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G Linzenmeier

Publications and source records attributed to G Linzenmeier.

At least 37 records · Page 2Linked to original sources

Evaluation of the MS-2 automated antimicrobial susceptibility testing system: report of a European collaborative study.

The MS-2 is an instrument for rapid automated testing of antimicrobial susceptibility. Its performance was evaluated by comparison with disc diffusion and MIC tests in a collaborative study in four European laboratories. Tests on independently isolated organisms showed the MS-2 to be in essential agreement with conventional methods in 94.8% of tests. A further series of 170 well-defined pathogens for which a reference antibiogram was available were tested by MS-2 and the manual methods in all of the participating laboratories. MS-2 results were in full accord in 90% of tests and in essential agreement in 94%. MS-2 results compared at least as well with the reference values as did either of the manual methods. Initial problems of false susceptibility results with erythromycin and penicillin were resolved by (1) the addition of small amounts of erythromycin which acted as an inducer and (2) by the use of a low content penicillin disc. MS-2 was found to be reliable and needed no attention following loading of the test cuvette cartridges. A print-out of the results was available 2-5 h after inception of the test.

Anti-Bacterial Agents

Pharmacokinetics of ticarcillin during cisplatin chemotherapy.

Cancer chemotherapeutic agents and antimicrobial antibiotics are often given concomitantly. Cisplatin, which has become increasingly important in cancer treatment, has shown nephrotoxicity as a dose-limiting feature. The alpha-carboxy-penicillin ticarcillin (tc) has a wide spectrum of antimicrobial activity, especially against Pseudomonas. The plasma half-life of tc is correlated with renal function. The combined use of cisplatin (20 mg/m2, days 1-5) and tc (3 X 5 g/24 h, days 1-5) with renal protection by vigorous hydration (2400 ml of 0.9% NaCl/24 h continuous infusion, days 1-5) in a group of 12 cancer patients did not alter the BUN and creatinine serum levels. The mean serum concentration of tc, which was monitored in a patient 15, 30, and 45 min after injection of 5 g on 4 consecutive days together with cisplatin, did not differ from the levels of tc reported when used without concomitant cisplatin therapy. Thus these preliminary data show that the pharmacology of tc may not be altered significantly when applied together with cisplatin and that cumulative nephrotoxicity must not be expected with this combination when sufficient hydration is used.

Bone Neoplasms

[Determination of sensitivity of rapid growing bacteria by the MS-2-system. A comparison with conventional methods (author's transl)].

The sensitivity of 333 gramnegative and grampositive isolates against 10 antimicrobial agents was determined by the MS-2 system (Abbott Diagnostics, Div. of Abbott Lab., Dallas, Texas). Results were related to sensitivity tests by agar diffusion technique and agar dilution method. 176 of these strains were tested by different authors (laboratories) in U.S.A. They elaborated a reference antibiogram as a base of comparison for all results. MIC determination by automation method (MS-2) agreed with the reference method in 92.4% for gramnegative organism and in 93.5% for grampositive cocci.

Anti-Bacterial Agents

[Microbiological surveillance in patients treated by bone marrow transplantation (author's transl)].

Patients suffering from acute leukemia were treated by bone marrow transplantation under strict gnotobiotic conditions. The microbiological surveillance was performed during three phases: the admission phase, the phase of decontamination and reverse isolation and the reconventionalisation phase. During the second phase no infections of exogenous origine occurred. All clinically manifest infections in this phase were induced by unsuppressed endogenous bacteria. In our study the bacteria of oropharynx was the main source of infections therefore this biotop deserves special attention during the microbiological surveillance of the immune compromised host. In leukemia patients selective decontamination will be the method of choice, but considering the possibility of GvHR in patients with bone marrow transplantation a complete decontamination should be achieved.

Anti-Bacterial Agents

[In vitro testing of newer cephalosporins (author's transl)].

