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  • 1
    ISSN: 1432-2277
    Keywords: Liver transplantation ; infections-Infections ; liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The first 49 consecutive patients who underwent orthotopic liver transplantation between 1984 and 1989 in our department were studied with regard to symptomatic and asymptomatic post-transplantation infections. The major infections carrying a risk of fatal outcome are presented. During the first 4 weeks, fungal and bacterial infections predominated, the percentages of patients affected being 27% and 35%, respectively. Eight patients (17%) suffered from bacterial septicemia, which in six cases was due to gram-negative micro-organisms. The bacterial septicemia was often associated with severe ischemic damage to the graft, rejection, or cholangitis. In addition, a concomitant invasive fungal infection supervened in seven out of eight septic patients, further aggravating the patients' condition. Seventeen of the 49 patients (35%) died after transplantation within 3.3 years. Infection was the cause of death in nine patients (18%), with bacterial septicemia and/or fungemia in eight of these. Cytomegalovirus (CMV) disease was the dominant cause of illness after the 1st month. While only 5 of the 49 patients developed CMV disease during the 1st month (10%), as many as 16 of the 40 recipients who survived beyond that time suffered from symptomatic CMV viremia (40%). CMV mismatching, i.e., the donation of a CMV-positive organ to a CMV-seronegative recipient, entailed the highest risk for CMV disease. Pneumocystis carinii pneumonia occurred within 4 months in 10% of the patients. The four liver recipients affected were among the 20 patients not receiving trimethoprim-sulfamethoxazole prophylaxis. None of the 28 patients who received this prophylaxis over a 12-month period developed this complication (P〈0.05). The time-related panorama of infectious complications observed in this study has immediate clinical implications for the screening, prophylaxis, and therapy of infections following liver transplantation.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    [s.l.] : Nature Publishing Group
    Nature 185 (1960), S. 57-58 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] In the present investigation spheroplasts of Escherichia coli B were produced by the lysozyme versene treatment of Repaske4. With the aid of serological techniques it has been shown that (a) cell-wall antigens remain in carefully washed membrane preparations from the spheroplasts and (b) there are ...
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 28 (1985), S. 333-337 
    ISSN: 1432-1041
    Keywords: cefotoxin ; renal failure ; peritoneal dialysis ; pharmacokinetics ; CAPD (continuous ambulatory dialysis) ; dialysate concentration ; intra peritoneal administration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The pharmacokinetics of cefoxitin was examined in 9 patients undergoing peritoneal dialysis for chronic renal failure. Cefoxitin was administered intraperitoneally in the dialysate fluid every 6 h for 24 h, in two different concentrations, 50 µg/ml and 100 µg/ml. The plasma half-life of cefoxitin was 20.2 h. The major route of elimination was non-renal, with a clearance of 8.0 ml/min. Peritoneal clearance was 4.1 ml/min. As expected, renal clearance was negligible. The peak plasma concentrations of cefoxitin at the two dose levels used were 7 µg/ml and 15 µg/ml, respectively, when assayed by HPLC, and 12 µg/ml and 24 µg/ml when determined by a microbiological assay. The cefoxitin concentration in the dialysate decreased from 50 µg/ml to 14 µg/ml and from 100µg/ml to 37 µg/ml during the 6 h of its retention in the peritoneal cavity.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 7 (1974), S. 51-58 
    ISSN: 1432-1041
    Keywords: Rifampicin ; plasma level ; pleural fluid concentration ; microbiological assay ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Single oral doses of rifampicin (RMP) were given to 31 patients with pleural effusions of various aetiologies. The concentrations of RMP and its active metabolites in pleural fluid and plasma were determined by an agar diffusion method using paper discs as diffusion centres. The plasma concentrations reached a peak within 3 h and then declined monoexponentially; in pleural fluid, RMP concentration rose slowly to reach a plateau that lasted for several hours. There were marked differences between subjects in the observed concentrations of RMP. During the first 12 h the plasma levels exceeded those in pleural fluid, but after 24 h the concentration of RMP in pleural fluid was higher than in plasma. If multiple oral doses of RMP 10 mg/kg b. w. are given every 24 h, as is common in the treatment of tuberculosis, therapeutic concentrations may be expected in pleural fluid for the major part of each day.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 4 (1972), S. 150-157 
    ISSN: 1432-1041
