PubMed Health⌕ Search

Biomedical subjects

A Bremmelgaard

Publications and source records attributed to A Bremmelgaard.

At least 19 recordsLinked to original sources
PubMed2000

Effect of laparoscopy on bacteremia in acute appendicitis: a randomized controlled study.

Laparoscopic appendectomy is increasingly used in treating acute appendicitis. Several controlled series have demonstrated the clinical benefit of the procedure. However, some basal pathophysiologic changes caused by the laparoscopy still need clarification, i.e., whether laparoscopy can give rise to bacteremia. The purpose of this randomized controlled study in 30 patients undergoing surgery due to suspected acute appendicitis, either by an open classic technique or by a laparoscopic technique, was (by collecting samples for blood culturing pre-, peri-, and postoperatively) to evaluate whether laparoscopy during carbon dioxide pneumoperitoneum could induce bacteremia. Six patients of 12 in the group treated by laparoscopy presented positive blood cultures peri- and postoperatively. No positive blood cultures were demonstrated in the open operated group. The difference was significant (P = 0.0183). The clinical significance of these findings should be clarified in further clinical investigations.

Acute Disease↗
PubMed1998

Few microorganisms associated with bacterial vaginosis may constitute the pathologic core: a population-based microbiologic study among 3596 pregnant women.

OBJECTIVE: To evaluate the association between various microorganisms isolated from the genital tract in pregnant women with bacterial vaginosis. STUDY DESIGN: A cross-sectional population-based study among pregnant women addressed at their first antenatal visit before 24 full gestational weeks from the referring area of the Department of Obstetrics and Gynecology at Odense University Hospital, Denmark, from November 1992 to February 1994. The main outcome measures were prevalence of various microorganisms and statistical estimates of interactions (crude, adjusted, and relative odds ratios) between the microorganisms isolated from the lower genital tract in pregnant women with and without clinical diagnosis of bacterial vaginosis. RESULTS: Three thousand five hundred ninety-six (3596) pregnant women were asked to participate. Of the 3596 pregnant women 3174 (88.4%) agreed to participate before 24 full gestational weeks. After controlling for the presence of other microorganisms, strong associations between Gardnerella vaginalis, anaerobic bacteria, Mycoplasma hominis, and present bacterial vaginosis were found. Similarly Lactobacillus spp. were found to be associated with the absence of bacterial vaginosis. The combination of G. vaginalis and anaerobic bacteria and/or M. hominis was found in 59.6% of the cases with bacterial vaginosis and in 3.9% of the cases without bacterial vaginosis (odds ratio 36.4, 95% confidence interval 27.8 to 47.8). The crude odds ratio was found to be as high as 74.8 (95% confidence interval 32.3 to 174.1) when the combination of G. vaginalis, M. hominis, anaerobic bacteria, and no Lactobacillus spp. was associated with bacterial vaginosis. CONCLUSION: There is a microbial foundation for bacterial vaginosis, and it is possibly due to an intermicrobial interaction in which the microorganisms G. vaginalis, anaerobic bacteria, and M. hominis are dominating, indicating that these constitute the pathologic core of bacterial vaginosis.

Adolescent↗
PubMed1997

Determination of the exocrine pancreatic function with the NBT-PABA test using a novel dual isotope technique and gas chromatography-mass spectrometry.

We describe a tubeless test of exocrine pancreatic function based on a new dual isotope technique, using N-benzoyl-L-tyrosyl-p-aminobenzoic acid (NBT-PABA) as a substrate for intestinal chymotrypsin activity and the stable isotope, 13C-PABA as marker. Gas chromatography-mass spectrometry (GC-MS) was used for the quantification of PABA and 13C-PABA in blood. The method involves hydrolysis, extractions, separation by HPLC, and methyl ester formation of the test substances before GC-MS analysis. The test is precise and shows good separation of healthy volunteers from patients with pancreatic insufficiency. The PABA/13C-PABA ratios in serum after 1.5 h were 2.64 +/- 0.14 (mean +/- SEM) in 10 healthy volunteers and 1.26 +/- 0.22 in 10 patients with exocrine pancreatic insufficiency. We present a sensitive and specific assay, which is free of analytical interference and radiation hazards and, additionally, it illuminates extrapancreatic pharmacokinetic conditions. This test can eliminate the need for duodenal intubation, which makes it very acceptable to the patients.

4-Aminobenzoic Acid↗
PubMed1997

Antimicrobial susceptibility testing of 230 Helicobacter pylori strains: importance of medium, inoculum, and incubation time.

