PubMed Health⌕ Search

Biomedical subjects

H Goossens

Publications and source records attributed to H Goossens.

At least 73 records · Page 4Linked to original sources
PubMed1999

Genetic identification of Candida species in HIV-positive patients using the polymerase chain reaction and restriction fragment length polymorphism analysis of its DNA.

The polymerase chain reaction was used to amplify a targeted region: an internal transcribed spacer region of the ribosomal DNA from 114 Candida isolates and 65 reference strains. Unique product sizes were obtained for Candida glabrata, C. guillermondii and C. inconspicua. Isolates of C. albicans, C. tropicalis, C. dubliniensis and C. krusei could be identified following restriction digestion of the PCR products. The methods proved to be both simple and reproducible and may offer potential advantages over phenotyping methods.

AIDS-Related Opportunistic Infections↗
PubMed1999

The epidemiology of vancomycin-resistant enterococci.

Major differences in the epidemiology of vanA carrying enterococci exist between Europe and the USA, where these organisms have been well investigated. These differences are probably related to the differences in antibiotic use in humans and animals in both continents, but more research is needed before firm conclusions can be drawn.

Journal Article↗
PubMed1999

Identification of clinically relevant viridans streptococci by analysis of transfer DNA intergenic spacer length polymorphism.

The utility of PCR analysis of transfer DNA intergenic spacer length polymorphism (tDNA-ILP) for the identification to the species level of clinically relevant viridans streptococci was evaluated with a collection of reference strains of 15 species of the salivarius, anginosus, mitis and mutans rRNA homology groups. PCR products generated by using fluorescent, outwardly directed, consensus tDNA primers were analysed by electrophoresis on denaturating polyacrylamide gels and by laser fluorescence scanning. Eleven species showed specific and distinct tDNA patterns: Streptococcus cristatus, Streptococcus gordonii, Streptococcus oralis, Streptococcus mitis, Streptococcus pneumoniae, Streptococcus sanguinis, Streptococcus parasanguinis, Streptococcus anginosus, Streptococcus mutans, Streptococcus criceti and Streptococcus ratti. Indistinguishable patterns were obtained among two groups of species: Streptococcus vestibularis and Streptococcus salivarius on the one hand and Streptococcus constellatus and Streptococcus intermedius on the other. S. mitis strains produced heterogeneous patterns that could be separated into three groups: a group containing S. mitis biovar 1 and two S. mitis biovar 2 groups, one of which clustered with S. parasanguinis strains while the other showed patterns unrelated to other species. These results agree in part with protein electrophoretic analysis showing that S. mitis biovar 2 strains belong to several streptococcal taxa. In conclusion, PCR analysis of tDNA-ILP holds promise for rapid identification of viridans streptococci that are difficult to identify by phenotypic tests.

Bacterial Typing Techniques↗
PubMed1999

Comparison of glycopeptide-resistant Enterococcus faecium isolates and glycopeptide resistance genes of human and animal origins.

One hundred thirty-two glycopeptide-resistant Enterococcus faecium (GREF) isolates from different hospitals and pig and poultry farms in Belgium were compared on the basis of (i) their antibiotic susceptibilities, (ii) their SmaI pulsed-field gel electrophoresis (PFGE) patterns, and (iii) the organization of their Tn1546 or related elements in order to detect possible phenotypic and genotypic relationships among both groups of isolates. Human and animal vanA-positive GREF isolates were found to have similar susceptibility patterns; they remained susceptible to gentamicin and were, in general, susceptible to ampicillin. PFGE demonstrated a very high degree of genomic heterogeneity in both groups of isolates. However, indistinguishable isolates were found within different farms or hospitals, and in two instances, epidemiologically unrelated pig and human isolates showed indistinguishable PFGE patterns. In total, eight different transposon types were identified, and all were related to the prototype transposon Tn1546. The two predominant types, Tn1546 and type 2 transposons, which differed at three band positions, were present in both human and animal isolates. Type 2 transposons were significantly associated with pig isolates. The other types were seldom detected. These data suggest a possible exchange of glycopeptide resistance markers between animals and humans.

