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Biomedical subjects

C Kamme

Publications and source records attributed to C Kamme.

At least 55 records · Page 3Linked to original sources

Aerobic and anaerobic bacteria in neurosurgical infections. Per-operative culture with flexible contact agar film.

Fourteen of 80 patients (17.5 per cent) who underwent elective craniotomy preceded by a strict pre-operative routine of skin decontamination contracted postoperative wound infection. Most of the infections were probably from endogenous sources and from eight of the wounds low-virulent resident skin bacteria, Propionibacterium acnes and/or Staphylococcus epidermidis, were isolated. Since thorough pre-operative preparation of the skin did not reduce the incidence of infection to an acceptable level, antibiotic prophylaxis might be indicated in this type of surgery.

Bacteria↗

Nosocomial Klebsiella pneumoniae infection: clinical and hygienic measures in a neonatal intensive care unit.

An outbreak in a neonatal intensive care nursery of severe infections caused by Klebsiella pneumoniae type K-17 has been studied. Over a 9-month period 20 epidemiologically linked cases of severe septicemia, meningitis and pneumonia were diagnosed. The specific epidemic strain could be identified. After introduction of a policy of hygienic measures the nosocomial infection could be eradicated although colonization still occurred. Thorough handwashing before and after the nursing care of each infant, individual gowning and disposable gloves in the care of infants below 1 500 g were important. The changing bacterial ecology of a neonatal unit should be followed closely by weekly routine throat cultures as well as by cultures of incubators and ventilation equipment. The present investigation has shown the importance of this procedure, which is mandatory for appropriate choice of antimicrobial agents when treating infections in critically ill or very low birth weight infants in the neonatal intensive care unit. Prophylactic antimicrobial treatment is not indicated. Control of K. pneumoniae nosocomial infections can only be achieved by maintaining a high standard of hygiene in the neonatal care.

Carrier State↗

Secretory otitis media: microbiology of the middle ear and the nasopharynx.

Specimens for bacterial culture were obtained from 117 children with secretory otitis media (SOM). From the nasopharynx Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis and group A streptococci were isolated in 79% of the patients. Of 168 ear exudates, 30 yielded growth (18%) from 26 of the patients (22%). Pneumococcal capsular polysaccharides could not be detected in exudates assayed by counterimmunoelectrophoresis. The recovery rate of bacteria from the ear exudates was significantly higher in patients with positive than with negative nasopharyngeal culture (p less than 0.05). The nasopharyngeal pathogens invading the middle ear in SOM seem to survive there for a period of time and are then replaced by other strains according to the fluctuation of the nasopharyngeal flora where approximately 40% of the strains were eliminated and replaced by other strains over a period of 12 to 13 days.

Bacteriological Techniques↗

Intrageneric and intergeneric transfer of Branhamella catarrhalis beta-lactamase production.

Intrageneric and intergeneric conjugational transfer of beta-lactamase production to a Branhamella catarrhalis recipient is described. The branhamella donor strains were fresh isolates subcultured onto penicillin-containing media directly from the primary plates. A beta-lactamase positive Moraxella nonliquefaciens served as donor in the intergeneric matings. The substrate profiles of the branhamella and moraxella enzymes were indistinguishable as determined by biological assays. Excessive endonuclease activity did not permit a conclusive characterization of isolated extrachromosomal DNA from the branhamella donors.

DNA, Bacterial↗

Serum and saliva concentrations of sulfamethoxazole and trimethoprim in adults and children: relation between saliva concentrations and in vitro activity against nasopharyngeal pathogens.

The combination sulfamethoxazole/trimethoprim (SMX/TMP) was given orally to 4 healthy adult volunteers in mean daily doses of 23.0/4.6 mg/kg body weight for 6 days. The serum and saliva concentrations of the drugs were assayed on days 1, 3 and 6. On the first day (0-12 h) there was no measurable concentration of SMX in the saliva. On days 3 and 6 the mean peak levels of SMX in saliva were 7.8 and 9.8 micrograms/ml, i.e. 8-9% of the corresponding mean peak serum levels. In contrast, the concentrations of TMP in saliva were more than twice as high as those in serum. The mean SMX/TMP ratios in saliva days 3 and 6 were 1.3 and 1.4, respectively, i.e. approximately one-twentieth of the mean SMX/TMP ratios in serum. SMX/TMP was also administered to children with serous otitis media. The drug concentrations in saliva were assayed 2-3 h after administration on days 6 and 9 of a 10-day course, with a mean daily dose of 34.5/6.9 mg/kg body weight. The mean saliva concentration of SMX in the children was slightly higher than in adults and the mean TMP concentration about half of that in adults. The mean SMX/TMP ratio in the children's saliva was 4.2. The in vitro activity of SMX/TMP 20:1 and 4:1 was determined against H. influenzae, D. pneumoniae, B. catarrhalis and group A streptococci. H. influenzae, D. pneumoniae and group A streptococci were found more susceptible to TMP than to SMX, while the reverse was true for B. catarrhalis. In the 3 former, the potentiation of SMX by TMP was more pronounced than was the potentiation of TMP by SMX, while the opposite was recorded for B. catarrhalis. The most beneficial effect of the SMX/TMP combination against nasopharyngeal pathogens was recorded for B. catarrhalis and the weakest effect for H. influenzae and group A streptococci. With the exception of B. catarrhalis, the administration of TMP alone to adults may be just as effective against nasopharyngeal pathogens as is the SMX/TMP combination in children.