No standardized method of susceptibility testing for Helicobacter pylori is currently available, so before a large agar dilution study comprising 230 H. pylori strains belonging to more than 80 genetically different groups was initiated, we performed a relatively small preliminary study to determine the influences of medium, inoculum density, and incubation time. Seven media were investigated and were primarily evaluated on the basis of their abilities to support growth both semiquantitatively and qualitatively; Iso-Sensitest agar supplemented with 10% horse blood was found to be well suited for the purpose; this was closely followed by Mueller-Hinton agar with 10% horse blood, Mueller-Hinton with 10% sheep blood, and finally, 7% lysed horse blood agar. Investigations of two inoculum densities and two incubation times resulted in recommendations for the use of 10(9) CFU/ml (10[6] CFU/spot) as the inoculum and 72 h as the incubation time. A modest inoculum effect was noted for amoxicillin and metronidazole. By the methodology derived from our preliminary study, the susceptibilities of 230 H. pylori strains to six antibiotics were subsequently determined. The results were generally in accord with those of others, and apart from metronidazole, the MIC of which for approximately 25% of the strains tested was >8 microg/ml, resistance was low in Denmark. The situation might, however, quickly change when and if the number of indications for antibiotic therapy for H. pylori infections increase. Consequently, susceptibility testing of all H. pylori strains is recommended in order to survey the development of resistance, and in our hands the described methodology was relatively easy to perform and the results were easy to read.

Animals↗
PubMed1997

Orthopedic wound infections. 182 cases after 8913 operations during an 8-year survey.

We performed a surveillance of postoperative wound infections at our department for a period of 8 years. The surveillance was based on forms completed by the surgeons at the department. Retrospectively, by scrutinizing the records of patients with recorded infections, the criteria for infections used by the surgeons were compared with the criteria recommended by the Centers for Disease Control, USA, for routine infection surveillance studies: 1) pus present in the wound, 2) bacteria isolated from the wound, 3) spontaneous wound breakdown or surgical intervention due to suspected infection; if culture is performed, it must be positive, 4) evidence of infection at reoperation or at radiologic or histopathologic examination (restricted to deep infections) or 5) diagnosis of infection by a surgeon. 182 infections were recorded; in 106 (58%) pus was present, drained either spontaneously or by surgical intervention, in 24 (13%) no pus was seen, but the culture was positive. In 116 cases, surgical intervention was performed or wounds spontaneously broke down; pus was found in 101 of these and culture of non-purulent material was positive in 13 and negative in 2. In 52 (29%) patients, only criterion 5 was fulfilled. In surveillance studies where the recordings are based on several observers, the subjective criterion 5 may, as in our study, give a falsely high number of infections, also preventing comparison between studies. We recommend that all suspected infections are cultured and that only criteria 1, 2 and 4 are used.

Humans↗
PubMed1995

Survival of patients with surgical wound infection: a case-control study of common surgical interventions.

A cohort of 4515 surgical patients was selected from ten different surgical intervention groups, and 291 of 317 with a postoperative wound infection were matched 1:1 with controls with regard to intervention, sex and age. The mortality rate was investigated from the time of operation, with a follow-up period from 4 years 4 months to 8 years 4 months. Eighty-seven patients with a deep infection had a significantly increased mortality rate, with a risk ratio of 1.7. Without a distinction between superficial and deep infection the former might mask the higher mortality rate associated with the latter.

Adolescent↗
PubMed1995

Prevalence and antibiotic sensitivity of Danish versus other European bacterial isolates from intensive care and hematology/oncology units.

The prevalence and antibiotic sensitivity patterns of bacteria collected consecutively from medical and surgical intensive care units (ICUs) and from hematology/oncology units in nine hospitals in Denmark were determined and compared to data collected simultaneously in 12 other European countries. Bacterial isolates from 794 Danish patients were tested and compared to 8,625 isolates from European patients. The minimal inhibitory concentrations of eight different antibiotics were determined using a microdilution plate. Similar to findings in European countries, the most common source of bacterial isolates in Danish units was the respiratory tract (49%), followed by blood (18%), urinary tract (14%) and surgical wounds (10%). Staphylococcus aureus was the most prevalent respiratory organism in Danish units, whereas Enterobacteriaceae and Pseudomonas aeruginosa dominated in other countries. In blood, Escherichia coli was most prevalent in Denmark while coagulase-negative staphylococci were predominant in other countries. Urinary tract isolates were dominated by Escherichia coli in both Denmark and the other countries, but Enterococcus faecalis and Pseudomonas aeruginosa were more frequently isolated in the other countries. Staphylococcus aureus was the most frequent wound isolate in Denmark, while Enterobacteriaceae other than Escherichia coli dominated in other European countries. Thus, in Denmark Escherichia coli and Staphylococcus aureus, followed by Pseudomonas aeruginosa and Klebsiella spp. (from ICUs) or Enterococcus spp. and Klebsiella spp. (from hematology/oncology units), are the most prominent pathogens in these units today. Indicator organisms of antibiotic consumption (Pseudomonas aeruginosa and methicillin-resistant coagulase-negative staphylococci and Staphylococcus aureus) were more frequent in other European countries than Denmark. In general the Danish isolates were more sensitive to antibiotics than the European isolates.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1994

