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Biomedical subjects

G Wewalka

Publications and source records attributed to G Wewalka.

At least 19 recordsLinked to original sources
PubMed1991

Educational programmes for infection control in Austria.

Educational aims and strategies (simply arousing awareness, sensitivity and understanding; and/or training in practical skills and knowledge; or the ability to teach infection control, and to convince those taught) depend on the target group. Infection control is part of the curriculum for students of medicine and other health care professions, and is included in course examinations. Postgraduate doctors may seek training on courses which are organized by the Hygiene Institute of the University of Vienna in co-operation with the Austrian Society of Hygiene, Microbiology and Preventive Medicine. Registered nurses may enroll in the Austrian Nurses' Association training scheme (6 weeks of theory with professional work for 2 years), leading to approval as Hygieneschwester/-pfleger. Postgraduate in-hospital education for all health-care professions occurs in many Austrian hospitals, with resources from Vienna and Linz. Hospital managements, health authorities and politicians are influenced via their own educational activities and via publications.

Austria↗
PubMed1990

Discrimination between antibodies to HIV-1 and HIV-2 in sera from northern Zaire.

136 selected sera from Northern Zaire were screened for antibodies against HIV-1 and HIV-2 using the ELISA method. Reactive sera were confirmed with commercially available Western Blots and additional tests. A data base was used for evaluation of the results. The sera were collected in the town Isiro and in remote rural areas. 36 sera were reactive in the HIV-1 ELISA (ELAVIA-1), 19 of them were confirmed in the HIV-1 Western Blot (Biorad). 21 sera were reactive in the HIV-2 ELISA, but they were not confirmed as HIV-2-specific in three HIV-2 Western Blots (Diagnostics Pasteur, Biorad, Paul-Ehrlich-Institut).

Blotting, Western↗
PubMed1989

[Dental care of HIV carriers].

As HIV infections continue to spread worldwide, the number of patients with known or unknown HIV positivity seen in dental practice is increasing. Some of the infected individuals need more frequent dental care than the general population, because HIV infections tend to be associated with specific oral manifestations. HIV-positive individuals have special psychosocial problems attributable both to their disease and to their frequent association with socially discriminated groups. These problems are also reflected in the dentist-patient relationships. Dental care of known HIV-positive individuals is much less hazardous than the treatment of undiagnosed HIV carriers. Building confidence between the dentist and the patient is essential. As HIV transmission is similar to that of hepatitis B, the full battery of hygienic precautions established for preventing hepatitis B should be observed in dental work to prevent HIV infections. Conditions of work in dental offices should meet the hygienic standards needed to preclude the risk of infections both for the dentists and their patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Monitoring infection at the intensive care unit--a multicenter pilot study].

During a period of 3 months an infection survey was carried out in 4 intensive care units (ICUs), 2 in Vienna, Austria, and one each in Ulm and Münster, Federal Republic of Germany, using a common protocol. A total of 329 patients was monitored prospectively. This pilot study was performed to evaluate the usefulness of parameters included in the monitoring form. It was attempted to characterize the patient populations of the four units. Mean duration of stay (1-12 days), mortality (8-26%), leading diagnosis upon admission, intubation rate (41-91%) and use of pulmonary artery catheter (12-35%) were distinctly different. The rate of patients admitted already with an infection was 9-43%, septicemia was diagnosed in up to 27% of the diseased. The rate of infection acquired in the unit was between 12 and 37%, the most frequent types were bronchopneumonia, septicemia and urinary tract infection. When septicemia patients were compared to non-septicemia patients who had been admitted for more than 3 days, it appeared that the latter stayed significantly shorter at the ICU and showed less frequently bronchopneumonia or urinary tract infection at the time of admission. Septicemia patients acquired more frequently additional infections like broncho-pneumonia or urinary tract infection while staying at the ICU. The median day of onset of septicemia was the fifth day and only in a quarter of cases diagnosis could be supported by a positive blood culture. The use of antibiotics in the 4 ICUs is compared and shows marked differences. Based upon experience with this type of infection survey a new modified protocol is introduced, which displays the time course of documented events.

Anti-Bacterial Agents↗
PubMed1987

Epidemiology of borrelia infections in Austria.

