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Biomedical subjects

M F Peeters

Publications and source records attributed to M F Peeters.

At least 19 recordsLinked to original sources
PubMed1998

Evaluation of PCR, culture, and serology for diagnosis of Chlamydia pneumoniae respiratory infections.

We prospectively studied 156 patients with a diagnosis of community-acquired pneumonia requiring admission. Several respiratory specimens were obtained for the detection of Chlamydia pneumoniae by cell culture and PCR. Three serum samples were obtained from each patient. Serological diagnosis of a C. pneumoniae infection was determined by the microimmunofluorescence (MIF) test, the complement fixation (CF) test, and recombinant lipopolysaccharide (LPS) enzyme-linked immunosorbent assay (ELISA; referred to as the rDNA LPS ELISA). Twenty-three patients (15%) had serological results compatible with acute C. pneumoniae infection; nine (39%) of these subjects were C. pneumoniae PCR positive. Twenty-two patients (14%) had positive PCR results without serological evidence of an acute C. pneumoniae infection. An attempt was made to calculate the sensitivities and specificities of the MIF test, rDNA LPS ELISA, and PCR for the diagnosis of chlamydial community-acquired pneumonia. Several "gold standards" were defined. Generally, the sensitivities of the rDNA LPS ELISA and MIF were comparable, while the sensitivity of the CF test was shown to be very low. Independent of the gold standard used, the best PCR results were obtained with nasopharyngeal specimens. However, the predictive value of a positive C. pneumoniae PCR result for patients with community-acquired pneumonia remains unknown and may be low. Although a widely accepted gold standard is still lacking, the rDNA LPS ELISA may currently be the preferred tool for diagnosing acute respiratory Chlamydia infections in routine clinical practice. However, the MIF test remains the method of choice for determining the prevalence of C. pneumoniae infections in a given community.

Adolescent↗
PubMed1998

Multicenter evaluation of the Amplicor Enterovirus PCR test with cerebrospinal fluid from patients with aseptic meningitis. The European Union Concerted Action on Viral Meningitis and Encephalitis.

The Amplicor Enterovirus PCR test was compared with viral culture for the detection of enteroviruses in cerebrospinal fluid (CSF) specimens. In a multicenter study in which nine laboratories participated, a total of 476 CSF specimens were collected from patients with suspected aseptic meningitis. Sixty-eight samples were positive by PCR (14.4%), whereas 49 samples were positive by culture (10.4%), demonstrating that the Amplicor Enterovirus PCR test was significantly more sensitive than culture (P < 0.001). After discrepancy analysis the sensitivity and specificity of the Amplicor Enterovirus PCR test obtained by using viral culture as the "gold standard" were 85.7 and 93.9%, respectively. Our results with the CSF specimens collected in different countries demonstrate that the Amplicor test is capable of detecting a large variety of enterovirus serotypes and epidemiologically unrelated isolates in CSF specimens from patients with aseptic meningitis. The Amplicor Enterovirus PCR test is a rapid assay which can be routinely performed with CSF samples and is an important improvement for the rapid diagnosis of enteroviral meningitis.

Cerebrospinal Fluid↗
PubMed1997

Primary-care-based randomised placebo-controlled trial of antibiotic treatment in acute maxillary sinusitis.

BACKGROUND: The value of antibiotics in acute rhinosinusitis is uncertain. Although maxillary sinusitis is commonly diagnosed and treated in general practice, no effectiveness studies have been done on unselected primary-care patients. We used a randomised, placebo-controlled design to test the hypothesis that there would be an improvement associated with amoxycillin treatment for acute maxillary sinusitis patients presenting to general practice. METHODS: Adult patients with suspected acute maxillary sinusitis were referred by general practitioners for radiographs of the maxillary sinus. Those with radiographic abnormalities (n = 214) were randomly assigned treatment with amoxycillin (750 mg three times daily for 7 days; n = 108) or placebo (n = 106). Clinical course was assessed after 1 week and 2 weeks, and reported relapses and complications were recorded during the following year. FINDINGS: After 2 weeks, symptoms had improved substantially or disappeared in 83% of patients in the study group and 77% of patients taking placebo. Amoxycillin did not influence the clinical course of maxillary sinusitis nor the frequency of relapses during the 1-year follow-up. Radiographs had no prognostic value, nor were they an effect modifier. Side-effects were recorded in 28% of patients given amoxycillin and in 9% of those taking placebo (p < 0.01). The occurrence of relapses was similar in both groups (21 vs 17%) during the follow-up year. INTERPRETATION: Antibiotic treatment did not improve the clinical course of acute maxillary sinusitis presenting to general practice. For these patients, an initial radiographic examination is not necessary and initial management can be limited to symptomatic treatment. Whether antibiotics are necessary in more severe cases warrants further study.

