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Biomedical subjects

E Vanek

Publications and source records attributed to E Vanek.

At least 37 records · Page 2Linked to original sources

Aerococcus bacteremia associated with granulocytopenia.

Two cases of bacteremic infection due to aerococci in granulocytopenic patients with acute leukemia and oral mucositis are described. Strains isolated from blood cultures of both patients were resistant to the antibiotics given orally for prophylaxis. One patient died in septic shock; surveillance cultures from oral washings in the other repeatedly showed high concentrations of aerococci. Aerococci were also isolated from surveillance cultures taken from 5 of 17 other patients with acute leukemia; however, their viable counts were lower than in the surviving patient.

Adult↗

[Endocarditis caused by Haemophilus parainfluenzae and Neisseria gonorrhoeae].

Infective endocarditis due to gramnegative bacteria is rare. Overall, its relative frequency seems to be much lower than 10 percent. According to the extensive literature reviewed most often the causative microorganisms belong to the families of enterobacteriaceae and pseudomonads. Extremely rare, however, are cases where certain fastidious gramnegative bacteria such as hemophili, neisseria and others are the causative organisms. We report two cases of infective endocarditis due to Haemophilus parainfluenzae and to Neisseria gonorrhoeae. Despite their fastidious growth, both organisms could rapidly be isolated from venous blood cultures. Both were sensitive to ampicillin or penicillin respectively, and adequate antimicrobial therapy could early be initiated. As compared to reports in the literature both cases showed typical valve involvement and took a relatively typical course under medical treatment. The Haemophilus parainfluenzae endocarditis presented as a subacute illness following a tooth extraction and showed large vegetations on a prolapsed mitral valve. In contrast to the findings of others signs of slight renal involvement but no signs of major arterial embolization were noted. Medical treatment with ampicillin plus an aminoglycoside was effective as in most other reported cases. Vegetations were echocardiographically no longer seen after five weeks. The gonococcal endocarditis early led to destructive lesions of the aortic valve, significant regurgitation, vascular congestion and complicating pneumonia. Medical treatment alone was not effective despite the high susceptibility to antibiotics ot the strain isolated. As reported für the majority of cases reviewed in the literature early valve replacement became necessary for a favourable outcome.

Adult↗

[Haemolysis as initial sign of Clostridium perfringens septicaemia in newborn (author's transl)].

Cases of Clostridium perfringens, septicaemia are subject to a very gloomy prognosis in adults. This applies likewise to the rare cases reported in paediatric literature. The present report describes the fatal case of a newborn with Clostridium perfringens septicaemia. The principal sign was a severe haemolysis which failed to respond to blood exchange transfusions and antibiotic treatment. The characteristic changes of colour of the skin usually observed in septicaemia of newborn had probably been masked for some time by the reddish discolouration caused by the haemolysis, so that diagnosis was established at a late stage only.

Anemia, Hemolytic↗

Risk factors for infections of the oropharynx and the respiratory tract in patients with acute leukemia.

The pathogenicity of microorganisms isolated by surveillance cultures, the neutrophil count in the peripheral blood, and the interaction of the two factors were analyzed as risk factors for infections of the oropharynx and the respiratory tract in patients with acute leukemia being treated in strict reverse isolation under antimicrobial modulation. A statistical method was developed for the identification of bacteria, the presence of which was correlated with an increased risk of infection. A significantly increased risk was found mainly for species of Klebsiella, Enterobacter, Proteus, and Pseudomonas. The degree of neutropenia was significantly correlated with the risk of infection, which was influenced by the microbiologic state of the oropharynx. Thus, patients with gram negative bacilli had significantly more days with infection at all levels of neutropenia than patients without gram-negative bacilli. These two risks factors were additive but did not potentiate each other.

Acute Disease↗

The efficiency of strict reverse isolation and antimicrobial decontamination in remission induction therapy of acute leukemia.

The efficiency of strict reverse isolation and antimicrobial decontamination in remission induction therapy of acute leukemia was studied retrospectively in 47 patients who were treated with a standardized aggressive chemotherapy of daunorubicin and cytosine arabinoside. Twenty-two patients were treated in strict reverse isolation with antimicrobial decontamination and 25 patients in the open ward without any measures against infections. In the patients in isolation the incidence of new infections per patient was 0.77 compared to 1.42 in the control group. The rate of complete remissions was 77% in the patients in isolation vs. 56% in the control patients.

Acute Disease↗

[Bacterial contamination as a complication of intravenous therapy in intensive care (author's transl)].

