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L Bevanger

Publications and source records attributed to L Bevanger.

At least 19 recordsLinked to original sources
PubMed2001

Antibiotic sensitivity still prevails in Norwegian blood culture isolates.

We describe the antimicrobial susceptibility of bacteraemia isolates from Norway. From March 1998 to February 1999, four university hospitals covering all parts of Norway collected their first 10 isolates each month. Minimal inhibitory concentrations were determined for: Enterobacteriaceae (n=192), staphylococci (n=89) and Streptococcus pneumoniae (n=69) using the Etest. NCCLS breakpoints were used. About 20% of all blood culture isolates in Norway in this period were investigated. Compared with countries outside Scandinavia antibiotic sensitivity still prevails. Only minor differences in resistance were found between participating hospitals, between hospital departments and between hospital- and community-acquired pathogens. The prudent use of antibiotics in Norway may contribute to the fact that antibiotic resistance still remains low in the most common bacterial pathogens causing bloodstream infections.

Anti-Bacterial Agents↗
PubMed2000

Distribution and expression of bca, the gene encoding the c alpha protein, by Streptococcus agalactiae.

A total of 52 clinical isolates of group B streptococci (GBS) was tested for expression of the c protein c(alpha) by a fluorescent antibody test (FAT) and by PCR amplification of a 202-bp stretch within the repeat unit of the bca gene encoding the c(alpha) protein. The strains were categorised as follows: c(alpha) FAT positive and PCR positive with amplification products of multiple sizes (category A, n = 12); FAT negative and with PCR products of multiple sizes (category B, n = 11); FAT negative and with a single PCR product of c. 200 bp (category C, n = 5); negative in both tests (category D, n = 24). A single amplification product of minimum size and additional products of larger sizes corresponded to one and more bca repeats, respectively. Five of the 11 category B strains showed expression of low Mr c(alpha) in whole cell-based Western blotting. The results showed that a proportion of the GBS isolates harboured bca gene elements that either were not expressed or they expressed c(alpha) molecular variants which could not be detected by the whole cell-based FAT. This genotype/phenotype discrepancy should be considered in relation to GBS typing, including the selection of antibody reagents and the technical approach to c(alpha) protein detection.

Adult↗
PubMed1999

[Pregnant women themselves can take specimens for identification of group B streptococci carriers].

Prenatal screening for group B streptococcus colonisation in pregnant women is controversial, though recommended in some countries. We aimed to compare the detection rate when pregnant women performed their own vaginal/anorectal swabs with the standard practice of physician obtained swabs. During six months, 89 pregnant women with high risk for premature labor collected their own vaginal/anorectal swab after instruction from a midwife. Afterwards a physician took a similar sample among 80 of the women. All together, 30 (34%) out of 89 women were carriers of group B streptococcus. Comparing the efficacy of the sampling procedures among 80 women who had taken both tests, we found that 25 of 26 positive cultures were identified by self-collected samples, while 17 out of 26 were identified by samples collected by the physicians. The difference in sensitivity (96% vs 65%) was statistically significant (p < 0.001) with a kappa value of 0.68. Self-collected vaginal/anorectal swabs for the identification of group B streptococcus carriers are at least as sensitive as the practice of physician performed swabs.

Bacteriological Techniques↗
PubMed1999

Properties and distribution of the putative R3 protein of Streptococcus agalactiae.

Strain-variable Streptococcus agalactiae (group B streptococci; GBS) proteins exposed at the bacterial cell surface are important markers in GBS serotyping. These proteins include the c proteins c(alpha) and c(beta) and the R proteins R1 through R4, of which R1 and R4 have been studied most extensively. This study presents the characteristics of a protein which was expressed by a capsular antigen type V GBS strain shown by means of polyclonal and monoclonal antibody testing. Examination of a number of reference and prototype strains by fluorescent antibody testing and Western blotting provided evidence that the serotype V-derived protein was the R3 protein of GBS, previously defined on the basis of immunoprecipitation assays. The putative R3 protein formed ladder-like banding patterns on Western blotting with polypeptides in the 30 kDa to > or = 140 kDa range, was destroyed by pepsin digestion, and partially degraded by trypsin digestion. The protein was expressed by 10 (6.5%) of 153 clinical GBS strains tested, the expression being restricted to isolates of the capsular antigen types II, III, and V. Some isolates expressed both the c(beta) and the R3 protein. Expression in combination with c(alpha) or R4 protein synthesis was not detected. Inclusion of the anti-R3 monoclonal antibody among antibody reagents for GBS serotyping will enhance the discriminatory power of this typing method.

