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H Finger

Publications and source records attributed to H Finger.

At least 19 recordsLinked to original sources
PubMed1992

[Thirty years of cellular immunity].

Mackaness' original article about cellular resistance to infection, published in 1962, is recalled. These experiments laid the foundation of the analysis of immune mechanisms against infection with facultatively intracellular microorganisms. Based on a simple murine model with Listeria monocytogenes, an array of data was compiled during three decades, clarifying the mechanism of inborn resistance and acquired immunity to this type of parasites. The idea of various immune cell populations cooperating via cytokines was developed and experimentally proven. Different forms of immunodeficiencies were conceived in the same model, and therapeutic approaches were evaluated. Thus, thirty years after the first publication, Mackaness' concept of cell-mediated immunity to infection is solidly based on experimental data, and is an integral part of our understanding of the mammal immune system.

Allergy and Immunology↗
PubMed1992

[The epidemiology of whooping cough].

Due to a low acceptance of active immunisation against Bordetella pertussis, whooping cough continues to be a frequent childhood disease in parts of Germany. The age distribution in the lower Rhine area showed a peak incidence at 4.3 years of age, whereas 11% of all cases were observed in infants, and 6% were observed in adults. A significant sex difference was not found in children suffering from pertussis; in adult patients, however, women were more often affected. Whooping cough occurred during the whole year, its peak incidence was found during early winter. In children, paroxysmal coughing fits, vomiting and whooping were the primary symptoms of disease; adults and infants, however, developed these symptoms only in reduced frequency. About 25% of all cases showed an atypical course, and could only be diagnosed by laboratory tests. While leukocyte count and ESR did not have diagnostic significance, a combination of microbiological and serological tests showed a high diagnostic sensitivity and specificity. In contrast to the former GDR and to most European neighbours, the former Federal Republic overrated the side effects of active vaccination as compared to the various risks of natural infection. This resulted in a decline of vaccine acceptance to less than 10% in several areas of the former FRG. It is anticipated that the altered recommendation in favour of vaccination, and especially the future application of acellular vaccines with less side effects, will result in the elimination of whooping cough in all areas of Germany.

Adolescent↗
PubMed1992

[Acellular pertussis vaccines].

Each vaccine is normally rated according to its efficacy and to the frequency and severity of unwanted side effects. The efficacy of whole-cell pertussis vaccines is beyond doubt, its frequent side effects, however, stimulated research into less reactogenic acellular vaccines. Several acellular pertussis vaccines of different composition have been developed. All of these produced significantly less local and systemic side effects, as compared to the conventional whole-cell vaccine. Various epidemiological data strongly suggest the efficacy of these vaccines. An equivalence of protective efficacy between whole-cell vaccines and acellular pertussis vaccines can, however, only be documented in controlled field trials, which are now ongoing in several countries.

Antigens, Bacterial↗
PubMed1992

[Outbreak of a nosocomial infection of SHV2-beta-lactamase-containing Klebsiella pneumonia strains in an operative intensive care unit].

Resistant strains of Klebsiella pneumoniae were found in increasing frequency as a cause of nosocomial infection in an intensive care unit between July and October 1990. The isolated strains had an almost identical biochemical profile, showed a similar pattern of antibiotic resistance, and produced type SHV2-broad-spectrum betalactamase. Thus, it was assumed that the isolates were copies of identical strains, causing an outbreak of nosocomial infections. The bacteria were resistant to third-generation cephalosporins, such as cefotiam, cefotaxime and ceftriaxone, and also to aminoglycosides and acylaminopenicillins. Approximately half of the strains were resistant to ceftazidim and aztreonam. The bacteria were sensitive in vitro to ciprofloxacin, imipenem, latamoxef and cefotetan. During three months, 10% (11) of all patients became infected; four of these patients (36%) died from septicemia. After conventional hygiene programs had failed to stop the outbreak, the intensive care unit was closed and disinfected, a measure, which effectively interrupted the infection.

Cephalosporins↗
PubMed1991

[Whooping cough in adults].