Intravenous infusion therapy has become an indispensible part of intensive care. Problems of bacterial contamination during this therapy are well known. To check on the possible routes of contamination we examined the infusion system in its several parts (infusion solution, infusion system, connection between infusion system and catheter and content of syringes). The highest rate of contamination was found at the connection between the infusion system and the catheter after use for 24 h (26.7%, 39 out of 146 probes); just at the beginning of the infusion we found bacterial growth in 7.1% (10 out of 141 probes). After injection of drugs into the system the infusion solution was contaminated in 1.9% (6 of 320 probes). The system for measuring the central venous pressure was contaminated in 2.7% (4 of 148 probes). At the end of infusion the infusion solutions were contaminated in 3.1% (9 of 287 probes). Different drugs in syringes in no case were contaminated. In most cases (59 probes) we found gram-positive bacteria (87.3%), in only seven cases (9.7%) gram-negative bacterias and in two cases Candida tropicalis. Our results show that the extrinsic or in use contamination plays the most important part in bacterial contamination of the infusion system. Infection control of intravenous therapy necessitates care in the hygienic standard adopted during the infusion and injection procedures.

Antisepsis↗

[Antibody coated bacteria in the urine: a specific test for pyelonephritis (author's transl)].

Three groups of subjects have been studied: the first group with sterile urine, the second with significant bacteriuria without antibody-coated bacteria and the third with significant bacteriuria with antibody-coated. IgG, IgA, IgM and transferrin were determined by immunological methods (partigen plates). The antibody coating was determined by immunofluorescence. Subcultures were prepared from the urine samples containing bacteria. The bacteria obtained from the subcultures were then incubated with the original urine which had been sterilised by passing through a filter. These were then treated with AH-IgG containing fluorescein. Serum was taken from several patients and incubated with the bacteria from the subcultures. These were also treated with AH-IgG fluorescein. In no case could specific antibodies against the infecting organisms be found, although IgG in the urine were elevated and specific antibodies were present in the serum. This leads to the conclusion that specific antibodies are formed by direct tissue contact of the bacteria and that coating is not established in the urine itself.

Antibodies, Bacterial↗

[Acute drug-induced agranulocytosis: comparison between openward treatment and antimicrobial decontamination in a plastic isolation bed system (retrospective study of 30 cases) (author's transl)].

Thirty patients with severe drug-induced agranulocytosis were admitted to the Ulm University Hospital between January, 1968 and October, 1976. All of 13 already infected patients treated with antimicrobial decontamination in a plastic isolation bed system survived. But nine of 17 patients treated in the open ward died. The cases were not randomised and there was a difference in age between the two groups, but nevertheless the results suggest that antimicrobial decontamination and isolation is superior to treatment in an open ward.

Adolescent↗

[Localization of urinary-tract infection by demonstrating antibody-coated bacteria in urine (author's transl)].

The immunofluorescence test for demonstrating antibody-coated bacteria as a direct method of localizing urinary-tract infection was performed on 34 patients, results being compared with the Fairley test. Mid-stream urine contained at least 10(5) bacteria/ml in all patients. The direct localization method revealed upper urinary-tract infection (renal bacteriuria) in 18 patients, lower urinary-tract infection (cystitis) in eight. Presence of antibody-coated bacteria correlated well with renal bacteriuria, such antibody having been demonstrated in all of the eighteen patients with renal bacteriuria but in none of the eight with lower urinary-tract infection (cause located in the bladder). The test has proved to be highly sensitive method for differentiating between upper and lower urinary-tract infection.

Antibodies, Bacterial↗

Use of limulus assay to compare the biological activity of peptidoglycan and endotoxin.

The gelation of a lysate prepared from the amebocytes of Limulus polyphemus, the horseshoe crab, has been used to detect endotoxin-like material in clinical studies and in "in vitro" experiments. The investigation of blood samples from 54 hospitalized patients suspected of having endotoxemia, revealed a positive limulus test in 14. Infections due to gram-positive organisms were not associated with positive assays. These results were in agreement with the observation that living gram-positive microorganisms - in contrast to gram-negative bacteria - did not initiate lysate gelation when studied "in vitro". Only very high concentrations of peptidoglycan, isolated from the cell walls of various gram-positive bacteria, induced the reaction. Therefore, these findings support the view, that the limulus test is relatively specific for the detection of gram-negative bacterial endotoxin and endotoxemia.

Animals↗