Animals↗
PubMed1999

Comparison of three different methods in monoclonal antibody-based detection of Streptococcus agalactiae protein serotype markers.

Surface-exposed proteins are important serotype markers in Streptococcus agalactiae (group B streptococci; GBS). The proteins include the c proteins c(alpha) and c(beta), the R4 protein and a protein provisionally called P. For all of these markers, protein-specific monoclonal antibodies (MAbs) have been generated. We have compared whole-cell-based fluorescent antibody testing (FAT), ELISA, and dot blotting for MAb-based detection of these proteins by testing a panel of 52 GBS isolates of different capsular antigen types. Of a total of 208 observations with each of the tests, positive signalling in the dot assay was observed in 32.2%, with ELISA in 27.8%, and with FAT in 26.4% of the recordings. Discordant results were noted most frequently with the c(beta) and c(alpha) MAbs. In the case of c(alpha) the reason for the discordant test results was further examined and it appeared that this could be attributed to low level expression of the c(alpha) protein, although structural variations of c(alpha) proteins cannot be excluded. Our findings favour dot blotting as the method of choice although we consider all three methods acceptable for serotyping of GBS.

Animals↗
PubMed1999

bca, beta gene, and gene product divergency in reference and prototype strains of streptococcus agalactiae.

Reference and prototype strains of Streptococcus agalactiae (GBS) were originally selected on the basis of phenotypic traits which, however, do not always mirror genotypic traits. A total of 14 reference and prototype GBS strains were examined by PCR designed to detect the bca and beta genes, encoding the c proteins c(alpha) and c(beta), respectively. The cognate proteins were detected by whole-cell-based fluorescent antibody testing and Western blotting. The PCR for beta gene detection and the antibody-based c(beta) protein detection showed concordant results with all of the isolates, whereas 7 of 14 strains which did not express c(alpha) protein at detectable levels contained bca gene elements, consistent with bca gene and gene product divergency in these strains. The results emphasize the importance of genetic characterization of reference and prototype strains of GBS which, in the past, have been selected on the basis of phenotypic traits.

Antibodies, Monoclonal↗
PubMed1998

[Spotted fever after travel to South Africa].

Three patients developed fever, malaise and a typical maculopapular rash a few days after returning to Norway from South Africa. In South Africa they had been bitten by ticks several times while hunting. Two patients, with lesions compatible with eschar, were hospitalized, and a diagnosis of rickettsial spotted fever was established based on the clinical presentation and positive Rickettsia conorii serology. Rickettsial diseases are extremely rare in Scandinavia, and a survey on rickettsioses is presented in this paper.

Boutonneuse Fever↗
PubMed1998

Cervical secretions in pregnant women colonized rectally with group B streptococci have high levels of antibodies to serotype III polysaccharide capsular antigen and protein R.

Group B streptococci (GBS) colonizing the female genital tract will often infect newborn infants during delivery. In 200 pregnant women studied, 14% were colonized with GBS in the cervix, 12% in the rectum, and 9% in both cervix and rectum. We have previously reported that antibody levels to GBS serotypes Ia, II, and III in sera and cervical secretions were increased in women colonized in the rectum and/or cervix, when analyzed by a whole-cell ELISA. Here, we report the levels of antibodies to GBS serotype III capsular polysaccharide antigen (CPS III) and to protein antigen R4, which are present in most GBS III strains. Compared to culture-negative women, the group of women colonized rectally had markedly elevated levels of immunoglobulin (Ig)A and IgG antibodies in cervical secretions to both CPS III and protein R4 (P < 0.01 and P < 0.001, respectively). In sera, the corresponding differences between culture-negative and culture-positive women were less pronounced, or not present. In contrast to antibody levels to whole-cell GBS, antibody levels to CPS III and protein R4 in cervical secretions were not significantly increased in women colonized only in the cervix, except that IgA antibodies to protein R4 were slightly elevated (P < 0.05). These findings suggest that capsular type-specific polysaccharides and protein R4 in a mucosal vaccine might induce protective antibodies against GBS colonization of the uterine cervix.

