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Biomedical subjects

K E Myrbäck

Publications and source records attributed to K E Myrbäck.

14 recordsLinked to original sources
PubMed2001

[Clostridium difficile-associated diarrhea--a growing problem in geriatric care].

From 1994 to 1998 the incidence of Clostridium difficile-associated diarrhoea (CDAD) in the Department of Geriatric Medicine, Huddinge University Hospital increased from 0.5% to 2.2% of all admissions. Corresponding figures for the whole hospital were 0.3% and 0.6%, respectively. The increase in CDAD at the Department of Geriatric Medicine was parallel with a more than doubled consumption of antibiotics. All geriatric patients with CDAD had been treated with antibiotics before onset of diarrhoea. Out of the antibiotic prescriptions 48% were a cephalosporin (mainly cefuroxim). In a matched reference group of geriatric patients 51% had been treated with antibiotics during the hospital stay. The patients with CDAD spent 27 +/- 14 days in hospital as compared to 13 +/- 9 days (P < 0.05) in the reference population.

Aged↗
PubMed2001

Marked differences in antibiotic use and resistance between university hospitals in Vilnius, Lithuania, and Huddinge, Sweden.

Antibiotic use and antimicrobial resistance was compared between Vilnius and Huddinge University hospitals. Drug use data were expressed in number of defined daily doses/100 bed-days; antimicrobial resistance were given as percentages of resistant isolates. Thirty-five and 48 different antibiotic drugs were used in Vilnius and Huddinge, respectively. The overall consumption of antibiotics was 15 DDD/100 bed-days in Vilnius and 43 DDD/100 bed-days in Huddinge. Benzylpenicillin, ampicillin, and aminoglycosides were the major antibiotics in Vilnius; beta-lactamase-resistant penicillins, cefalosporins, and quinolones in Huddinge. In Vilnius, gentamicin made up one-quarter of the use. Staphylococcus aureus and Gram-negative isolates from wounds and blood were more resistant to gentamicin in Vilnius. S. aureus was more often methicillin resistant in Vilnius than in Huddinge. There was no S. aureus-resistant to vancomycin in either hospital. The vancomycin-resistant enterococci made up from 4% to 10% in Vilnius hospital, but they were not detected in Huddinge hospital (0%). The majority of Streptococcus pneumoniae isolates were sensitive to benzylpenicillin in both hospitals. The higher resistance of microorganisms to some antibiotics in Vilnius may be explained by heavy use of few antibiotics. Lower level of hygiene procedures, sampling bias, and other methodological issues may also have contributed. Guidelines for antibiotic use and hygienic procedures are now under development in Vilnius.

Anti-Bacterial Agents↗
PubMed2000

Is it safe to treat allogeneic stem cell transplant recipients at home during the pancytopenic phase? A pilot trial.

After myeloablative treatment and allogeneic stem cell transplantation (ASCT), patients are kept isolated in the hospital to prevent infections during neutropenia. To date, 22 patients have been given the choice of being treated at home. Eleven could not be treated at home, and they served as controls. Most had haematological malignancies. The donors were 12 HLA-compatible unrelated, nine HLA-identical siblings and one twin. In the home care group, three developed bacteraemia, compared to nine in the controls (P < 0.01). Patients in the home care group had fewer days of total parenteral nutrition (median 3 vs 24, P < 0.001), required fewer erythrocyte transfusions (median 4 vs 8, P = 0.01), fewer days on i.v. antibiotics (median 6 vs 13 days), and on analgesics (median 0 vs 15) than the controls (P < 0.05). Days with fever, time to engraftment, days with G-CSF and acute GVHD were the same in the two groups. Seven of 11 patients treated at home were readmitted to the ward for a median of 3 (0-7) days, due to fever or lack of a caregiver at home. Days to discharge to the out-patient clinic were faster in the group treated at home (median 20 vs 35 days, P < 0.01). Patients who were treated at home enjoyed being active and taking a walk when they felt like it. This preliminary report suggests that home care after ASCT is not only safe, but superior to isolation in the hospital.

Adolescent↗
PubMed1990

Comparison of Oxoid Signal and biphasic blood culture systems in clinical practice.

The 1-bottle Oxoid Signal blood culture system was compared with a biphasic 2-bottle system in a clinical trial. A total of 851 routine blood samples were processed in the study which was run as a multicenter study at 4 university hospitals. Microorganisms were isolated from 104 (12.2%) blood cultures by one or both methods. 75 (72%) were clinically significant isolates, 61 of them were recovered in both systems, 9 in Oxoid Signal only and 5 in the biphasic system only. 29 isolates (28%) were judged as contaminants, 6 of them were found in both systems, 18 in Oxoid Signal only and 5 in the biphasic system only. The Oxoid Signal System had many advantages although it sometimes gave false positive signals in the device. The growth of pathogens was equally good, 93% versus 88% positive cultures.