Within a period of four years the diagnosis of pertussis was made in 169 adults (105 women, 64 men; mean age 35.8 [18-79] years). based on symptoms, specific antibodies and bacteriological examination of nasopharyngeal swabs (in 53). The findings were compared with those obtained in a control group of 2,771 children (1,381 females, 1,390 males; mean age 4.3 years). In the adult the dominant symptom was persisting cough, at times convulsive, while the other symptoms, characteristic in children, of rib retraction and vomiting were significantly less common in adults (retraction: 3% vs 40%; vomiting 12% vs 59%). A history of contact was elicited in only 17% of adults (38% in children). Confirmation of the diagnosis was obtained by growing Bordetella pertussis from a nasopharyngeal swab (6 of 53 patients [11%]; in children 45%), or finding significantly elevated antibody concentration or titre rise of specific antibodies against B. pertussis (IgG: 81% vs 68%; IgA: 91% vs 73%; IgM: 44% vs 72%). Half the adult patients were aged between 20 and 35 years. Contrary to the sex distribution of pertussis in children, significantly more women than men contracted the infection (P less than 0.01). It is concluded that even in adults pertussis should be considered in the differential diagnosis of persisting cough.

Adult↗
PubMed1991

The epidemiological situation of pertussis in the Federal Republic of Germany.

Whooping cough continues to be a major childhood disease in parts of West Germany. At age six, more than one third of the children in our area have had pertussis according to parental information, whereas only 12% received a specific vaccination. During a four-year period from 1984 to 1987, a total of 2,881 clinically diagnosed cases of whooping cough were investigated. The children had a mean age of 4.1 years, 11% of all patients were younger than one year and 6% of the patients were adults with a mean age of 35.8 years. No sex difference was observed in children (less than 20 years) with clinically overt whooping cough. The seasonal distribution showed that whooping cough was present throughout the year, peaking in early winter. In relation to clinical symptoms, the isolation rate of Bordetella pertussis or Bordetella parapertussis from nasopharyngeal swabs continuously decreased with the duration of paroxysms, starting with 56% positive swabs on day 1. Titers (greater than or equal to 1:100) of IgA-antibodies to B. pertussis antigens increased with the duration of paroxysmal coughing. B. pertussis, however, was also isolated from 152 of 964 patients without the clinical signs of whooping cough. IgA-antibodies were also found in 522 patients with non-typical respiratory symptoms, but not in healthy blood donors. Children with clinically diagnosed whooping cough were compared to a group of children showing the symptoms but without any clinical or laboratory signs of whooping cough. We can assume from our data that the incidence and duration of non-paroxysmal coughing, the nocturnal increase in coughing, fever, auscultatory findings and a contact anamnesis occurred with a similar frequency in the whooping cough group and the control group. Apart from the typical paroxysmal fits, whooping and vomiting were found significantly more often in the pertussis group. At least 19% of patients with a recent infection with B. pertussis, however, were not diagnosed by clinical symptoms. The leukocyte count differed only marginally between the three groups and was of no great diagnostic value. A relative lymphocytosis, however, was found significantly more often in whooping cough patients and in patients with laboratory-diagnosed infection with B. pertussis. Our study indicates that part of the symptomatology and some laboratory findings in whooping cough patients in endemic areas of West Germany may differ from the classical form of the disease. Furthermore, our data stress the importance of an accurate procedure in diagnosing B. pertussis infection, and this can be facilitated by a combination of bacteriological and serological tests.

Adolescent↗
PubMed1988

Histomorphology of experimental listeriosis.

This paper is a survey of the histomorphology of experimental listeriosis based on cooperative studies performed within the past ten years. The influence of various parameters of the infectious agent (pathogenic Listeria monocytogenes serovar 4b, nonpathogenic Listeria innocua serovar 6b etc.) as well as of the host (euthymic NMRI-mice conditioned with dextran sulfate 500 or cyclosporin A, athymic nude mice etc.) on the course, morphology and outcome of the Listeria infection was investigated. From the experimental models used and the studies performed much could be learned concerning the factors that determine the histomorphological manifestations of listeriosis in humans.

Animals↗
PubMed1988

Alteration of non-specific resistance to infection with Listeria monocytogenes.

