratifying patients in intensive care units (ICUs) by risk of developing nosocomial pneumonia (NP), based on variables generally available in an ICU, and to determine the probability of a patient developing NP in the ICU. Design and setting A 2-year prospective cohort study conducted in a medical and surgical ICU. Patients 756 patients admitted to the ICU for 48 h or more were followed up until the development of NP or death or discharge from the ICU. Measurements and results 129 (17.1%) patients developed NP, 106 (14%) in the first 2 weeks. The following independent risk factors were identified by multivariate analysis: no infection on admission [relative risk (RR)=3.1, 95% confidence intervals (CI)=2.0 to 4.8]; thorax drainage (RR=2.1, 95% CI=1.2 to 3.5); administration of antacids (RR=2.1, 95% CI=1.4 to 3.1); partial pressure of oxygen (PO2)〉110 mmHg (RR=1.6, 95% CI=1.0 to 2.6); administration of coagulation factors (RR=1.8, 95% CI=1.0 to 3.2); male gender (RR=2.7, 95% CI=1.2 to 6.3); urgent surgery (RR=2.4, 95% CI=0.9 to 6.4); and neurological diseases (RR=4.2, 95% CI=1.9 to 9.4). To obtain a predictive risk index for NP, a scoring system was developed using a multivariate model. The probability of developing NP varied between 11.0% in the lowest risk group and 42.3% in the highest risk group. The patients' risk of acquiring NP was seven times higher in the highest score category (IV) than in the lowest one (I). Conclusions ICU patients can be stratified into high- and low-risk groups for NP. No infection on admission, thorax drainage, administration of antacids, and PO2〉110 mmHg were associated with a higher risk of NP during the entire 2-week period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709329
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  • 2
    Electronic Resource
    Electronic Resource
    Scoring system for nosocomial pneumonia in ICUs (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1155-1161 
    Details
    ISSN: 1432-1238
    Keywords: Key words Nosocomial pneumonia ; Scoring system ; Risk factors ; Intensive care units
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To develop a scoring system for stratifying patients in intensive care units (ICUs) by risk of developing nosocomial pneumonia (NP), based on variables generally available in an ICU, and to determine the probability of a patient developing NP in the ICU. Design and setting: A 2-year prospective cohort study conducted in a medical and surgical ICU. Patients: 756 patients admitted to the ICU for 48 h or more were followed up until the development of NP or death or discharge from the ICU. Measurements and results: 129 (17.1%) patients developed NP, 106 (14%) in the first 2 weeks. The following independent risk factors were identified by multivariate analysis: no infection on admission [relative risk (RR)=3.1, 95% confidence intervals (CI)=2.0 to 4.8]; thorax drainage (RR=2.1, 95% CI=1.2 to 3.5); administration of antacids (RR=2.1, 95% CI=1.4 to 3.1); partial pressure of oxygen (PO2) 〉110 mmHg (RR=1.6, 95% CI=1.0 to 2.6); administration of coagulation factors (RR=1.8, 95% CI=1.0 to 3.2); male gender (RR=2.7, 95% CI=1.2 to 6.3); urgent surgery (RR=2.4, 95% CI=0.9 to 6.4); and neurological diseases (RR=4.2, 95% CI=1.9 to 9.4). To obtain a predictive risk index for NP, a scoring system was developed using a multivariate model. The probability of developing NP varied between 11.0% in the lowest risk group and 42.3% in the highest risk group. The patients‘ risk of acquiring NP was seven times higher in the highest score category (IV) than in the lowest one (I). Conclusions: ICU patients can be stratified into high- and low-risk groups for NP. No infection on admission, thorax drainage, administration of antacids, and PO2〉110 mmHg were associated with a higher risk of NP during the entire 2-week period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709329
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  • 3
    Electronic Resource
    Electronic Resource
    MIC and serum bactericidal activity of clindamycin against methicillin-resistant and -sensitive Staphylococci (1993)
    Springer
    Infection 21 (1993), S. 407-409 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In dieser Studie wurde dieIn-vivo-Aktivität von Clindamycin gegen 50 Oxacillin-sensible (MSSA) und 50 Oxacillin-resistenteStaphylococcus aureus(MRSA-)Stämme mit dem Serumbakterizidie-Test/(SBA) untersucht. Sechs Probanden wurde einmalig 600 mg Clindamycin intravenös infundiert. Weiterhin wurde die minimale Hemmkonzentration (MHK) von Clindamycin gegen 50 Oxacillin-sensible und -resistenteS. aureus und 50 Oxacillin-resistenteStaphylococcus epidermidis-Stämme, von welchen die Hälfte Schleim produzierten, bestimmt. Clindamycin hatte eine gleich hohe Serumbakterizidie gegen Oxacillin-sensible und-resistenteS. aureus-Stämme (durchschnittlicher reziproker SBA Titer von MSSAvs MRSA 1h nach Applikation: 13,0vs 13,45), obwohl die MHK-Werte gegen die Oxacillin-sensiblenS. aureus deutlich geringer waren (MHK 90 von MSSAvs MRSA: 0,06vs 32 mg/l). Die MHK-Werte gegen die Oxacillin-resistentenS. epidermidis-Stämme waren ebenfalls niedrig, ein Unterschied zwischen Schleim-, beziehungsweise nicht schleimproduzierenden Stämmen bestand nicht.