The spectrum of activity of the newer cephalosporins is considerably wider and includes a number of gram-negative bacteria. Test results using cephalothin as 'class disc' of a class of antibiotics is therefore no longer valid for the newer members. Like cefazoline, all of the above-mentioned antibiotics are more effective against Escherichia coli. Cefuroxin and cefoxitin also display increased effectiveness against Klebsiella, as do cefoxitin against Serratia and indolpositive Proteus species, and cefamandole and cefuroxime against Enterobacter. Cefotaxim is superior to all other agents, as was also demonstrated in our own inhibition zone tests; in addition cefotaxim is effective against Pseudomonas aeruginosa. Since the various pathogens do not exhibit a uniform pattern of resistance to these antibiotics, the four new agents should for the time being be tested independently of cephalothin and cefazoline.

Cefamandole

[Short-term oral chemoprophylaxis before intestine surgery. Quantitative determination of bacteria and fungi in stool specimens (author's transl)].

The methods of quantitative analysis of aerobe and anaerobe microbes and fungi stool specimens are described. The results of the studies in health people are compared to the results in patients undergoing surgical treatment of intestinal tract. A group of these patients received Neomycin and Bacitracin orally as short-time chemoprophylaxis to diminish possible woundinfection and/or sepsis. After oral medication germs as Bifidobacterium, Bacteroides and Clostridium (not Cl. perfringens) are reduced or lost, Veillonella, Eubacterium, Fusiformis, Peptostreptococcus and Lactobacillus were suppressed. Resistant strains of E. coli and Enterococci increased to high concentration/g faeces. After treatment the rate of gram-negative bacteria resistant to Neomycin increased. This might be of epidemiologically importance for the distribution of microbes resistant to Neomycin and other aminoglycosides as Klebsiella, Candida spec. and Torulopsis.

Administration, Oral

Protective isolation and antimicrobial decontamination in patients with high susceptibility to infection. A prospective cooperative study of gnotobiotic care in acute leukaemia patients. III: The quality of isolation and decontamination.

In a cooperative study, the quality of protective isolation and of antibiotic decontamination of the digestive tract was studied in patients with acute leukaemia by (bio)-typing of Enterobacteriaceae species, Pseudomonas aeruginosa and Staphylococcus aureus isolated from oral washings and faecal samples. These samples were collected before and during treatment of 82 patients who were either isolated and decontaminated for which latter purposes a combination of neomycin, polymyxin, bacitracin and nystatin was used (group A); isolated without decontamination (Group B) or treated on the ward without decontamination (Group C). The results indicated that protective isolation had only been completely successful during the entire (remission induction) treatment period in one of the 32 patients in Group B. In Group A patients, who underwent antibiotic decontamination in addition, successful isolation was achieved in 57% of 28 patients. Successful antibiotic decontamination of the digestive tract for the entire treatment period as far as all potentially pathogenic species are concerned, was realized in 4 (14%) of the 28 patients of Group A. Bacteriologically confirmed infections occurred in 50% of Group A patients, in 59% Group B patients and in 64% of Group C patients. It is concluded that the quality of isolation had in general been insufficient but that it was improved by oral nonabsorbable antibiotics and, furthermore, that the antibiotic decontamination procedure also requires improvement.

Adolescent

[Results of enteral antibiotic preparation prior to colon surgery].

Of the 108 patients explored, all received four days preoperatively dietary and mechanical preparation and were given one of the two antibiotic combinations according to their date of birth (58 patients, group I--Neomycin-Bacitracin; 50 patients, group II--Cephaloridin-Colistinsulfate). Bacteriologic studies of stools from the day before beginning of preparation, preoperatively and from the day of operation (intestinal mucous membrane of 70 patients) revealed that the fecal flora of the majority of the patients was abnormal. After antibiotic treatment the bacteriologic studies of stools showed a significant reduction of bacteria. In group II, full asepsis was reached in 42.4% of patients, in group I, in only 13.5%. The price of antibiotics and the preoperative intestinal bacteria should be used as criteria in choosing the preparation for colon operations.

Anti-Bacterial Agents

[Nalidixic acid levels in the serum with restricted renal function (author's transl)].