The experimental infection of murine hosts with Listeria monocytogenes is often used as a model for cell-mediated immunity. However, the natural immunity or non-specific resistance to listeriosis can be influenced by the parasite itself and also by a wide array of endogenous and exogenous host factors. The most important host factor in inbred mouse strains is their genetically determined susceptibility or resistance to Listeria monocytogenes. Secondly, the age of the mice is crucial for the outcome of infection. Resistance is only slowly developed by newborn mice, while aged mice possess an increased non-specific resistance as compared to young adult animals. Resistance is further influenced by the nutritional status, by pregnancy or by a simultaneous second antigenic stimulation. Regarding exogenous factors, macrophage blocking agents can totally abolish the resistance to listeriosis, while a lot of immunomodulating agents, such as BCG, killed Bordetella pertussis or Propionibacterium acnes organisms, lipopolysaccharides, suramin etc., can either increase or decrease the resistance. The mononuclear phagocyte system seems to be the main target of all these immunomodifiers. The timing between listeria infection and application of the immunomodulator determines the effect on non-specific resistance. A simultaneous injection of parasite and immunomodulator results in a decrease of resistance, while the application of immunoadjuvants several days before infection can dramatically increase the resistance to listeriosis. The delicate equilibrium of the mononuclear phagocyte system must therefore be taken into account, when infection with Listeria monocytogenes is used to test for immune-modifying agents, which are intended for use in humans or animals.

Adjuvants, Immunologic↗
PubMed1988

Use of fosfomycin disks for isolation of diphtheroids.

A fosfomycin disk (200 micrograms) placed on blood agar was used to select diphtheroids from clinical specimens. All Corynebacterium type strains tested, representing ten different groups of diphtheroids, and 150 toxigenic strains of Corynebacterium diphtheriae from different outbreaks, overgrew the fosfomycin disk, while other aerobic gram-positive rods had a large inhibition zone. The method increased the rate of isolation of diphtheroids in 1267 clinical specimens fivefold, from 1.4% to 7.6%, especially when the diphtheroids were found concomitantly with other bacteria. Overgrowth of the disk by other microorganisms occurred in 11% of the samples tested, but such microorganisms could easily be distinguished by culture morphology or Gram stain. Fosfomycin disks provide a simple, highly sensitive but not very specific aid for isolation of Corynebacterium diphtheriae and diphtheroids from clinical specimens.

Corynebacterium↗
PubMed1988

Use of supplemented Stainer-Scholte broth for the isolation of Bordetella pertussis from clinical material.

The use of Stainer-Scholte broth supplemented with (2,6-O-dimethyl)beta-cyclodextrin (heptakis) for the isolation of Bordetella pertussis from clinical specimens was evaluated with 3,632 nasal swabs from children and adults with suspected whooping cough or from their family contacts. The liquid enrichment medium was subcultured on charcoal agar with 10% defibrinated horse blood. Charcoal agar and soft charcoal agar served as the standard procedure to detect B. pertussis. We isolated 772 strains of B. pertussis (21%). Charcoal agar alone detected 87% of all strains (n = 668), soft charcoal agar grew 78% (n = 602), and 637 strains (83%) were isolated when Stainer-Scholte broth with heptakis was used. We detected 590 isolates with all three media. Whereas 65 strains grew only on charcoal agar, 27 strains were detected by soft charcoal agar. Supplemented Stainer-Scholte broth allowed the isolation of an additional 77 strains which did not primarily grow on charcoal media (P less than 0.05). Our data indicate that Stainer-Scholte medium supplemented with heptakis can be effectively used as an enrichment medium for detection of B. pertussis in clinical specimens.

Adult↗
PubMed1987

[Effect of anti-D prevention on the incidence of irregular erythrocyte antibodies in pregnant patients].

The immunohaematology results found during antenatal care from 1963-1981 were used to try to answer the question whether and how much the anti-D-prophylaxis, which was started in 1967 and was given to German and foreign pregnant women post partum or after abortion, had affected the frequency of immunization to D and other erythrocyte antigens. The results allow the following statements: 1. From 1973-3 or 4 years after the general introduction of anti-D prophylaxis-until 1981, a continuously sustained decline in the frequency of anti-D in the German pregnant women was found. This could not be found in the corresponding group of foreign pregnant mothers. 2. Additionally, a statistically significant reduction in the frequency of anti-D + C could only be found in the German group. 3. After 1973, other erythrocyte antibodies in combination with anti-D were only found sporadically. A rise in the frequency of other erythrocyte antibodies, such as anti-C, was not observed. 4. The frequency of "non-anti-D antibodies" was significantly higher in the foreigners than in the German group during the whole observation period. This was due to the significant increase in anti-Lea, anti-Leb, anti-H, anti-P1 and the nonidentifiable antibodies in the foreign group.

Antibodies, Anti-Idiotypic↗
PubMed1986

[The significance of "nonpathogenic" Corynebacteria as a cause of opportunistic infections].