    Notes: Summary Six volunteers were given 600 mg clindamycin intravenously to investigate the serum bactericidal activity (SBA) against 50 methicillin susceptible (MSSA) and 50 methicillin resistantStaphylococcus aureus (MRSA) strains. Minimal inhibitory concentrations (MIC) against MSSA, MRSA and 50 methicillin resistant strains ofStaphylococcus epidermidis (MRSE), of which 50% were slime-producing, were determined. SBA of clindamycin against MSSA and MRSA was equally high (mean reciprocal SBA titer against MSSAvs MRSA 1h after application was 13.0vs 13.45), although MICs against MRSA were markedly higher than against MSSA (MIC 90 of MRSAvs MSSA: 0.06vs〉32 mg/l). There was no difference in MICs between slime- and non-slime-producing MRSE.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01728926
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  • 4
    Electronic Resource
    Electronic Resource
    Exogenous or endogenous reservoirs of nosocomialPseudomonas aeruginosa andStaphylococcus aureus infections in a surgical intensive care unit (1993)
    Springer
    Intensive care medicine 19 (1993), S. 161-165 
    Details
    ISSN: 1432-1238
    Keywords: Nosocomial infections ; Intensive care unit ; Staphylococcus aureus ; Pseudomonas aeruginosa
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective A 4 month prospective study was performed to assess the incidence and routes of endogenous or exogenous colonization and nosocomial infection caused byStaphylococcus aureus andPseudomonas aeruginosa in surgical critically ill patients. Design A total of 4634 specimens ware obtained. Patient's nasal, scalp, and rectal swabs as well as tracheal secretion (TS) were cultured every second day beginning on the day of admission. Nasal swabs and hand cultures of the personnel as well as cultures from gowns were also taken. all isolates ofS. aureus were phage typed and 116 of these isolates were also plasmid typed.P. aeruginosa isolates were sero-and pyocin typed. Resistance patterns were determined in all isolates. Setting The suty was carried out in the surgical intensive care unit (SICU) of an teaching hospital. Patients During the study period each patient (a total of 153 patients) admitted to the SICU entered the study. Results P. aeruginosa andS. aureus colonisation rate on admission were 5% and 36.5% respectively. Only 10 patients (6.5%) were colonized withP. aeruginosa during hospitalization, and only 7 patients (4.5%) acquiredS. aureus in the surgical intensive care unit (SICU). The most common primary colonisation site ofP. aeruginosa was the rectum, whereasS. aureus was predominantly found in nasal cultures. Horizontal transmission ofS. aureus occured in only 2 patients. Conclusion The study suggests that colonisation withP. aeruginosa andS. aureus occurs from endogenous rather than from exogenous sources and that the endogenous acquisition of both bacteria play a more important role in development of nosocomial infections than the exogenous route of transmission.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01720533
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  • 5
    Electronic Resource
    Electronic Resource
    In vitro activity of vancomycin and teicoplanin againstStaphylococcus aureus andStaphylococcus epidermidis colonizing catheters (1993)
    Springer
    European journal of clinical microbiology & infectious diseases 12 (1993), S. 545-548 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a quantitative in vitro model the activity of vancomycin and teicoplanin in two concentrations (4×MBC and 1 mg/l) againstStaphylococcus aureus and a slime-producingStaphylococcus epidermidis strain colonizing the internal surface of polyurethane and silicone catheters was studied. In comparison with vancomycin, teicoplanin achieved a significantly greater reduction (p〈0.05) in the counts ofStaphylococcus aureus andStaphylococcus epidermidis adhering to both polyurethane and silicone catheters.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01970962
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  • 6
    Electronic Resource
    Electronic Resource
    Enhancement of in vitro bactericidal activity of neutrophils from trauma patients in the presence of granulocyte colony-stimulating factor (1993)
    Springer
    European journal of clinical microbiology & infectious diseases 12 (1993), S. 121-124 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to determine whether granulocyte colony-stimulating factor (G-CSF) can enhance the bactericidal activity of polymorphonuclear leukocytes (PMNL) in trauma patients, PMNL obtained from severely injured patients one or two days after trauma were incubated with G-CSF andStaphylococcus aureus for different periods of time. G-CSF at a concentration of 6000 units/ml significantly improved the antibacterial activity of PMNL in trauma patients (n=10) and healthy volunteers (n=12) during the incubation period of 180 min. No difference in the bactericidal function of PMNL could be found between severely injured patients and healthy donors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01967588
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  • 7
    Electronic Resource
    Electronic Resource
    Serum bactericidal activity after administration of four cephalosporins in healthy volunteers (1993)
    Springer