    Keywords: Antibiotics ; pharmacokinetics ; microbiological assay ; drug control ; neonatal septicaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The various steps of a paper disc micromethod for quantitative determination of plasma concentrations of antibiotics is described. Only 10 µl of plasma is needed for a single determination, allowing easy and repeated capillary sampling. Separate assay was attempted of three antibiotics in a mixture (streptomycin, cloxacillin and ampicillin), both by use of selective inhibitors (semicarbazide, penicillinase) in the culture medium and by choosing suitable strains of bacteria. In this way, it was possible to determine streptomycin and cloxacillin separately when all three antibiotics were present simultaneously in the plasma. The assay of ampicillin, however, was always influenced by the presence of even small concentrations of cloxacillin. The 95% confidence intervals of the standard curves for the three antibiotics are presented. — The method is suitable both for pharmacokinetic studies and for routine clinical control of plasma antibiotic levels, even in premature children.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1041
    Keywords: antibiotics ; gastric surgery ; drug utilization ; bacterial susceptibility ; septic complications ; nosocomial infection ; hospital treatment ; community treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The relationship between hopsital and catchment area ultilization of antimicrobial agents and the antibiotic sensitivity of bacteria isolated from primary infections has been studied after 750 gastric operations performed between 1972 and 1986 at the Huddinge University Hospital. Over 80% of the antibiotics were used in the catchment area. Penicillins (G and V) overall were the most commonly used drugs and comprised 37% of the total antibiotic consumption in 1977–1986. Narrow-spectrum antibiotics dominated throughout the period under investigation. No change in the bacterial resistance to antimicrobial agents was found over time. Many strains of Klebsiella/Enterobacter and E. coli resistant to ampicillin and tetracyclines were recovered throughout the period under investigation. No aerobic Gram-negative bacteria were resistant to gentamicin. All Bacteroides strains except two were sensitive to cefoxitin. Tetracyclines and ampicillin/amoxycillin were mainly used in the catchment area, and cefoxitin and aminoglycosides were almost exclusively used in the hospital. Antimicrobial agents primarily used for out-patients in the catchment area seemed to have more influence on the susceptibility of microorganisms isolated from postoperative infections than agents primarily used in the hospital.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Sechs Personen erhielten sieben Tage lang Phenoxymethylpenicillin oral in Dosen von 800 mg zweimal täglich. Sechs weitere Personen erhielten sieben Tage lang Bacampicillin in Tablettenform in Dosen von 400 mg dreimal täglich. Zur Kultivierung aerober und anaerober Bakterien wurden Speichel, Rachenabstriche und Stuhlproben entnommen. Im Beobachtungszeitraum waren nur geringe Veränderungen der normalen Speichel- und Rachenflora und keine Veränderungen der faekalen Flora zu beobachten. Sechs Patienten erhielten über einen Zeitraum von zwölf Stunden 2 g Cefoxitin in sechsstündlichen Abständen parenteral appliziert. Daraufhin traten ausgeprägte Veränderungen in der Zusammensetzung der Colonflora auf. Unter den aeroben Bakterien nahmen die Enterobakterien ab, cefoxitinresistente Enterokokken nahmen zu; unter den anaeroben Bakterien war die Zahl der gramnegativen Stäbchen reduziert. In der Phase nach der Antibiotikaapplikation nahm die Zahl aller cefoxitinresistenten Stämme ab, und die supprimierten Enterobakterien und Bacteroidesstämme vermehrten sich wieder.
    Notes: Summary Phenoxymethylpenicillin was given orally in doses of 800 mg twice daily for seven days to six patients, and bacampicillin was given in doses of 400 mg three times per day for seven days to another six patients. Saliva, throat and faecal specimens were taken for cultivation of aerobic and anaerobic bacteria. Only small changes in the normal saliva and throat flora were observed, and no changes in the faecal flora were noticed during the observation period. Cefoxitin was administered parenterally in doses of 2 g at 6 h intervals for 12 h to six other patients. Pronounced changes in the colon flora occurred. Of the aerobic bacteria, enterobacteria decreased and cefoxitin-resistant enterococci increased in number; of the anaerobic bacteria, gramnegative rods decreased in number. At the end of the administration period, all cefoxitin-resistant strains decreased, and suppressed enterobacteria and bacteroides increased in number.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical microbiology & infectious diseases 7 (1988), S. 135-143 
