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Biomedical subjects

L Verbist

Publications and source records attributed to L Verbist.

At least 19 recordsLinked to original sources
PubMed1996

In vitro activity of amoxycillin/clavulanate and ticarcillin/clavulanate compared with that of other antibiotics against anaerobic bacteria: comparison with the results of the 1987 survey.

The activity of amoxycillin/clavulanate (Augmentin) and ticarcillin/ clavulanate (Timentin) was tested against 351 strict anaerobic clinical isolates collected from September 1993 to April 1994 in eight Belgian university hospitals and compared with that of 8 other antibiotics using the NCCLS reference agar dilution procedure. Production of beta-lactamase was detected by the nitrocefin test in 48% of the isolates. At NCCLS-recommended breakpoints, more than 90% of isolates were susceptible to amoxycillin/clavulanate, ticarcillin/clavulanate, piperacillin/tazobactam, imipenem, chloramphenicol and metronidazole but only 77%, 72% and 48% to cefoxitin, clindamycin and penicillin, respectively. In comparison with the results of a similar survey conducted in 1987 no major changes in susceptibility were observed except for the susceptibility to clindamycin that declined from 83% to 72% overall, and from 83% to 66% in the B. fragilis group. Furthermore one isolate of Clostridium clostridioforme was found produce beta-lactamase and few B. fragilis group isolates showed reduced susceptibility to metronidazole.

Amoxicillin↗
PubMed1996

Comparative activity of piperacillin/tazobactam against 5625 isolates from hospitalised patients. Multicentre Study Group.

The comparative activities of piperacillin/tazobactam and other antibiotics against 5625 Gram-negative and Gram-positive bacteria freshly isolated from hospitalized patients was examined. The percentage of Enterobacteriaceae susceptible to piperacillin/tazobactam, ceftazidime, imipenem and ciprofloxacin was very similar and varied from 81% to 84% in the Enterobacteriaceae with inducible type 1 beta-lactamases and from 93 to 97% in the non-inducible organisms. Piperacillin/tazobactam was similar in activity to ceftazidime against Pseudomonas aeruginosa and more active than imipenem or ciprofloxacin. Piperacillin/tazobactam is more active than ceftazidime against Gram-positive bacteria (staphylococci, enterococci) and seems to be a promising antibiotic for nosocomial infections.

Bacteria↗
PubMed1996

Belgian multicentre study on the in vitro activity of cefepime against gram-negative bacilli.

The in vitro activity of cefepime has been compared with that of cefotaxime, ceftazidime, aztreonam, and piperacillin against 1826 Enterobacteriaceae including 537 inducible Enterobacteriaceae (Enterobacter spp., Serratia spp., Citrobacter spp,. Morganella morganii) and 572 non-fermenters, including 401 Pseudomonas aeruginosa and 111 Acinebacter spp. isolated from hospitalized patients in 28 Belgian hospitals. Overall, cefepime was found substantially more active than the third-generation cephalosporins, aztreonam and piperacillin against Enterobacteriaceae species producing inducible type I cephalosporinases. Notably, cefepime remained active against 96% of Enterobacteriaceae resistant to cefotaxime, ceftazidime or aztreonam while it displayed a similar activity against E. coli and the other Enterobacteriaceae. Against non-fermenters, cefepime was found less active than ceftazidime but more than cefotaxime or aztreonam.

Anti-Bacterial Agents↗
PubMed1995

Liver injury related to amoxycillin-clavulanic acid: interlobular bile-duct lesions and extrahepatic manifestations.

We report eight cases of liver injury related to amoxycillin-clavulanate. Liver biopsy performed in seven patients revealed varying degrees of injury to interlobular bile ducts in all cases. Lesions included irregularity of the nuclei, vacuolization of the cytoplasm, lymphocytic infiltration, destruction and endothelialization of the bile duct epithelium. Ductopenia was not observed. In two patients liver injury was accompanied by prominent extrahepatic manifestations (acute interstitial nephritis in one and acute lacrimal gland inflammation and sialadenitis with prolonged xerostomia in the other). We conclude that interlobular bile-duct lesions of varying severity are a common feature in liver injury related to amoxycillin-clavulanate. Side effects of the drug include acute interstitial nephritis and sialadenitis.

Aged↗
PubMed1995

Treatment of Clostridium difficile colitis. Summary of a round table held in Brussels on March, 3rd, 1994.

Due to the growing incidence and the severity of infections due to vancomycin resistant enterococci, it is now recommended to treat mild to moderate cases of Clostridium difficile-associated diarrhoea with metronidazole while maintaining the use of oral vancomycin in serious or life-threatening colitis. Clostridium difficile is a common cause of diarrhoea after antibiotic therapy and induces a spectrum of diseases ranging from mild diarrhoea to pseudomembranous colitis (PMC). It is considered to be the first cause of diarrhoea occurring among hospitalized patients (1).

