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Biomedical subjects

G Coman

Publications and source records attributed to G Coman.

At least 19 recordsLinked to original sources

Molecular characterization of beta-lactam resistance of Salmonella isolates from pediatric patients in Romania.

The molecular characterization of 16 clinical isolates of Salmonella enterica (14 serotype Typhimurium and 2 serotype Kingston) obtained between January and June 1999 from feces of children hospitalized in Iasi, Romania were genotypically compared by pulse field gel electrophoresis of XbaI restricted bacterial DNA. The majority of the clinical isolates (12/16) belonged to cluster A and (4/16) to unrelated strains, correlating to the OMP profile. Two major different patterns of beta-lactamases were identified: the first with pI of 5.4, 8.2 in 6/16 strains and the second with pI of 5.4 in 5/16. The blaTEM beta-lactamase was identified in 14/16 of the clinical isolates and the blaSHV-5 gene in one strain. We concluded that extended spectrum beta-lactamase (ESBL) with pIs of 8.2 was the most frequent enzyme produced by serotype Typhimurium isolates which were related.

Base Sequence↗

Molecular typing of Streptococcus pneumoniae in northeastern Romania: unique clones of S. pneumoniae isolated from children hospitalized for infections and from healthy and human immunodeficiency virus-infected children in the community.

Microbiologic, serologic, and molecular typing techniques were used to characterize 272 isolates of Streptococcus pneumoniae colonizing or infecting children in Iasi, Romania, during a surveillance study conducted in 1996-1998. The 574 children in the study were from the following groups: healthy children attending 2 institutions, healthy children hospitalized for elective surgery, hospitalized children with pneumococcal infections, and human immunodeficiency virus (HIV)-infected children in an orphanage. Pneumococci colonizing healthy children from closed communities showed close similarities to pneumococci from children with pneumococcal infections; they expressed a limited number of similar serotypes, showed high frequency of penicillin and multidrug resistance, and shared several common clonal types. In contrast, isolates recovered from healthy children hospitalized for elective surgery expressed a large variety of serotypes, were less frequently resistant to antimicrobial agents, and showed great genetic diversity. Pneumococcal flora colonizing HIV-infected children showed a more complex epidemiology. These observations suggest a possible epidemiologic connection between the flora of S. pneumoniae colonizing healthy children in closed communities and the flora found in children hospitalized for infection.

Child↗

An evaluation of the telepsychiatry programme in Victoria, Australia.

We evaluated the use of telepsychiatry in Victoria, a state of Australia with some five million people. There were 39 sites at the time of the survey, 12 metropolitan and 27 rural. Interviews and postal questionnaires were used. A total of 99 staff were surveyed, 69 by post and 30 during visits. There were 37 participants from metropolitan sites and 62 from rural sites. Rural sites conducted an estimated 137 sessions per month (i.e. an average of 5.1 per month per site). The majority (70%) of the usage in Victoria was for clinical purposes, both primary and secondary consultations.

Female↗

Varicella-zoster virus infection in Romanian children infected with the human immunodeficiency virus.

OBJECTIVE: Varicella-zoster virus (VZV) infections can cause severe disease in immunocompromised individuals. To evaluate the spectrum of VZV infections in human immunodeficiency virus (HIV)-infected children, we retrospectively analyzed all the cases of VZV infection in a cohort of children cared for at a hospital for infectious diseases in Bucharest, Romania. METHODS: The records of 391 HIV-infected children admitted to the acquired immunodeficiency syndrome pavilion of Colentina Hospital during the period January 1, 1991, through March 31, 1992, were reviewed for evidence of VZV infection. The diagnosis of varicella or zoster was made clinically and information was collected concerning course of the illness, number of skin lesions, and clinical evidence of complications. Lymphocyte subpopulation typing, as an estimate of immune function, was performed by either a standard fluorescent activated flow cytometric method or by immunofluorescent technique. RESULTS: Thirty-eight cases of varicella (9.7%) and seven cases of zoster (1.8%) were adequately documented among the 391 records reviewed. The duration of varicella was prolonged; in 57% of the children it was greater than 10 days. Forty percent of children with varicella developed a complication, including superinfection of the skin, pneumonia, or thrombocytopenia. None of the children developed clinical hepatitis or encephalitis. Two children (5%) died during varicella, both of respiratory failure. None of the 7 children with zoster had chronic, recurrent, or disseminated lesions. Lymphocyte subset analysis was available for 22 of 38 children with varicella and 3 of 7 children with zoster. Fifteen of the 22 children had normal, age-adjusted, absolute CD4 counts within 3 months of the diagnosis of varicella. All 3 children with zoster who had lymphocyte subset analysis had low CD4 counts and absolute numbers. None of the 45 children received antiretroviral therapy and only 1 child with varicella and 1 with zoster received acyclovir. CONCLUSIONS: The spectrum of VZV infection in this hospitalized group of HIV-infected children was broad. The majority (57%) experienced a prolonged course of disease and a higher rate of complications than normal children hospitalized with varicella.