From April 1984 to July 1985 873 cases of Borrelia infections were registered at the Hygiene Institute of the University of Vienna. 2609 serum samples of these patients were investigated for antibodies against B. burgdorferi by means of IFA- and ELISA-tests. Erythema chronicum migrans (ECM) was recognized in 60.9% of patients, neurological abnormalities were recorded in 23.4% of which the majority manifested themselves as polyradiculitis and meningopolyneuritis (MPN). Acrodermatitis chronica atrophicans (ACA) was recognized in 11.5%. A small number of patients suffered from Lymphadenosis cutis benigna (LCB), arthritis and cardiac abnormalities. Sixty percent of patients were females and 40% males. Infections were found in all age groups ranging from 2-83 years in females and 1-85 years in males. Tick- or insect-bites prior to the onset of illness were reported by 47.2% and 15.6% of patients, respectively. The main vector is the hard tick Ixodes ricinus. Flying insects from the family tabanidae, i.e. Chrysops caecutiens and Haematopota species, must also be considered as transmitters. Antibodies to B. burgdorferi were found in 22.3%, 93.6% and 100% of sera from patients with ECM, MPN and ACA, respectively. Six of 11 patients with LCB and all with arthritis and cardiac abnormalities showed serologic reactivity. Geographically, Borrelia infections are distributed in all states of Austria. The seasonal distribution of cases show a peak in July and August, but the onset of clinical manifestation could be observed throughout the year. These results present Austria as an area where tick- or insect-borne Borrelia infections are very frequent and endemic in all Austrian states.

Acrodermatitis↗
PubMed1986

[Hepatitis A outbreak in a shelter for the homeless in Vienna].

An outbreak of hepatitis A was observed in a shelter for the homeless in Vienna with about 200 inhabitants. Twenty-two cases occurred within a period of 6 months. The outbreak could not be brought under control by measures of general hygiene. However, after the administration of hepatitis A immunoglobulin (120 IU/ml), at a dosage of 0.05 ml/kg body weight, to 102 of the 105 seronegative inhabitants and members of staff, no further clinical cases of hepatitis A were reported from this group. Nevertheless, 8 of these 102 "protected" persons showed signs of subclinical infection at subsequent follow up. Apart from these, 2 further cases of hepatitis A occurred among the non-immunised children at risk, whose parents had refused permission for serological investigation or immunoglobulin administration.

Adolescent↗
PubMed1986

Borrelia transfer by ticks during their life cycle. Studies on laboratory animals.

Ticks of the species Ixodes ricinus were cultured in the laboratory. Yellow silver rabbits, gerbils and white mice served as blood hosts. Borrelia burgdorferi could be detected by means of an IFA test in homogenates of female ticks, their eggs as well as the respective larval and nymphal ticks. Blood infection of splenectomized gerbils and ordinary white mice or of ordinary white mice alone has been demonstrated after feeding of larval or nymphal ticks on them, respectively. Spirochetemia started 5 to 8 days after feeding and lasted for ca 3 weeks. Two distinct peaks in the cell count of spirochetal organisms per ml blood plasma could be observed on days 11-13 (5 X 10(5) to 2 X 10(6) cells/ml) and 17-19 (10(5) cells/ml), regardless whether splenectomized gerbils or white mice were used. The results display that B. burgdorferi is vertically from the female ticks to their eggs and transstadially transmitted. The transmission-rate from larval to nymphal ticks is 100%. These findings show the tick itself as a main reservoir of B. burgdorferi. The established mouse-model appears to be a useful tool to detect Borrelia carrying ticks.

Animals↗
PubMed1986

Evaluation of procedures for hygienic hand-disinfection: controlled parallel experiments on the Vienna test model.

Controlled parallel experiments were performed on the Vienna test model for the evaluation of procedures for hygienic hand-disinfection in three laboratories (Vienna, Mainz, Birmingham). The degerming activity of four procedures, each taking 1 min, was assessed repeatedly and compared with that of a standard disinfection procedure (ST) using isopropanol 60% (v/v). The mean log reductions (mean log RF) for each procedure were as follows: n-propanol 50% (v/v) 4.85 and 5.14 in Vienna (V) and Mainz (M) respectively, ethanol 70% (v/v) + chlorhexidine-gluconate 0.5% (w/v), 4.01 (V), 3.76 (M) and 4.00 in Birmingham (B). Washing procedures were less effective, mean log RF's of 3.19 (V), 3.49 (M) and 3.04 (B) were obtained with povidone-iodine soap, and 2.91 (V), 3.37 (M) and 3.27 (B) with a liquid phenolic soap. Analysis of variance on the data from Vienna and Mainz revealed significant differences of means not only between procedures ('preparations') but also on repeat testing. To compensate for the influence of variables such as test subjects, laboratory and day, the Vienna test model provides a method of standardization by testing a ST in parallel with the test procedure (P). Standardization of the results was obtained by pair-wise substraction, log RFPi-log RFSTi. Analysis of variance on the resulting values demonstrated that comparability of the results between laboratories and on repeat testing was achieved. The relative variation of the measurements within the laboratories ranged from 0.9 to 4.2%. As assessed by power-analysis, a disinfection procedure will be detected as significantly (P = 0.1) inferior to the standard processes in 95 of 100 experiments if it produces a mean log RF that is at least 0.55-0.65 log units smaller than that of the standard.