Antibodies, Bacterial↗
PubMed1998

Identification of nasopharyngeal carriage of an outbreak strain of Neisseria meningitidis by pulsed-field gel electrophoresis versus phenotypic methods.

The clustering of four cases of meningococcal disease during a 3-month period in a small community with 2233 inhabitants prompted an interventional carrier survey in persons < 19 years old and in family members of the patients. The aims of the survey were to identify the nasopharyngeal carriers and the carriage rate of the outbreak strain, to offer chemoprophylaxis to those carrying the outbreak strain, and to study the discriminatory power of phenotypic methods versus pulsed-field gel electrophoresis (PFGE) on carrier isolates during an outbreak. A high percentage of the population in the age group 0-19 years (73.7%) participated in the study. Among the 469 samples collected in this age group, meningococci were grown from 43 (9.2%). The highest carriage rates were in the age group 18-19 years (36.4%). With a provisional definition of the outbreak strain (group B or non-groupable Neisseria meningitidis with reduced sulphonamide sensitivity), six carriers were identified. All were treated with a single dose of ofloxacin. Four of these persons (0.76% of all tested) were later shown to have harboured the outbreak strain when analysed by PFGE. Three of them were epidemiologically closely related to one of the index cases. Serogrouping alone is not sufficient for the identification of an epidemic strain of N. meningitidis. Complete concordance of type and subtype antigens correctly identified the outbreak strain in this study. PFGE is well suited for the identification of an outbreak strain of N. meningitidis versus non-epidemic strains in tonsillo-pharyngeal specimens.

Adolescent↗
PubMed1998

Constant low rate of fungemia in norway, 1991 to 1996. The Norwegian Yeast Study Group.

Since 1991 information on yeast isolates from blood cultures has been recorded prospectively from all microbiological laboratories (5 university and 16 county or local hospital laboratories) in Norway (population, 4.3 million). From 1991 to 1996 a total of 571 episodes of fungemia in 552 patients occurred (1991, 109 episodes; 1992, 81 episodes; 1993, 93 episodes; 1994, 89 episodes; 1995, 98 episodes; and 1996, 101 episodes). The fungemia rates per 10,000 patient days were 0.29 in 1991 and 0.27 in 1996. The average rates for the years 1991 to 1996 were 0.37 for the university laboratories and 0.20 for the other laboratories. These rates are low compared to the rate (0. 76) in five Dutch university hospitals in 1995 and the rate (2.0) in Iowa in 1991. The four most frequently isolated species were Candida albicans (66%), Candida glabrata (12.5%), Candida parapsilosis (7.6%), and Candida tropicalis (6.4%). The incidences of both C. albicans (range, 63 to 73%) and C. glabrata (range, 8.4 to 15.7%) varied somewhat throughout this period, but no significant increase or decrease was noted. MICs of amphotericin B, flucytosine, and fluconazole were determined for 89% of the isolates. All were susceptible to amphotericin B, and only 29 (5.6%) strains had decreased susceptibility to flucytosine. All C. albicans isolates were susceptible to fluconazole. The percentage of yeast isolates with decreased susceptibility to fluconazole (MICs, >/=16 microgram/ml) did increase, from 9.6% in 1991 and 1992 to 12.2% in 1994, 16.1% in 1995, and 18.6% in 1996. This was largely due to increases in the percentages of resistant C. glabrata and Candida krusei strains in the last 2 years. Compared to the incidence in other countries, it is remarkable that Norway has such a low and constant incidence of fungemia. A possible reason for this difference might be a restricted antibiotic use policy in Norway.

Adult↗
PubMed1997

Streptococcus agalactiae beta gene and gene product variations.

