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B Bruun

Publications and source records attributed to B Bruun.

At least 19 recordsLinked to original sources

Shewanella algae and Shewanella putrefaciens: clinical and microbiological characteristics.

The occurrence of the two Shewanella species found in clinical specimens, Shewanella algae and Shewanella putrefaciens, correlates with the temperature and salinity of seawater. This means that Shewanella infections occur in warm climates or during especially warm summers in temperate climates. The infections described most commonly involve ears, skin and soft tissue, with or without bacteraemia. Primary bacteraemia with a fulminant course is also seen in immunocompromised patients. Important differential characteristics between the two species include the ability of S. algae to produce mucoid colonies with beta-haemolysis on sheep blood agar, to grow at 42 degrees C and in NaCl 6% w/v, and to reduce nitrite, and an inability to produce acid from maltose, all of which are in contrast to the characteristics of S. putrefaciens. Automated identification systems fail to differentiate between S. algae and S. putrefaciens, as S. algae is not included in the databases of these systems. Presumably for this reason, most Shewanella infections reported during recent years have been attributed to S. putrefaciens. However, when extensive phenotypic characterisation is performed, most human infections are seen to be caused by S. algae. As the two species seem to have different pathogenic potential for humans, correct identification is important, and this is possible in routine clinical microbiology laboratories.

Animals↗

Fusarium fungaemia in immunocompromised patients.

Fusarium spp. cause infections only rarely in immunologically competent hosts, but disseminated infection may occur in severely immunocompromised patients. Symptoms of disseminated infection are persistent fever, despite broad-spectrum antibacterial and antifungal treatment, associated with skin lesions, most commonly on the extremities, in 60-80% of patients. A mortality rate of 50-75% has been reported for patients with disseminated fusariosis. Despite treatment failures, amphotericin B remains the preferred drug, in part because of lack of alternatives. Voriconazole is a promising new agent, but more clinical experience is required.

Aged↗

Bactec 9240 blood culture system: to preincubate at 35 degrees C or not?

Bactec Plus blood culture bottles were preincubated at 35 degrees C or at room temperature before entry into the Bactec 9240 instrument to determine the influence of preincubation temperature and time. Of 463 positive blood culture sets, 956 bottles were positive, of which the instrument detected 92.1%. Of 76 positive bottles undetected by the instrument, 68 were preincubated at 35 degrees C and eight at room temperature. The median entry delay and instrument detection times were 17.9 and 7.2 h for preincubated bottles, and 16.4 and 13.4 h for bottles held at room temperature. Short entry delay and inspection before entry into the instrument are necessary if preincubation at 35 degrees C is used.

Automation↗

Problems in identification of Francisella philomiragia associated with fatal bacteremia in a patient with chronic granulomatous disease.

Francisella philomiragia is a rare gram-negative, halophilic coccobacillus with bizarre spherical forms on primary isolation. A case of F. philomiragia bacteremia in a 24-year-old patient with chronic granulomatous disease is reported. Identification of F. philomiragia was problematic with conventional tests but was done correctly and rapidly by kit 16S ribosomal DNA sequencing.

Adult↗

Direct identification and susceptibility testing of enteric bacilli from positive blood cultures using VITEK (GNI+/GNS-GA).

OBJECTIVE: To study the possibility of reporting results of identification and susceptibility testing of Gram-negative bacilli the same day as bacteremia is detected by using direct inoculation from positive blood cultures (Bactec 9240) into VITEK GNI+ and GNS-GA cards. METHODS: All blood cultures with Gram-negative enteric bacillus-like morphology on microscopy found to be positive on workdays between 15 June 1999 and 29 February 2000 were included. Identification and susceptibility testing were done by three methods: the direct method using a suspension made by differential centrifugation of positive blood culture broth for inoculation of the VITEK cards; the standard method using an inoculum made from an overnight culture on a solid media; and the routine method (reference method) using conventional testing. RESULTS: Of 169 isolates, the direct method resulted in 75% correct identifications, 9% misidentifications and 17% non-identifications. All misidentified isolates were Escherichia coli, of which 80% were reported as Salmonella arizonae. Five biochemical tests yielded most of the aberrant results; correcting the citrate and malonate reactions in most cases led to correct identification by the VITEK database. Despite a negative H2S reaction, 11 E. coli isolates were reported as S. arizonae. Two-thirds (69%) of identifications were reported within 6 h, and 95% of these were correct. The direct susceptibility testing method was assessable for 140 isolates. Correct results were found in 99% of isolate-antimicrobial combinations, and 85% were reported within 6 h. CONCLUSION: The direct VITEK method could correctly report identifications and susceptibility patterns within 6 h, making same-day reporting possible for almost two-thirds (63%) of bacteremic episodes with Gram-negative bacilli. These results could probably be improved by modification of the identification algorithms of the VITEK software.

