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Biomedical subjects

H Mittermayer

Publications and source records attributed to H Mittermayer.

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

Resistance of gram-negative bacilli and staphylococci from blood cultures to aminoglycoside antibiotics. Comparison of 3 in vitro investigations from Austria 1982-1988.

A total of 790 blood culture isolates was collected during 3 study periods in 1982/83, 1984/85 and 1987/88. Staphylococci were the most frequent bacteria in the first two periods (56.5% and 63%, respectively). During the last period, E. coli was the most frequent of all species (27%). Differences in the distribution of bacteria between the laboratories were considerable. In one laboratory in Vienna, coagulase-negative staphylococci dominated in all 3 study periods (32%, 33% and 47%). Susceptibility against gentamicin, tobramycin and netilmicin (MIC less than or equal to 4 mg/l), as well as against amikacin (MIC less than or equal to 8 mg/l) were determined by a microdilution method. The resistance rates against gentamicin (G) were 25%, 21% and 25%, against tobramycin (T) 27%, 19% and 25%, against netilmicin (N) 6%, 4% and 19%, and against amikacin (A), 5%, 2% and 19%. Most resistant strains were staphylococci (G 26%-41%, T 26%-46%, N 3%-31%, A 3%-36%), whereas gram-negative bacilli were more susceptible (G 12%-14%, T 7%-11%, N 7%-9%, A 1%-7.5%). The increase of resistance against netilmicin and amikacin in staphylococci was most striking. Nearly all those strain could be attributed to one laboratory in Vienna. Most of them were coagulase-negative staphylococci. In the first study period, the most frequent pattern was resistance against gentamicin and tobramycin, whereas in the last period resistance to all 4 aminoglycosides dominated. The study demonstrates considerable local differences in antibiotic resistance. Monitoring of antibiotic resistance in collaborative studies using standardized methods should be a valuable tool in planning strategies for controlling an epidemic spread of resistance.

Amikacin↗
PubMed1989

[Diarrhea induced by antibiotics].

The most frequent cause of antibiotic-associated colitis is Clostridium difficile. This gram-positive, spore-forming anaerobic bacillus releases toxins, which produce diarrhea and damage the colonic mucosa. Endoscopy shows a wide range of alterations, "unspecific colitis" with reddening or edema, ulcerations or at the worst pseudomembranous colitis. Nearly all antibiotics are able to trigger Clostridium difficile colitis. An enhanced risk is exerted by broad spectrum substances, which act also on the anaerobic flora protecting the gastrointestinal tract from unphysiological colonization. Clusters of cases were observed in hospitalized patients. The patients risk factors coincide with the administration of antibiotics. Furthermore Clostridium difficile is likely to be spread as a nosocomial infection in many instances. Less often colitis is observed in connection with oral antibiotics outside the hospital. However, substantial underreporting of cases has to be considered. Clinical symptoms usually start 4 to 10 days after first administration of the antibiotic. Leading symptoms are frequent profuse watery stools. Abdominal cramps and tenderness as well as fever and leukocytosis are common. Intense symptoms can simulate serious conditions like perforation. Upon clinical suspicion the diagnosis is made by endoscopy, stool culture and possibly demonstration of toxin. The predictive value of the stool culture equals that of toxin detection. In adult patients there is a good correlation between positive stool culture and clinical presentation. Infants can carry Clostridium difficile as part of their normal flora, therefore positive stool culture or toxin detection in an infant cannot necessarily be linked to clinical symptoms. In some cases Clostridium difficile has to be regarded as etiologic organism also in infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1988

Antibacterial treatment of otitis and sinusitis with ciprofloxacin and penicillin V--a comparison.

80 adult outpatients suffering from otitis media, sinusitis (maxillaris or frontalis) or peritonsillitis were treated with 500 mg ciprofloxacin b.i.d. (n = 40) or with 2 g penicillin V t.i.d. (n = 40). The patients were randomly allocated. Three groups of patients resulted, clinically and bacteriologically evaluable, or only clinically evaluable because the isolated strains were resistant to ciprofloxacin or penicillin V or because no strains were isolated. Ciprofloxacin was superior to penicillin V; there were fewer resistant strains (one compared to 11), and the eradication rate (57% compared to 43%) as well as the clinical efficacy (60% compared to 48%) of ciprofloxacin were better than those of penicillin V--even in a daily dose of 6.0 g. Both treatments were well tolerated; side effects were neither reported nor found.

Adult↗
PubMed1988

Distribution and resistance patterns of Haemophilus influenzae: a European cooperative study.