Streptococcus agalactiae (group B streptococci; GBS) are serotyped on the basis of the capsular polysaccharide antigens and subtyped on the basis of the strain-variable and surface-localised c proteins c alpha, c beta, and R proteins. This study compared c beta protein detection and the polymerase chain reaction (PCR) for beta gene detection, by examining 50 clinical GBS strains. The c beta protein was detected by antibody-based immunofluorescence in a GBS whole-cell assay and Western blotting by probing with the anti-c beta antibody or human IgA. Absorption experiments were performed to test for surface-anchoring of c beta; and bacterial supernates were examined to test for c beta production. Primers for the PCR target regions resulted in a 620-bp product that included beta gene-encoding IgA-binding domains. The results demonstrated four categories of GBS with respect to the beta gene and the c beta protein: (1) strains (16 of 50) that harboured the beta gene and regularly expressed normal surface-localised c beta with a M(r) of 120 kDa; (2) strains (5 of 50) that harboured the gene but did not express the protein; (3) strains (2 of 50) that harboured the gene but expressed a c beta that was not surface-localised and had reduced M(r); (4) strains (27 of 50) without beta gene and c beta expression. One strain amongst the third group generated a PCR product of 1330 bp. These results demonstrate considerable strain variability of the beta gene of GBS and of its product the c beta protein.

Adult↗
PubMed1996

Microbial contamination of contact lens cases among medical students.

PURPOSE: We performed a systematic examination of the rate and level of contamination of contact lens cases in a population of asymptomatic contact lens wearers using commercially prepared chemical disinfection solutions. METHODS: Solutions from the lens cases and from the conjunctiva of 21 asymptomatic contact lens wearers were examined. RESULTS: Contamination was found in five (24%) of the lens cases; four of the isolated microorganisms were recognized as potential ocular pathogens, namely Xanthomonas maltophilia, Pseudomonas cepacia, Serratia liquefaciens, and Serratia plymuthica. Serratia organisms have not been previously isolated from lens care solutions preserved with guanide, and, in addition, this was the first time that Serratia plymuthica has been isolated from a lens care system. Acanthamoeba was not detected in any of the examined samples, and no potential pathogens were isolated from the conjunctiva. Among students having contaminated lens cases, all reported problems such as itching, redness, dryness, and coating of the lens. CONCLUSIONS: The percentage of contaminated lens cases in this study was lower than in other studies. However, since the microorganisms identified in 80% of the contaminated lens cases were considered potential ocular pathogens, we feel contact lens wearers should be encouraged to frequently replace their lens cases.

Adult↗
PubMed1995

Distribution of serovariants of group B streptococci in isolates from England and Norway.

The distribution of capsular polysaccharide antigen (CHO) types, surface-exposed c proteins alpha (c alpha) and beta (c beta) and an R-protein antigen was examined in 334 group B streptococci (GBS) isolates from three groups of patients hospitalised in England and Wales or Norway. The isolates were from 108 carriers, 67 cases of neonatal infection and 154 cases of adult infection. Each group contained all CHO types (Ia, Ib, II, III, IV, V and NT); type III strains predominated except in the adult infected group. Strains within each CHO type could be further subdivided by the protein markers into five subtypes by a combined typing system. The proportion of type Ib and type III strains in the neonatal infection cases and of type Ib strains in the adult infection cases significantly outnumbered isolates of these serotypes among the carrier strains. Twenty-nine different serovariants were identified; 24, 13 and 23 serovariants among the carrier, neonatal infection and adult infection isolates, respectively. Certain CHO antigen-protein associations were identified, notably those between Ia/c alpha, Ib/c alpha beta and III/R. The proportion of invasive isolates that expressed protein was not higher than in the carrier isolates. All CHO-type Ib isolates contained a c protein, but 7% of the Ib isolates did not contain any of these proteins. These findings indicate that this combined typing approach may be useful in examining epidemiological problems associated with GBS.

Adult↗
PubMed1995

A Streptococcus agalactiae R protein analysed by polyclonal and monoclonal antibodies.

