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Biomedical subjects

M Rotter

Publications and source records attributed to M Rotter.

At least 55 records · Page 3Linked to original sources

Effects of aerobic exercise and weight loss on riboflavin requirements of moderately obese, marginally deficient young women.

In a previous study, exercise was shown to increase riboflavin requirements of active, normal weight young women. The present study examined the effect of exercise and weight loss on riboflavin status of moderately overweight women. The experiment was designed as a two-period cross-over with an initial base-line period and two 5-wk metabolic periods. The basic diet contained 1200 kcal with a riboflavin concentration of 0.8 mg/1000 kcal. Exercise consisted of a program of dance exercise. Riboflavin depletion, as measured by increased erythrocyte glutathione reductase activity coefficients and decreased urinary excretion of riboflavin, occurred during both nonexercise and exercise periods. Erythrocyte glutathione reductase activity coefficients increased from a base-line mean of 1.28 +/- 0.11 to 1.40 +/- 0.12 during nonexercise and to 1.49 +/- 0.16 during exercise. Urinary excretion of riboflavin fell from 48 +/- 12% of intake during base-line to 30 +/- 13% during nonexercise and to 19 +/- 6% during exercise. Riboflavin depletion was not related to the rate or composition of weight loss or to change in aerobic capacity.

Adult

Effectiveness of cefamandole against methicillin-resistant strains of Staphylococcus aureus in vitro and in experimental infections.

An investigation was carried out into the effectiveness of cefamandole as compared to that of cephalothin against methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus both in vitro and in mice with the experimental peritonitis-induced septicaemia as a model for a generalized infection. In the agar-diffusion test 95% of 118 and in the broth-dilution test 80% of 30 methicillin-resistant strains were sensitive to cefamandole. In experimental infections the ED50 with methicillin-resistant strains was 20 times greater than that required for the methicillin-sensitive strain although the MIC was only twice that for the latter. Doses of cephalothin required for treatment of infections due to methicillin-resistant strains were also twenty times greater than for those due to the methicillin-sensitive strain. But these differences were consistent with those in MIC (by factors of 16-32). Thus, the results of in-vitro testing of cefamandole are not predictive for its therapeutic efficacy in staphylococcal infections with methicillin-resistant strains. Therefore, rather than relying on inhibition zone diameter and MIC, the information that a staphylococcal strain is methicillin-resistant should be used as an indication not to choose cefamandole for chemotherapy.

Animals

[Control of infection in a primarily surgical intensive care unit].

All of one year's 251 patients of a predominantly surgical intensive care unit (i.c.u.) were continuously followed up for infections according to a standard protocol. These protocols were evaluated for 174 patients who stayed at least 48 h at the unit. More than one third (36.7%) were already infected on admission (external origin), 35% contracted infections at the unit, primarily or additionally (internal origin) and 40% remained without an infection. Fifty eight percent of patients already infected on admission were surgical and required intensive care for complications. Among the patients who contracted their infection solely at the unit 61.5% suffered from trauma. Patients having contracted their infections at the i.c.u. stayed significantly longer than those without (additional) infections (13 and 6 days respectively). Mortality was highest (45%) in patients who were already infected on admission and who acquired additional infections during their stay at the i.c.u. Of patients with infections of exclusively external or internal origin 23.5 and 17.9% respectively died whereas among those who remained uninfected this proportion was only 7%. The 75 infections acquired before admission to the i.c.u. included infections of the respiratory tract in 14.4% of all patients, peritonitis with 10.3%, urinary tract in 8.0% and septicemia in 5.2%. Artificial ventilation was employed more often in infected patients (73.8-100%) than in non-infected ones (56.3%). They also carried more intravasal catheters (2.76-3.05 per patient) than the latter group (1.79). Of the 82 infections acquired in the i.c.u. the respiratory tract was affected in 19.5% of all patients and the urinary tract in 13.8%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Evaluation of procedures for vaginal disinfection].