[Resistant gram-negative bacteria at seven intensive care units in Denmark].

A prospective study on the prevalence of resistance to 16 antibiotics in 704 Gram-negative bacteria isolated from seven intensive care units was undertaken in 1990. A microtitre panel carrying 16 antibiotics was used for susceptibility testing. The study revealed minor differences in resistance between the participating centres. The overall resistance was relatively low in Denmark, but there was increased resistance among E. coli from intensive care units compared to E. coli isolates from bloodcultures collected in 1988. At one centre the susceptibility of P. aeruginosa to gentamicin was slightly lower than at other centres, indicating a minor outbreak during the collection period. P. aeruginosa and Enterobacteriaceae with inducible production of beta-lactamases showed cross-resistance between penicillins and cephalosporins, but not between penicillin/cephalosporins and imipenem gentamicin or ciprofloxacin. The resistance among the repeated isolates of inducible Enterobacteriaceae was slightly higher than among the initial isolates indicating acquisition of resistance or selection of resistant mutants.

Denmark↗
PubMed1994

[Prevention of duodenal ulcer recurrence with penicillin].

The aim of this study was to test the hypothesis that infection with Helicobacter pylori is essential for recurrence of duodenal ulcer. We performed a randomized controlled trial of the relapse rate of duodenal ulcer during 12 weeks treatment with penicillin V or placebo in 170 out-patients from five centres. The relapse rate was 9% during treatment with penicillin and 50% with placebo, P < 0.0001. It is concluded that infection with penicillin-sensitive bacteria, i.e. H. pylori, plays an important role for recurrence of duodenal ulcer disease. Penicillin V suppresses this infection but does not eradicate it.

Adult↗
PubMed1994

Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs.

A cohort of 4515 surgical patients in ten selected intervention groups was followed. Three hundred and seventeen developed postoperative wound infections, and 291 of these cases were matched 1:1 to controls by operation, sex and age. In comparison to the controls the cases stayed longer in hospital after the intervention and had more contact after discharge with the social security system. Using data from a national sentinel reference database of the incidence of postoperative wound infections, and using national activity data, we established an empirical cost model based on the estimated marginal costs of hospital resources and social sick pay. It showed that the hospital resources spent on the ten groups, which represent half of the postoperative wound infections in Denmark, amounted to approximately 0.5% of the annual national hospital budget. This stratified model creates a better basis for selecting groups of operations which need priority in terms of preventive measures.

Adolescent↗
PubMed1994

Evaluation of the E-test for susceptibility testing of the Bacteroides fragilis group. Danish study group.

The susceptibilities of 100 clinical isolates belonging to the Bacteroides fragilis group to 9 antibiotics, i.e. ampicillin, piperacillin, ceftriaxone, cefotaxime, cefoxitin, imipenem, erythromycin, clindamycin, and metronidazole, were tested using a standard agar dilution method and the E-test. Overall, 81% of the E-test MICs were within one log2 dilution step of the agar dilution MICs and 95% were within two log2 dilution steps. The E-test showed significantly lower MIC values than the agar dilution method for ampicillin, cefotaxime, and imipenem, and significantly higher MIC values for piperacillin, ceftriaxone, erythromycin, clindamycin, and metronidazole. However, this only resulted in minor discrepancies that did not change the susceptibility status. The E-test is easy to perform and read, and the MIC values correlated well with the MICs obtained by the agar dilution method when testing susceptibility of the Bacteroides fragilis group.

Ampicillin↗
PubMed1993

Comparison of detection speed and yield in BACTEC NR-860 and Roche BCB blood culture systems.