Animals↗
PubMed1999

Comparison of direct plating and broth enrichment culture for the detection of intestinal colonization by glycopeptide-resistant enterococci among hospitalized patients.

The results of prevalence studies on glycopeptide-resistant enterococci (GRE) in the intestine may be influenced by the detection methods applied. In most studies different media, different concentrations of antibiotics, and different methods are used, and these differences result in differences in recovery rates. In this cross-sectional study on the carrier state of GRE among patients at the University Hospital Antwerp, Antwerp, Belgium, performed on 21 May 1996, direct plating and broth enrichment were compared by using the same media. Stool samples (n = 213) or rectal swabs (n = 122) were plated directly on Enterococcosel agar (bioMérieux) and after enrichment in Enterococcosel broth. The prevalence of GRE was 12.8%. Direct plating recovered 53.4% of the GRE isolates, and broth enrichment recovered an additional 46.5% of them; in the latter test the isolates were thus present at less than 10(3) CFU per g of feces. The prevalence of GRE among dialysis patients was higher than among the other patients, but the difference was not significant (P = 0.06), possibly as a result of the small numbers of dialysis patients examined. The GRE species isolated included 19 E. gallinarum (44.2%), 13 E. faecium (30.2%), 6 E. faecalis (13.9%), and 5 E. casseliflavus (11.6%) isolates. All E. faecalis and E. faecium strains isolated carried the vanA gene, and E. gallinarum and E. casseliflavus carried the vanC1 and vanC2 gene, respectively. The majority of isolates were polyclonal. Our data indicate that the rate of detection of GRE from both stool samples and rectal swabs is significantly increased with enrichment cultures.

Anti-Bacterial Agents↗
PubMed1999

Evaluation of the discriminatory power of typing methods for Neisseria gonorrhoeae.

A panel of 18 strains of Neisseria gonorrhoeae, known to be temporally and geographically diverse, was used to evaluate a number of typing systems, including conventional auxotyping and serotyping and the molecular methods of arbitrarily primed PCR (AP-PCR), amplified ribosomal-DNA restriction analysis (ARDRA), opa typing, and pulsed-field gel electrophoresis (PFGE). The discriminatory power of the different typing methods were determined with a collection of 87 clinical isolates from commercial sex workers in Indonesia, and Simpson's index of diversity was calculated. Of the two traditional techniques, auxotyping and serotyping, the latter gives the highest discriminatory index (DI) (DI, 0.846). The combination of auxotyping and serotyping yields a high DI (DI, 0. 928). D11344- and D8635-primed PCR showed low DIs of 0.608 and 0.622, respectively, but a combination of the two primers had a DI of 0. 849. The combination of serotyping with D11344-primed or D8635-primed PCR resulted in DIs of 0.936 and 0.937, respectively. ARDRA revealed a low DI of 0.743 alone but a DI of 0.955 in combination with serotyping. PFGE using the restriction enzyme BglII and opa typing produced the highest discrimination (DIs, 0.997 and 0. 996, respectively) for isolates of N. gonorrhoeae.

Bacterial Typing Techniques↗
PubMed1998

Management of rhinosinusitis in children: consensus meeting, Brussels, Belgium, September 13, 1996.

OBJECTIVES: To (1) provide definitions for the different forms of pediatric rhinosinusitis, with an enumeration of the main symptoms and signs; (2) provide indications for microbiological, allergic, and immunologic assessment as well as for imaging studies; (3) suggest standard medical management with judicious use of antimicrobial agents; and (4) discuss indications for surgery. DATA SOURCES: Clinical studies and literature data relevant to the different topics of pediatric rhinosinusitis. CONCLUSIONS: Rhinosinusitis in children is a multifactorial disease in which the importance of several predisposing factors changes with increasing age. Continued study to obtain a better understanding of the disease and carefully controlled comparative evaluations of medical and surgical therapies are suggested.