Bacteremia↗

Mecillinam susceptibility as an indicator of beta-lactamase production in Staphylococcus aureus.

The use of direct susceptibility testing from specimens has led to the fortuitous observation that penicillin-susceptible strains have larger inhibition zones for mecillinam than do beta-lactamase producers. The current study was, therefore, undertaken to test 179 Staphylococcus aureus isolates for mecillinam susceptibility by Rosco Neo-Sensitabs and to compare the results with commonly used tests for beta-lactamase production, i.e. size and character of penicillin inhibition zones, chromogenic cephalosporin (nitrocefin) tests and clover leaf assays. Agreement between methods was reached for 175 of 179 strains when disregarding the results of the nitrocefin tests, 88 isolates being found susceptible and 87 being found to be beta-lactamase producers. All 88 susceptible isolates had mecillinam zones of >22 mm, with the great majority being >25 mm; double zones did, however, occur. The 87 beta-lactamase producers had zones <14 mm or no zones. Four isolates presenting problems in had mecillinam zones of <or=20 mm and were without tapering growth at the penicillin inhibition zone edge. In conclusion, the size of the mecillinam inhibition zone is found to be a useful supplementary test in the clinically important distinction between beta-lactamase-producing and non-producing isolates of S. aureus.

Amdinocillin↗

Clinical significance and taxonomy of Actinobacillus hominis.

Clinical findings in 36 immunosuppressed patients with lower respiratory tract infection or bacteremia with Actinobacillus hominis are described. Animal contact was only recorded for three patients; nine patients died despite appropriate antimicrobial treatment. Although infections with this microorganism seem to be rare, the fact that 37 of 46 strains characterized in this study have been found in Copenhagen indicates that under-reporting may occur. A. hominis is phenotypically relatively homogeneous but can be difficult to differentiate from other Actinobacillus species unless extensive biochemical testing is performed. Mannose-positive strains of A. hominis are especially difficult to differentiate from A. equuli. Attempts to identify A. hominis by automatic identification systems may lead to misidentifications. Ribotyping and DNA-DNA hybridization data show that A. hominis is a homogeneous species clearly separated from other species within the genus Actinobacillus.

Actinobacillus↗

Effects of targeting herpes simplex virus type 1 gD to the endoplasmic reticulum and trans-Golgi network.

Glycoprotein D (gD) of herpes simplex virus type 1 (HSV-1) was modified to encode targeting signals known to localize proteins to either the endoplasmic reticulum (ER) or the trans-Golgi network. These motifs conferred the predicted targeting properties on gD in transfected cells as judged by immunofluorescence staining, and the exclusion of targeted gD from the cell surface was confirmed by the fact that these molecules exhibited substantially reduced activity in cell-cell fusion assays. Recombinant viruses expressing Golgi-targeted forms of gD grew to wild-type levels in noncomplementing cells, exhibited unaltered particle/infectivity ratios, and were found to contain wild-type levels of gD, whereas a recombinant expressing ER-retained gD was helper cell dependent and, when grown on noncomplementing cells, produced virions of low specific infectivity with greatly reduced levels of gD. These data imply that HSV-1 acquires its final membrane from a post-ER compartment and lend support to the view that the virus undergoes de-envelopment and reenvelopment steps during virus egress.

Animals↗

Problems of identification in clinical microbiology exemplified by pig bite wound infections.