Detection speed and yield were compared between BACTEC NR-860 and Roche BCB blood culture systems. From a total of 1,550 paired blood cultures inoculated with the same volume of blood, 161 (10.4%) grew 180 organisms from 140 adult patients. Sixty-six percent of the isolates were clinically significant. The BACTEC system detected more clinically significant isolates than the BCB system, 91% vs 76% (p < 0.01), especially Enterobacteriaceae. In 39 paired blood cultures, 42 significant organisms were detected at different times in the two systems. The vast majority (93%) were detected first (on average 1 day faster) by the BACTEC system (p < 0.05), especially Escherichia coli and streptococci. Generally, detection times were shorter in the BACTEC system. Three fourths (76%) of all significant organisms were detected within the first incubation day as compared to less than half (42%) in the BCB system (p < 0.001). Generally, the agitated aerobic resin medium BACTEC 26 Plus had the fastest detection and highest yield in our study. The contamination rate, below 2% in both systems, was acceptable. The BACTEC NR-860 system with resin-containing media proved to be a reliable, sensitive and fast blood culture system, which deserves further investigation.

Adult↗
PubMed1993

Prevention of duodenal ulcer recurrence with penicillin. A double-blind, placebo-controlled trial.

Eradication of Helicobacter pylori is associated with a reduced recurrence of duodenal ulcer (DU). The relationship between H. pylori and DU has been interpreted as causal, but the evidence has been criticized for methodologic reasons. To ascertain whether an antibiotic with no effect on epithelial-cell integrity prevents DU recurrence, we conducted a randomized double-blind trial of phenoxymethylpenicillin (PEN), 2.4 twice daily, and placebo (PLA). Patients with an active DU and positive H. pylori culture from antral biopsy specimens were treated with 40 mg omeprazole daily for 4 weeks, but at week 2 they were allocated at random to PEN (85 patients) or PLA (85 patients) for up to 14 weeks. Those without recurrence during this treatment were followed up for another 6 months. Endoscopy and H. pylori culture were performed at the end of the treatment period and at the end of follow-up, and in between if ulcer symptoms recurred. During the treatment period the ulcer relapse rate was 5 of 58 (9%) in the PEN group and 34 of 68 (50%) in the PLA group (P < 0.0001, log-rank test), with 53% and 14%, respectively, of the patients in the two groups being H. pylori-negative. The relapse rate in the PEN group did not differ between H. pylori-negative and H. pylori-positive patients. The recurrence rate in the PEN group remained low for another 5 months but then approached the rate in the PLA group. The prevalence of H. pylori-negative patients at the end of follow-up was 20% in the PEN group and 10% in the PLA group. These data provide strong evidence that DU has a bacterial cause, with H. pylori as the likely agent.

Double-Blind Method↗
PubMed1993

Antibiotic sensitivity of the Bacteroides fragilis group in Denmark. Danish Study Group.

Resistance rates to 9 antibiotics were determined for 370 isolates of the Bacteroides fragilis group submitted during a 5-month period in 1990-91 from 6 laboratories in Denmark. There was no resistance to imipenem (MIC > 8 mg/l) or metronidazole (MIC > 16 mg/l), while resistance to ampicillin was the rule (97% at > 4 mg/l) and to ceftriaxone rather common (19% at > 32 mg/l). Resistance was uncommon to cefoxitin (0.5% at > 32 mg/l), cefotaxime (6% at > 32 mg/l), piperacillin (7% at > 64 mg/l), ampicillin/sulbactam (1% at > 16 mg/l), and clindamycin (3% at > 4 mg/l). Two hundred and thirty-nine strains were Bacteroides fragilis. The 131 other strains were generally more resistant than the Bacteroides fragilis strains. For 5 antibiotics the Bacteroides fragilis had a significantly lower MIC in western than in eastern laboratories. For the group with other strains there was no significant difference.

Anti-Bacterial Agents↗
PubMed1991

[Measurement of basal temperature with the Tempadot disposable thermometer for oral use].

Twenty-two healthy women of fertile age who participated in an immunological investigation recorded basal temperature curves (BTC) with the object of illustrating the course of the menstrual cycle by means of daily measurements of the morning temperature with the Tempadot disposable thermometer for oral use. The total of 63 BTC's were assessed on the basis of the requirement of normal diphasic curves. The number of diphasic BTC was less than anticipated. In addition, four other healthy women measured the morning temperature daily with the Tempadot disposable thermometer orally and with a mercury thermometer rectally for a calendar month. It is concluded that employment of the Thermadot disposable thermometer orally is associated with great unreliability even in this material where the measurements were carried out on repeated occasions by young healthy persons.

Adult↗