Child, Preschool↗
PubMed1998

Construction of an internal control for the detection of Chlamydia pneumoniae by PCR.

For the detection of Chlamydia pneumoniae by polymerase chain reaction (PCR) in respiratory samples, an internal control was constructed to monitor the efficiency of amplification in each reaction. The internal control was designed in a way that the same primer pair can be used to amplify the internal control and target DNA. Nasopharyngeal aspirates of children suffering from asthma (> 2 years of age; 24 patients) or bronchiolitis (< 2 years of age; 47 patients) were analysed for the presence of C. pneumoniae, using the internal control in each amplification reaction. Two specimens from asthma patients, both children of 8 years old, were positive for C. pneumoniae. The number of cases studied is too small to draw conclusions regarding the incidence of C. pneumoniae in different age categories in children.

Asthma↗
PubMed1998

The implementation of in vivo dosimetry in a small radiotherapy department.

PURPOSE: In vivo dosimetry has been shown in a number of evaluation studies, generally carried out in larger academic centres, to be a reliable method of checking the overall treatment accuracy. The object of this study was to investigate whether it was possible and useful to perform in vivo dosimetry in a small radiotherapy department and to detect if there were any systematic errors in the overall treatment set-up. MATERIALS AND METHODS: All patients were treated on a cobalt-60 unit equipped with a verification system. Six hundred fifty entrance dose measurements were performed with silicon diodes. RESULTS: The analysis showed a mean deviation of -1.3%. This negative deviation was mainly due to the mean deviation obtained in the treatment of head and neck (-1.6%) or breast (-2.5%) cancer patients. The results for pelvic or lung irradiation showed almost no deviation (-0.8 to 0.43%). Further investigation showed that the negative values for head and neck or breast irradiation were due to the irradiation technique; the lack of scattering material causes a reduction of the dose at the reference point, which is not taken into consideration by the treatment planning system. By performing in vivo dosimetry, we were also able to detect two large errors in 650 measurements and could prevent erroneous treatment. CONCLUSION: Even when the overall treatment set-up is very accurate, in vivo dosimetry is very useful in a small department since only a small effort can detect and prevent errors.

Cobalt Radioisotopes↗
PubMed1998

Decreasing antibiotic resistance of Enterobacteriaceae by introducing a new antibiotic combination therapy for neutropenic fever patients.

Prompt empiric antibiotic therapy is of critical importance for patients with neutropenic fever. However, a major concern with important clinical consequences is the emergence of bacterial resistance to antibiotics. After using ceftazidime with a glycopeptide as initial empiric therapy for neutropenic fever, we were confronted with a 75% reduced susceptibility rate to ceftazidime of inducible Enterobacteriaceae collected in 1994. The initial empiric therapy was therefore replaced in May 1995 by a combination of cefepime with amikacin, with addition of a glycopeptide after 48 h if necessary. After this change, we observed a significant decrease in reduced susceptibility of inducible Enterobacteriaceae, not only to ceftazidime, but also to amikacin, cotrimoxazole and ciprofloxacin. There was also a decrease in reduced susceptibility of non-inducible Enterobacteriaceae, such as Klebsiella spp, to ceftazidime. The reduction of resistance may be related at least in part to the combined use of cefepime together with an aminoglycoside. This study shows that it is possible to reverse bacterial resistance by modifying the antibiotic regimen used.

Adult↗
PubMed1998

A multicentre survey of antimicrobial resistance in gram-negative isolates from Belgian intensive care units in 1994-1995. Belgian Multicenter ICU Study Group.