CD4-Positive T-Lymphocytes↗

Intralesional human leukocyte interferon treatment alone or associated with IL-2 in non-AIDS related Kaposi's sarcoma.

Patients with classical European Kaposi's sarcoma were treated by intra- and peritumoral injections of human alpha leukocyte interferon (IFN) (12 cases) or, alternatively, with IFN and naturally synthesized IL-2 (8 cases). All the patients were HIV negative with tumors which had been present for at least six months. In each patient, one tumor received 1 ml (50,000 IU) IFN alone or alternatively associated with 1 ml IL-2 twice a week for 4-6 weeks; another nodule situated 10-12 cm away was considered as a control and remained uninjected. The clinical follow-up revealed that, in the same patient in the same anatomical area, the treated nodule was cured in all the investigated cases; the untreated one was not. These data strongly suggest that IFN is the factor responsible for the involution and final cure of these Kaposi tumors treated by perilesional inoculations. Association with IL-2 (and certainly also other interleukins) increases the beneficial clinical activation of the tumor involution. Histological examination showed that important histopathological changes occur in the treated nodules: complete disappearance of the Kaposi's aspect, fibrosclerous modifications progressively replacing the fibroblasts characteristic of Kaposi's sarcoma, abundant infiltrations of leukocytes, especially lymphocytes and necrotic patches, often with hemorrhagic centers. IL-2 association seems to especially induce this last type of histological phenomenon.

Acquired Immunodeficiency Syndrome↗

[Bacteremia following tooth extractions].

A study was made of the incidence and nature of bacteremia occuring after extractions in a group of 189 patients hospitalised in the maxillo-facial surfery department of Iassy. The figure of 65.5% positive blood cultures demonstrates the particular role of dental extraction in the pathogenesis of bacterial endocarditis. Antibiotic sensitivity studies of streptococci, the bacteria isolated most frequently, showed their remarkable sensitivity to penicillin and erythromycin (95.9%) and their remarkable resistance to streptomycin (83.8%). This would indicate penicillin to be the antibiotic of choice in the treatment of post-extraction bacteraemia, replaced by erythromycin in individuals allergic to penicillin. Study of the relationship between the incidence of bacteraemia and the number of teeth extracted indicates the possibility of grouping several extractions at the same session, thereby reducing the period of administration of antibiotics as a "cover". As far as the type of anaesthesia, local or general, was concerned, the higher level of post-extractional bacteraemia in patients who had received a general anaesthetic suggests that loco-regional anaesthesia should be the method of choice.

Ampicillin↗

[Erysipelothrix rhusiopathiae bacteremia in a child with acute leukemia].

The systemic infections caused by E. rhusiopathiae and reported in literature are very rare, majority evolving with endocarditis. The authors present a child with acute leukemia, to whom the blood culture during a high temperature episode allows to isolate this bacterium, without valvular lesions. The case is interesting because of the arisen bacteriological diagnosis problems and because of the pathogenic aspects of the infection. An animal source contact being absent, we took in account the intestinal carriage which, under the profound depression of the defence (the underlaying disease and the cytostatic therapy) could result in a persistent bacteremia. The treatment with cefazolin allows the infection to be cured.

Adolescent↗

The interleukin-1, interleukin-2, interleukin-6 and tumour necrosis factor alpha serological levels in localised and systemic sclerosis.