Austria↗
PubMed1985

Isolation of spirochetes from the skin of patients with erythema chronicum migrans in Austria.

Spirochetal organisms were isolated from biopsies (skin punches) of the erythematous anular skin lesion of three patients with erythema chronicum migrans. The organisms were cultivated in modified Kelly's medium and - after an incubation period of 2 weeks - discovered by dark field microscopy (X 200). Compared with the Lyme disease agent Borrelia burgdorferi the organisms did not differ in shape, motility and reaction with polyclonal antiserum. Differences to B. burgdorferi were found in (i) very slow growth of the isolated organisms in modified Kelly's medium and in (ii) non reactivity with monoclonal antibodies against the outer membrane protein of B. burgdorferi. It is concluded that the Austrian isolates are closely related to but not identical with the Lyme disease agent.

Adult↗
PubMed1984

Postoperative infections in colonic surgery after enteral bacitracin-neomycin-clindamycin or parenteral mezlocillin-oxacillin prophylaxis.

In a prospective randomized, blind trial, three groups of patients undergoing elective colonic surgery were compared for frequency of surgical wound infection, intra-operative wound contamination and other postoperative infections. All patients allotted to the three groups received whole gut irrigation (101 balanced salt solution) by gastric tube on the evening before surgery and were treated as follows. Group A: no antibiotics; Group B: neomycin (1 g/l) + bacitracin (50,000 IU/l) + clindamycin (900 mg/l), contained in the last 31 of irrigation fluid; Group C: mezlocillin (4 g) + oxacillin (2 g) intravenously (iv) at induction of anaesthesia, followed by two identical doses at 8 and 16 h. The rate of postoperative wound infection was highest in A (38 per cent) and much lower in B (3.3 per cent, P less than 0.002) and C (6.9 per cent, P less than 0.004). The difference between B and C was statistically not significant. In A a correlation was established between the degree of wound contamination and the occurrence of wound infection. Intra-operative wound contamination was lowest in B (30 per cent), equal in A (58.1 per cent) and B (55.2 per cent). Other infections were least frequent in group C (four of 29 patients), but were not significantly different to groups B (six of 30) and A (nine of 31). It is concluded that antibiotics together with an effective mechanical preparation considerably reduce the rate of wound infection in colonic surgery.

Adult↗
PubMed1984

[Control of infection in a primarily surgical intensive care unit].

All of one year's 251 patients of a predominantly surgical intensive care unit (i.c.u.) were continuously followed up for infections according to a standard protocol. These protocols were evaluated for 174 patients who stayed at least 48 h at the unit. More than one third (36.7%) were already infected on admission (external origin), 35% contracted infections at the unit, primarily or additionally (internal origin) and 40% remained without an infection. Fifty eight percent of patients already infected on admission were surgical and required intensive care for complications. Among the patients who contracted their infection solely at the unit 61.5% suffered from trauma. Patients having contracted their infections at the i.c.u. stayed significantly longer than those without (additional) infections (13 and 6 days respectively). Mortality was highest (45%) in patients who were already infected on admission and who acquired additional infections during their stay at the i.c.u. Of patients with infections of exclusively external or internal origin 23.5 and 17.9% respectively died whereas among those who remained uninfected this proportion was only 7%. The 75 infections acquired before admission to the i.c.u. included infections of the respiratory tract in 14.4% of all patients, peritonitis with 10.3%, urinary tract in 8.0% and septicemia in 5.2%. Artificial ventilation was employed more often in infected patients (73.8-100%) than in non-infected ones (56.3%). They also carried more intravasal catheters (2.76-3.05 per patient) than the latter group (1.79). Of the 82 infections acquired in the i.c.u. the respiratory tract was affected in 19.5% of all patients and the urinary tract in 13.8%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Evaluation of procedures for vaginal disinfection].