Clostridioides difficile↗
PubMed1995

In vitro activity of piperacillin/tazobactam against recent clinical isolates from hospitalized patients in ten Belgian hospitals.

The in vitro activity of the combination piperacillin/tazobactam has been compared to that of piperacillin, ticarcillin/clavulanate, cefotaxine, ceftazidime, imipenem and ciprofloxacin against 678 Enterobacteriaceae, 173 nonfermenters, 185 staphylococci, 96 E. faecalis, 217 S. pneumoniae, 202 H. influenzae and 178 M. catarrhalis isolated from hospitalized patients. Piperacillin/tazobactam was similar in activity to third generation cephalosporins, imipenem and ciprofloxacin, and more active than piperacillin alone and ticarcillin/clavulanate.

Bacteria↗
PubMed1995

Capsular types and antibiotic susceptibility of pneumococci isolated from patients in Belgium with serious infections, 1980-1993.

During the 13-year period from 1 November 1980 to 31 January 1993, we received and serotyped a total of 5,619 clinically significant strains of Streptococcus pneumoniae isolated in more than 75 laboratories in Belgium (4,079 [72.6%] were from blood or pleural fluid, 462 [8.2%] were from cerebrospinal fluid, 691 [12.3%] were from middle ear aspirates, and 387 [6.8%] were from various other body fluids). The isolates belonged to 64 of the 84 currently recognized serotypes. Among the 4,722 isolates tested for susceptibility since 1983, 22% were resistant to at least one antimicrobial agent. Resistance to penicillin has slowly increased since 1985 but remained stable at a level of 2%-4% between 1986 and 1993. Of the 119 isolates with reduced penicillin susceptibility, only 23 were fully resistant (MIC, > or = 2 micrograms/mL) and none of these proved to be resistant to cephalosporins. Resistance to erythromycin increased significantly from 5.2% in 1986 to 21.5% in 1993. Resistance to penicillin and erythromycin was also more frequently recognized in a smaller number of capsular types of S. pneumoniae.

Adolescent↗
PubMed1995

Evaluation of a new identification system, Crystal Enteric/Non-Fermenter, for gram-negative bacilli.

A total of 505 fermentative and 201 nonfermentative gram-negative bacilli, identified by conventional methods, were tested by the Crystal Enteric/Non-Fermenter ID kit and by the API 20E or API 20NE identification system. The overall correct results for fermenters were 92.9% by the Crystal kit and 89.1% by the API 20E system. The false identifications (genus and species incorrect) accounted for 3.1 and 7.1% for the Crystal and API systems, respectively. For nonfermenters, figures for correct identifications by the two systems were comparable (Crystal, 75.9%; API 20NE, 75.3%) while the API 20NE system gave twice as many incorrect results (13.8%) as Crystal (6.3%); however, Crystal failed to precisely identify several species included in a "miscellaneous" group. The Crystal Enteric/Non-Fermenter system is an easy-to-use kit which compares favorably with other commercial systems.

Bacterial Typing Techniques↗
PubMed1995

Acute renal infarction and heavy marijuana smoking.

The first case of acute renal infarction in a patient with heavy marijuana smoking is described. The patient had no concomitant previous medical history. There was no evidence of a primary or secondary hypercoagulable state. Underlying neoplasm was excluded. Recovery was associated with normalization of transaminases and lactic dehydrogenase but with a persistent triangular hypoechogenic area in the right kidney. The combination of marijuana-associated alterations in systemic blood pressure due to peripheral vasodilation, functional anemia and an adrenergic effect might have been the cause of the arteria renalis thrombosis in our patient, but the real underlying pathophysiological mechanism still remains unresolved.

Adult↗
PubMed1995

Diagnosis of amoebic infection of the liver: report of 36 cases.

The classical clinical picture of amoebic infection of the liver consists of fever, right upper quadrant pain and hepatomegaly. In recent years, the widespread availability of ultrasound and serology made an early diagnosis possible, which could result in less prominent clinical pictures. Thirty six cases of liver amoebiasis diagnosed in Antwerp between 1985 and 1992, were reviewed. Three patients acquired their infection in Belgium. For the other patients, the average delay between arrival in Belgium and the first symptoms was 5.64 months. The classical triad of clinical signs (fever, right upper quadrant pain and hepatomegaly), was observed in only 13.9% of the patients, whereas it was much more frequent in earlier studies (68-75%). The right lobe was the most frequently affected (94%). The colour of the liquid, obtained by puncture, was brown in 61% of patients in whom it was reported. Amoebic cysts were found in the stools of only one patient. Amoebic serology was initially negative in only one patient, but became positive on second testing. Chest X-rays were abnormal in 34% of the patients. All patients who develop unexplained fever during the year after a stay in tropical countries should undergo an abdominal ultrasound examination and serological testing for Entamoeba histolytica.