Simultaneous chemical and microbiological determinations during antibacterial therapy with normal doses of nalidixic acid (4 X 1 g/day) in patients with cystopyelonephritis and restricted renal function (serum creatinine 1.5-14.0 mg%) yielded markedly higher serum levels than in patients with normal kidney function. But no side effects could be observed on longer treatment up to two weeks. The active substance was thus present in the urine in lower concentrations than are found with normal renal function. However, they lie within the range of therapeutically necessary minimal inhibitory concentrations for various gram-negative pathogens. Reduction of the dose of nalidixic acid in severe renal insufficiency seems not to be necessary, and even illogical, because otherwise ineffective plasma and urine levels are obtained. The treatment was effective against sensitive pathogens.

Humans

[Hygiene in medical practice (author's transl)].

Ideas and suggestions for hygiene in medical practice ought to be a stimulus for colleagues in active practice in town and country and also for specialists. Within the scope of a reviw, neither rules, standards nor checklists should be given, because self-determination and self-control- with the help of these stimuli too-are preferable to bureaucratic control. Order and cleanliness are part of the picture of a good doctor. The aspects of hygiene in their many branches, not only for defense against infection, ought to contribute in fact and psychologically to the benefit of the patient.

Communicable Disease Control

In vitro susceptibility of clinically important bacteria to amikacin: correlation of results of broth dilution and disk sensitivity tests and effect of medium composition.

Minimal inhibitory concentrations of amikacin for 296 strains of gram-positive and gram-negative bacteria determined in Mueller-Hinton broth by the method recommended by the International Collaborative Study Group confirmed previous observations that amikacin is effective against current clinical isolates sensitive to gentamicin and that strains moderatly sensitive or resistant to gentamicin are often inhibited by clinically achievable concentrations. A simple linear regression analysis was used for comparison of zone sizes obtained with 10-mug disks of amikacin with minimal inhibitory concentrations obtained by the tube dilution technique. For 152 strains, including seven species of Enterobacteriaceae, the correleation coefficient (r) was -0.79 on Oxoid diagnostic senstivity test agar (which yields zone sizes similar to those obtained on Mueller-Hinton medium) and -0.78 on Oxoid isotonic sensitest agar (which contains cations in isotonic concentrations); the figures were -0.74 and -0.66, respectively, for 80 strains of Pseudomonas aeruginosa. Zone sizes for enteric gram-negative bacilli were on the average 2-3 mm smaller on isotonic sensitest agar than on diagnostic sensitivity test agar, and about 6 mm smaller for strains of P. aeruginosa and Providencia. Minimal inhibitory concentrations of amikacin can be estimated satisfactorily by extrapolation of results of agar diffusion tests, but the composition of the medium, particularly its calcium and magnesium content, should be defined precisely.

Amikacin

[Effectiveness of antibiotic premedication in colonic surgery].

The value of preoperative bowel preparation with antibiotics in colon surgery was studied in a prospective randomized trial: 58 patients received only mechanical and dietary preparation and 50 patients were treated additionally with a combination of neomycin and bacitracin 4 days preoperatively. Bacteriologic studies of stools from the day before beginning of preparation and from the day before surgery which were done quantitatively per 1 gram stool revealed that the fecal flora of 90% of the patients with colonic disease is abnormal. After antibiotic treatment a significant reduction of Escherichia coli, Bacteroides, Bifidus, Clostridium, and Proteus was obtained in more than 70% of the patients. The effect on Klebsiella was poor. Candida were increased in 86% of the cases without resulting in a systemic candida infection. In the stool samples of 16 patients no bacteria were found after antibiotic treatment. If there was a high bacterial count in the preoperative stool infectious complications followed postoperatively. The rate of infectious complications was 28 (48.7%) in the control group and 7 (14%) in the antibiotic group. This significant lower rate of complications speaks in favor of preoperative bowel preparation with neomycin and bacitracin, especially in the absence of adverse side-effects.

Anti-Bacterial Agents