The first European survey of the prevalence of antibiotic resistance in Haemophilus influenzae was conducted between February and October 1986. Eighty laboratories in nine countries participated (Austria, Belgium, France, FRG, The Netherlands, Spain, Sweden, Switzerland and the UK). A total of 1,961 clinical isolates was examined for type b encapsulation, beta-lactamase production and susceptibility to ampicillin, chloramphenicol, cefaclor, erythromycin and tetracycline, using a unique microdilution method. The proportion of isolates resistant to these antibiotics varied considerably between individual countries. The highest prevalence of ampicillin resistance was found in Spain (30.6%), and the lowest in the FRG (1.6%), with a mean value of 10% for all countries. Chloramphenicol resistance was highest in Spain (24.9%) and Belgium (10.9%) and lowest in The Netherlands (0.6%) and Austria (0.5%), with a mean value of 4.7%. Resistance to erythromycin ranged from 27% of the isolates in The Netherlands to 1.1% in Austria. For tetracycline, values ranged from 1.5% in the UK to 17.8% in Belgium and 25.4% in Spain. The lowest mean prevalence of resistance was observed for cefaclor (breakpoint 8 mg/l): 5% or less in all countries. These inter-country differences could only partially be explained by variations in the proportion of type b strains, the source of the isolates and the mode of collection.

Ampicillin Resistance↗
PubMed1987

[Campylobacter pylori colonization of the antrum mucosa in patients with chronic gastritis and peptic ulcer].

Campylobacter pylori, a bacterium specifically adapted to the environment of gastric mucous is closely associated with peptic gastric diseases. It is detected within the mucus and in relationship to the intercellular spaces in cases of active chronic gastritis. Approximately 70% of patients with chronic type-B-gastritis are infected with C. pylori. In type A or reflux gastritis C. pylori is hardly seen. A causal relationship seems likely. More than 80% of patients with duodenal ulcer and round half of the cases with gastric ulcer show C. pylori in the gastric mucosa. The pathomechanism, how C. pylori facilitates the development of peptic ulcer is since hypothetical. It is discussed that the bacterium leads to a local breakdown of gastric mucosal defence.

Campylobacter↗
PubMed1986

[Microbiologic findings in nephrology].

Infections of the urinary tract belong to the most frequently encountered bacterial diseases of man. Up to 20% of urinary tract infections take a chronic course and thus give rise for complications. Culture and identification of microorganisms as well as susceptibility testing are an essential part of the diagnostic procedures and give a basis for specific treatment. Bacteriological reports have an increasing importance also for the physician in private practice, since therapy failures and complications can only be avoided if the resistance patterns of the causative organisms are known. Appropriate collection and transport of specimens are an important prerequisite for clinically relevant reports. In most cases properly collected mid-stream urine is sufficient for microbiology. Catheterization and other collection methods are less frequently applied. The urine sample should reach the laboratory as fast as possible and should be stored refrigerated until processing. As an alternative dip-slide cultures can also be used. Dip-slides, however, yield much less information than urine specimens. Bacterial counts of 10(5)/ml or greater are usually considered as significant bacteriuria. Under certain conditions lower counts can be clinically relevant. The most frequent causes of urinary tract infections are still Escherichia coli and other enterobacteriaceae. Hemodialysis patients and kidney transplant recipients are highly infection-prone. In hemodialysis infections of the vascular shunt are frequently seen. These infections are mainly caused by Staphylococcus aureus. About one third of all complications after kidney transplantation are related infectious conditions. Thus early detection and surveillance of infections to preserve the transplant function are a great concern for clinical microbiology.

Bacteria↗
PubMed1986

[Susceptibility of the Bacteroides fragilis group to 10 antibiotics. Results of 4 laboratories in Austria].

The susceptibility of 197 strains of the Bacteroides fragilis group (109 B. fragilis, 27 B. thetaiotamicron, 23 B. vulgatus, 1 B. distasonis, 11 B. ovatus and others) to penicillin G, cefoxitin, latamoxef, piperacillin, mezlocillin, clindamycin, metronidazole, tetracycline, doxycycline and chloramphenicol was tested by an agar dilution method. 4 microbiological laboratories in Austria participated in this investigation. In all laboratories the same method was used and a joint quality control carried out. The most active substances were metronidazole and clindamycin (MIC50 1.0 and 0.5 respectively; MIC90 4 mg/l for both). Tetracycline showed only little activity, whereas doxycycline inhibited a major portion of the strains at therapeutically relevant concentrations (MIC50 16 and 2 mg/l, MIC90 32 and 16 mg/l, respectively). The MIC90 of chloramphenicol was 8 mg/l. Piperacillin and mezlocillin were about equally active (MIC50 both 16, MIC90 32 and 64 mg/l, respectively). For penicillin G, the MIC values were also favourable, the MIC90 being 32 mg/l. The possible causes for the discrepancy between the good in vitro activity and the clinical ineffectiveness of penicillin G are discussed. The cumulative MIC values (50, 90%) for cefoxitin were 8 and 32 mg/l, respectively. The MIC's of latamoxef showed a wide distribution resulting in a low MIC50 (4 mg/l) and a high MIC90 (128 mg/l). This distribution was due to the differing susceptibility of the individual species within the Bacteroides fragilis group. For B. thetaiotaomicron the highest MIC values were determined. This species as a whole was less susceptible to the beta-lactam antibiotics tested. The non beta-lactam antibiotics showed no substantial species related differences. No relevant differences between the individual laboratories were observed.