At the occasion of the usual preparations preceding gynecological operations the average vaginal bacterial release of 42 patients, already anaesthesized, was assessed by a rinsing technique to be 5,04 +/- 0,98 log10 c.f.u. per ml sampling fluid after aerobic and anaerobic culture. The reduction of this bacterial release caused by the measurement itself is relatively small, therefore the technique was found to be suitable for evaluation of the efficacy of germreducing measures like irrigation or disinfection. An irrigation with isotonic saline during 30 s was measured to reduce the vaginal bacterial release by 0,4 +/- 0,5 log-steps. A solution containing 0,08% chlorhexidine gluconate + 0,1% benzalkon gluconate applicated during 5 min caused a reduction of 1,04 +/- 0,76 and a watery solution of povidone-iodine one of 2,29 +/- 1,00 log-units when used for 3 min. When after disinfection the sustained antimicrobial action of the chlorhexidin-containing preparation was not neutralized already during the sampling process by Tween 80 + lecithine + histidine being contained in the sampling fluid, an erroneously optimistic log reduction of 2,35 +/- 0,48 was measured. From the results it was calculated that 17-23 volunteers are necessary in order to detect with sufficient statistical safety an observed mean log reduction to be 0,5 log-units smaller than a hypothetical minimal reduction of 2,00 log-steps as required provisionally on an arbitrary basis.

Aerobiosis

Bacteraemia in surgical patients with intravenous devices: a European multicentre incidence study. The European Working Party on Control of Hospital Infections.

A survey of the incidence of bacteraemia and the use of intravenous (IV) devices among 10,616 surgical patients was performed in 42 hospitals in eight countries. It was found that 63 per cent of the patients surveyed had an IV device inserted at some time during their hospital stay, with national variations between 40 and 99 per cent. The incidence of device-related thrombophlebitis was 10.3 per cent, with national variations between 7.8 and 28.4. Among the surgical patients not given IV therapy, 1.5/1000 had a bacteraemia, 0.5/1000 of them hospital-acquired. The corresponding figures for patients with a peripheral but no central IV device were 6.9 and 3.7, and for patients with a central venous catheter (CVC) 59.0 and 44.8, respectively. Even though there was a strong correlation between the incidence of bacteraemia and certain diagnoses there was also an independent correlation between it and CVCs or peripheral IV lines. No correlation was demonstrated between the number of catheter days per site for patients with a peripheral IV device, and hospital-acquired bacteraemia. This may be due to the low mean number of catheter days per site that was observed. There was a large and not easily explained national variation in the incidence of bacteraemia in patients with CVCs of between 16 and 108/1000.

Catheterization

[Comparison of the ELISA (lipopolysaccharide) and Widal reactions (O antigen) in the diagnosis of Salmonella infections].

At various times after the onset of disease 50 sera of patients with bacteriologically proven salmonella infections were investigated for O-antigen specific antibodies in ELISA and Widal-tests. 21 of these sera were derived from patients with typhoid fever, 10 from patients with gastroenteritis due to various species of salmonella group D and 19 from patients with group B salmonella-gastroenteritis. Additional 44 sera stemming from patients without such infection were included in the investigation as a control. With ELISA the sera were examined for antibodies of the IgM- and IgG-class separately. As antigens lipopolysaccharide W-preparations from S. typhi ("group D-antigen") and S. typhimurium ("group B-antigen") were used in the ELISA. High reciprocal titers (geometric means: 1404, 2560, and 1020) of IgM were demonstrable in sera drawn 11-30 days after onset of the disease with group D- and group B-antigen respectively (Fig. 1, Table 1 and Table 2). With increasing distance of time from the onset of the disease these titers decreased rapidly. The titers of agglutinating antibodies as measured in the Widal-test behaved similarly to those of IgM (Fig. 1, Table 1 and 2), and the correlation between both was high (r = +0.93, Fig. 2). In contrast, titers of IgG-antibodies reached their maximum later, namely 31-60 days after onset of the disease (Table 1), and the correlation to the agglutinin-titers (r = +0.33, Fig. 3) was much lower. In sera of patients with typhoid fever reciprocal titers of IgM against the homogeneous group antigen surmounted those of IgG at the average by about 5 log2-step (mean g: 1404 and 79 respectively) between the 11th and 30th day of disease. At this stage of the disease also sera from patients with gastroenteritis due to both salmonella D or B demonstrated clearly an IgM-dominated ratio. After a period of more than 2 month this ratio was about 1:1 in sera of patients with typhoid fever or with salmonella group D-gastroenteritis, but was clearly IgG-dominated in sera obtained from patients with group B-gastroenteritis. This might be due to the fact that most of the sera classified as "obtained greater than 2 months after onset" stemmed from excreters of salmonella B species.(ABSTRACT TRUNCATED AT 400 WORDS)

Antibodies, Bacterial

Vaginal organisms in prepubertal children with and without vulvovaginitis. A vaginoscopic study.