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of ofloxacin on the microflora in saliva, gastric juice, and feces was evaluated in 24 patients undergoing gastric surgery. A single peroral dose of 400 mg ofloxacin was given to each patient 2–4 h before surgery. The concentrations of ofloxacin in serum, saliva, gastric juice, and gastric mucosa tissue were assayed. OnlyBranhamella cocci were affected in the saliva. In the gastric juice, both the aerobic and anaerobic flora were suppressed on the day of surgery, but increased in number afterwards. There was a significant correlation between gastric pH and the number of microorganisms isolated in the gastric juice on day 0. In faeces, the aerobic and part of the anaerobic flora were suppressed by the administration of ofloxacin. Ofloxacin was well tolerated by the patients. Four of 24 patients developed postoperative complications. Microorganisms isolated from wound sepsis and intraabdominal sepsis (three patients) wereStaphylococcus epidermidis, Staphylococcus aureus, hemolytic streptococci group A,Streptococcus sp. andEscherichia coli. All related infections occurred in patients with very low ofloxacin serum concentrations, probably due to impaired absorption. Oral antibiotic prophylaxis is not recommended in patients in whom impaired gastric emptying can be expected.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Medical microbiology and immunology 168 (1980), S. 283-297 
    ISSN: 1432-1831
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract From 30 consecutive cases of premature rupture of the membranes (PROM) and matched controls, specimens from urine, cervix, amniotic fluid, and placenta as well as neonatal nose and throat swabs were investigated bacteriologically and virologically. In addition virus serological investigation was done. Among the PROM cases the anaerobic cervical isolates outnumbered the aerobic ones, and the total number of aerobic as well as anaerobic isolates was less in the control group. The anaerobesB. fragilis andStrept. intermedius were isolated from the cervix, amniotic fluid, or placenta in 23% and 30% of the PROM patients, respectively. None of the controls harbouredB. fragilis, whileStrept. intermedius was isolated from 6.7% of the controls. Group B streptococci were recovered from the mother's cervix in 20% of the PROM patients and in 6.7% among the controls. Four cases of neonatal septicaemia were encountered, and another two cases were clinically suspected, but not microbiologically verified, contributing to a high perinatal mortality rate (17,6%). Of the PROM patients, 27% developed puerperal infection, while none of the control mothers had such complications. The significance of the anaerobic bacteria as well as group B streptococci for the maternal and neonatal outcome in cases of PROM is discussed, and a possible aetiological role of ascending infection in this complication of pregnancy is postulated.
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  • 10
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An einer schwedischen Universitätsklinik wurde ein Jahr lang eine prospektive Studie über Bakteriämie durchgeführt. Bei 3,6% aller eingewiesenen Patienten wurden Blutkulturen angelegt. Bei 142 Patienten (davon 59% Männer) fanden sich 148 Ereignisse mit Bakteriämie. Die mittlere Bakteriämie-Inzidenz betrug 4,3 Episoden auf 1000 Einweisungen. Bei 1,3% der positiven Blutkulturen lag eine Kontamination vor. Die häufigsten Diagnosen waren Malignome und Harnwegserkrankungen, die häufigsten prädisponierenden Faktoren chirurgische Eingriffe, Zentralvenenkatheter und Zytostatikatherapie. Im Krankenhaus und außerhalb des Krankenhauses erworbene Bakteriämien verhielten sich wie 1,3 : 1; die Letalität betrug 12,7%. Als häufigste pathogene Erreger fanden sich gramnegative Stäbchen aus der Familie derEnterobacteriaceae, als nächst-häufigsteStaphylococcus aureus undStaphylococcus epidermidis. Die verantwortlichen Erreger wiesen ein recht günstiges Empfindlichkeitsspektrum auf. Von denS. aureus-Stämmen war keiner resistent gegen Isoxazolyl-Penicilline oder Gentamicin. Nur einEscherichia coli-Stamm war gegen Gentamicin resistent, aber keiner der Klebsiella-Stämme. Die Ergebnisse wurden mit einer fünf Jahre früher durchgeführten, retrospektiven Studie über ein Jahr verglichen: Die Bakteriämie-Inzidenz hatte sich in der Zwischenzeit nicht geändert.
    Notes: Summary A one-year prospective study of bacteremia was carried out at a Swedish university hospital. Blood cultures were taken in 6.3% of all patients admitted to the hospital. 148 episodes of bacteremia were recorded in 142 patients, 59% of whom were males. The mean incidence of bacteremia was 4.3 episodes per 1,000 admissions. The incidence of contamination was 1.3%. Malignancy and urinary tract disorders were the most common diagnoses and surgical intervention, central venous catheters and cytostatic drugs the most common predisposing factors. The ratio of hospital to community-acquired bacteremia was 1.3:1. The fatality rate was 12.7%. Gram-negative rods belonging to theEnterobacteriaceae were the most common pathogens, followed byStaphylococcus aureus andStaphylococcus epidermidis. The antibiotic sensitivity pattern of the causative bacteria was quite favorable. NoS. aureus strains were resistant to isoxazolyl penicillins or gentamicin. No Klebsiella strain and only oneEscherichia coli strain was resistant to gentamicin. The results were compared to a one-year retrospective study carried out in the same hospital five years ago. The incidence of bacteremia had not increased between the two studies.
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