Adult↗

Transfer of beta-lactamase production in Branhamella catarrhalis.

A beta-lactamase positive Branhamella catarrhalis strain, B.c. 002 PcR, is described. The strain has the ability to transfer beta-lactamase production. The strain was isolated from nasopharynx in an adult patient with long-standing laryngitis. It showed atypical colony morphology.

Adult↗

Risk factors in cesarean section infection.

Factors associated with risk of postoperative infection after cesarean section were studied in 321 patients not given antibiotic prophylaxis. Infections occurred in 56 (25%) of the 228 patients who were delivered by emergency cesarean section and in eight (9%) of the 93 patients who underwent elective surgery (P less than .01). These frequencies corresponded well with the infection rates reported after administration of antibiotics in other studies. Risk factors were: duration of operation more than one hour; blood loss more than 800 ml; presence of Staphylococcus aureus in the nares; signs of intrauterine infection before surgery; and failure of progress in labor. The results indicated that obstetric interventions had been performed more frequently in patients at risk of infection, rather than being the real cause of the infections. The importance of strict preoperative hygienic routine is discussed.

Bacterial Infections↗

Prevention of synthetic arterial graft infections by improved hygienic routine and dicloxacillin administration.

30/60 patients electively reconstructed with synthetic arterial grafts were randomly treated with dicloxacillin per- and postoperatively for 6 days. Wound infections occurred in 10 of the non-treated patients. 1 of whom had a graft infection. In the dicloxacillin group no wound infection was recorded. Overgrowth with bacteria resistant to isoxazolylpenicillin was not noticed during treatment. No late infections occurred. In comparison with previous results, improved hygienic routines before, during and after operation reduced the incidence of postoperative graft infections from 15 to 3%. As postoperative infections after synthetic arterial graft implantation are serious complications, per- and postoperative antibiotic treatment seems justified as a complement to a rigorous hygienic routine.

Adult↗

Biotypes of capsulated and non-capsulated Haemophilus influenzae. Correlation between biotypes and beta-lactamase production.

396 Haemophilus influenzae strains were biotyped according to Kilian. 393 of the strains were assigned to biotypes I to V, while 3 strains remained unclassified. Eighty-nine per cent of the capsulated strains produced both urease and ornithine decarboxylase, biotypes I or IV, while 95 per cent of the non-capsulated strains produced only one of the enzymes, biotypes II, III, or V. Of consecutive strains from the upper respiratory tract, the incidence of beta-lactamase-positive strains was higher among capsulated than among non-capsulated strains (p less than 0.025). None of 133 non-capsulated beta-lactamase-positive strains produced both urease and ornithine decarboxylase, in contrast to 15 out of 147 non-capsulated beta-lactamase-negative strains (p less than 0.001). The type e strains were all of biotype IV and 3 of 7 consecutive strains were beta-lactamase-positive.

Haemophilus influenzae↗

High isolation rate of Branhamella catarrhalis from the nasopharynx in adults with acute laryngitis.

Branhamella catarrhalis was isolated from the nasopharynx in 55% of 40 noncompromised adult patients suffering from acute laryngitis. Diplococcus pneumoniae and haemophilus influenzae were found in another 5 and 8%, respectively; one patient had group A streptococci in the throat specimen. In 90% of the patients the laryngitis complaints were preceded by symptoms of an acute respiratory tract infection. Two of the patients with B. catarrhalis showed a significant titre conversion against influenza B and parainfluenza type e virus, respectively. Attempts to isolate virus failed in all cases. The results indicate that B. catarrhalis, known to cause acute otitis media in small children and respiratory tract infections in adult compromised hosts, may be involved in the etiology of acute laryngitis in otherwise healthy adults.

Acute Disease↗

Evaluation of spiramycin in meningococcal carriage.

Spiramycin was administered to healthy carriers of meningococci in doses of 1.5 g twice daily or 2.5 g once daily for 3 days, or 1.5 g once daily for 10 days. Meningococci were eliminated from the nasopharynx and throat in approximately 50% of the carriers with all dose schedules. In the remaining carriers only a temporary suppression of the strain was achieved. Elimination occurred only in carriers where spiramycin saliva concentrations reached or surpassed the MIC value of respective strain for 42 h or more. Evidence of reinfection from close contacts was not obtained. Due to side effects the dose of spiramycin could not be increased. Further trials with spiramycin as the sole agent for eliminating meningococci in carriers do not seem warranted.

Adult↗