At the occasion of the usual preparations preceding gynecological operations the average vaginal bacterial release of 42 patients, already anaesthesized, was assessed by a rinsing technique to be 5,04 +/- 0,98 log10 c.f.u. per ml sampling fluid after aerobic and anaerobic culture. The reduction of this bacterial release caused by the measurement itself is relatively small, therefore the technique was found to be suitable for evaluation of the efficacy of germreducing measures like irrigation or disinfection. An irrigation with isotonic saline during 30 s was measured to reduce the vaginal bacterial release by 0,4 +/- 0,5 log-steps. A solution containing 0,08% chlorhexidine gluconate + 0,1% benzalkon gluconate applicated during 5 min caused a reduction of 1,04 +/- 0,76 and a watery solution of povidone-iodine one of 2,29 +/- 1,00 log-units when used for 3 min. When after disinfection the sustained antimicrobial action of the chlorhexidin-containing preparation was not neutralized already during the sampling process by Tween 80 + lecithine + histidine being contained in the sampling fluid, an erroneously optimistic log reduction of 2,35 +/- 0,48 was measured. From the results it was calculated that 17-23 volunteers are necessary in order to detect with sufficient statistical safety an observed mean log reduction to be 0,5 log-units smaller than a hypothetical minimal reduction of 2,00 log-steps as required provisionally on an arbitrary basis.

Aerobiosis↗
PubMed1983

Indirect immunofluorescence assay (IFA), microagglutination test (MA) and enzyme-linked-immunosorbent assay (ELISA) in diagnosis of legionellosis.

Lipopolysaccharide was extracted with cold phenol water from Legionella pneumophila and used as antigen for ELISA. IgG and IgM antibodies were measured with the ELISA and the immunofluorescence assay (IFA). Agglutinating antibodies were measured by the microagglutination (MA) test. In tests on sera from 27 patients with confirmed Legionella infections predominantly due to L. pneumophila serogroup 1 the results with the ELISA, the IFA and the MA were compared to each other. Antibody titers obtained by the ELISA were in general much higher than those obtained by both other tests. The ELISA proved to be the most sensitive method (IgG: 91.3%, IgM: 52.2%) whereas the sensitivities of IFA and MA were IgG: 69.6%, IgM: 30.4% and 60.9%, respectively. There was low correlation of the IgG antibody titers but good correlation of the IgM titers. Further 49 sera from patients without Legionella infection were screened to calculate the specificities of the three tests which were equally good with all methods (98%).

Agglutination Tests↗
PubMed1983

Sero-epidemiology of legionellosis in Austria.

Out of 1961 patients with the clinical diagnosis of atypical pneumonia 11 cases (0.65%) of recent Legionella infections were diagnosed by indirect immunofluorescence test (IFA). A higher incidence (1.37%) has been found in 364 patients in whom clinicians suspected a Legionella infection and therefore asked for serological testing. Prevalence of antibodies (greater than or equal to 1:32) reacting with antigens of L. pneumophila serogroup 1 to 6 was highest to serogroup 6 (37%), and lowest to serogroup 1 (4.3%). Specificity of IFA for reciprocal titer of 128 to L. pneumophila serogroup 1 was calculated with 99.5%, for serogroup 6 with only 87.7%. Morbidity of severe Legionella pneumonias in Austria can be estimated at about 1.5 cases per 100 000 inhabitants.

Antibodies, Bacterial↗
PubMed1982

[Antibiotic concentrations in wound secretions and bone during the simultaneous administration of mezlocillin and oxacillin].

Mezlocillin and oxacillin have been used in combination for short-term antibiotic prophylaxis in orthopedic surgery. Antibiotic concentrations were measured in serum, wound secretions from subcutaneous tubings and bone. Half an hour after the i. v. application of 4 g mezlocillin + 2 g oxacillin, the concentrations in wound secretions were 20% of the serum levels. After four hours the levels of both antibiotics in wound secretions increased to 2.66 times the serum levels of mezlocillin, and 5.37 times those of oxacillin. After eight hours the concentrations in wound secretions dropped to about one half, but remained well within therapeutic levels. The parallel course of the concentrations of both antibiotics in wound secretions indicates that mezlocillin and oxacillin have very similar half-lives in wound secretions, although the serum half-lives (t 50% beta) of the two antibiotics are different. The concentrations obtained from cancellous bone were approximately. 10% of the serum levels one to two hours after the antibiotic infusion.

Aged↗