Acute Disease↗
PubMed1997

Pitfalls and fallacies of cat scratch disease serology: evaluation of Bartonella henselae-based indirect fluorescence assay and enzyme-linked immunoassay.

The diagnostic value of the detection of immunoglobulin G (IgG) and IgM by Bartonella henselae-based indirect fluorescence assay (IFA) and enzyme-linked immunoassay (EIA) for the diagnosis of cat scratch disease (CSD) was evaluated. The IFA was performed either with B. henselae that was cocultivated for a few hours with Vero cells or with noncocultivated B. henselae as the antigen. Additionally, the performance of a Bartonella PCR hybridization assay based on the 16S rRNA gene was determined and compared with those of the serologic assays. The study group consisted of 45 patients suspected of suffering from CSD by fulfilling one or more of the classical criteria. The specificities of the immunoassays were set at > or = 95% by analysis of sera from 60 healthy blood donors. It is shown that the sensitivities of the IgG assays are very low (40.9% for the IFA with noncocultivated B. henselae as antigen) and that those of the IgM assays are higher (71.4% for the EIA) for patients who fulfilled two or more criteria for CSD. The IgM EIA showed the highest sensitivity: 71.4% in patients with two or more criteria for CSD and 80.6% for patients with a positive Bartonella PCR result. The results indicate that the specificities of both IFA and EIA IgG serologies and the sensitivity of the IFA IgM serology need to be improved. The PCR hybridization assay showed a sensitivity of 86.4% for patients who fulfilled two or more criteria for CSD and 100% for seven patients who fulfilled three or more criteria. The kinetics of IgG and IgM antibody production were studied in 18 patients with CSD on the basis of a positive B. henselae IFA IgM serology. The results indicate that there is no standard course of anti-B. henselae IgG and IgM production in patients with CSD, because some patients produced high levels of both IgG and IgM, others produced only high levels of IgM, and a few patients produced only low levels of antibodies.

Antibodies, Bacterial↗
PubMed1997

Direct intraperitoneal insemination compared to intrauterine insemination in superovulated cycles: a randomized cross-over study.

The aim of this randomized cross-over study was to determine whether direct intraperitoneal insemination (DIPI) is superior to intrauterine insemination (IUI) in hyperstimulated cycles. The treatment cycles were stimulated with either clomiphene citrate and human menopausal gonadotrophins, or buserelin and human menopausal gonadotrophins. 207 subfertile couples with a cervical factor, a male factor, a combined cervical and male factor, or an unexplained subfertility were randomly assigned to the first treatment cycle. IUI and DIPI were performed in alternate cycles to a maximum of 6 cycles per couple. Every treatment cycle was followed by a nontreatment cycle. The pregnancy rate per completed cycle was 24% for IUI and 16% for DIPI (p = 0.018), whereas the cumulative pregnancy rates for IUI and DIPI were 53 and 40%, respectively (p = 0.002). There were no significant differences between pregnancy rates for IUI and DIPI in the different categories of subfertility. We conclude that DIPI does not offer better pregnancy chances than IUI in superovulated cycles.

Adult↗
PubMed1995

Comparison of human immunodeficiency virus biological phenotypes isolated from cerebrospinal fluid and peripheral blood.