Anti-Bacterial Agents↗
PubMed1985

[Resistance of blood culture isolates in vitro to 4 aminoglycoside antibiotics in Austria--1982/83].

Over the period September 1982 to February 1983 268 blood culture isolates were consecutively collected in 4 microbiological laboratories in Austria (Linz, Vienna, Graz, Feldkirch) and 251 of these strains (streptococci excluded) were tested for resistance to Gentamicin (G), Tobramycin (T), Netilmicin (N) and Amikacin (A) using a microtitre broth dilution method. This investigation was part of an international study. Of the bacterial strains examined 57% were staphylococci (34% Staphylococcus aureus) and 43% gram-negative rods (18% E. coli, 17% other enterobacteriaceae and 5% Pseudomonas aeruginosa etc.). 25% of all strains tested were resistant to Gentamicin (MIC greater than 4 mg/l), 27% to Tobramycin (MIC greater than 4 mg/l), 6% to Netilmicin (MIC greater than 4 mg/ml) and 5% to Amikacin (MIC greater than 8 mg/l). The resistance rate of staphylococci was markedly greater towards Gentamicin (35%) and Tobramycin (39%) than Netilmicin (4%) and Amikacin (6%). The respective percentages of resistant gram-negative rods were considerably smaller, except in the case of Netilmicin (G 13%, T 11%, N 8%, A 4%). Regional differences were observed between Linz and Vienna in the resistance of staphylococci to Gentamicin (24% versus 49%) and Tobramycin (33% versus 53%). On a weight basis Netilmicin was the most active substance in combating nearly all groups of bacteria. Also in strains sensitive to the other aminoglycosides the MIC values of Netilmicin were considerably lower than for the other substances. A noteworthy feature in comparison with the results of other countries participating in this international study was the distinctly higher incidence of staphylococci among the blood culture isolates and the considerably higher percentage of aminoglycoside-resistant strains in Austria. Analysis of the data suggests that the high resistance rates among staphylococci are a consequence of selection by frequently used antibiotics. Hence, it appears essential to observe the development of aminoglycoside resistance in Austria closely and to recommend that these substances, of extreme value in the treatment of severe infections, should be used solely for the most stringent indications.

Aminoglycosides↗
PubMed1984

Augmentin in acute exacerbations of chronic bronchitis.

Forty-five patients with acute chronic bronchitis were treated with Augmentin, an amoxycillin combined with the beta-lactamase inhibitor clavulanic acid, initially by parenteral administration followed by oral treatment after 3 days lasting in the mean 7.1 days. The over-all clinical evaluation showed a cure rate of 93%. Side-effects were comparable to therapy with other amoxycillins. Bacteriological evaluation of the sputum samples demonstrated in 91% of cases an elimination of the initially isolated organism. Prior to therapy we found in 25% of the isolated strains beta-lactamase-producing and Augmentin-sensitive organisms. The parenteral formulation of Augmentin seems to be a valuable addition to the parenteral therapy of lower respiratory tract infections.

Acute Disease↗
PubMed1984

Single dose cefuroxime/metronidazole versus metronidazole alone in elective colorectal surgery.

Sixty assessable patients undergoing elective colonic and rectal surgery were randomly allocated to receive prophylaxis with a combination of 1.5 g cefuroxime plus 500 mg metronidazole or 500 mg metronidazole alone as single doses by the intravenous route, given at the beginning of anesthesia. The two groups were matched for age, sex, malignancy, and type of operation. Primary wound infections were observed in one patient (3.7%) in the combination group and six (18.2%) in the group given metronidazole alone. This trend was not statistically significant. Bacteriologic examination of the anastomoses, abdominal walls, and wounds showed significantly more sterile cultures in the combination group, although more aerobic cefuroxime-resistant isolates were seen in this group. There is no evidence that the emergence of resistant strains had any influence on the outcome of patients in the study. It was concluded that an appropriate antibiotic prophylactic regimen for colorectal surgery should be directed against aerobic and anaerobic organisms. Cefuroxime plus metronidazole is an effective regimen for the prevention of postoperative infection.