Serological level of interleukin-1 (IL-1), Interleukin-2 (IL-2), Interleukin-6 (IL-6) and tumour necrosis factor (TNF) alpha was investigated in 26 patients with scleroderma, divided into three lots, by the extension and the progress of the disease. Determinations were performed by ELISA in attack and in remission (after treatment with prednison). Normal values: IL-1 (0-5 pg/ml), IL-2 (0-5 pg/ml), IL-6 (5-15 pg/ml), TNF (0-16 pg/ml). Lot A. Results obtained at the first determination showed that IL-1 is elevated in 4 cases (10-15 pg/ml), IL-2 in 5 cases (10-32 pg/ml), IL-6 in 5 cases (15-42 pg/ml) and TNF in 4 cases (18-34 pg/ml). In the second determination IL-1 was increased in 1 case (8 pg/ml), IL-2 in 1 case (9 pg/ml), IL-6 in 2 cases (12 pg/ml) and TNF was normal. Lot B. In the first determination IL-1 was elevated in 5 cases (8-12 pg/ml), IL-2 in 5 cases (10-15 pg/ml), IL-6 in 7 cases (16-20 pg/ml) and TNF was raised in 3 cases (18-25 pg/ml). At the second determination IL-1 showed normal values in all the cases, IL-2 was raised in 2 cases (10 pg/ml), IL-6 in 2 cases (12.15 pg/ml), TNF in 1 case (20 pg/ml). Lot C. In the first determination there were raised values in 4 cases for IL-1 (6-8 pg/ml), 3 cases for IL-2 (10-18 pg/ml), 5 cases for IL-6 (18-20 pg/ml), 2 cases for TNF (20 pg/ml). At the second determination IL-2 was elevated in 1 case (10 pg/ml), IL-6 in 1 case (15 pg/ml). We consider that in scleroderma there is a disturbance of the investigated cytokines due to the activation and involvement of the secretory cells into the pathogenesis of the disease. The increase of the serological levels of IL-1, IL-2, IL-6 and TNF depends on the extension of the lesions and the clinical and biological activity periods of the disease. The absence of the increase of the serological levels does not exclude their activity at the lesional site.

Adolescent↗

Diethylaminoethanol action in the arthritis with Freund adjuvant, in rats.

The authors have studied the action of diethylaminoethanol on Freund adjuvant arthritis, induced in female Lewis rats. They worked on 3 groups, each one including 14 rats, weighing 110-130 g: group I = control; group II = rats injected intracutaneous with 0.1 ml Freund adjuvant; group III = rats injected with Freund adjuvant and treated with diethylaminoethanol i.m. (10 mg/kg body weight), and gel application (2.5%) on paws and tail, daily. During the experiment clinical observations and measurements were made and when the animals were killed, blood was sampled for haematological and immunological assays (CD4, CD8, CD25 T cells and NK cells, antinuclear autoantibody and immune complexes). While in all the rats from group II (without treatment) inflammatory processes developed at the level of the peripheral joints, in group III (diethylaminoethanol treated), these ones were present in only 64% of the rats and by much more reduced forms, followed by a short period of involution. The paw volume, measured with an electronic plethysmometer, was more reduced in the treated rats (7.1-14.2%) than in the non treated ones (27.7-29.3%). The haematologic examination showed an increased number of neutrophiles in both groups with FA injecting. The immunological investigations revealed: a decrease of CD4 cells and an increase of CD8 T cells and NK cells in both groups, a much more decreased level (13.2%) of circulatory immune complexes in treated rats, as compared to the non-treated ones (71.7%). No differences were found regarding the CD25 cells and antinuclear antibodies. The histo-pathological examination showed that the intensity and the extension area of the joint lesions (granulation tissue with fibrous change, cartilage invasion and dilaceration, bone atrophy) were much more reduced in the treated rats. The authors put forward the hypothesis that these effects might be due to diethylaminoethanol antiinflammatory properties.

Animals↗

ICAM-1, ELAM-1, TNF-alpha and IL-6 in serum and blister liquid of pemphigus vulgaris patients.

The levels of ICAM-1, ELAM-1, TNF-alpha and IL-6 were determined in 12 patients with pemphigus vulgaris (PV) both in serum and the blister liquid. As a control, the same parameters were determined in 7 patients with herpes zoster (HZ). The patients with PV presented significantly higher values of ICAM-1 in the blister liquid, as compared to the serum values. The values of TNF-alpha and IL-6 were increased both in serum and the blister liquid. The ELAM-1 values did not show significant differences between serum and the blister liquid. In HZ patients, the blister liquid values did not significantly exceed the serum values both for ICAM-1 and ELAM-1. TNF-alpha and IL-6 presented high values both in serum and the blister liquid. We consider that the high values of ICAM-1 in the blister liquid from PV patients suggest the involvement of this adhesion molecule in the PV pathogenic features. The implication of ICAM-1 could be nonspecific and limited, and could possibly represent a reaction to the destruction of the desmosomal bonds within keratinocytes.