Quantitative human immunodeficiency virus (HIV) cultures were carried out on cerebrospinal fluid (CSF), peripheral blood mononuclear cells (PBMCs), and plasma from patients with HIV in order to compare the infectious HIV load. The HIV strains isolated were studied for syncytium-inducing (SI) capacity, using the MT-2 cell line, in order to compare the HIV strain phenotype of blood and CSF isolates. Forty-two patients with HIV-1 infection were enrolled in the study, 33 of whom had neurological symptoms and 9 of whom were without neurological symptoms. HIV was isolated from 16 (38%) of the 42 CSF cultures, with a low mean titer of 6.3 +/- 3.4 tissue-culture-infective doses (TCID) per milliliter. Patients with HIV-positive CSF culture had a viral load in PBMCs of 40.5 +/- 15.5 TCID per 10(6) PBMC and in plasma of 104.7 +/- 9.3 per milliliter. Two (15%) of the 13 CSF isolates were SI strains, compared to 17 (56.6%) of the 30 PBMC isolates and 13 (54%) of the 24 plasma isolates (P < 0.05). Five of the nine patients from whom CSF and blood strains were obtained had the same viral biological phenotype. This study suggests that different HIV variants may be found in different body fluids and/or cells.

Adult↗
PubMed1993

Neonatal herpes policy in The Netherlands. Five years after a consensus conference.

In order to establish whether the recommendations of an in 1987 organized consensus conference about neonatal herpes policy in the Netherlands had been followed, an inquiry was held in January 1992 among gynecologists, pediatricians and microbiologists. Compared with the results of an inquiry that was held five years before, it was found that the incidence of neonatal herpes had not increased in the last ten years (approximately five cases annually or one per 35,000 neonates) despite the lower frequency of caesarean sections (more than 50 sections a year before 1987 and less than 10 sections a year after 1987). It is concluded that the consensus statements not only have been followed, but that they also proved to be sound.

Cesarean Section↗
PubMed1992

Maxillary sinusitis in children.

In 169 children with a runny nose the difference between the group with rhinitis and those diagnosed as having sinusitis was indistinct. History and examination, and the results of radiology, ultrasound, the appearance of the sinus washings, the number of leucocytes in the washings, and the presence of pathogenic bacteria in the culture of the secretion from the nose and sinuses had little correlation with each other or with the clinical picture. In our view there is no marked difference between rhinitis and simple sinusitis, that is, mucosal inflammation of the maxillary sinus. This difference is also of no therapeutic relevance, and both diseases may be regarded as part of an upper airway infection. It is important to distinguish between sinusitis with and without empyema, because empyema must be treated differently. The latter disease produces distinct symptoms in the acute stage resembling ethmoiditis in children or maxillary and frontal sinusitis in adults. This type of sinusitis did not occur in our patients. Further investigation in children with a runny nose is indicated only in those with typical symptoms of an empyema.

Bacteria↗
PubMed1991

Bacteriological and clinical aspects of Aeromonas-associated diarrhea in The Netherlands.

Aeromonas species were isolated from 0.61% of 34,311 fecal samples during a 5-year period. Most strains belonged to DNA hybridization groups (HG) 4 (A. caviae), 8 (A. sobria), and 1 (A. hydrophila). Mannitol-negative A. schubertii (HG 12) and ornithine-positive A. veronii (HG 10) were not found. Multivariate analysis of the clinical data showed that Aeromonas-associated diarrhea cannot be attributed solely to cytotoxin production of the strains, but that it is also strongly associated with host factors.

Aeromonas↗
PubMed1990

[Is Chlamydia TWAR of significance in The Netherlands?].

Chlamydia TWAR is as a newly recognised organism that causes respiratory tract infection with human-to-human transmission. Our sero-epidemiological study showed that in The Netherlands prevalence of TWAR antibodies is very low in children under the age of five years, increases after beginning of school age until adolescence, and remains high (80%) during adulthood. It is known that Chlamydia TWAR can cause acute lower respiratory tract infection. However, the exact clinical spectrum within the various groups of patients still needs to be defined.

Adolescent↗