In a prospective clinical and microbiological study covering 67 prepubertal children the vaginal flora of 31 asymptomatic children was compared to 36 children suffering from abnormal vaginal discharge and/or vulvovaginitis. Vaginoscopy was employed to obtain bacteriological specimens without contamination. Swabs were inoculated into prereduced transportmedia (PORT A CUL, BBL) and cultured aerobically and anaerobically. The most prevalent aerobic organisms were Staphylococcus epidermidis. Enterococci and Escherichia coli; the predominant anaerobic bacteria were Peptococcus and Peptostreptococcus, Veillonella parvula, Eubacteria, Propionibacterium and Bacteroides species. A similar microbiological pattern was found in both groups, although anaerobes, like Peptococci and Peptostreptococci and Bacteroides species, as well as yeasts, like Candida albicans were significantly more frequent in the group with signs and symptoms. Lactobacilli were less common in this group.

Adolescent

Endometrial bacteriology in patients with endometrial cancer before and after primary intracavitary irradiation using IR-192 and an afterloading technique.

In a prospective clinical and bacteriological study the endocervical and endometrial flora of 38 patients with biopsy proven cancer of the endometrium was studied before and after intrauterine irradiation with 10 Gy (Ir-192, afterloading device, Buchler, Braunschweig). Bacteriological swabs were taken transcervically. Anaerobic transport media were used and cultures were done aerobically and anaerobically. The mean number of aerobic organisms per patient increased from 2.13 to 2.49 (not significant (n.s.)), and of anerobic organisms from 1.42 to 2.00 (n.s). Neither the recovery rate of aerobic and anaerobic bacteria nor the composition of endometrial flora was altered significantly by intracavitary irradiation. Only aerobic sporeformers increased from 5.3% to 21% (2 p less than 0.05). The most prevalent aerobic species were S. epidermidis, streptococci and E. coli, the predominant anaerobic species Pepto- and Peptostreptococcus and Bacteroides. Our results clearly show that the intrauterine administration of 10 Gy by a Ir-192-afterloading device does not sterilize the endocervix or endometrium and infections may occur after intracavitary radiotherapy.

Aged

Urinary-tract infection and bacteraemia in hospitalized medical patients--a European multicentre prevalence survey on nosocomial infection.

A co-ordinated survey of 3899 medical patients in 169 wards, performed simultaneously in eight countries, showed a point-prevalence of urinary-tract infection (UTI) and bacteraemia of 12.6 and 1.6 per cent, respectively. One-half of the infections were acquired after the patients' admission. The bacteriological patterns of hospital- vs community-acquired infections were different, but showed no unexpected features. Antibiotic treatment was recorded in 22.3 per cent of the patients in this study, urinary-tract disinfectants, sulphonamides or penicillins being used in 95 per cent of those treated for UTI. The overall prevalence of urinary-tract drainage was 11.0 per cent with no significant difference between the two sexes. At ward level the rate of catheterized patients varied from below 5 per cent to more than 25 per cent, indicating--besides variations in the ward populations--differences in policies. The association between nosocomial UTI and the presence of an indwelling catheter and/or female sex was confirmed, while high age appeared to be a secondary risk factor among catheterized patients. The prevalence of nosocomial bacteraemia in patients with UTI was five times higher than in those without urinary-tract involvement, and a significant part of the nosocomial cases of both UTI and bacteraemia was clearly device-related. Guidelines for the use of indwelling catheters should be restrictive and provide for prompt removal. When introduced and followed they will effectively reduce nosocomial UTI and bacteraemia.

Age Factors

[Anaerobic microflora of praepubertal children (author's transl)].

Bacteriologic cultures of the vagina and the cervix of 38 praepubertal children, aged 3 months to 16 years (average age 9 years) from the outpatient department for infants and juveniles of the 1st Department of Obstetrics and Gynecology of the University of Vienna were obtained vaginascopically using anaerobic transportmedia (Port a Cul) and were examined for aerobic and anaerobic bacteria. An average of 5.3 species was also isolated per child (2.9 aerobic and 2.5 anaerobic species). The commonest anaerobes were Peptococcus, Peptostreptococcus, Bact. melaninogenicus, Proprionibacterium and Veillonella parvula, the prevalent aerobes, were Enterococci, E coli and Staphylococcus epidermidis. Our results suggest that anaerobic bacteria amount a significant component of the flora of the lower genital-tract of healthy children, as well as of infants with vaginal discharge.

Adolescent

[Identification of Gram negative rods and evaluation of their antibiotic sensitivity: comparison of the BIOTEST MHK/ID-system with the API 20E-system and the agar diffusion test].