Our experience from attempts to identify bacteria isolated from boar bite/gore wounds is the background for a discussion of identification problems. Some organisms, although not very common or well-known, can be identified when using commercial kits or conventional methods, provided they are sufficiently characterized, as exemplified by Pasteurella aerogenes isolated from cases 1 and 2. Some organisms may be wrongly identified, or not identified, by both commercial kits and conventional methods, unless seen by experienced microbiologists with knowledge of the original literature. This is exemplified by case 3, in which the final identification result was Bisgaard's taxon 15. Sometimes isolates cannot be identified even in reference laboratories and by using available identification tables and databases. In such cases, the organism involved may turn out to belong to a previously undescribed taxon. This is illustrated by the strains isolated from cases 4 and 5.

Adolescent↗

Ribotyping of strains of Moraxella (Branhamella) catarrhalis cultured from the nasopharynx and middle ear of children with otitis media.

Moraxella (Branhaomella) catarrhalis is frequently present in the nasopharyngeal microflora of small children, especially during episodes of acute otitis media . By means of ribotyping (restriction endonuclease analysis of chromosomal DNA combined with rRNA probing), we studied the genetic heterogeneity of 78 cultures of M. catarrhalis obtained from different localities in the nasopharynx of nine young children with secretory otitis media. Using HindIII and PstI as endonucleases, five different ribotypes were recognized, representing at least five different genotypes of M. catarrhalis. The distribution of these types was found to be almost identical to the distribution among 16 M. catarrhalis strains cultured from middle ear exudates of 16 children with acute otitis media. Ribotype HAPA was found in two-thirds of all the cultures investigated, and 44% of the children harboured more than one ribotype in the nasopharynx at the same time. The vast majority of the nasopharyngeal M. catarrhalis cultures were beta-lactamase positive. One child had both a HAPA ribotype, beta-lactamase-negative strain in the nasopharyngeal secretions, and HAPA ribotype, beta-lactamase-positive strains at the entrance of the eustachian tube, the nasopharyngeal tonsils, the folds of the nasopharyngeal tonsils and the oropharynx. All except one of the M. catarrhalis strains cultured from middle ear exudates were beta-lactamase positive.

Child↗

Glycoproteins gB, gD, and gHgL of herpes simplex virus type 1 are necessary and sufficient to mediate membrane fusion in a Cos cell transfection system.

Herpes simplex virus type 1 glycoproteins gB, gD, and gHgL were expressed by transient transfection of Cos cells. Polykaryocyte formation above the background level seen in untransfected controls was observed only if all three components were expressed. Thus, gB, gD, and gHgL are necessary and sufficient to induce membrane fusion.

Animals↗

Site-directed and linker insertion mutagenesis of herpes simplex virus type 1 glycoprotein H.

The gH-gL complex of herpes simplex virus type 1 (HSV-1) is essential for virion infectivity and virus-induced cell fusion, but functional domains of the gH molecule remain to be defined. We have addressed this question by mutagenesis. A set of linker insertion mutants in HSV-1 gH was generated and tested in transient assays for their ability to complement a gH-negative virus. Insertions at three sites in the C-terminal third of the external domain affected the ability of gH to function in cell-cell fusion and virus entry, while insertions at six sites in the N-terminal half of the external domain induced conformational changes in gH such that it was not recognized by monoclonal antibody LP11, although expression at the cell surface was unchanged. A recombinant virus in which a potential integrin-binding motif, RGD, in gH was changed to the triplet RGE entered cells as efficiently as the wild type, indicating that HSV-1 entry is not mediated by means of the gH-RGD motif binding to cell surface integrins. Furthermore, mutagenesis of the glycosylation site which is positionally conserved in all herpesvirus gH sequences in close proximity to the transmembrane domain generated a recombinant virus that grew in vitro with wild-type single-step kinetics.

Animals↗

Clinical manifestations and molecular epidemiology of Vibrio vulnificus infections in Denmark.