Adult↗
PubMed1977

[Testmethod for the evaluation of procedures for the hygienic disinfection of hands. Part 1: Discription of testmethod (author's transl)].

A detailed test design for the evaluation of procedures for the hygienic disinfection of hands is described together with suitable methods for statistical analysis of the results. In principle the release of testbacteria from the finger-tips of artificially contaminated hands is measured before and after disinfection. A procedure under test is accepted if it is not less effective than a standard-disinfection procedure. As such the disinfection with iso-propanol 60% (ml/ml) applied through 1 min was agreed upon. This standard procedure is to be performed the same day with the same day with the same testpersons and under identical environmental conditions prior to the procedure under test.

1-Propanol↗
PubMed1976

[Further experimental investigations on the therapy of gas gangrene with ozone and oxygen (author's transl)].

In continuation of a recently-published investigation on the effect of intramuscular injections of an ozone-oxygen mixture on experimental gas gangrene in the guinea pig, 2 additional experiments were performed in order to establish the efficacy of the therapy when given twice daily instead of only once. Futhermore, the effect of an analogous therapy was investigated with the use of pure oxygen. The ozone-oxygen therapy reduced the death rate from 100% in untreated control animals to 73.6 and 70.0%, respectively, in the 2 series of experiments. The median survival times were prolonged from 0.56 and 1.33 days to 5.50 and 6.66 days. The use of oxygen twice daily reduced the death rates significantly even further to 57.0 and 47.9%. With this therapy the median survival time was increased to 8 and more than 12 days. The differences in therapeutic effect of the 2 gases were not, however, statistically significant. On account of its simple applicability previous experiments on animals it is proposed that this therapy be employed also in cases of human gas gangrene. In addition, the bactericidal effect of CaCl2, as used in this experimental study, on vegetative forms of Clostridia is demonstrated.

Animals↗
PubMed1976

Staphylococcal toxic epidermal necrolysis: species and tissue susceptibility and resistance.

The staphylococcal exfoliatin, which is responsible for the "scalded skin syndrome" in man, cleaves the epidermis directly beneath the stratum granulosum. Its activity in vivo is paralleled in organ cultures, providing a rapid and convenient assay. The cutaneous responses of several mammalian and nonmammalian species were examined both in vivo and in vitro. Human and murine skin, as well as that of hamsters and monkeys exfoliated, while all other species tested (rat, rabbit, guinea pig, dog, frog, and chicken) were refractory. Results were identical in vivo and in vitro. Susceptibility and resistance are inherent, presumably genetic, attributes of the epidermis, since neither dermal elements nor circulating factors interfered with or influenced sensitivity to staphylococcal exfoliatin. Besides possessing species specificity, this exfoliatin is also tissue specific, failing to cleave all mouse nonkeratinizing epithelia tested, while the reactions of some extracutaneous keratinizing epithelia were equivocal. The species and tissue specificity of the staphylococcal scalded-skin syndrome may be attributable to either keratinocyte receptors specific for exfoliatin or the presence of specific, as yet undefined, substances in the intercellular space.

Animals↗
PubMed1976

[Kinetics of the release of testbacteria from the artificially contaminated hand (author's transl)].

It is demonstrated that the release of testbacteria from the finger tips of artificially contaminated hands is influenced to a very small degree only by application of the finger tip method when compared to the effect of ablutions. Therefore, without apprehension of influencing the post-values this method may be employed in order to assess pre-values as required by the test-model of Rotter and Mittermayer (5) for the evaluation of procedures for the hygienic disinfection of hands. In addition, it can be shown directly that it is irrelevant for the number of bacteria released after a germ-reducing procedure, whether the finger tip-method has been used or not, preceedingly. In contrast, all technical variations that aim at the restitution of the supposed loss of testbacteria (like renewed contamination after the assessment of prevalues) change the postvalues measurably and must be avoided, therefore. Drying of bacterial suspensions on the hands, as after artificial contamination, reduces the release of viable testbacteria depending on the time. This effect is stronger on the palms than on the finger tips. The influence of handbrushes on the release of testbacteria with simultaneous useage of detergents compares well with the effect of an alcohol disinfection. However, this method is not suitable to eliminate pathogens safely.

Escherichia coli↗