Adult↗

[Clinical and therapeutical correlations in Moraxella catarrhalis respiratory infection in children].

In childhood recurrent respiratory infection with Moraxella catarrhalis have high incidence demonstrated by multiple risk factors association (atopia, immunsuppresion, chronic diseases, malnutrition) that makes this common bacteria pathogen. The study was carried on 56 children (0-16 years old). Authors try to find correlations between clinical signs and microbiological markers that determine recurrent respiratory infection with Moraxella catarrhalis. Treatment consisted of association between "target" antibiotherapy and immunomodulation drugs. Efficacy of this treatment was proven by decreased numbers of recurrent infection (in 35% cases comparing to 53% selected cases for immunomodulation), improvement of evolution of chronic diseases, decreased number of days and price of hospitalisation.

Adolescent↗

Resistance mechanism for a number of non-typhoidic Salmonella strains isolated in Iaşi, Romania.

The aim of this study was to find a possible explanation for the resistance pattern of the selected strains and to evaluate the impact in case of isolating such strains. During the period February-March 1998, in the Pediatric Hospital "Sf. Maria" from Iasi, Romania, 12 non-typhoidic Salmonella strains, non-duplicates were isolated from stools of newborns and, in one case, from mother as well. Identification was done by standard methods, and sensitivity testing by disk diffusion method, against the following antimicrobials: Ampicillin (A), Amoxycilin/Clavulanic Acid (AMC), Tetracycline (T), Streptomycin (S), Cloramphenicol (C), Nalidixic Acid (NA), Ciprofloxacin (CIP), Cephalotin (KF), Cefuroxime (CXM), Ceftriaxone (CRO), Cefotaxime (CTX), Ceftazidime (CAZ), Aztreonam (AZT), Imipenem (IPM), Amikacin (AK). All strains showed resistance to: A, AMC, T, S, C, NA, CRO, CAZ, CXM, CTX, KF except one strain, CTX and CRO sensitive. The possible explanation is the production of an extended-spectrum beta-lactamase (ESbLA), detected by microbiological methods (Masuda and clover-leaf). Resistance transfer was realised by using the previously described method. In conjugation experiments we have obtained only one transconjugant, identified as E. coli, that has acquired all resistance determinants. This report highlights on the isolation of multiresistant non-typhoidic Salmonella strains in hospitalised patients without previous antibiotic treatment and possibility of detecting such strains by being aware of the correlation: resistance phenotype-resistance mechanism.

Adult↗

Study of outer membrane proteins (OMPS) and their role in co-modulation of resistance in non typhoidic Salmonella strains isolated in Iaşi.

OBJECTIVES: To characterize the OMP profile and to study the possible interference with other resistance determinants. MATERIAL AND METHODS: 16 non-typhoidic Salmonella strains, isolated in 1999 from stools of pediatric patients, were selected according to their resistance phenotype: resistance to Ampicillin (AMP), Amoxycillin/Clavulanic Acid (AMC), and third generation cephalosporins: Ceftriaxone (CRO) and Ceftazidime (CAZ). Identification and sensitivity testing were done by DADE MicroScan System. beta-Lactamases were characterized by isoelectric focusing (IEF) with preformed minigelss. OMPs were studied on membrane preparations on SDS-urea gels. RESULTS: Isoelectric points: Majority of the isolates had the association 5.4 +/- 7.6 (3/16) or 5.4 + 8.2 (6/16). The second beta-lactamase has the capacity to hydrolyse CAZ. We found three different patterns of OMPs: I: 30, 29 and 25 kDa; II: 30, 26 and 24 kDa; III: 30 and 25 kDa. We couldn't find any correlation between the OMPs profile and resistance phenotype, showing that the beta-lactamase production is the only resistant determinant. CONCLUSIONS: The study shows the high frequency of extended-spectrum beta-lactamases (ES beta LA) amongst the non-typhoidic Salmonella; association of TEM type and ES beta LA enzymes diminishes considerably the therapeutic resources: inhibitor associated combinations are non effective. In non-typhoidic Salmonella, porins seems to have no influence in co-modulation of resistance.

Anti-Bacterial Agents↗