BIOTEST MHK/ID is a new system for the identification of gramnegative fermentative and non fermentative rods and for the simultaneous determination of the minimal inhibitory concentrations (MICs) against 15 antimicrobial drugs. Its identification system was compared with the API 20E kit. When the computer generated identification manuals for each of the systems were used 99.5% of the 190 strains tested were identified. Of these identifications 98.4% were identical. Comparing the results of altogether 16 biochemical reactions 92.3% (table 4) were conformable. Considering each single test low agreement was found with the results of the Citrate-, Urea-, Voges-Proskauer- and Arginindehydrolase-tests (76.8, 79.5, 85.3 and 86.8% agreement, respectively). The BIOTEST MHK/ID system yielded more positive reactions. But despite of these differences there was no influence on the accuracy in identifying the species. Thus, both systems must be considered equally suited to identify gramnegative rods. The results of both BIOTEST MHK/ID system (MIC-values) and the agardiffusion test (inhibition zone sizes) were transferred into the interpretative criteria "sensitive", "intermediate" and "resistant" (table 1) and compared for each strain. The overall-agreement amounted to 93.0% (table 7). With the MIC-test, however, more (7.2%) strains were found "intermediate" than with the agardiffusion test (3.1%, table 8).

Anti-Bacterial Agents

[Vaginal bacterial flora of patients with operated endometrial carcinoma prior to and following intracavitary vaginal irradiation (Ir-192, afterloading)].

In a prospective bacteriological and clinical study the vaginal bacterial flora of 35 patients with endometrial carcinoma, who underwent surgery 4 to 6 weeks earlier, was investigated prior to and following intracavitary vaginal irradiation with 10 Gy in 0,75 cm(Ir-192, afterloading device, Buchler). Bacteriological swabs were taken prior to and following ther insertion of a tube applicator. Anaerobic transport-media were used an cultures were performed aerobically and anaerobically. The mean number of aerobic species per patient increased slightly from 3.26 to 3.60 (n.s), anaerobic species remained constant (1.36 before and 1.30 after irradiation). Also the frequency of isolation of most aerobic and of all anaerobic species was statistically not altered following irradiation. Staphylococcus epidermidis decreased from 51.4% to 22.8% significantly (2 p less than 0.05), Micrococci increased from 0.0% to 11.4% (2 p less than 0.05) and aerobic sporeformers form 0.0% to 34.3% (2 p less than 0.01). Among the anaerobes Pepto- and Peptostreptococci were isolated prior to and following intracavitary irradiation in 11 to 14%, Bacteroides-species in 11 to 20%. Our bacteriological results suggest, that intracavitary irradiation in the therapeutically usual doses has no sterilizing effect on the vaginal flora. This flora plays an important role in infection following gynecologic radiotherapy.

Adult

[Penicillin-resistance as indicator of resistance of Staphylococcus aureus towards cephalosporines and structure-related substances (author's transl)].

81 strains of Staphylococcus aureus (41 methicillin-resistant and 40 -sensitive ones) were tested against older and newer cephalosporines in both broth-dilution and agardiffusion-tests using Mueller-Hinton (MH)-broth and MH-agar respectively in order to establish the degree of parallel-resistance. The substances used were cephalothin, cefazolin, cephalexin, cefamandol, cefuroxim, cefoxitin, cefotaxim and cefsulodin. Furthermore, for reasons of comparison the relatively new substance "Oxabetalaktam" was included in the investigation. As shown in Fig. 1 and Table 1 all methicillin-resistant strains required at the average at least 10 times the concentrations of cephalosporine (excepting cefsulodin) which was necessary to inhibit methicillin-sensitive strains. Again excepting cefsulodin, for each cephalosporine there was a clear bimodal distribution indicating a clear separation of both populations of strains: methicillin-sensitive and -resistant ones. Cephalothin cannot be used as test substance in agardiffusion-tests with staphylococci as there is no correlation between MIC and the inhibition zone size (Fig. 2). This is not necessary, anyway, since all methicillin-resistant strains must be regarded as resistant against virtually all cephalosporines available on the market (with the possible exception of cefamandol). By contrast, all methicillin-sensitive strains may be attacked successfully by concentrations of cephalosporines that are thought to be also effective in vivo. Since in agardiffusion-tests methicillin-resistant strains of staphylococcus aureus are recognizable as easily as are otherwise merely penicillinase-producing ones (5) by using a paper disk loaded with 6 microgram benzyl-penicillin and since infections due to other grampositive organisms than staphylococci are no indication for treatment with cephalosporines there is no need to test any other betalactam-antibiotic than benzyl-penicillin with gram-positive organisms.

Cephalosporins