[Ischemic pancreatitis after profuse hemorrhage in cesarean section].
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Adult↗
Biomedical subjects
G Evaldson
Publications and source records attributed to G Evaldson.
Gardnerella-associated vaginitis and anaerobic bacteria.
12 patients with mild or moderate symptoms of Gardnerella-associated vaginitis were examined clinically and microbiologically on 52 different occasions, 27 of which were asymptomatic. The symptomatic state was defined by fulfilling at least three of the following criteria: (1) subjective symptoms; (2) pH above 4.5; (3) positive amine test, and (4) clue cells in wet smear. Variation of the vaginal microflora was considerable. No causative bacterial species could be identified. Microorganisms of the genus Bacteroides were significantly (p less than 0.02) more often found in the symptomatic condition. The presence of either peptococci , peptostreptococci or anaerobic streptococci was similarly related to symptoms (p less than 0.01). Lactobacilli were significantly more often present when the patient was free of symptoms (p less than 0.05). Gardnerella vaginalis was a common isolate whether the patient suffered from symptoms or not. It is concluded that the presence of this microorganism indicates a disturbed ecologic situation within the vagina, resulting in loss of predominance of lactobacilli and hence liability to develop symptoms.
Adult↗
The role of immunoglobulins in amniotic fluid growth inhibition of Bacteroides fragilis, herpes simplex, coxsackie B 5 and cytomegalovirus.
In serum and amniotic fluid (AF) from 30 pregnant women, antibodies against the anaerobe Bacteroides fragilis were determined by enzyme-linked immunosorbent assay (ELISA) and the results were compared with those of previously performed tests of B. fragilis growth inhibition by AF. The neutralizing effects of serum and AF against herpes simplex virus (HSV), cytomegalovirus (CMV) and coxsackie B 5 virus were also investigated, and antibody titres were determined by ELISA. No correlation could be demonstrated between the growth-inhibitory capacity of AF and the presence of antibodies against B. fragilis in serum or AF. Neutralizing antibodies against HSV and coxsackie B 5 virus were found in 73% and 51%, respectively, of the sera and in 36% and 13%, respectively, of both serum and corresponding AF. In no case could an AF neutralizing effect upon HSV, coxsackie B5 or CMV be demonstrated without a corresponding positive serum neutralization. It is concluded that the growth-inhibitory effect of AF on viruses in antibody-mediated, while AF inhibition of B. fragilis, and possibly other bacteria as well, seems to depend upon other antimicrobial mechanisms.
Amniotic Fluid↗
Bacteroides fragilis, Streptococcus intermedius and group B streptococci in ascending infection of pregnancy. An animal experimental study.
By means of bacteriological, histological and immunofluorescence methods, the ascending spread of endocervically inoculated bacteria was studied in 14 pregnant sheep. 8 ewes near term were exposed to group B streptococci, Bacteroides fragilis or Streptococcus intermedius for 2-4 days. 6 other animals in mid pregnancy were exposed to one of the bacteria mentioned for 30 days. Before inoculation, aerobic and anaerobic culture specimens from cervix and amniotic fluid were obtained. At delivery by caesarean section, in addition to culture specimens, membrane and placental tissues were collected. Bacterial detection by means of indirect immunofluorescence showed significant invasion of the membranes and the placentas by the microorganisms inoculated. In one case, inoculated with S. intermedius, the ascending infection could be shown to pass the intact membranes reaching the amniotic fluid. It is concluded that endocervical bacteria in the indigenous microflora might cause pregnancy complications by establishing ascending infection. Furthermore, as the bacteria tested have been implicated in premature rupture of the membranes, an aetiological role of ascending infection in this pregnancy complication is postulated.
Animals↗
The normal human anaerobic microflora.