The clinical manifestations of and epidemiological data from 11 patients infected with Vibrio vulnificus admitted to Danish hospitals during the unusually warm summer of 1994 are reported. All patients contracted the disease after exposure to seawater; however, none had consumed seafood. Four patients developed bacteremia, one of whom subsequently died; nine patients, including the four with bacteremia, exhibited skin manifestations. Four patients contracted the disease while fishing; in at least one case the patient had handled eels. All Vibrio vulnificus strains were highly susceptible to 11 antimicrobial agents tested. Plasmid analysis revealed that 8 of 11 strains carried plasmids. Ribotyping using the enzyme HindIII on the 11 strains showed five different types, two of which comprised four strains each. The present study provides the first clinical and epidemiological data about a series of human Vibrio vulnificus infections from a temperate zone.

Adult↗

Neonatal Salmonella meningitis: two case reports.

Two cases of neonatal Salmonella meningitis are reported. Both infants were seriously ill: one died 6 days after admittance to the hospital; the other required artificial ventilation for 4 days and recovered without sequelae. In both cases close relatives had shown signs of gastrointestinal infection just prior to the reported cases. The symptoms, the outcome and antibiotic treatment are discussed. In view of the increasing incidence of salmonella infections in Denmark and the serious prognosis of neonatal meningitis, it is important to consider the diagnosis in all cases of bacterial meningitis in infancy.

Anti-Bacterial Agents↗

Serum antibody response to outer membrane proteins of Moraxella (Branhamella) catarrhalis in patients with bronchopulmonary infection.

A Western blot (immunoblot) method for detecting antibodies against outer membrane protein (OMP) epitopes of Moraxella (Branhamella) catarrhalis was evaluated. Paired serum samples from patients suspected of M. catarrhalis (n = 38) and non-M. catarrhalis (n = 25) bronchopulmonary infection were examined for the presence of antibodies of the immunoglobulin M (IgM), IgG, and IgA classes to OMPs from M. catarrhalis by a gel electrophoresis-immunoperoxidase technique (Western blotting); sera from 40 healthy adult blood donors were also included. A significantly (P = 0.004) more frequent occurrence of IgM-class antibodies and/or an increase in the number of IgG-class antibodies against different M. catarrhalis OMPs from acute- to convalescent-phase serum samples was found for patients with M. catarrhalis (79%) than for patients without M. catarrhalis (40%). IgM-class antibodies against OMPs of M. catarrhalis were found in acute- and/or convalescent-phase serum samples form 58% of patients with M. catarrhalis and 32% of patients without M. catarrhalis. Fifty percent of patients with M. catarrhalis and 16% of patients without M. catarrhalis had, from acute- to convalescent-phase serum samples, an increased number of IgG-class antibodies directed against different OMPs. A total of 34% of patients with M. catarrhalis and 4% of patients without M. catarrhalis had, from acute- to convalescent-phase serum samples, an increased number of IgA-class antibodies directed against different OMPs. The present study indicates that M. catarrhalis is one of the bacteria involved in acute exacerbations of chronic bronchitis.

Adolescent↗

In vitro susceptibility of 124 Xanthomonas maltophilia (Stenotrophomonas maltophilia) isolates: comparison of the agar dilution method with the E-test and two agar diffusion methods.

The in vitro susceptibility of 124 Xanthomonas maltophilia isolates was tested by four methods: Agar dilution (reference method), E-test, a disk diffusion and a tablet diffusion method. Trimethoprim-sulfamethoxazole had the highest activity against X. maltophilia, followed by a combination of aztreonam-clavulanic acid at different ratios, the ratio 1:1 being the most active with a susceptibility rate of 85% as compared to 2% for aztreonam alone. Addition of the beta-lactamase inhibitor tazobactam to piperacillin enhanced the rate of susceptible isolates from 31% to 53%, Relatively few isolates were susceptible to ciprofloxacin (27%) and gentamicin (9%). Generally, the disk diffusion method had a considerably higher frequency of "very major" discrepancies when compared with the agar dilution method than with the other methods. The susceptibility of X. maltophilia to trimethoprim-sulfamethoxazole and ciprofloxacin could reliably be determined by all the diffusion methods tested, but otherwise the agar dilution method is to be preferred. A standardized and reliable diffusion method for susceptibility testing of X. maltophilia remains to be found. Trimethoprim-sulfamethoxazole must be considered the drug of choice in the treatment of severe X. maltophilia infections. The combination aztreonam-clavulanic acid is promising, but must be proved in a clinical setting.

Anti-Bacterial Agents↗