The aim of this prospective study was to evaluate the distribution and antibiotic susceptibility of aerobic Gram-negative bacilli isolated from patients in intensive care units in 18 Belgian hospitals during 1994 and 1995. A standardised method (i.e. the E-test) was used in each center to determine the minimum inhibitory concentrations of 12 major antibiotics against 1435 consecutive, non duplicate, Gram-negative isolates (close to 100 strains per hospital) during a period of 6 months. The isolates were mainly isolated from the lower respiratory tract (57.4%), urinary tract (17.7%), pus (7.9%) or blood specimens (7.8%) and were mainly P.aeruginosa (20.3%), E.coli (19.9%) and Enterobacter spp. (12.6%). Overall inducible Enterobacteriaceae (IE) accounted for 29.8% of all isolates, and E.aerogenes was the most frequently isolated species in this group (27.6%). The overall susceptibility rate (all species confounded) was about 70% to piperacillin, ticarcillin-clavulanic acid and ceftriaxone, 78% to piperacillin-tazobactam; 87% both to ceftazidime and to ciprofloxacin; and 90% to imipenem. Widespread resistance was observed in several IE species to third generation cephalosporins, broad-spectrum penicillins and to ciprofloxacin. By contrast, imipenem and the aminoglycosides still retained excellent activity against most multiresistant species. Although there were wide differences between hospitals in the frequencies of resistance to most antibiotics, these were not related to the types (general vs. university) of hospitals or to the number of beds. Some variations were however observed in the distribution of bacterial species: the prevalence of inducible Enterobacteriaceae was significantly higher in university than in general hospitals and in hospitals located in Brussels and in Wallonia than in the Flanders. Overall few trends in resistance rates were observed in comparison to a similar survey performed in 1991.

Cross Reactions↗
PubMed1998

Spread of vancomycin-resistant enterococci: differences between the United States and Europe.

There are major differences in the epidemiology of vancomycin-resistant enterococci (VRE) between the United States and Europe. In contrast with Europe, VRE in the United States are resistant to many antibiotics, and there appears to be less genetic variability among these isolates. European VRE of human origin are usually susceptible to many other antibiotics and are highly polyclonal. These clinical isolates have the same susceptibility profiles as VRE isolated from animals. The differences in the spread of VRE between the United States and Europe might be explained by the overconsumption of glycopeptides and other antibiotics in hospitals in the United States and the use of avoparcin as a growth promotor in Europe.

Animals↗
PubMed1998

Surgical prophylaxis in Belgian hospitals: estimate of costs and potential savings.

Between 1991 and 1995 the Belgian National Program for Surveillance of Hospital Infections (NSIH) collected data on perioperative antibiotic prophylaxis in 72 acute care hospitals. From the costs of prophylactic antibiotics for six categories of surgical procedure and from discharge summaries for hospitalization episodes nationwide, annual drug costs were estimated for 73% of Belgian surgical activity. Costs of antibiotics used in these surgical activities were estimated at 386-410 million Belgian francs (Bf) per year (US$12.1-12.9 million). After agreeing recommendations for best practice, the hypothetical costs of 'optimal' antimicrobial prophylaxis were calculated for the same selection of surgical procedures. It was calculated that savings of at least 194 million Bf (US$6.1 million) could be made if recommendations were followed closely. Only the costs borne by the National Health Insurance Institute for reimbursement of the dispensed drugs were considered in this study. Other direct costs, such as those related to drug storage, dispensing and administration, were not included.

Anti-Bacterial Agents↗
PubMed1998

Whole-cell protein electrophoretic analysis of viridans streptococci: evidence for heterogeneity among Streptococcus mitis biovars.

One hundred reference strains representing all species belonging to the different phylogenetic lineages of the viridans streptococci were examined by means of one-dimensional whole-organism protein electrophoresis. For most of the species examined, multiple strains characterized by DNA-DNA hybridization were included and, wherever described, representatives of different biochemical variants were analysed. Most species were clearly differentiated. The data support the viewpoint that members of the Streptococcus anginosus group constitute a single species and indicate that Streptococcus mitis biovar 2 is a heterogeneous taxon comprising strains from several streptococcal species.

Bacterial Proteins↗