    European journal of clinical microbiology & infectious diseases 12 (1993), S. 856-860 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serum bactericidal activity (SBA) was determined against ten strains each ofStaphylococcus aureus, Klebsiella pneumoniae, Proteus vulgaris andEnterobacter cloacae in six volunteers 1 h and 4 h after intravenous infusion of 1 g and 2 g cefotaxime and cefmenoxime, and 2 g flomoxef, and against ten strains ofPseudomonas aeruginosa after infusion of 1 g and 2 g ceftazidime. Flomoxef showed the highest SBA against methicillin-susceptibleStaphylococcus aureus. All cephalosporins had high SBA against gram-negative rods. Cefotaxime had the highest SBA againstKlebsiella pneumoniae andEnterobacter cloacae. The SBA againstPseudomonas aeruginosa after 1 g and 2 g doses of ceftazidime was very similar.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02000408
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  • 8
    Electronic Resource
    Electronic Resource
    Concentrations of roxithromycin (RU 28965) in serum and in sinus mucosa (1988)
    Springer
    Infection 16 (1988), S. 250-250 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01650767
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  • 9
    Electronic Resource
    Electronic Resource
    Combination effect of SCE-2787 and cefepime with aminoglycosides on nosocomial gram-negative bacteria (1991)
    Springer
    Infection 19 (1991), S. 186-189 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Mittels der Checker-board-Agar-Dilutionstechnik wurden Cefepime und SCE-2787, zwei neue parenterale Cephalosporine sowie die Kombinationswirkung dieser Substanzen mit den Aminoglykosiden Tobramycin und Gentamicin gegen klinisch wichtige gramnegative Erreger untersucht. Cefepim zeigte eine ausgezeichneteIn-vitro-Wirksamkeit gegenüberKlebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens andProteus vulgaris, wobei die MHK90-Werte zwischen 0,03 und 0,125 mg/l lagen; eine gute bis mäßige Aktivität zeigte die Substanz gegenAcinetobacter anitratus, Pseudomonas aeruginosa undPseudomonas cepacia (MHK90-Werte zwischen 4 und 16 mg/l). SCE-2787 wies eine ausgezeichnete Aktivität gegenCitrobacter spp. (MHK90 0,125 mg/l) und eine sehr gute Aktivität gegenA. anitratus, P. aeruginosa undP. vulgaris auf (MHK90-Werte 1–2 mg/l),Pseudomonas maltophilia wurde allerdings von therapeutisch erreichbaren Konzentrationen nicht gehemmt (MHK90 64 mg/l). Bei 14–28% der Stämme wurde ein synergistischer Effekt der SCE-2787-Aminoglycosid-Kombination und in 8,6% der Stämme eine synergistische Wirkung der Cefepim-Gentamicin-Kombination beobachtet. Eine antagonistische Wirkung konnte bei keiner der untersuchten Kombinationen festgestellt werden.
    Notes: Summary Thein vitro activity of cefepime and SCE-2787, two new parenteral cephalosporins, and the combination effect with tobramycin and gentamicin against nosocomial gram-negative rods was studied using checker-board agar dilution technique. Cefepime showed excellentin-vitro activity againstKlebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens andProteus vulgaris (MIC90 0.03–0.125 mg/l) and good to moderate activity againstAcinetobacter anitratus, Pseudomonas aeruginosa andPseudomonas cepacia (MIC90 4–16 mg/l). SCE-2787 had an excellent activity againstCitrobacter spp. (MIC90 0.125 mg/l) and a very good activity againstA. anitratus, P. aeruginosa andP. vulgaris (MIC90 1–2 mg/l).Pseudomonas maltophilia was not inhibited at therapeutically achievable concentrations (MIC90 64 mg/l). On average, 14–28% of the strains were inhibited by synergistic SCE-2787 aminoglycoside-combinations, whereas only 8.6% were inhibited by a synergistic effect of the combination with cefepime and gentamicin. No antagonism occurred with any of the combinations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01643250
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  • 10
    Electronic Resource
    Electronic Resource
    Differential cytokine production in stimulated blood cultures from intensive care patients with bacterial infections (1997)
    Springer
    Infection 25 (1997), S. 206-212 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mice infected with bacteria develop an interferon-γ (IFN-γ) dependent hypersensitivity to lipopolysaccharide (LPS) and other bacterial components. The broader aim of this study is to find out whether such hypersensitivity also occurs in patients suffering from bacterial infections. The capacity of stimulated peripheral blood cells from infected, intensive-care patients to produce cytokines (IFN-γ, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6)) was compared to that of healthy donors. Culturing of the cells was carried out preferentially in whole blood diluted 1:3. Whole blood cultures (WBC) were stimulated with lipopolysaccharide (LPS), whole killedSalmonella typhimurium andStaphylococcus aureus and concanavalin A (ConA), and the cytokine production was determined. Two main findings emerged from this study: The IFN-γ production by WBC of patients was, compared to healthy donors, markedly suppressed, regardless of stimulus used. Further, patients' WBC exhibited a suppressed TNF-α production after stimulation with LPS. Surprisingly, following stimulation with bacteria (S. typhimurium andS. aureus) an elevated TNF-α and IL-6 response was obtained. Thus, in severely infected patients the cytokine responses of peripheral blood cells to LPS may be suppressed, while the response to other bacterial components is enhanced.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01713144
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