Unexpected cross-reactivity between two Streptococcus agalactiae (GBS) isolates formed the basis for purification of a GBS protein called the Ra antigen, and raising of murine monoclonal antibody (MAb) against Ra. The Ra protein was resistant to trypsin digestion, susceptible to pepsin digestion, formed a ladder-like pattern of lines with a periodicity of approximately 8 kD on immunoblotting, was surface-localized in GBS strains, and was variably expressed by GBS. These characteristics provided evidence that the Ra antigen belonged to the R proteins of GBS. By testing of reference GBS isolates and antiserum, including an anti-R4 protein serum, cross-reactivity was recorded consistent with the assumption that Ra is a R4 protein. The Ra/R4 protein also showed cross-reactivity with a previously described GBS protein called protein Rib (J. Exp. Med. 177: 1593-1603, 1993). Several characteristics of the Ra/R4 protein were similar to those of the GBS protein c alpha, but the two proteins showed no cross-reactivity. The anti-Ra/R4 MAb has proved useful in serosubtype determination of GBS of known serotype and should be a valuable tool for studying the immunobiological function of antibodies targetting the surface-localized Ra/R4 protein.

Antibodies↗
PubMed1994

Comparative analysis of antibodies to Francisella tularensis antigens during the acute phase of tularemia and eight years later.

Approximately 8 years after treatment for tularemia, 14 of 22 (63.6%) individuals tested still had a positive microagglutination test for Francisella tularensis antibodies. An enzyme-linked immunosorbent assay for anti-F. tularensis outer membrane antibodies was positive for 55% (immunoglobulin A [IgA]), 95% (IgG), and 27% (IgM) of the late-phase sera, but with antibody levels significantly reduced from those in the acute-phase sera. IgG and IgA antibody levels in the late-phase sera showed significant correlation with levels in the acute-phase sera. The IgG/IgM ratio calculation discriminated between acute-phase and persistent antibodies for most sera, but Western blot (immunoblot) patterns did not. Immunoblotting indicated that the F. tularensis lipopolysaccharide is a major target for antibodies in both groups of sera. Our results substantiate the need for caution in the interpretation of positive serological test results for tularemia, which could result from disease occurring years earlier.

Acute Disease↗
PubMed1993

Serological testing for campylobacteriosis with sera forwarded for Salmonella and Yersinia serology.

Single serum specimens forwarded for Salmonella and Yersinia serology, from a total of 250 patients, were tested for anti-C. jejuni antibodies of the IgG class. Anti-Salmonella and anti-Y. enterocolitica O3 antibodies were examined by a microagglutination test and anti-C. jejuni antibodies by ELISA against a C. jejuni ultrasonicate before (ELISA) and after neutralization of antibodies which cross-reacted with Helicobacter pylori antigens (ELISA-Abs). Blood donor sera (n = 50) and sera (n = 40) from patients with various infectious diseases served as controls. A positive test for anti-Salmonella antibodies was recorded in 4/250 (1.6%) of the patients, for anti-Yersinia antibodies in 7/250 (2.8%), and for anti-C. jejuni antibodies in 7/250 (2.8%) in the ELISA; in 25/250 (10%) in the ELISA-Abs. No mixed infection was recorded by the serological testing. The ELISA-Abs showed a diagnostic specificity of 97.7%. Our results support the inference that diagnostic serology for enteropathogenic bacteria should include serology for C. jejuni, preferably by tests which exclude participation by antibodies which cross-react with H. pylori antigens.

Antibodies, Bacterial↗
PubMed1992

Characterization of the alpha antigen of the c proteins of group B streptococci (GBS) using a murine monoclonal antibody.

A murine monoclonal antibody raised against the alpha antigen of the group B streptococcal c proteins was analysed by immunofluorescence and whole-cell ELISA against a collection of 22 c protein-producing GBS. All the strains showing fluorescence and reactivity in ELISA turned out to be alpha antigen-carrying strains as defined by polyclonal rabbit antisera, while none of the strains producing only the beta antigen was positive. Western blot analyses of the alpha antigen released into the culture medium of growing bacteria suggest that the alpha antigen is present as distinct proteins of variable molecular weights. The upper limit of the molecular weights varies considerably from one strain to another, from approximately 200 kD to 70 kD. With all strains, the bands seen by the MAb occurred at regularly spaced intervals of about 10 kD throughout the gel. Some strains gave rise to 15-16 bands, while others gave rise to only one or two bands. The present investigation suggests that alpha antigens include several, probably identical, repeating subunits of approximately 10 kD. The epitope recognized by the MAb seems to be located on a 10-kD fragment, and in addition, it appears to be surface located, making the MAb a suitable tool in serodiagnostic work.

Antibodies, Bacterial↗