Bacteriological Techniques↗
PubMed1989

A method to evaluate the cleaning and disinfectant action of surface disinfectants.

Surface disinfection tests, used to evaluate new disinfectants, do not take into account the effects of detergents or of the mechanical cleaning process. We describe methods which evaluate both the disinfection and cleaning effect of disinfectants on organic matter. When testing alcohols at high concentrations (greater than or equal to 70%) on blood spots contaminated with Staphylococcus aureus, we found that the organisms were trapped and fixed to the test surface, probably due to denaturation of the blood. This gave a low inactivating factor (IF), as well as a poor subjective cleaning effect (SC). If serum was used instead of blood, we observed less pronounced trapping, resulting in a high IF although the SC was still poor. When broth was used, both IF and SC were satisfactory. With alcohols at a concentration of 42%, trapping was markedly reduced which improved the SC in blood contamination, with serum or broth contamination trapping did not occur. However, 42% ethanol lost its killing effect (i.e. low IF), whereas 42% isopropanol still demonstrated a high IF.

Bacteria↗
PubMed1982

Bacterial colonization of newborn infants in a neonatal intensive care unit.

The bacterial colonization of the nose, umbilicus, perineum and faeces in 85 newborns was studied during one period of high and one of low occupancy in a neonatal intensive care unit. Cultures were taken on admission, at three days, at one week of age, and then weekly during the stay in the unit. Colonization took place early and potential pathogens were responsible for a significant part of the spectrum. At one week of age, more than 50% of the infants had Staphylococcus aureus in the nose and umbilicus, 25% had E. coli and/or Klebsiella enterobacter in the umbilicus, and 60% had Klebsiella enterobacter in the perineum. Neither the occupancy rate in the unit nor the clinical state of the infant seemed to influence the colonization pattern significantly. Changes in flora were frequent in the individual infant. However, the bacterial spectrum remained essentially the same with increasing age during the stay in the unit and during the two periods. Only on two occasions was the same phage type of Staphylococcus aureus found in two infants at the same time. Two cases of septicemia occurred in the 85 infants during the three months of the study. Both infants were colonized beforehand with the causative organism. The results may indicate that the clinical state of the infant is of greater importance for risk of septicemia than the pattern of the bacterial colonization.

Bacteria↗
PubMed1978

Hemolytic streptococci among infants in a maternity department. Report of an outbreak.

Reports of several streptococcal infections among babies after discharge from a maternity department initiated an epidemiologic study. Out of 100 infants in the 3 maternity wards 67% were colonized on the umbilicus with hemolytic streptococci group A. It was assumed that the spread had occurred from infant to infant in connection with the nursing. By means of new and strict hygienic routines, isolation and penicillin treatment of the colonized infants the spread was rapidly brought to an end. A retrospective study among the children delivered up to 6 weeks earlier showed that no less than 64% had had clinical signs of infection of possible streptococcal origin. Infections had also occurred among many family members. The observations emphasize the importance of strict hygienic routines and continuous bacteriologic surveillance in maternity departments, as well as close contact between maternity departments and health centers for children.

Adult↗
PubMed1978

Prevalence of hospital-associated infections in five Swedish hospitals in November 1975.

The prevalence rate of hospital-associated infections in 5 Swedish hospitals on November 4, 1975 is reported. In all, 4246 patients were included in the study, 3657 in acute disease clinics and 589 in chronic disease clinics. The overall prevalence rate was 17%, 11% in acute disease clinics and 59% in chronic disease clinics. The highest rate was found in intensive care units (72%), while in ophthalmological units it was 1%. 50% of all hospital-associated infections were urinary tract infections, 68% of which occurred in patients with an indwelling urinary catheter. 25% of all infections in acute disease clinics were postoperative wound infections, and 20% in chronic disease clinics were skin infections, including infections in varicose and decubital ulcers. 58% of the bacterial isolates from hospital-associated infections were gram-negative rods, while 12% were Staphylococcus aureus. Also in postoperative wound infections the gram-negative rods dominated over Staph. aureus, 35 vs. 23%. A prevalence study of this order of size seems adequate to assess the overall rate of hospital-associated infections in Sweden as compared to other countries. However, differences in prevalence rates between hospitals and clinics should be interpreted with great care. The seriousness and effect of reported infections must be evaluated otherwise, as well as the day-to-day infection control and the evaluation of prophylactic measures need other methods.

Acute Disease↗