Anaerobic bacteria are prevalent among the bacterial populations of the human body, particularly on mucous membrane surfaces. The major sites with a rich anaerobic normal microflora are the mouth, the gastrointestinal tract and the female genital tract. The oral cavity harbours more than 300 different bacterial species. The concentrations of bacteria in saliva are 10(8) to 10(9) colony forming units/ml and anaerobic bacteria outnumber aerobic bacteria by 10:1. On the tooth surfaces, the concentrations of bacteria are 10(10) to 10(11) cfu/ml with a predominance of anaerobes. Bacterial concentrations in gingival scrapings are 10(11) to 10(12) cfu/ml with anaerobic bacteria outnumbering aerobic bacteria by 1000:1. In the saliva and on the tongue surface, the predominant anaerobic bacteria are cocci, while in the gingival crevice large concentrations of gram-negative rods are recovered. Microorganisms found in the upper intestinal tract are different from those in the lower intestinal tract. In the stomach and the proximal small bowel, the microorganisms found as normal flora are a reflection of the oral flora. Bacterial concentrations in this region are 10(2)-10(5) cfu/ml intestinal content. In the colon, bacterial concentrations of 10(11)-10(12) cfu/g faeces are found. About 500 different bacterial species are recovered in the lower intestine. The most common anaerobic microorganisms are bifidobacteria, lactobacilli and bacteroides. Recent studies have used quantitative techniques for analyses of the vaginal flora and it has been found that anaerobic bacteria outnumber aerobic bacteria in the vagina by approximately 10:1. The most prevalent bacteria are peptococci, present in counts of 10(7)-10(8) cfu/ml. Lactobacilli, corynebacteria, eubacteria and bacteroides are also isolated.
Anaerobiosis↗
[Management of breech presentation].
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Breech Presentation↗
Amniotic fluid activity against Bacteroides fragilis and group B streptococci.
The antimicrobial capacity of amniotic fluid (AF) against B. fragilis, group B streptococci and Escherichia coli, the latter as a reference indicator, was investigated in samples from 30 patients. In order to study trimester as well as individual variations in the antibacterial activity, 10 individual samples from each trimester of pregnancy (AF1, AF2, AF3), were separately tested. With B. fragilis all trimester samples showed initial inhibition lasting for 8 h, the bacteria then regaining growth capacity in all AF1, and the majority of AF2 and AF3 specimens. However, 4 AF2 and 3 AF3 samples showed continued bacteriostatic activity for up to 24 h. Group B streptococci exhibited uninhibited growth in all trimester samples. The growth of E. coli in AF1 and AF2 was not inhibited, whereas in AF3 a temporary arrest was observed at 8 h, this being followed by growth to control levels at 24 h. The findings may explain the frequent isolation of B. fragilis from cases of septic abortions during the first trimester. Individual variation in the effectiveness of the antibacterial activity against B. fragilis in AF2 and AF3 may explain why this microorganism, which is often implicated in severe maternal and neonatal infections, is occasionally recovered from the mother's endocervix without signs of disease. The inefficacy of AF in defence against group B streptococci correlates well with the frequent isolation of these bacteria from cases of severe congenital infections associated with premature delivery.
Amniotic Fluid↗
Microbiological findings in pregnant women with premature rupture of the membranes.
From 30 consecutive cases of premature rupture of the membranes (PROM) and matched controls, specimens from urine, cervix, amniotic fluid, and placenta as well as neonatal nose and throat swabs were investigated bacteriologically and virologically. In addition virus serological investigation was done. Among the PROM cases the anaerobic cervical isolates outnumbered the aerobic ones, and the total number of aerobic as well as anaerobic isolates was less in the control group. The anaerobes B. fragilis and Strept. intermedius were isolated from the cervix, amniotic fluid, or placenta in 23% and 30% of the PROM patients, respectively. None of the controls harboured B. fragilis, while Strept. intermedius was isolated from 6.7% of the controls. Group B streptococci were recovered from the mother's cervix in 20% of the PROM patients and in 6.7% among the controls. Four cases of neonatal septicaemia were encountered, and another two cases were clinically suspected, but not microbiologically verified, contributing to a high perinatal mortality rate (17,6%). Of the PROM patients, 27% developed puerperal infection, while none of the control mothers had such complications. The significance of the anaerobic bacteria as well as group B streptococci for the maternal and neonatal outcome in cases of PROM is discussed, and a possible aetiological role of ascending infection in this complication of pregnancy is postulated.
Adult↗
Premature rupture of the membranes.
The etiology of premature rupture of the membranes (PROM) has been investigated in 30 consecutive cases and 30 matched controls. The significance of several possible factors predisposing to this condition is discussed and the obstetric and pediatric outcome reviewed. Significantly increased frequencies of previous genital operations, cervical operations and lacerations were found in the PROM group, which also contained significantly more heavy smokers. The relation between the length of the PROM delivery time interval and the risks of prematurity and infection are discussed. Patients delivered > 24 hours after PROM had significantly more puerperal infections than those with a latent period of < 24 hours. Maternal fever was found to be an unreliable prognostic indicator. The incidence of puerperal infection amounted to 27 per cent in the PROM group. A 12 per cent incidence of proven neonatal septicaemia contributed to a high perinatal mortality rate (17.6 per cent).
Abortion, Induced↗