A lot of corynebacterial species, summarized as "diphtheroids" has its normal habitat on the human skin. Consequently, these bacteria are often isolated from various clinical materials and mostly regarded as indeginous flora. The same bacteria, however, can cause serious infections, when the balance between host and microorganisms is impaired. Multiresistant corynebacteria group JK are used as an example to describe the development of such infections. Central venous catheters and other plastic devices can facilitate the entry of the bacteria. Simultaneously, resistant strains of corynebacteria benefit from a concurrently administered antimicrobial chemotherapy. Subsequently, these bacteria can be found as a cause of septicemia, endocarditis, wound infection, osteomyelitis, peritonitis and meningitis. The antimicrobial chemotherapy is hampered by the extreme resistance and vancomycin is the only antibiotic of choice. Colonization or infection of the single patient can be differentiated by clinical criteria only. According to the individual risk, a microbiological monitoring can be helpful in the early detection of colonization and infection.

Catheterization↗
PubMed1985

Group JK corynebacteria in skin flora of healthy persons and patients.

The presence of group JK corynebacteria in the skin flora of the axilla and inguinal regions was monitored for several months in three groups comprising 45 oncological patients, 49 dialysis patients and 36 healthy staff members. Oncology patients were colonised significantly more often (51%) than dialysis patients and staff members (33% and 36% respectively). The frequency of isolation did not differ between male patients and staff whereas female patients were colonised significantly more often than female staff members. The inguinal region was colonised more often than the axilla. Oncological patients had the highest proportion of antibiotic resistant group JK corynebacteria strains on their skin and staff members the lowest proportion.

Axilla↗
PubMed1985

Serological diagnosis of whooping cough.

Cooperating with pediatricians in private practice and in hospitals, we tried to evaluate the diagnostic relevance of three serological methods for the detection of antibodies to Bordetella pertussis. The tests employed were a microagglutination, a complement fixation and an enzyme-linked immunoassay (ELISA) to measure specific IgG, IgM, IgA and IgE with whole B. pertussis phase I cells as an antigen. In addition, sera were tested for complement-fixing antibodies to respiratory-syncytial (RS) virus. Microbiological procedures also were used to detect B. pertussis in pernasal swabs. Single sera from 259 children and adults with suspected whooping cough were tested. Of these 117 samples did not contain any measurable antibodies to B. pertussis (45%) and only four sera of this group exhibited complement-fixing antibodies to RS-virus (3%). Antibodies to B. pertussis could be found in the sera of 142 patients. In this group, complement-fixing antibodies to RS-virus were detected in 23 sera (16%). Comparing the methods used to measure antibodies to B. pertussis showed that the ELISA was the most sensitive test, followed by complement fixation and microagglutination. In 21 additional cases, paired sera and several swabs could be obtained from individual patients. These data allowed us to follow the antibody response to B. pertussis during whooping cough, which seemed to be characterized by a relatively late onset with a subsequent rapid increase of initially IgM and IgA and then IgG antibodies. Analogously, the titers of complement-fixing and agglutinating antibodies increased during the later stages of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Antibiotic therapy in patients with immunologic deficiency].

Basic aspects in the treatment of immunocompromised patients are discussed with respect to medical and paediatric oncology, surgical intensive care and clinical pathology. Defining the type of immunological deficiency seems of primary importance, since it can be caused by haematological diseases, their treatment, by repeated surgery or by a polytrauma. The degree of immune deficiency should be quantitated by laboratory procedures, whenever possible. The treatment of these patients may include substitution therapy, decontamination and antimicrobial chemotherapy. Since the immune deficiency can only rarely be specifically substituted, hygiene plans should be made up for every patient, including the selective decontamination. An intensive microbiological surveillance can give early information about the prevalence of certain microorganisms, thereby facilitating a subsequent treatment. The antimicrobial chemotherapy of an overt infection in medical and pediatric oncology can follow fixed schedules, taking into account the various causative agents that can be expected. This procedure has proven to be efficient in the treatment of infections occurring during the therapy of acute lymphoblastoid leukemia in childhood. In surgical intensive care units, however, treatment of infections should be based on microbiological findings in conjunction with the local profile of bacterial resistance. Furthermore, it is important to be aware that "non-pathogenic" microorganisms can be the cause of life-threatening infections in immunocompromised patients. Our experience shows that interdisciplinary cooperation and a mutual exchange of information is important for an efficient treatment of infections in patients with immunological deficiencies.

Animals↗