Adult↗
PubMed1994

Salmonella typhi osteomyelitis.

Salmonella infections in man can be divided in five clinical groups: enteric fever, septicaemia without localization, focal disease, gastroenteritis and the carrier state. Salmonella typhi is mostly associated with enteric fever and the carrier state. Bone infections due to S. typhi have been reported relatively seldom. They usually occur as the result of metastatic spread during septicaemia or, more rarely, after direct inoculation. Two patients with S. typhi osteomyelitis of the forearm without evidence of a primary infection or direct inoculation are presented here.

Adult↗
PubMed1994

Prevalence of fluoroquinolone resistance in Europe. Study Group 'Bacterial Resistance' of the Paul-Ehrlich-Society for Chemotherapy e. V.

Since 1984, when the first fluoroquinolone, norfloxacin, was marketed in Europe, there has been a marked increase in the usage of this class of drugs. In order to evaluate the influence of this drug usage on the prevalence of resistance to fluoroquinolones in clinical isolates of the family Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus, coagulase-negative staphylococci and Enterococcus faecalis we reviewed the susceptibility data from four collaborative surveys conducted between 1983 and 1990 by the Study Group 'Bacterial Resistance' of the Paul-Ehrlich-Society for Chemotherapy. All participating laboratories used the same standardized methods. Minimal inhibitory concentrations were determined by the broth microdilution method. More than 20,000 bacterial strains were tested. The results are presented for ciprofloxacin, which is regarded as the representative of the fluoroquinolones. Using > or = 4 mg/l as a breakpoint for resistance to ciprofloxacin, the prevalence of resistant strains of the family Enterobacteriaceae in Central Europe between 1983 and 1990 remained below 1%. In contrast, the resistance rates in P. aeruginosa were 0.7%, 1.0%, 3.8% and 7.0%, in S. aureus 0%, 0.5%, 6.6% and 6.8%, and in E. faecalis 2.2%, 0.7%, 4.9% and 7.7% in 1983, 1986, 1989 and 1990, respectively. The latest study carried out in cooperation with 78 laboratories from 12 European countries revealed great differences in the prevalence of resistance to fluoroquinolones from one species to another ranging from 0% with Proteus vulgaris and Salmonella spp. to 26.7% with Providencia stuartii.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Infective Agents↗
PubMed1994

Orthodeoxia and platypnea in liver cirrhosis: effects of propranolol.

Chronic liver disease is well known to be associated with pulmonary abnormalities. Hypoxemia, clubbing, cyanosis and hyperventilation are common. The hypoxemia in cirrhotic patients has several causes: diffuse shunts due to intrapulmonary arteriolar vasodilatation, impaired hypoxic vasoconstriction, impaired matching of ventilation to perfusion, pleural effusions and diaphragmatic dysfunction. Because of gravity, shifting of blood to the dilated precapillary beds of the lung bases results in an increased hypoxemic dyspnea when the patient is in the upright position, also known as orthodeoxia and platypnea. It has only been described in 5% of the cirrhotic patients and has not been described in a Belgian refereed journal (Medline literature search 1983-Aug 1993). It should be considered in the initial differential diagnosis of hypoxemia in patients with liver cirrhosis and dyspnea. Measuring arterial blood gases in the lying and upright position can prevent further invasive investigations, and whole body nuclide scan with technetium-99m macroaggregated albumin can confirm the diagnosis. Standard therapy with spironolactone (Aldactone) can worsen the condition and we found no additional benefit of beta-antagonists (propranolol/Inderal) in the reduction of the shunt fraction, probably because the main reason for the shunting is precapillary vasodilatation. Since there are no anatomical porto-pulmonary shunts, surgery is also inappropriate. The only therapy consists of oxygen supplements and low dose diuretics in patients with edema.

Aged↗
PubMed1994

In vitro susceptibility of recently isolated respiratory tract pathogens to minocycline and comparable antibiotics. A multicentre study.

The in vitro susceptibility of recently isolated respiratory tract pathogens (217 S. pneumoniae, 202 H. influenzae and 178 M. catarrhalis, has been examined against minocycline, doxycycline, amoxycillin, amoxyclavulanate, cefuroxime, clarithromycin and ciprofloxacin. M. catarrhalis was fully susceptible to all antibiotics except amoxycillin (62% susceptible). H. influenzae showed full susceptibility to minocycline, cefuroxime and ciprofloxacin but different percentages of resistance to the other antibiotics. Among S. pneumoniae isolates resistance was observed to all antibiotics tested between 12% to beta-lactams and 22% to doxycycline.

Adult↗